Harefuah
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A 30 years old parturient was admitted to the operating theatre for revision of uterus after spontaneous labor because of hemorrhage. She underwent general anesthesia induced by rapid sequence induction (RSI) technique. ⋯ Genetic tests revealed heterozygosity for the K variant of BChE. This may explain the increased sensitivity to succinylcholine during pregnancy.
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Pain is undertreated in children due to historical reasons. The pain afferent tracts are developed in 21 weeks of gestation and it is well documented that preterm and neonates can experience pain. Pain in neonates leads to ncreased distress and altered pain response later in life. pain assessment in children is chalLenging. ⋯ The family doctor may be looking for serious causes for the pain. Referrals to specialists can Leave children without proper pain management or treatment. The Pediatric Pain Clinic is a multidisciplinary program specifically aiming to provide treatment and support for acute and chronic pain in children to conquer pain, help children to cope with chronic pain and avoid future complications.
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Alzheimer's disease is the leading cause of dementia in advanced age with a prevalence of above 40% among persons 80 years or older. In recent years, new studies have made some important discoveries regarding the pathogenesis of the diseases and potential therapeutic measures. These developments have led to the announcement of new guidelines for the diagnosis of the disease published by the National Institute on Aging and the ALzheimer's Association. ⋯ These biomarkers include atrophy of the medial temporal lobe by MRI, reduction of glucose metabolism in specific brain areas by PET-FDG and presence of beta-amyloid staining in the brain by PET-amyloid scan. In addition, there are also cerebrospinal fluid ICSF) biomarkers characteristic of Alzheimer's disease, which consist of low levels of Abeta42 and elevated levels of total and phosphorylated TAU. These biomarkers may be used to diagnose the disease in the early pre-symptomatic phase, to differentiate Alzheimer's disease from other causes of dementia and may be helpful in the follow-up of newly developed specific treatments.
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The diagnosis of Parkinson's disease (PD) is based on the identification of at least two of the cardinal motor signs of the disease: rest tremor, bradykinesia, rigidity, and in progressive state the loss of postural reflexes. The disease is manifested mainly by motor signs but several non-motor features are present in patients with PD. ⋯ We review part of the different non-motor symptoms that can be present in patients with PD. In many cases, the non-motor symptoms could cause important Limitations in the functionality of the patients, no less than the motor symptoms, and they are often difficult to treat.
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Idiopathic pulmonary fibrosis (IPF) is the most common interstitial lung disease (ILD) characterized by exertional dyspnea, hypoxemia and exercise intolerance. The pathophysiology of IPF usually presents restrictive physiology of lung volume and impaired gas exchange. Most of the research which supports the effectiveness of pulmonary rehabilitation (PR) comes from chronic obstructive pulmonary disease (COPD) patients' studies. ⋯ Nevertheless, PR guidelines for IPF patients have not yet been established. This review presents the current existing data on the effectiveness of PR programs in IPF patients. Large and well controlled trials are needed for the establishment of clinical guidelines of PR in IPF patients.