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4.
J Med Virol ; 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32401352

RESUMO

Though infection with the SARS-CoV2 virus predominantly manifests in the lung as an interstitial pneumonia ("ground glass opacities"), there is increasing evidence that the virus invades all compartments of the body, particularly the eyes, heart, skin, kidneys, and the central nervous system(CNS).1 This article is protected by copyright. All rights reserved.

7.
J Neuromuscul Dis ; 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32333547

RESUMO

OBJECTIVES: laboratory tests for work-up of hereditary and acquired neuropathies of peripheral nerves are frequently uncritically utilized. This overview focuses on the most common laboratory tests and investigations needed for diagnosing PNPs by the general neurologist Method: literature searchResults:laboratory tests recommended for the work-up of hereditary and acquired neuropathies should be chosen according to the individual and family history, clinical presentation, and electrophysiological findings. Laboratory tests should be selected specifically according to the suspected type of neuropathy to avoid unnecessary tests and expenses. Work-up should include as few samples as necessary for uncovering the etiology and should consider the sensitivity/specificity of the tests applied.. Basic screening tests for neuropathies should include a blood cell count, thyroid, renal and liver function tests, blood glucose levels, HbA1c, vitamin-B12, and immunofixation. Other laboratory investigations should be carried out only if a specific phenotype is present or if unexpected changes of the disease course occur. In these cases referral to a neuromuscular center is recommended. CONCLUSIONS: Laboratory tests are helpful for the diagnosis of acquired and hereditary neuropathies but these tests should be ordered according to the history, clinical presentation and findings on electrophysiological investigations. If basic laboratory parameters fail to uncover the etiology, patients should be referred to a center specialized in neuromuscular disorders.

12.
Cardiology ; : 1-7, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32348999

RESUMO

INTRODUCTION: Takotsubo syndrome (TTS) may be complicated by left-ventricular (LV) thrombus formation in 1.3-5.3% of patients. Risk factors for thrombi comprise apical TTS, elevated levels of C-reactive protein and troponine, thrombocytosis, persisting ST segment elevation and right-ventricular involvement. Embolic risk appears high, and anticoagulation is recommended. CASE PRESENTATION: We present 3 females, aged 60-82 years, with TTS-associated LV thrombi and cerebral embolism despite therapeutic anticoagulation. Two patients showed apical and 1 patient midventricular ballooning. In 2 patients LV thrombi had not been present at the first echocardiographic examination. LV thrombi were multiple and highly mobile in 2 patients; 1 patient had a single immobile thrombus associated with spontaneous echocardiographic contrast (SEC). In each case, 3 of the described risk factors for LV thrombus formation were identified. The embolic stroke occurred 41-120 h after TTS symptom onset and 21-93 h after the initiation of therapeutic anticoagulation. Two patients were discharged with a neurological deficit, and 1 of them eventually died as a consequence of the stroke. LV thrombectomy to prevent embolism, which has been reported in a small number of cases, had not been considered in our patients. CONCLUSION: At present, the management of patients with TTS-related thrombi is still unclear, and further studies are urgently needed to assess the best methods for imaging and anticoagulation and to determine the role of thrombolysis and cardiac surgery. Until these studies are available, we suggest the following approach: patients with a TTS-related thrombus should be monitored by echocardiography while receiving anticoagulation. In case of highly mobile LV thrombi, the heart team may consider cardiac surgery to prevent systemic embolism. The role of SEC in TTS remains to be determined.

13.
J Med Virol ; 2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32311107

RESUMO

It is well appreciated that SARS-CoV2 does not exclusively affect the lungs.1,2 Virus-RNA can be detected in most of the body compartments, including the cerebrospinal fluid (CSF).3 Neurological manifestations have been recently investigated in a retrospective study of 214 SARS-CoV2-infected patients.1 This article is protected by copyright. All rights reserved.

19.
Eur J Med Genet ; 63(5): 103899, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32156559
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