Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
SJS constitutes a dermatological emergency. Patients with documented "Mycoplasma" infections can be treated with oral macrolide or oral doxycycline.
Initially, treatment is similar to that for patients with thermal burns, and continued care can only be supportive (e.g. intravenous fluids and nasogastric or parenteral feeding) and symptomatic (e.g., analgesic mouth rinse for mouth ulcer). Dermatologists and surgeons tend to disagree about whether the skin should be debrided.
Beyond this kind of supportive care, no treatment for SJS is accepted. Treatment with corticosteroids is controversial. Early retrospective studies suggested corticosteroids increased hospital stays and complication rates. No randomized trials of corticosteroids were conducted for SJS, and it can be managed successfully without them.
Other agents have been used, including cyclophosphamide and cyclosporin, but none has exhibited much therapeutic success. Intravenous immunoglobulin treatment has shown some promise in reducing the length of the reaction and improving symptoms. Other common supportive measures include the use of topical pain anesthetics and antiseptics, maintaining a warm environment, and intravenous analgesics.
An ophthalmologist should be consulted immediately, as SJS frequently causes the formation of scar tissue inside the eyelids, leading to corneal vascularization, impaired vision, and a host of other ocular problems. Those with chronic ocular surface disease caused by SJS may find some improvement with PROSE treatment (prosthetic replacement of the ocular surface ecosystem treatment).
Treatment is in the form of supportive care. If there is light-headedness, the victim should lie with feet partly elevated. If there is severe wheezing, then intramuscular epinephrine should be given, 0.5–1 ml at dilution of 1/1000 (standard medical emergency kit). An intravenous antihistamine like diphenhydramine should be given if needed.
Specific treatments are not mentioned. The affected person may go to a medical clinic that specializes in sexual health. If no medical problems are found, therapy may be used to help deal with stress, or anxiety medicines may be used.
Disorders, who they affect, and how they affect are different within each culture. In order to diagnose someone, it is necessary to make the effort to understand their home culture. Whether it is a culture bound syndrome or not, a person’s background determines how they see and interpret their own symptoms and how it must be treated.
There is currently no treatment or cure for CARASIL. Most frequently, a combination of supportive care and medications to prevent the occurrence of stroke are recommended.
As of April 2020, there is no specific treatment for COVID-19. Research is, however, ongoing. For symptoms, some medical professionals recommend paracetamol (acetaminophen) over ibuprofen for first-line use. The WHO does not oppose the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for symptoms, and the FDA says currently there is no evidence that NSAIDs worsen COVID-19 symptoms.
While theoretical concerns have been raised about ACE inhibitors and angiotensin receptor blockers, as of 19 March 2020, these are not sufficient to justify stopping these medications. Steroids, such as methylprednisolone, are not recommended unless the disease is complicated by acute respiratory distress syndrome.
Medications to prevent blood clotting have been suggested for treatment, and anticoagulant therapy with low molecular weight heparin appears to be associated with better outcomes in severe COVID‐19 showing signs of coagulopathy (elevated D-dimer).
Research into potential treatments started in January 2020, and several antiviral drugs are in clinical trials. Remdesivir appears to be the most promising. Although new medications may take until 2021 to develop, several of the medications being tested are already approved for other uses or are already in advanced testing. Antiviral medication may be tried in people with severe disease. The WHO recommended volunteers take part in trials of the effectiveness and safety of potential treatments.
The FDA has granted temporary authorisation to convalescent plasma as an experimental treatment in cases where the person's life is seriously or immediately threatened. It has not undergone the clinical studies needed to show it is safe and effective for the disease.
Since the mutation is a genetic issue, there is currently no cure for the flush reaction. Clinicians and the East Asian public generally know about the alcohol flushing response. Prevention would include not drinking alcohol.
In China, traditional treatment based on the causes suggested by cultural beliefs are administrated to the patient. Praying to gods and asking Taoist priests to perform exorcism is common. If a fox spirit is believed to be involved, people may hit gongs or beat the person to drive it out. The person will receive a yang- or yin-augmenting Chinese medicine potion, usually including herbs, pilose antler (stag of deer) or deer tail, and tiger penis, deer penis, or fur seal penis. Other foods for therapy are pepper soup, ginger soup and liquor.
