INVOLUÇÃO... Um Alerta... (Portuguese Edition)

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A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants.

The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy. Assays for myasthenia gravis. This patent describes an improvement in a process for diagnosing myasthenia gravis.

The process comprises the steps of preparing a complex of acetycholine receptor protein, toxin and a radioactive isotope, incubating the complex with a serum sample from a patient so as to join antibodies engendered in connection with myasthenia gravis to the complex, precipitating the complex joined with antibody with anti-immunoglobulin and measuring radioactivity, from the radioactive isotope, of the precipitated complex. The improvement is that the acetylcholine receptor protein is derived from cells of the TE Line.

Masticatory performance in patients with myasthenia gravis. Masticatory muscle electromyograms EMGs were recorded while patients with bulbar myasthenia gravis chewed artificial food and compared with those of patients with ocular myasthenia gravis , patients in clinical remission who had previously suffered from bulbar myasthenia gravis and healthy.

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Gallium scans in myasthenia gravis. A study was conducted to determine whether 67 Ga scans could be used for the detection of thymomas and to investigate the activity of the thymus gland in patients with myasthenia gravis. Scans of the anterior mediastinum proved to be a reliable way to detect thymomas.

The scans were positive in eight patients including three with myasthenia gravis and histologically proved thymomas, three others with severe myasthenia gravis and thymic tumors, and two with histologically proved thymomas not associated with myasthenia. Activity on 67 Ga scans was not directly related to the increased activity of the thymus gland that is presumed to be associated with myasthenia gravis.

A timectomia radical por videotoracoscopia ofereceu bom controle da miastenia gravis. The relationship between myasthenia and the thymus is evident and the current treatment of this condition includes thymectomy. However, a revision of our experience with thymectomy has revealed the necessity of a more radical technique. To analyze, retrospectively, myasthenia gravis patients who underwent videothoracoscopic radical thymectomy. Tongue force in patients with myasthenia gravis.

Objectives - The aim was to study tongue force in patients with bulbar myasthenia gravis and compare it with that of patients with ocular myasthenia gravis , patients in clinical remission who previously suffered from bulbar myasthenia gravis , and healthy subjects.

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Material and methods - Tongue force. Multiple Thymoma with Myasthenia Gravis. Full Text Available The actual incidence of multiple thymoma is unknown and rarely reported because it remains controversial whether the cases represent a disease of multicentric origin or a disease resulting from intrathymic metastasis. In this case, a patient underwent total thymectomy for multiple thymoma with myasthenia gravis via bilateral video-assisted thoracic surgery. Both tumors were type B2 thymoma.

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Few cases of multiple thymoma with myasthenia gravis have ever been reported in the literature. We report a case of synchronous multiple thymoma associated with myasthenia gravis. Thymectomy in Myasthenia Gravis. In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis MG. Likelihood of remission was highest in preoperative mild disease classification Osserman classification 1, 2A. In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy.

In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques.

However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches. Thymus irradiation for myasthenia gravis. Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of rads 30 Gy to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period.

The improvement lasted a median of 1. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia. Muscle strength in myasthenia gravis. Myasthenia gravis MG is characterized by fatigue and fluctuating muscle weakness as a result of impaired neuromuscular transmission NMT. Although MG is a prototypic fatiguing disorder, little is known about how the condition affects fixed weakness, and if present, whether weakness Matrix Metalloproteinases in Myasthenia Gravis.

Myasthenia gravis MG is an autoimmune disease with weakness in striated musculature due to anti-acetylcholine receptor AChR antibodies or muscle specific kinase at the neuromuscular junction. Side effect of urografin. Full Text Available Ocular myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Diplopia and ptosis are common symptoms at the onset of ocular myasthenia gravis. It may occur due to the antibodies developed against various drugs. We are reporting a case of ocular myasthenia gravis which was developed in a patient post angiography which may be due to antibody developed against the dye used in angiography.

Diagnosis and management of myasthenia gravis. Myasthenia gravis is a rare long-term neurological condition that is characterised by fluctuating skeletal muscle weakness and fatigue, as well as respiratory difficulties. It is both an acquired autoimmune disease and a chronic neuromuscular disorder. Because of its rarity, myasthenia gravis is relatively unknown and may be unfamiliar to many nurses.

