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HIV related Myelopathy

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21. HIV-1 Associated Cerebrovascular Complications (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

22. HIV-1 Encephalopathy and AIDS Dementia Complex (Overview)

inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other discussions of HIV infection, see (...) : Bradley WG, Daroff RB, Fenichel GM. Neurologic manifestations of human immunodeficiency virus infection in children. Neurology in Clinical Practice . 2004. 2: 1603-1611. Ances BM, Ellis RJ. Dementia and neurocognitive disorders due to HIV-1 infection. Semin Neurol . 2007 Feb. 27(1):86-92. . World Health Organization. AIDS Epidemic, 2009. Available at . Accessed: June 30, 2011. Navia BA. Clinical and biologic features of the AIDS dementia complex. Neuroimaging Clin N Am . 1997 Aug. 7(3):581-92

2014 eMedicine.com

23. HIV-1 Associated Opportunistic Infections: CNS Toxoplasmosis (Overview)

-related opportunistic infections. Drugs . 1997 Jan. 53(1):40-73. . Marra MC. Infections of the central nervous sytem in patients infected with human immunodeficiency virus. Continuum . 2006. 12:111-32. Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol . 2006 May. 61(5):393-401. . Verma A. Neurological manifestations of human immunodeficiency virus infection in adults. Neurology in Clinical Practice . 2004. Vol 2: 1581-1601 (...) Jan 19 . . Mesquita RT, Ziegler AP, Hiramoto RM, Vidal JE, Pereira-Chioccola VL. Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients. J Med Microbiol . 2010 Jun. 59:641-7. . Alfonso Y, Fraga J, Fonseca C, et al. Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients. Cerebrospinal Fluid Res . 2009 Mar 6. 6:2. . . Mahadevan A, Ramalingaiah AH, Parthasarathy S, Nath A, Ranga U, Krishna SS

2014 eMedicine.com

24. HIV-1 Associated CNS Complications (Overview) (Overview)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

25. HIV-1 Associated Cerebrovascular Complications (Overview)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

26. Dementia Due to HIV Disease (Overview)

inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other discussions of HIV infection, see (...) : Bradley WG, Daroff RB, Fenichel GM. Neurologic manifestations of human immunodeficiency virus infection in children. Neurology in Clinical Practice . 2004. 2: 1603-1611. Ances BM, Ellis RJ. Dementia and neurocognitive disorders due to HIV-1 infection. Semin Neurol . 2007 Feb. 27(1):86-92. . World Health Organization. AIDS Epidemic, 2009. Available at . Accessed: June 30, 2011. Navia BA. Clinical and biologic features of the AIDS dementia complex. Neuroimaging Clin N Am . 1997 Aug. 7(3):581-92

2014 eMedicine.com

27. HIV-1 Encephalopathy and AIDS Dementia Complex (Follow-up)

. [ , ] Human immunodeficiency virus (HIV) enters the central nervous system (CNS) early in the course of the infection and causes several important CNS conditions over the course of the disease, such as HIV encephalopathy and AIDS dementia complex. [ ] As part of the acute HIV syndrome during seroconversion, patients may experience HIV encephalopathy. HIV-associated progressive encephalopathy (HPE) is a syndrome complex with cognitive, motor, and behavioral features seen in children. [ ] Prior (...) , these patients are likely to be less inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other

2014 eMedicine.com

28. HIV-1 Associated Opportunistic Infections: CNS Toxoplasmosis (Follow-up)

-related opportunistic infections. Drugs . 1997 Jan. 53(1):40-73. . Marra MC. Infections of the central nervous sytem in patients infected with human immunodeficiency virus. Continuum . 2006. 12:111-32. Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol . 2006 May. 61(5):393-401. . Verma A. Neurological manifestations of human immunodeficiency virus infection in adults. Neurology in Clinical Practice . 2004. Vol 2: 1581-1601 (...) Jan 19 . . Mesquita RT, Ziegler AP, Hiramoto RM, Vidal JE, Pereira-Chioccola VL. Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients. J Med Microbiol . 2010 Jun. 59:641-7. . Alfonso Y, Fraga J, Fonseca C, et al. Molecular diagnosis of Toxoplasma gondii infection in cerebrospinal fluid from AIDS patients. Cerebrospinal Fluid Res . 2009 Mar 6. 6:2. . . Mahadevan A, Ramalingaiah AH, Parthasarathy S, Nath A, Ranga U, Krishna SS