Chinese folk beliefs hold that the Yin (Chinese: 陰) represents femininity, slow, cold, wet, passive, water, the moon, and nighttime. And that Yang represents masculinity, fast, dry, hot, aggressive, fire, the sun, and daytime.
Loss of yang would result in an abundance of Yin. It is also believed that if a case of Shenkui is severe enough, it could result in death.
Informal or incomplete education about sexual health in China leaves a lot of room for folk beliefs to thrive. Often, advertisements support such beliefs to encourage use of traditional medicines. In Chinese folk beliefs, the loss of semen can cause imbalance in the body, leaving you with aches and pains and trouble performing.
In the acute phase of an attack, administration of potassium will quickly restore muscle strength and prevent complications. However, caution is advised as the total amount of potassium in the body is not decreased, and it is possible for potassium levels to overshoot ("rebound hyperkalemia"); slow infusions of potassium chloride are therefore recommended while other treatment is commenced.
The effects of excess thyroid hormone typically respond to the administration of a non-selective beta blocker, such as propranolol (as most of the symptoms are driven by increased levels of adrenaline and its effect on the β-adrenergic receptors). Subsequent attacks may be prevented by avoiding known precipitants, such as high salt or carbohydrate intake, until the thyroid disease has been adequately treated.
Treatment of the thyroid disease usually leads to resolution of the paralytic attacks. Depending on the nature of the disease, the treatment may consist of thyrostatics (drugs that reduce production of thyroid hormone), radioiodine, or occasionally thyroid surgery.
The first stage of treatment used to be a reversible colostomy. In this approach, the healthy end of the large intestine is cut and attached to an opening created on the front of the abdomen. The contents of the bowel are discharged through the hole in the abdomen and into a bag. Later, when the patient's weight, age, and condition are right, the "new" functional end of the bowel is connected with the anus. The first surgical treatment involving surgical resection followed by reanastomosis without a colostomy occurred as early as 1933 by Doctor Baird in Birmingham on a one-year-old boy.
Treatment of Hirschsprung's disease consists of surgical removal (resection) of the abnormal section of the colon, followed by reanastomosis.
Cardiac and respiratory complications are treated symptomatically. Physical and occupational therapy may be beneficial for some patients. Alterations in diet may provide temporary improvement but will not alter the course of the disease. Genetic counseling can provide families with information regarding risk in future pregnancies.
On April 28, 2006 the US Food and Drug Administration approved a Biologic License Application (BLA) for Myozyme (alglucosidase alfa, rhGAA), the first treatment for patients with Pompe disease, developed by a team of Duke University researchers. This was based on enzyme replacement therapy using biologically active recombinant human alglucosidase alfa produced in Chinese Hamster Ovary cells. Myozyme falls under the FDA Orphan Drug designation and was approved under a priority review.
The FDA has approved Myozyme for administration by intravenous infusion of the solution. The safety and efficacy of Myozyme were assessed in two separate clinical trials in 39 infantile-onset patients with Pompe disease ranging in age from 1 month to 3.5 years at the time of the first infusion. Myozyme treatment clearly prolongs ventilator-free survival and overall survival. Early diagnosis and early treatment leads to much better outcomes. The treatment is not without side effects which include fever, flushing, skin rash, increased heart rate and even shock; these conditions, however, are usually manageable.
Myozyme costs an average of US$300,000 a year and must be taken for the patients' entire life, so some American insurers have refused to pay for it. On August 14, 2006, Health Canada approved Myozyme for the treatment of Pompe disease. On June 14, 2007 the Canadian Common Drug Review issued their recommendations regarding public funding for Myozyme therapy. Their recommendation was to provide funding to treat a very small subset of Pompe patients (Infants less one year of age with cardiomyopathy). Genzyme received broad approval in the European Union. On May 26, 2010 FDA approved Lumizyme, a similar version of Myozyme, for the treament of late-onset Pompe disease.