While there are various types of myasthenia, this article focuses on myasthenia gravis , exploring its symptoms, diagnosis and treatment, and examining the nurse's role in managing the condition. The symptoms of myasthenic crisis and cholinergic crisis are also explained, and the experience of patients with myasthenia gravis in hospital and community settings is illustrated using case studies. Computer tomography in myasthenia gravis. In this report, preoperative CT diagnosis of the thymus was reevaluated in 15 operated patients with myasthenia gravis.

Five cases of thymoma, 5 out of 6 cases of thymic hyperplasia and 3 cases of normal thymus were correctly diagnosed. One hyperplasia was diagnosed as normal and one normal thymus as hyperplasia. At the CT evaluation of the thymus in patients with myasthenia gravis , it is easy to detect thymoma, but it is often difficult to differentiate thymic hyperplasia and normal thymus due to the aging changes in the gland and the presence of localized hyperplasia.

Myasthenia gravis is one of the most common disorders that affect neuromuscular transmission. It is currently one of the most understood and characterised autoimmune disorders Its typical symptoms are fluctuating weakness and fatigue that affects a combination of ocular muscles, bulbar functions, as well as limb and respiratory muscles, which are due to an immune attack against the postsynaptic membrane of the neuromuscular junction.

The diagnosis of myasthenia gravis is based on clinical and serological test.


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It is a disease that can be effectively controlled with the current therapeutic lines, even achieving a complete remission. An update of this interesting disorder is now presented. RI scintigraphy in myasthenia gravis. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas.

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RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type. This is a 10 year retrospective review of patients managed at the Ahmadu Bello Teaching hospital, Zaria, Nigeria for myasthenia gravis. Only 4 patients were identified from the hospitals records. Myasthenia gravis appears uncommon in this environment. Reasons for the apparent rarity of this condition and other Isolated laryngeal myasthenia gravis for 26 years.

Laryngeal myasthenia gravis is a relatively rare variant of myasthenia gravis. We present a year-old woman with recurrent episodic isolated dysphonia associated with diffuse bilateral vocal cord paresis on laryngoscopy since the age of Dysphonia became permanent since 6 months. A diagnosis of laryngeal myasthenia gravis was made based on abnormal single-fiber electromyography and spectacular response to pyridostigmine treatment. Repetitive nerve stimulation was normal and anti-acetylcholine receptor and anti-muscle specific tyrosine kinase antibodies were absent. This case shows that laryngeal myasthenia gravis can be isolated during 26 years of follow-up.

We propose that even when myasthenia gravis seems unlikely as underlying mechanism of isolated dysphonia because of lack of antibodies, normal repetitive nerve stimulation, and absence of extra-laryngeal involvement after years of follow-up , single-fiber electromyography should be performed and myasthenia gravis treatment should be tried. Tratamento das formas severas de miastenia pelo ACTH por via intravenosa. We report on a case of a year-old female, patient, who presented with clinical signs suggestive of myasthenia gravis over a period of approximately 3 months.

The therapeutic option using neostigmine gave an improvement of the dysphagia and palpebral ptosis. A chest radiograph image demonstrated a mass occupying the medium mediastinum with projection to the right. Computed tomography of the thorax revealed the presence of a mass in the medium mediastinum, and thus surgery was inicated. During the operation the was was observed in the medium mediastinum suggesting thymoma. What caught our attention was the unusual location of the tumor as normally thymomas are found in the upper and anterior mediastinum. Psychiatric disorders in myasthenia gravis.

To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis MG. Psychiatric disorders in MG are common, especially depressive and anxiety disorders. Myasthenia gravis MG is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations.

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Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG. So far, their measurement properties have not been compared, so we aimed to study their psychometric properties using the Rasch model.

We studied fit to the Rasch model at the first visit, and compared item fit, thresholds, differential item functioning, local dependence, person separation index, and tests for unidimensionality. We also assessed test-retest reliability and estimated the Minimal Detectable Change. There was local dependence in both scales, as well as differential item functioning for ocular and generalized disease.

The minimally detectable change was 4. Neither scale fulfilled Rasch model expectations. Both tools have items with disordered thresholds, differential item functioning and local dependency. There was evidence of multidimensionality in the QMGS. The minimal detectable change values are higher than previous studies on the minimal significant change. These findings might inform future modifications of these tools. Neuropsychological performance in patients with myasthenia gravis.

