Læknablađiđ
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Patients with hypochondriasis are preoccupied with the fear or belief that they have a serious, undiagnosed disease. This concern derives from misinterpretations of benign physical sensations, and persists despite appropriate reassurance to the contrary. ⋯ Physicians, in turn, may feel discouraged and frustrated in relation to these individuals where their best efforts to help often prove ineffective or are even rejected. Recent scientific studies have shown that cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRI) are effective treatment options for health anxiety as demonstrated in clinical trials.
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The complement system is an important immune system. Its activation results in membranolytic elimination of microbes and opsonization. The classical, alternative and lectin pathways (LP) activate complement. ⋯ Numerous studies indicate that MBL deficiency is a risk factor for invasive and recurrent infections, especially when other immune systems are immature, deficient or compromised. Research in ficolins is limited but last year ficolin-3 deficiency was described. This review focuses on these recently WHO defined immunodeficiencies.
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Review Case Reports
[Acute abdominal pain caused by acute intermittent porphyria - case report and review of the literature].
We describe a case of acute intermittent porphyria in a woman who presented repeatedly with abdominal pain. Porphyrias are caused by decreased enzyme activity in the heme biosynthetic pathway leading to overproduction of heme precursors if demand increases. This can cause symptoms such as abdominal pain, nausea and vomiting, constipation, tachycardia and hypertension. Treatment includes removal of causative factors, administration of carbohydrates or hemin to reduce the production of heme precursors as well as symptomatic treatment.
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Multiple sclerosis is an inflammatory disease of the central nervous system and a common cause of disability among young people. MS is thought to be an autoimmune disease involving both inheritance and environmental factors. ⋯ The importance of timely diagnosis has increased with the availability of effective treatment. The purpose of this article is to review symptoms, signs, diagnosis and treatment of multiple sclerosis.
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Review Case Reports
[Central and extrapontine myelinolysis following correction of extreme hyponatremia. Case report and review of the literature].
We report a case of a 43-year-old woman who developed osmotic demyelination syndrome following correction of extreme hyponatremia that was considered to be of chronic nature. The serum sodium level was 91 mmol/L on admission to hospital. It was decided to correct the serum sodium slowly with the goal that the rate of correction would be no more than 12 mmol/l per 24 hours. ⋯ The patient received supportive therapy and eventually made full recovery. Current concepts in the pathophysiology of osmotic demyelination syndrome and the treatment of hyponatremia are reviewed. We recommend that the rate of correction of chronic hyponatremia should not exceed 8 mmol/l per 24 hours.