A new treatment option for this disease is called Lumizyme. Lumizyme and Myozyme have the same generic ingredient (Alglucosidase Alfa) and manufacturer (Genzyme Corporation). The difference between these two products is in the manufacturing process. Today, the Myozyme is made using a 160-L bioreactor, while the Lumizyme uses a 4000-L bioreactor. Because of the difference in the manufacturing process, the FDA claims that the two products are biologically different. Moreover, Lumizyme is FDA approved as replacement therapy for late-onset (noninfantile) Pompe disease without evidence of cardiac hypertrophy in patients 8 years and older. Myozyme is FDA approved for replacement therapy for infantile-onset Pompe disease.
Recent studies on chaperone molecules to be used with myozyme are starting to show promising results on animal models.
SJS (with less than 10% of body surface area involved) has a mortality rate of around 5%. The mortality for toxic epidermal necrolysis (TEN) is 30–40%. The risk for death can be estimated using the SCORTEN scale, which takes a number of prognostic indicators into account. It is helpful to calculate a SCORTEN within the first 3 days of hospitalization. Other outcomes include organ damage/failure, cornea scratching, and blindness.. Restrictive lung disease may develop in patients with SJS and TEN after initial acute pulmonary involvement. Patients with SJS or TEN caused by a drug have a better prognosis the earlier the causative drug is withdrawn.
H-wave therapy (HWT) is a form of electrical stimulation that produces a direct, localized effect on the conduction of underlying nerves. The electrical stimulation used in HWT differs from other forms of electrical stimulation such as TENS in terms of its waveform; it is intended to emulate the H waveform found in nerve signals, thus permitting the machine to use less power while attaining greater and deeper penetration of its low-frequency current. The waves used in HWT are distinct from the H-waves that are part of electromyography. It has been used in the treatment of pain related to diabetic neuropathy, muscle sprains, temporomandibular joint disorders, type I complex regional pain syndrome as well as the healing of wounds such as diabetic ulcers. This electroanalgesic modality was originally recommended as an alternative to TENS for dental analgesia. In a 1999 randomized controlled trial involving a mechanical pain model, the analgesic effects of HWT were found to be short-lasting and identical to those provided by TENS therapy. HWT has not been shown effective in reducing pain in cases other than diabetic neuropathy, nor has it been shown effective in reducing edema or swelling, and it has specifically not been shown effective in treating chronic pain due to ischemia.
Yunnan sudden death syndrome is a label used to define unexplained cases of cardiac arrest, which afflicted significant numbers of rural villagers in Yunnan province, in southwest China. Cases occurred almost always during the midsummer rainy season (from June to August), at an altitude of . The cause turned out to be a mushroom now blamed for an estimated 400 deaths in the past three decades.
The mysterious fatalities were recorded for decades before researchers from the Chinese Center for Disease Control and Prevention isolated a significant factor common in every case: a tiny unknown mushroom which was unintentionally gathered and consumed during wild mushroom harvests in the region. Previously the syndrome was thought to be caused by Keshan disease, caused by the Coxsackie virus.
The mushroom, "Trogia venenata", is also known as 'Little White'. It has been determined that families collecting fungi to sell have been eating these Little White mushrooms as they have no commercial value. Three amino acids present in the mushrooms have been shown to be toxic. The mushrooms have also been shown to contain very high quantities of barium, and it may be that some of the deaths are simply from barium poisoning.
In the hours before death, about two-thirds of the victims had such symptoms as nausea, dizziness, heart palpitations, seizures and fatigue.
However, in December 2012 it was announced that Dr Xu Jianping (徐建平) has been collecting samples of "Trogia venenata" in Yunnan for the past three years, and his research now shows that barium levels in the wild mushroom are no higher than those of common foods such as poultry and fish. Nonetheless, it appears the mushroom will still likely play a role. Since publication of the widely circulated 2010 "Science" article, no instances of Yunnan sudden death syndrome have been reported.
