The Comprehensive Physicians Guide To The Management Of Pans And Pandas
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The Comprehensive Physicians' Guide to the Management of PANS and PANDAS
An evidence-based guide for doctors diagnosing, testing, and treating children with PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep infections). In the early 1990s, a group of researchers at the National Institute of Mental Health began collecting data on children who had developed neuropsychiatric disorders (OCD and tics) following infections. They found evidence that antineuronal antibodies had developed in some of these children which attacked the basal ganglia region of the brain. MRI and PET scans in these children demonstrated inflammatory changes in the basal ganglia as well. In 1997, the researchers published the first article to describe this syndrome that they named PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep infections). In PANDAS, an autoimmune attack on the brain occurs following a Strep infection. PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) is a broader term that also includes cases following exposure to other infections, toxins, and even stress. Clinicians treating children with PANS and PANDAS have found that antibiotics targeted at the offending organisms, steroids, and IVIG results in marked improvement and occasionally complete remission of the neuropsychiatric symptoms. Disturbing symptoms consistent with many DSM-5 psychiatric disorders manifest in patients with PANS and PANDAS—yet we know that there is a biologic basis for the changes in these children. As a result, these disorders require us, as physicians, to view mental illness in an entirely new way. Resistance to this change in paradigm has made PANS and PANDAS difficult for clinicians to diagnose, unbearable for parents to endure, and controversial for scholars to accept. As such, there is no recognized standard of care. We have written this work in an effort to change that. This is a textbook by physicians for physicians. It was written to bring back some of the art of medicine to physicians caring for a group of children and families who really need it. PANS and PANDAS are complex disorders that demand a rich, multifaceted response with novel treatment approaches. The material in this book is assembled from the peer-reviewed medical literature, in combination with over thirty years of clinical experience caring for the sickest patients, both in and out of the hospital. Here you will find conclusive evidence for the existence and pathophysiology of PANS and PANDAS, alongside testing and treatment interventions the author has successfully used in his own practice with hundreds of children. The book concludes with rich appendices including commonly used labs, doses of medications and supplements, a sample flare protocol, extensive support for parents, sample IVIG orders, and much more. We hope this resource allows you, the physician, to help these suffering families heal.
Evidence-based Public Health
Author: Amanda Killoran
language: en
Publisher: Oxford University Press, USA
Release Date: 2010
A follow up to Public Health Evidence: Tackling Health Inequalities, this book builds on the themes already introduced, and provides a broader perspective on an evidence-based approach to public health, concentrating on health inequalities.
Computer-Aided Oral and Maxillofacial Surgery
Computer-Aided Oral and Maxillofacial Surgery: Developments, Applications, and Future Perspectives is an ideal resource for biomedical engineers and computer scientists, clinicians and clinical researchers looking for an understanding on the latest technologies applied to oral and maxillofacial surgery. In facial surgery, computer-aided decisions supplement all kind of treatment stages, from a diagnosis to follow-up examinations. This book gives an in-depth overview of state-of-the-art technologies, such as deep learning, augmented reality, virtual reality and intraoperative navigation, as applied to oral and maxillofacial surgery. It covers applications of facial surgery that are at the interface between medicine and computer science. Examples include the automatic segmentation and registration of anatomical and pathological structures, like tumors in the facial area, intraoperative navigation in facial surgery and its recent developments and challenges for treatments like zygomatic implant placement. Provides comprehensive, state-of-the-art knowledge of interdisciplinary applications in facial surgery Presents recent algorithmic developments like Deep Learning, along with recent devices in augmented reality and virtual reality Includes clinical knowledge of two facials surgeons who give insights into the current clinical practice and challenges of facial surgeons in university hospitals in Austria and China