2014 eMedicine.com

29. HIV-1 Associated CNS Complications (Follow-up) (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

30. HIV-1 Associated Cerebrovascular Complications (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NzAwOC1vdmVydmlldw== processing > Central Nervous System Complications in HIV Updated: Apr 12, 2018 Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Central Nervous System Complications in HIV Overview Overview Based on current World Health Organization (WHO) statistics, there are more than 36 million people living with human immunodeficiency virus (HIV) today. More than 19 million of them receive antiretroviral therapy (ART (...) With HIV Infection in the Era of Antiretroviral Therapy. Top Antivir Med . 2017 Jul/Aug. 25 (3):97-101. . Nath A. Neurologic Complications of Human Immunodeficiency Virus Infection. Continuum (Minneap Minn) . 2015 Dec. 21 (6 Neuroinfectious Disease):1557-76. . Schacker T, Collier AC, Hughes J, Shea T, Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med . 1996 Aug 15. 125 (4):257-64. . Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al

2014 eMedicine.com

31. Dementia Due to HIV Disease (Follow-up)

inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other discussions of HIV infection, see (...) : Bradley WG, Daroff RB, Fenichel GM. Neurologic manifestations of human immunodeficiency virus infection in children. Neurology in Clinical Practice . 2004. 2: 1603-1611. Ances BM, Ellis RJ. Dementia and neurocognitive disorders due to HIV-1 infection. Semin Neurol . 2007 Feb. 27(1):86-92. . World Health Organization. AIDS Epidemic, 2009. Available at . Accessed: June 30, 2011. Navia BA. Clinical and biologic features of the AIDS dementia complex. Neuroimaging Clin N Am . 1997 Aug. 7(3):581-92

2014 eMedicine.com

32. Dementia Due to HIV Disease (Diagnosis)

inhibited and are more prone to HIV-related risk behavior (eg, unprotected intercourse), and they therefore pose a greater risk of transmission of the virus. In addition to HIV itself, other causes of neurologic complications in HIV-infected individuals include opportunistic infections, tumors, and antiretroviral drugs. Other neurologic complications that arise from primary HIV infection include vacuolar myelopathy, peripheral neuropathies, and polymyositis. For other discussions of HIV infection, see (...) : Bradley WG, Daroff RB, Fenichel GM. Neurologic manifestations of human immunodeficiency virus infection in children. Neurology in Clinical Practice . 2004. 2: 1603-1611. Ances BM, Ellis RJ. Dementia and neurocognitive disorders due to HIV-1 infection. Semin Neurol . 2007 Feb. 27(1):86-92. . World Health Organization. AIDS Epidemic, 2009. Available at . Accessed: June 30, 2011. Navia BA. Clinical and biologic features of the AIDS dementia complex. Neuroimaging Clin N Am . 1997 Aug. 7(3):581-92

2014 eMedicine.com

33. Animal models on HTLV-1 and related viruses: what did we learn? Full Text available with Trip Pro

Animal models on HTLV-1 and related viruses: what did we learn? Retroviruses are associated with a wide variety of diseases, including immunological, neurological disorders, and different forms of cancer. Among retroviruses, Oncovirinae regroup according to their genetic structure and sequence, several related viruses such as human T-cell lymphotropic viruses types 1 and 2 (HTLV-1 and HTLV-2), simian T cell lymphotropic viruses types 1 and 2 (STLV-1 and STLV-2), and bovine leukemia virus (BLV (...) leukemia. The development of different strains of immunodeficient mice strains (SCID, NOD, and NOG SCID mice) provide a useful and rapid tool of humanized and xenografted mice models, to test new drugs and targeted therapy against HTLV-1-associated leukemia, to identify leukemia stem cells candidates but also to study the innate immunity mediated by the virus. All together, these animal models have revolutionized the biology of retroviruses, their manipulation of host genes and more importantly