Many treatments have been tried for port-wine stains including freezing, surgery, radiation, and tattooing; port-wine stains can also be covered with cosmetics.
Lasers may be able to destroy the capillaries without significant damage to the overlying skin. Lasers and other light sources may therefore be able to reduce the redness of stains, although there is not enough evidence to recommend one form over another.
For most people in trials of pulsed dye laser, more than 25% of the redness was reduced by laser after one to three treatments. Adverse effects were rare in these trials, although some people had changes to the color of the skin, especially Chinese people with darker skin. There can be pain, crusting, and blistering in the two weeks after treatment. The trials only followed people for six months, so long-term outcomes are not known. Up to 10 treatments may be necessary for improvement, but complete removal may not result.
The use of topical rapamycin as an adjunct to pulsed dye laser may improve results.
Treatment is generally given before one year of age. However, as it is recommended to be performed under anesthesia (15 minutes) on small children, it is not always possible to get frequent treatments. For example in Finland a child gets treated 2-3 times per year, resulting in a target of "being ready before school age" (7 years) "(needs citation)".
After the laser treatment the skin is filled with black marks, the size of a pen. This is due to the laser instrument's size; the black marks disappear within 1–3 weeks. The treated area can be sore and swollen for a couple of days.
Transcutaneous acupoint electrical stimulation, or TAES, is a variant of TENS therapy that involves applying cutaneous electrodes at classical Chinese acupoints and stimulating with alternating high- and low-frequency electric current ("dense-disperse"). Acupoint stimulation is as effective as dermatomal stimulation in producing an analgesic-sparing effect after lower abdominal surgery
The prognosis for individuals with Pompe disease varies according to the onset and severity of symptoms. Without treatment the disease is particularly lethal in infants and young children.
Myozyme (alglucosidase alfa) is a recombinant form of the human enzyme acid alpha-glucosidase, and is also currently being used to replace the missing enzyme. In a study which included the largest cohort of patients with Pompe disease treated with enzyme replacement therapy (ERT) to date findings showed that Myozyme treatment clearly prolongs ventilator-free survival and overall survival in patients with infantile-onset Pompe disease as compared to an untreated historical control population. Furthermore, the study demonstrated that initiation of ERT prior to 6 months of age, which could be facilitated by newborn screening, shows great promise to reduce the mortality and disability associated with this devastating disorder. Taiwan and several states in the United States have started the newborn screening and results of such regimen in early diagnosis and early initiation of the therapy have dramatically improved the outcome of the disease; many of these babies have reached the normal motor developmental milestones.
Another factor affecting the treatment response is generation of antibodies against the infused enzyme, which is particularly severe in Pompe infants who have complete deficiency of the acid alpha-glucosidase. Immune tolerance therapy to eliminate these antibodies has improved the treatment outcome.
A Late Onset Treatment Study (LOTS) was published in 2010. The study was undertaken to evaluate the safety and efficacy of aglucosidase alfa in juvenile and adult patients with Pompe disease. LOTS was a randomized, double-blind, placebo-controlled study that enrolled 90 patients at eight primary sites in the United States and Europe. Participants received either aglucosidase alfa or a placebo every other week for 18 months. The average age of study participants was 44 years. The primary efficacy endpoints of the study sought to determine the effect of Myozyme on functional endurance as measured by the six-minute walk test and to determine the effect of aglucosidase alfa on pulmonary function as measured by percent predicted forced vital capacity.
The results showed that, at 78 weeks, patients treated with aglucosidase alfa increased their distance walked in six minutes by an average of approximately 25 meters as compared with the placebo group which declined by 3 meters (P=0.03). The placebo group did not show any improvement from baseline. The average baseline distance walked in six minutes in both groups was approximately 325 meters.
Percent predicted forced vital capacity in the group of patients treated with aglucosidase alfa increased by 1.2 percent at 78 weeks. In contrast, it declined by approximately 2.2 percent in the placebo group (P=0.006).