Myasthenia gravis is a chronic autoimmune disease that affects the neuromuscular transmission. Controversial findings had been reported about cognitive impairment in this disease. The aim of this study was to investigate the cognitive pattern of patients with myasthenia gravis. There were enrolled 24 patients with myasthenia gravis , anti-acetylcholine receptor antibodies ACRA positive, and 24 healthy controls.

Malignant thymona with symptoms of myasthenia gravis. The rare case of malignant tumor of thymus - Thymoma malignum was described. The initial diagnosis was difficult, because of the irregular symptoms of myasthenia gravis. The diagnostic difficulties, treatment and clinical features of this neoplasm were also discussed. Drugs to be Avoided. Many different drugs have been associated with worsening myasthenia gravis MG. However, these drug associations do not For this app, we are only Myasthenia Gravis and Its Aeromedical Implications.

Myasthenia gravis is an autoimmune condition where antibodies form against the acetylcholine receptors at the neuromuscular junction, eventually causing damage to the motor end plate. The clinical features include muscle fatigability as well as ocular, bulbar, and limb weakness, which can have implications on the role of a pilot or air traffic controller. A search of the United Kingdom Civil Aviation Authority medical records database from to identified 11 individuals with a diagnosis of myasthenia gravis. Data were extracted for the class of medical certificate, age at diagnosis, symptoms, acetylcholine receptor antibody status, treatment, the time from diagnosis to loss of medical certification, and the reasons for loss of certification.

There were two Class 1 certificate holders for professional flying and six Class 2 certificate holders for private pilot flying and three air traffic controllers. The mean and median ages at diagnosis were 53 and 57 yr, respectively, with a range of yr. The mean and median intervals from diagnosis to loss of certification were 22 and 11 mo, respectively, with a range of 0 to mo. The aeromedical implications of myasthenia gravis , including complications, types of treatment, and functional impact, are considered. A policy for medical certification following a diagnosis of myasthenia gravis is proposed.

Myasthenia gravis and its aeromedical implications. Aerosp Med Hum Perform. Randomized Trial of Thymectomy in Myasthenia Gravis. Thymectomy has been a mainstay in the treatment of myasthenia gravis , but there is no conclusive evidence of its benefit. We conducted a multicenter, randomized trial comparing thymectomy plus prednisone with prednisone alone. We compared extended transsternal thymectomy plus alternate-day prednisone with alternate-day prednisone alone. Patients 18 to 65 years of age who had generalized nonthymomatous myasthenia gravis with a disease duration of less than 5 years were included if they had Myasthenia Gravis Foundation of America clinical class II to IV disease on a scale from I to V, with higher classes indicating more severe disease and elevated circulating concentrations of acetylcholine-receptor antibody.

The primary outcomes were the time-weighted average Quantitative Myasthenia Gravis score on a scale from 0 to 39, with higher scores indicating more severe disease over a 3-year period, as assessed by means of blinded rating, and the time-weighted average required dose of prednisone over a 3-year period. A total of patients underwent randomization between and at 36 sites.

Patients who underwent thymectomy had a lower time-weighted average Quantitative Myasthenia Gravis score over a 3-year period than those who received prednisone alone 6. Multiple thymoma in a patient with myasthenia gravis: A thymoma often occurs in patients with myasthenia gravis , but the development of multiple thymoma is very rare.

The authors report the radiologic and pathologic findings of multiple invasive thymoma in a year-old male with myasthenia gravis. Many patients with myasthenia gravis MG still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of oral corticosteroids, since full remission is not common. Our analysis demonstrated that disease severity, oral corticosteroids, and depressive state are the major factors negatively associated with QOL, and that QOL of MM status patients taking CSR and is a target of treatment.

In order to achieve early MM or better status with prednisolne strategy that can achieve early improvement by performing an aggressive therapy using combined treatment with plasmapheresis and high-dose intravenous methylprednisolone and then maintain an improved status using low-dose oral corticosteroids and calcineurin inhibitors. Myasthenia gravis is an autoimmune disease that is characterised by muscle weakness and fatigue, is B-cell mediated, and is associated with antibodies directed against the acetylcholine receptor, muscle-specific kinase MUSK , lipoprotein-related protein 4 LRP4 , or agrin in the postsynaptic membrane at the neuromuscular junction.

