Southern medical journal
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Myasthenia gravis (MG) is an autoimmune disorder resulting from the production of antibodies against acetylcholine receptors leading to the destruction of the postsynaptic membrane at the neuromuscular junction. In the US there are about 18,000 people with MG. Myasthenia gravis crisis (MGC) is defined as any MG exacerbation necessitating mechanical ventilation. ⋯ Acute management of MGC requires supportive general and ventilatory therapy and institution of measures to improve the neuromuscular blockade. The latter includes plasma exchange or i.v. immunoglobulin, and removal of the offending trigger. The outcome of patients with MGC has improved significantly and the current mortality rate is about 4 to 8%.
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Southern medical journal · Jan 2008
Historical ArticleLooking into the future of cell-based therapy.
Recent research points to the future of regenerative medicine. In the past year, a handful of research groups have demonstrated that mature, adult cells could be "reprogrammed" to a very primitive, embryonic state via the forced expression of four genes (Oct-3/4, c-Myc, Klf4, and Sox2). ⋯ While the reprogramming of human fibroblasts into iPS cells remains to be seen, it is nevertheless difficult to overstate the value that this new research contributes to the field of regenerative medicine and its academic relative developmental biology. Herein, we attempt to bring these monumental works into greater focus and comment on how they work to shape the future of cellular therapies.
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Southern medical journal · Jan 2008
Comparative StudyGastrointestinal tract bleeding in intellectually disabled adults.
Gastrointestinal (GI) tract bleeding in intellectually disabled (ID) individuals presents peculiar diagnostic and management difficulties. This study details the experience of a tertiary referral teaching hospital in Central Saudi Arabia in the management of GI bleeding necessitating admission in ID adults. ⋯ Bleeding GERD remained the most common etiology of upper GI bleeding necessitating admission. Endoscopy is the mainstay in diagnosis and initial management of ID patients. Continued surveillance endoscopy is recommended for early diagnosis of Barrett changes. Bleeding from developmental malformations may have association with intellectual disability.
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Southern medical journal · Jan 2008
Mounier-Kuhn syndrome: report of 8 cases of tracheobronchomegaly with associated complications.
Mounier-Kuhn syndrome is a rare congenital abnormality characterized by atrophy or absence of elastic fibers and thinning of smooth muscle layer in the trachea and main bronchi. These airways are thus flaccid and markedly dilated on inspiration and collapsed on expiration. First- to fourth-order bronchi are affected. ⋯ Eight cases of tracheobronchomegaly with its associated complications are reported. Computed tomography scan of the chest was used for the diagnosis of tracheobronchomegaly. Treatment is mainly supportive with chest physiotherapy and antibiotics; however, there are a few reported cases where insertion of a tracheal stent resulted in some success.