Within the qigong community, there are specific treatments believed to be effective for addressing different forms of Zou huo ru mo. In particular, depending upon somatic versus psychological symptoms, and whether the condition is considered temporary or an intrinsic mental disorder, self-correction treatments can involve relaxation, walking, self-vibrating, self-patting, and self-massage; whereas clinical treatments can involve psychological counseling, expert guidance of practice, acupuncture, massage, "external qi" treatments, and symptomatic correction
In historical culture-bound cases, reassurance and talks on sexual anatomy are given. Patients are treated with psychotherapy distributed according to symptoms and to etiologically significant points in the past. Prognosis appears to be better in cases with a previously functional personality, a short history and low frequency of attacks, and a relatively uncomplicated sexual life.
For sporadic Western cases, careful diagnostic workup including searching for underlying sexual conflict is common. The choice of psychotherapeutic treatment is based on the psychiatric pathology found.
The exact nature of the poison is still unclear. In the U.S. outbreak, the source of the fish was traced by the Centers for Disease Control and Prevention, and studies of other fish from the same sources showed a hexane-soluble (and hence non-polar lipid) substance that induced similar symptoms in mice; other food-borne poisons commonly found in fish could not be detected. It cannot be inactivated by cooking, as all six CDC cases had consumed cooked or fried fish. Palytoxin has been proposed as a disease model. It has also been suggested that the toxin may have thiaminase activity (i.e. it degrades thiamine, also known as vitamin B1).
A lallation (also called cambia-letras or troca-letra, "letter changer", in Latin American countries) is an imperfect enunciation of the letter "L", in which it sounds like "R" (or vice versa), as frequently found in infantile speech.
The speech pattern has been particularly associated with the use of the Portuguese, Spanish and English languages by Chinese, Korean, and Japanese people. The use of lallation has thus been a common feature of Western stereotypes of East Asian people. It is also common among English-speakers in parts of East Africa.
Beard, with his partner A.D. Rockwell, advocated first electrotherapy and then increasingly experimental treatments for people with neurasthenia, a position that was controversial. An 1868 review posited that Beard's and Rockwell's knowledge of the scientific method was suspect and did not believe their claims to be warranted.
William James was diagnosed with neurasthenia, and was quoted as saying, "I take it that no man is educated who has never dallied with the thought of suicide."
In 1895, Sigmund Freud reviewed electrotherapy and declared it a "pretense treatment." He emphasized the example of Elizabeth von R's note that "the stronger these were the more they seemed to push her own pains into the background."
Nevertheless, neurasthenia was a common diagnosis during World War I for "shell shock", but its use declined a decade later. Soldiers who deserted their post could be executed even if they had a medical excuse, but officers who had neurasthenia were not executed.
In China, frigophobia is known as Wei Han Zheng (畏寒症). From the standpoint of traditional Chinese beliefs, the disorder is highly influenced by an imbalance of yin (the female element) and yang (the male element). Chinese traditional beliefs also states that working women are particularly susceptible to frigophobia, triggered by a combination of stress, menopause, pregnancy and other disorders such as anemia. During winter, these women are likely to experience coldness in extremities and back pains caused by the disorder.
It is believed that the disorder can be treated using a combination of diet in order to re-balance the yin and yang. A common dietary treatment include:
- Chicken soup
- Turnip juice mixed with ginger juice and honey, three times a day
- Red tea with ginger juice and sugar, two times a day
- Foods containing yeast (e.g. bread)
- Spices (ginger, chili pepper)
- Vinegar diluted in water
It is also believed that the dietary treatment will be more effective if taken in conjunction with an acupuncture routine.
A case study of a 45-year-old Singaporean housewife with frigophobia was studied and the results concluded: frigophobia is closely related to, and strongly influenced by cultural beliefs. Generally speaking, in therapy, treatments would consist of using low dose of anxiolytics and antidepressants, and psychological interventions. But usually when Asian women are notified of the illness, they would adopt various measures to recover. These include withdrawal from workforce, avoid exposure to cold air and wind, and most importantly they will take dietary precautions. It would be rather important to consider the patient’s cultural beliefs about the “illness” in comparison to the therapist’s belief of the illness, and then find a negotiable approach for the treatment.