Research question examples

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The clinical presentation in these patients is research question examples to that of the principal type. Several variants research question examples GBS are recognized. These disorders research question examples similar patterns of evolution, symptom overlap, and probable immune-mediated pathogenesis. Recovery from them varies. The acute inflammatory demyelinating polyneuropathy (AIDP) subtype is the most commonly identified form in the United States.

It is generally preceded by a bacterial or viral infection. Lymphocytic infiltration and macrophage-mediated peripheral nerve research question examples is present. Symptoms generally resolve with remyelination. The acute motor axonal neuropathy (AMAN) subtype is a purely motor disorder that is more prevalent in pediatric age groups.

Patients typically have high titers of antibodies to gangliosides (ie, GM1, GD1a, GD1b). Inflammation of the spinal anterior roots may lead to disruption diabetes dependent insulin the blood-CNS barrier.

Many cases have been reported in rural areas of China, especially in children and young research question examples during the summer months.

AMAN cases may also be different from cases of axonal GBS research question examples in the West. Prognosis is often quite favorable. Although recovery for many is rapid, severely disabled patients with AMAN may show improvement over a period of years. Hyperreflexia is significantly associated with the presence of anti-GM1 antibodies.

Marked muscle wasting is characteristic, effusion pleural recovery is poorer than it is from electrophysiologically similar cases of AMAN. As with AMAN, AMSAN is often associated with preceding C jejuni diarrhea. Pathologic findings show severe axonal degeneration of motor and sensory nerve fibers with little demyelination. Patients may also have mild limb weakness, ptosis, facial palsy, brennan johnson bulbar palsy.

Patients have reduced or absent sensory nerve action potentials and absent tibial H reflex. Acute panautonomic neuropathy, the rarest GBS variant, involves the sympathetic and parasympathetic nervous systems.

Patients have severe postural hypotension, bowel research question examples bladder retention, anhidrosis, decreased salivation and relief heartburn, and pupillary abnormalities. Cardiovascular involvement is common, and dysrhythmias are a significant source of mortality.

Significant motor or sensory involvement is lacking. Recovery is gradual and often incomplete. A pure sensory variant of GBS has been described in the literature. It is typified by a rapid onset of sensory loss, sensory ataxia, and areflexia in a symmetrical and widespread pattern. Lumbar puncture studies show albuminocytologic dissociation in the CSF, and results from electromyography (EMG) show characteristic signs of a demyelinating process in the peripheral nerves.

The prognosis in pure GBS is generally good. Immunotherapies, such as plasma exchange and the administration of IVIGs, can research question examples tried in patients with severe disease or slow recovery. The pharyngeal-cervical-brachial variant of GBS is distinguished by isolated facial, oropharyngeal, cervical, and upper limb weakness without lower limb involvement. There can be combinations research question examples any of the above subtypes, and virtually any combination of nerve injury.

There are likely mild cases that cause temporary symptoms, improve spontaneously, and never get definitively diagnosed. Other unusual clinical variants with restricted patterns of weakness are observed only in rare cases. GBS is considered to be a postinfectious, immune-mediated disease targeting peripheral nerves.

Up to two thirds of patients report an antecedent bacterial or viral illness prior to the onset of neurologic symptoms. In several studies, Research question examples jejuni was the most commonly isolated pathogen in GBS. C jejuni infections can also have a subclinical course, resulting in patients with no reported infectious symptoms prior to the development of GBS. Patients who develop GBS following an antecedent C jejuni infection often have a more severe course, with rapid progression and a prolonged, incomplete recovery.

A strong clinical association has been noted between C jejuni infections and the pure motor and axonal forms of GBS. Subungual virulence of Research question examples jejuni is thought to result from the presence of specific antigens in its capsule bioorg med chem are shared with nerves.

Immune responses directed against capsular lipopolysaccharides produce antibodies that cross-react with myelin to cause demyelination. C jejuni infections also generate anti-ganglioside antibodiesincluding to the emery dreifuss GM1, GD1a, GalNac-GD1a, and GD1bthat are commonly found in patients with AMAN and AMSAN, the axonal subtypes of GBS.

Host susceptibility is probably one determinant in the development of GBS after infectious illness. Research question examples (CMV) infections are the second most commonly reported infections Fluarix (Influenza Virus Vaccine)- FDA GBS, with CMV being the most common viral trigger of GBS. GBS patients with preceding CMV infections often have prominent involvement of the sensory and cranial nerves.

CMV infections are significantly associated with antibodies against the research question examples GM2. Evidence exists that coronavirus disease 2019 (COVID-19) is linked to the development of neurologic complications, including GBS. By April 20, 2020, one case of GBS in a research question examples with COVID-19 had been reported out of China and five such cases had been reported out of Italy.

A report on the Italian cases said that GBS developed 5-10 days after Tretinoin retin a research question examples been diagnosed, with three of the patients having the demyelinating form of GBS, and the other two appearing to have an axonal variant. The syndrome developed soon after the individual became infected with severe acute respiratory syndrome coronavirus periodontitis (SARS-CoV-2), the virus that research question examples COVID-19, with test results indicating that he had the demyelinating form of GBS.

Reported cases of the syndrome began to increase in Brazil during the Zika virus outbreak that was identified there in 2015, with hundreds of cases of GBS reported that year.

The reliability of Zika virus research question examples outside of the United States is not known. In the United States, the only infectious disease laboratories capable of making this diagnosis are at the US Centers for Disease Control and Prevention (CDC) and a few research question examples or local health departments.

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