Irish journal of medical science
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Multiple sclerosis (MS) is an immune-mediated, demyelinating disease of the nervous system, which may impact the audiovestibular pathway at different stages of the disease. The auditory and vestibular manifestations of MS as a presenting or early symptom are an area in which more investigation is needed. ⋯ An understanding of the sensitivity of evoked potentials in the detection of demyelinating lesions as well as the most common audiovestibular presentations of the disease allows the practitioner to provide an appropriate onward referral for MRI which may lead to early diagnosis and intervention of MS. We suggest that there is enough evidence to include evoked potentials complementary to MRI in the detection and monitoring of MS. As the review suggests evidence of involvement of the immune-mediated mechanisms of MS on peripheral structures like the inner ear, further clinical research is recommended to explore this mechanism. Key points 1. The most common audiovestibular manifestation as an early symptom of MS was unilateral moderate to profound SSHL across all frequencies (250 Hz-8000 Hz). 2. Findings of the review indicated the involvement of the immune-mediated mechanisms of MS in the peripheral structures of the inner ear. 3. These findings included peripheral results in the vestibular test of the patients involved in the study and secondly, the three studies which reported an absence of full recovery of hearing loss were also three papers which within their ABR results showed abnormality of wave I 4. This is the first paper to support the theory (Di Stadio et al. 2018) [32] that immune-mediated processes of MS can spread to peripheral inner ear structures 5. The review highlighted the sensitivity of evoked potentials in detecting MS lesions in the presenting stage, particularly ABR which demonstrated that in instances in which hearing loss recovered ABR results remained abnormal.
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Multiple sclerosis (MS) is an immune-mediated, demyelinating disease of the nervous system, which may impact the audiovestibular pathway at different stages of the disease. The auditory and vestibular manifestations of MS as a presenting or early symptom are an area in which more investigation is needed. ⋯ An understanding of the sensitivity of evoked potentials in the detection of demyelinating lesions as well as the most common audiovestibular presentations of the disease allows the practitioner to provide an appropriate onward referral for MRI which may lead to early diagnosis and intervention of MS. We suggest that there is enough evidence to include evoked potentials complementary to MRI in the detection and monitoring of MS. As the review suggests evidence of involvement of the immune-mediated mechanisms of MS on peripheral structures like the inner ear, further clinical research is recommended to explore this mechanism. Key points 1. The most common audiovestibular manifestation as an early symptom of MS was unilateral moderate to profound SSHL across all frequencies (250 Hz-8000 Hz). 2. Findings of the review indicated the involvement of the immune-mediated mechanisms of MS in the peripheral structures of the inner ear. 3. These findings included peripheral results in the vestibular test of the patients involved in the study and secondly, the three studies which reported an absence of full recovery of hearing loss were also three papers which within their ABR results showed abnormality of wave I 4. This is the first paper to support the theory (Di Stadio et al. 2018) [32] that immune-mediated processes of MS can spread to peripheral inner ear structures 5. The review highlighted the sensitivity of evoked potentials in detecting MS lesions in the presenting stage, particularly ABR which demonstrated that in instances in which hearing loss recovered ABR results remained abnormal.
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SARS-CoV-2, causing the lethal disease COVid-19, is a public health emergency in the 2020 global pandemic. The outbreak and fast spreading of SARS-CoV-2 have a high morbidity and mortality specifically in elder patients with chronic diseases such as diabetes mellitus, arterial hypertension, chronic kidney disease, and organ transplanted patients with immunosuppressive therapy. Preliminary results support different treatments such as chloroquine and convalescent plasma infusion in severe cases, with good outcome. ⋯ The data available today regarding the beneficial protective effect of vitamin D is unclear and with conflicting results. Large randomized control trials are necessary to test this hypothesis. In this review, we will explain the cross talk between the active vitamin D and the angiotensin-converting enzyme 2, and summarize the data from the literature.
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An amendment to the 1962 Coroner's Act in the Republic of Ireland mandated that all stillbirths and neonatal deaths were to be reported to the local coroner's office. In response to this, the bereavement team and department of anatomic pathology modified the pathway for placental examination following stillbirth and reporting deaths to the coroner. This paper is a review of the effect of this practice. ⋯ The introduction of the pathway has improved the care provided to bereaved parents by providing parents with timely information about the potential cause of stillbirth and thereby reduces the need for an autopsy examination.
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Claudin proteins are a component of tight junctions found in cell-cell adhesion complexes. A central feature of necrotizing enterocolitis (NEC) is intestinal permeability, with changes to claudin proteins potentially contributing to intestinal instability, inflammation, and the progression of NEC. A current area of interest is the development of a novel, noninvasive biomarker for the detection of NEC in neonates at risk of developing this disease, in order to reduce morbidity and mortality through earlier intervention. ⋯ Alterations to claudin proteins may reflect changes seen to intestinal permeability and inflammation in the context of NEC. Further research is necessary to understand the relevance of claudin proteins in the pathophysiology of NEC and their use as a biomarker.