Patients with myasthenia gravis should be classified into subgroups to help with therapeutic decisions and prognosis. Subgroups based on serum antibodies and clinical features include early-onset, late-onset, thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis. Agrin-associated myasthenia gravis might emerge as a new entity. The prognosis is good with optimum symptomatic, immunosuppressive, and supportive treatment. Pyridostigmine is the preferred symptomatic treatment, and for patients who do not adequately respond to symptomatic therapy, corticosteroids, azathioprine, and thymectomy are first-line immunosuppressive treatments.

Additional immunomodulatory drugs are emerging, but therapeutic decisions are hampered by the scarcity of controlled studies. Long-term drug treatment is essential for most patients and must be tailored to the particular form of myasthenia gravis. Muscle autoantibodies in myasthenia gravis: Myasthenia gravis is an autoimmune disorder of the neuromuscular junction. A number of molecules, including ion channels and other proteins at the neuromuscular junction, may be targeted by autoantibodies leading to abnormal neuromuscular transmission.

Antibodies to other muscle antigens may be found in the subsets of myasthenia gravis patients, potentially providing clinically useful diagnostic information, but their utility as relevant biomarkers measures of disease state or response to treatment is currently unclear.

Seronegative myasthenia gravis associated with malignant thymoma. Myasthenia gravis MG is generally caused by antibodies directed against the neuromuscular junction, including antibodies against the postsynaptic nicotinic acetylcholine receptor AChR. Pathologic abnormalities of the thymus gland, including thymoma, are associated with MG.

We report a year-old woman who presented with double vision. Single fiber EMG confirmed myasthenia gravis. Chest CT demonstrated a malignant thymoma. We report the first case of seronegative myasthenia gravis associated with malignant thymoma. The case challenges the conventional wisdom that all patients with thymoma associated MG test positive for antibodies against AChR.

Autoimmune Thyroiditis and Myasthenia Gravis. Full Text Available Autoimmune diseases AIDs are the result of specific immune responses directed against structures of the self. They are frequently associated with other organ or non-organ specific AIDs, such as myasthenia gravis MG. The etiology of both diseases is multifactorial and it is due to genetic and environmental factors, and each of them has specific characteristics. The two pathologies show many commonalities, such as the organ-specificity with a clear pathogenic effect of antibodies, the pathological mechanisms, such as deregulation of the immune system and the implication of the genetic predisposition.

They also show some differences, such as the mode of action of the antibodies and therapies. In this review that focuses on ATD and MG, the common features and the differences between the two diseases are discussed. Autoimmune diseases AIDs are the result of specific immune responses directed against structures of the self.

Higgs decays and brane gravi -vectors. Higgs boson decays in flexible brane world models with stable, massive gravi -vectors are considered. Such vectors couple bilinearly to the standard model fields through either the standard model energy-momentum tensor, the weak hypercharge field strength, or the Higgs scalar.

The role of the coupling involving the extrinsic curvature is highlighted. It is found that within the presently allowed parameter space, the decay rate of the Higgs into two gravi -vectors which would appear as an invisible Higgs decay can be comparable to the rate for any of the standard model decay modes.

Miastenia grave en la adolescencia: Apropos of a case. A male adolescent that started with a picture of muscle weakness after doing exercises that led him to fail the physical education subject is presented in this paper. Later on, he began to have difficulties to eat and to pronounce words, and to show asymmetry in the muscular strength of both hemibodies. He was admitted and a few days after he had respiratory alterations and it was decided to transfer him to an intensive care unit and to couple him to a mechanical ventilator. In that opportunity, there was no response to the administration of anticholinesterase agents; however, he began to improve with steroids.

His evolution was satisfactory with a slow and progressive recovery of the muscle strength. The treatment with anticholinesterase agents was gradually re-established with a good response this time. Maximal bite force and surface EMG in patients with myasthenia gravis. Masticatory muscle strength was quantified in patients with bulbar myasthenia gravis and compared with that of patients with ocular myasthenia gravis , patients in clinical remission whether or not pharmacological who previously suffered from bulbar myasthenia gravis , and healthy subjects.

Clinical predictors for the prognosis of myasthenia gravis. Clinical predictors for myasthenia gravis relapse and ocular myasthenia gravis secondary generalization during the first two years after disease onset remain incompletely identified. This study attempts to investigate the clinical predictors for the prognosis of Myasthenia Gravis. Eighty three patients with myasthenia gravis were concluded in this study. Baseline characteristics were analyzed as predictors. Treatment effect including glucocorticoid, pyridostigmine, thymectomy, IVIG, immunosuppressive drugs did not show significant difference between the relapsed and non-relapsed groups.