2012 Frontiers in microbiology

34. Assessment of balance disorders

syndrome) Spinal cord trauma Guillain-Barre syndrome (GBS), polyradiculopathy Spinal spondylosis Spinal cord tumour Neuromyelitis optica (NMO) Subacute combined degeneration of the cord Syphilis, tabes dorsalis TB (Pott's disease) HIV infectious myelopathy Human T-lymphotrophic virus (HTLV)-1 infectious myelopathy SLE inflammatory myelopathy Anxiety disorder Drug toxicity Contributors Authors Instructor in Otology and Laryngology Harvard Medical School Boston MA Disclosures AP declares that he has (...) ). Dizziness and balance difficulty may also result from psychiatric disease, especially panic or anxiety disorders. However, patients with vestibular disorders also have a higher prevalence of panic and anxiety disorders. It is also important to consider that the cause of the balance disorder may be multifactorial. For example, a chronic alcoholic may have problems with balance due to alcohol-related neuropathy, alcohol-related cerebellar degeneration, and bilateral vestibulopathies from thiamine

2018 BMJ Best Practice

35. CRACKCast E108 – Neuromuscular Disorders

= Moves but unable to resist gravity 1 = Flicker but no movement 0 = No movement [3] Compare myelopathy, motor neuron disease, neuropathy, neuromuscular junction disease, and myopathy with respect to history, strength, DTR’s, sensation and muscle wasting. Clinical Characteristics of Neuromuscular Diseases (Table 98.1) Disease History Strength DTR Sensation Wasting Myelopathy Trauma, infection, cancer Normal to decreased Increased Normal to Decreased No Motor neuron disease (ALS) Progressive difficulty (...) swallowing, speaking, walking Decreased Increased Normal Yes Neuropathy Recent infection, ascending weakness Normal or decreased, distal>proximal Decreased Decreased Yes Neuromuscular junction disease Food (canned goods), Tick exposure, easy fatigability Normal to fatigue Normal Normal No Myopathy Thyroid disease, previous similar episodes Decreased, proximal>distal Normal Normal Yes [4] List 6 myelopathies, 1 motor neuron diseases, 4 neuropathies, 4 diseases of the NMJ, and 5 myopathies. Myelopathies

2017 CandiEM

36. BSR guideline Management of Adults with Primary Sjögren's Syndrome Full Text available with Trip Pro

pathology other than SS including sarcoidosis, IgG4 disease [ ] and graft vs host disease [ ] may be implicated. Salivary gland aplasia and ductal atresia [ ] are both rare causes of oral sicca and viral infections including hepatitis C and HIV can cause salivary gland disease with hypertrophy and sicca symptoms. Xerostomia can be a feature of oral dysaesthesias with no objective reduction in salivary flow rate. Oral dysaesthesia or burning mouth syndrome is a chronic pain condition currently classified (...) Academy of Ophthalmologists reviewed the evidence for the oral antibiotics doxycycline, minocycline and azithromycin in the management of ocular surface disease arising from disorders of the meibomian glands. They identified eight studies that documented an improvement in meibomian gland-related ocular surface disease after treatment with these agents, although side effects were common. Only one study was a randomized, controlled trial. They concluded oral antibiotics may be an effective treatment

