A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infect...A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis(MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP Ig G in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.展开更多
Background Following the standardized nomenclature proposed by the American Clinical Neurophysiology Society(ACNS),rhythmic high-amplitude delta activity with superimposed spikes(RHADS)can be reported as an extreme de...Background Following the standardized nomenclature proposed by the American Clinical Neurophysiology Society(ACNS),rhythmic high-amplitude delta activity with superimposed spikes(RHADS)can be reported as an extreme delta brush(EDB).The clinical implications of similar electrographic patterns being reported as RHADS versus EDB are important to highlight.We aim to review the electrographic characteristics of RHADS,evaluate whether RHADS is seen in other neurological disorders,and identify the similar and unique characteristics between RHADS and EDB to ultimately determine the most accurate way to differentiate and report these patterns.We believe that the differentiation of RHADS and EDB is important as there is a vast difference in the diagnostic approach and the medical management of associated underlying etiologies.Data source We conducted an extensive search on MEDLINE and Pubmed utilizing various combinations of keywords.Searching for“gamma polymerase and EEG”,or“RHADS”or“Alpers syndrome and EEG”or“EEG”AND“Alpers–Huttenlocher syndrome”.Results Three articles were found to be focused on the description of“RHADS”pattern in Alpers Syndrome.No publication to date were found when searching for the terms“EDB”AND“children”,AND“infant”AND“adolescent”excluding“encephalitis”and“neonate”.Although RHADS and EDB appear as similar EEG patterns,meticulous analysis can differentiate them.RHADS is not exclusive to patients with Alpers–Huttenlocher syndrome and may manifest in regions beyond the posterior head region.Reactivity to eye-opening and response to anesthesia can be two other elements that help in the differentiation of these patterns.Conclusion RHADS is not exclusive to patients with AHS and may manifest in regions beyond the posterior head region.Reactivity to eye-opening and response to anesthesia are features that help in the differentiation of these patterns.展开更多
文摘A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis(MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP Ig G in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.
文摘Background Following the standardized nomenclature proposed by the American Clinical Neurophysiology Society(ACNS),rhythmic high-amplitude delta activity with superimposed spikes(RHADS)can be reported as an extreme delta brush(EDB).The clinical implications of similar electrographic patterns being reported as RHADS versus EDB are important to highlight.We aim to review the electrographic characteristics of RHADS,evaluate whether RHADS is seen in other neurological disorders,and identify the similar and unique characteristics between RHADS and EDB to ultimately determine the most accurate way to differentiate and report these patterns.We believe that the differentiation of RHADS and EDB is important as there is a vast difference in the diagnostic approach and the medical management of associated underlying etiologies.Data source We conducted an extensive search on MEDLINE and Pubmed utilizing various combinations of keywords.Searching for“gamma polymerase and EEG”,or“RHADS”or“Alpers syndrome and EEG”or“EEG”AND“Alpers–Huttenlocher syndrome”.Results Three articles were found to be focused on the description of“RHADS”pattern in Alpers Syndrome.No publication to date were found when searching for the terms“EDB”AND“children”,AND“infant”AND“adolescent”excluding“encephalitis”and“neonate”.Although RHADS and EDB appear as similar EEG patterns,meticulous analysis can differentiate them.RHADS is not exclusive to patients with Alpers–Huttenlocher syndrome and may manifest in regions beyond the posterior head region.Reactivity to eye-opening and response to anesthesia can be two other elements that help in the differentiation of these patterns.Conclusion RHADS is not exclusive to patients with AHS and may manifest in regions beyond the posterior head region.Reactivity to eye-opening and response to anesthesia are features that help in the differentiation of these patterns.