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The treatment outcome also showed no difference between the single OMG and second generalized groups. Occurrence of associated autoimmune disease can serve as a potential predictor for myasthenia gravis relapse. Either ptosis or diplopia, as well as thymic hyperplasia can predict generalization in the first six months. On the generalized gravi -magnetic hypothesis.

According to a generalization of the gravi -magnetic hypothesis GMH any neutral mass moving in a curvilinear path with respect to an inertial frame creates a magnetic field, dependent on the curvature radius of the path. A simple astrophysical consequence of the generalized GMH is suggested considering the special cases of binary pulsars and binary neutron stars. Vegetables, Soups, Sauces, Gravies and Beverages. Developed as part of the Marine Corps Institute MCI correspondence training program, this course on vegetables, soups, sauces, gravies , and beverages is designed to increase Marine Corps cooks' effectiveness as food handlers, using the proper techniques in the preparation of these items.

Introductory materials include specific information for…. Plasmapheresis in myasthenia gravis. Plasmapheresis plays an important role in the acute management of patients with severe myasthenia gravis. Although plasmapheresis is now in use for more than 20 years, some controversies remain about the indication and the place in the therapy. It is generally found that the effect starts one week. CT evaluation of thymus in myasthenia gravis. The relationship between myasthenia gravis and the thymus was well establish and myasthenia gravis occurs in the presence of thymic hyperplasia or thymoma or occasionally in histologically normal thymus.

Since not every patients with myasthenia gravis is a candidate for thymectomy, unless a thymoma is present, the differentiation of normal and hyperplastic thymus from thymoma becomes important. Authors reviewed retrospectively clinical records and chest CT scans of 18 patients with myasthenia gravis who underwent thymectomy during recent 5 years, to evaluate the role of CT scan. The results were as follows. Of 5 cases of normal thymus, no false positive cases were noted in CT scan. Of 6 cases of thymic hyperplasia, CT findings were normal except 1 cases of thickened left thymic lobe.

Of 7 cases of thymoma, no false negative cases were noted in CT scan. CT findings of benign thymoma were round or oval shaped, discrete, slightly enhancing soft tissue mass in anterior mediastinum. CT findings of malignant thymoma were lobulated contoured, infiltrative, soft tissue mass lesion in anterior mediastinum with calcifications, pleural tumor implants, and SVC compression.

CT yielded valuable information on differential diagnosis of thymoma, thymic hyperplasia and normal thymus. Also CT was a highly sensitive method in the detection of thymoma and determining the extent and invasiveness. Ocular myasthenia gravis in a setting of thyrotoxicosis. Full Text Available Ocular myasthenia gravis in conjunction with thyroid disorders, although rare, has been reported in the past. However, the similarity in the presentation of both the entities and the tendency of myasthenia gravis to get overlooked easily, even by experienced clinicians, necessitates a thorough knowledge, a strong consideration, and a vigilant approach, to aid in its diagnosis.

We discuss a case of a female in a thyrotoxic state, with symptoms of ocular myasthenia gravis , and a brief overview of this entity. Reversible man-in-the-barrel syndrome in myasthenia gravis. Full Text Available Man-in-the-barrel syndrome MBS is an uncommon presentation due to bilateral, predominantly proximal muscle weakness that has not been described to be associated with myasthenia gravis. We describe a case of myasthenia gravis presenting as MBS. While electrophysiology is an important tool in the diagnosis of myasthenia gravis , pathological EMG patterns do not exclude the diagnosis of myasthenia gravis.

Man-in-the-barrel syndrome MBS is an uncommon presentation due to bilateral, predominantly proximal muscle weakness that has not been described to be associated with myasthenia gravis. Causada pela levedura, Cryptococcus neoformans. Mais frequente em adultos, comumente diagnosticada em pacientes imunodeprimidos, como os soropositivos, fator predisponente mais frequente. Myasthenia gravis is an autoimmune disease caused by antibodies leading to the destruction of nicotinic acetylcholine receptors on the neuromuscular junction.

It is characterized by muscle weakness that gets aggravated with physical activity and improves at rest. Myasthenia Gravis Foundation of America made the clinical classification of Myasthenia gravis which is still in use today. In addition to this test repeated muscular stimulation can be used as well as the analysis of specific autoantibodies. Treatment of Myasthenia Gravis. In conservative treatment of Mysthenia gravis anticholinesterases, immunosuppressants and plasmapheresis can be used.