2017 British Society for Rheumatology

37. Guideline for the management of adults with Systemic Lupus Erythematosus Full Text available with Trip Pro

treatment should be guided by a diagnostic renal biopsy. Immunosuppressive agents are recommended in class III A or III A/C (±V) and IV A or IV A/C (±V) nephritis, and also in pure class V nephritis if proteinuria exceeds 1 g/24 h despite the optimal use of renin–angiotensin–aldosterone system blockers. 3.2 The ultimate goals of treatment in LN are long-term preservation of renal function, prevention of disease flares, avoidance of treatment-related harms and improved quality of life and survival (...) in pure class V nephritis if proteinuria exceeds 1 g/24 h despite the optimal use of renin–angiotensin–aldosterone system blockers. 3.2 The ultimate goals of treatment in LN are long-term preservation of renal function, prevention of disease flares, avoidance of treatment-related harms and improved quality of life and survival. Treatment should aim for complete renal response with UPCR <50 mg/mol and normal or near-normal (within 10% of normal GFR if previously abnormal) renal function. Partial renal

2017 British Society for Rheumatology

38. Sciatica (lumbar radiculopathy)

pain have a herniated intervertebral disc [ ]. The incidence of sciatica is related to age, peaking in the 5th decade before declining. Sciatica is rarely seen in people younger than 20 years old [ ]. Causes What are the causes? Sciatica is caused by compression of one or more nerve roots in the lumbosacral spine. The compression can be caused by: A herniated intervertebral disc ('slipped disc') — about 90% of cases. This most commonly occurs at the L4/L5 and L5/S1 levels. Spondylolisthesis — when (...) , depression, and psychosocial impact on family. Time off work, reduced productivity, and loss of employment — non-specific low back pain is cited in some studies as being responsible for 11–13.5% of all time off work [ ]. The estimated working days lost in the UK in 2015–16 due to work-related back disorders was 3.4 million. On average each person took 15.9 days off work as a result of back pain [ ]. Risk factors What are the risk factors? There are differing opinions in the published literature relating

2018 NICE Clinical Knowledge Summaries

39. Multiple sclerosis

a history of tick bites, arthralgia, and rashes. For more information, see the CKS topic on . Tertiary syphilis — classically, dorsal column abnormalities with dementia. For more information, see the CKS topic on . HIV — can cause encephalopathy and myelopathy. For more information, see the CKS topic on . Tropical spastic paraparesis — caused by infection with human T-lymphotropic virus and is mainly seen in the Caribbean area. It causes a slowly progressive myelopathy. Vascular disorders: Primary CNS (...) and neurological function gradually worsens, with or without continued relapses. Primary progressive MS (PPMS) — there is a steady gradual worsening of the disease from the onset, without remissions. This occurs in about 10–15% of people with MS. The trigger of the inflammation causing MS is unknown but known risk factors include genetic factors, the Epstein-Barr virus, low vitamin D levels, geographical location (extremes of latitude), smoking, obesity during adolescence, and female gender. Presenting

2018 NICE Clinical Knowledge Summaries

40. Clinical Practice Guidelines on Prevention, Diagnosis and Management of Tuberculosis

patients, other means of obtaining sputum should be utilised, including sputum induction and gastric lavage. Grade D, Level 3 27 8 In patients presenting with extrapulmonary disease, a chest radiograph should also be done to determine if there is concomitant pulmonary tuberculosis and sputum samples obtained to determine if the case is infectious. Grade D, Level 3 28 9 Patients with newly diagnosed tuberculosis should be screened for human immunodeficiency virus (HIV) and diabetes mellitus. Grade D (...) the diagnosis of drug resistant tuberculosis. These tests should be used on respiratory samples obtained from persons who are failing or have failed anti-tuberculosis therapy with first line agents, patients who come from countries with high prevalence of MDR-TB, individuals who have been non-adherent to treatment and those who are exposed to a known MDR-TB case. 61 Screening for HIV and diabetes mellitus in tuberculosis patients Human immunodeficiency virus (HIV) infection is the strongest predisposing

2016 Ministry of Health, Singapore

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