Presse Med
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Generalized anxiety disorder (GAD) is a condition that is common in the general population and in general practice; it is disabling and often unrecognized. Its recognition is difficult because of the need to differentiate between normal anxiety and the other psychiatric disorders with which it is often associated. The primary drugs used for GAD are the antidepressants that have been authorized for this indication (venlafaxine XR, paroxetine, and escitalopram). ⋯ Drug treatment of GAD must continue for a sufficiently long period (at least 6 months) to minimize the chance of a relapse. Cognitive and behavioral therapies (CBT) are as effective as antidepressants. They are often desirable, but their limited availability impedes their use as a first-line treatment.
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Botulism is a potentially fatal infectious disease induced by a neurotoxin secreted by Clostridium botulinum, a sporulated species of obligate anaerobic bacteria. This neurotoxin inhibits the normal release of acetylcholine in the synaptic cleft, inducing presynaptic neuromuscular blockade. The diagnosis is often difficult because of the range and the lack of specificity of the symptoms. ⋯ These two cases remind us of the necessity to keep botulism in mind when systemic atropinic symptoms are found together with generalized, progressive and extensive paralysis. The diagnosis is confirmed by electromyogram and serology. There is no specific treatment for botulism; only intensive care surveillance and symptomatic treatment improve survival.
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Comment Letter Historical Article
[The controversy concerning Friedrich Wegener].
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Tuberculosis of the central nervous system is a major cause of morbidity and mortality in developing nations where it accounts for 10 to 30% of intracranial space-occupying lesions. It preferentially affects young subjects, predominantly male. MRI and in particular new methods, including magnetization transfer and diffusion-weighted imaging, are useful for positive and differential diagnoses of central nervous system tuberculosis and surveillance during treatment.