If conservative treatment does not lead to the desired remission, surgical treatment is indicated. The most accepted indication for thymectomy is the presence of thymoma with generalized form of Myasthenia gravis in adults. Mechanism of the disease development is the reason'for the increased sensitivity or resistance of these patients to certain types of drugs used in anesthesia. Based on 35 years of experience in the surgical treatment of patients with Myasthenia gravis anesthesiologists at the Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina.

Anesthesiologists may have to deal with a patient with myasthenia gravis in different types of surgical interventions. The protocol for anesthesia and perioperative management of these patients. The following areas were evaluated: Evidence of depression was found: Neuropsychological performance declines in patients with myasthenia gravis: Full Text Available Myasthenia gravis is a chronic autoimmune disease that affects the neuromuscular transmission.

Myasthenia Gravis in Pregnancy: Full Text Available Objective. To present a case of maternal myasthenia gravis in pregnancy and give a systematic review of the literature. The newborn was transferred to the pediatric unit for surveillance and did not show any signs of muscular weakness in the course of time.

The mother developed a respiratory insufficiency on the second day postpartum.


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  5. The myasthenic crisis led to a progressive dyspnoea within minutes, which exacerbated in a secondary generalized seizure with cardiac-circulatory arrest. After successful cardiopulmonary resuscitation, the patient was transferred to intensive care. The interdisciplinary therapeutic approach included ventilatory assistance via endotracheal intubation, parenteral pyridostigmine, azathioprine, and steroids. By interdisciplinary measures, a stable state was regained.

    Myasthenia gravis especially when associated with pregnancy is a high-risk disease. As this disease predominantly occurs in women of reproductive age, it is important to be aware of this condition in obstetrics and its interdisciplinary diagnostic and therapeutic management. Myasthenia gravis MG is generally a rare disorder and may thus be easily misdiagnosed.

    Misdiagnosis is even more likely when the presentation is atypical. A year-old man presented with progressive Neuromuscular disease mimicking myasthenia gravis in a Nigerian Nemaline rod disease is a congenital myopathy, presentation of which may mimic myasthenia gravis. We report a suspected case of nemaline rod disease in a female adolescent who presented with features similar to myasthenia gravis but failed to respond effectively to its conventional management Myasthenia gravis MG is an acquired autoimmune disorder causing skeletal muscle fatigue and weakness.

    It highlights possible hereditary component of this condition which has not been commonly reported in Factors affecting outcome in ocular myasthenia gravis. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables.

    We reviewed a cohort of Caucasian patients followed from September to January Several independent variables were considered as prognostic factors: Changes in mental and physical subscores of health-related quality of life HRQoL were assessed with SF questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients.

    Conversion to GMG occurred in Antibody titer above the mean value of Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening. Relatar um caso, revisar a etiopatogenia e o tratamento do raquitismo carencial. Autoimmune Myasthenia Gravis after Sternal Fracture. Full Text Available We report a year-old woman who suffered a commotio cerebri, whiplash injury and a chest trauma with sternal fracture due to a high-velocity car accident.

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    Do you believe that this item violates a copyright? J Gerontol Nurs ; 29 4: Treatment of HIV infection in the older patient. Expert Rev Anti Infect Ther ; 2 5: Planning HIV education programs for older adults: J Gerontol Nurs ; 30 3: Perspective on HIV infection and aging: Clin Infect Dis ; 41 6: J Antimicrob Chemother ; 57 1: Trends in sexually transmitted infections other than HIV in older people: Sex Transm Infect ; 84 4: Nguyen N, Holodniy M. HIV infection in the elderly. Clin Interv Aging ; 3 3: The aging of the HIV epidemic. Enfermagem ; 16 4: The older HIV-positive adult: Am J Med ; Association between widowhood and risk of diagnosis with a sexually transmitted infection in older adults.

    Am J Public Health ; 99 Bourne C, Minichiello V. Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic. Australas J Ageing ; 28 1: Human immunodeficiency virus in an aging population, a complication of success. J Am Geriatr Soc ; 57 The ageing of HIV: Age Ageing ; 39 5: Sexually transmitted infections and the aging female: Maturitas ; 67 2: Human immunodeficiency virus HIV in older people.