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Phongsisay, Vongsavanh, and vongsavang@yahoo com au. "Campylobacter jejuni and the Guillain-Barré syndrome." RMIT University. Applied Sciences, 2006. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20061221.100446.
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Campylobacter jejuni is an enteric bacterium that causes human gastroenteritis worldwide. Some C. jejuni strains exhibiting human ganglioside-like lipooligosaccharide (LOS) structures, such as GM1 ganglioside, can induce an autoimmune neuropathy of the peripheral nervous system known as the Guillain-Barré syndrome (GBS). This GBS-inducible determinant is encoded by a gene cluster, which shows a high degree of variation among C. jejuni strains. The experiments presented in this thesis were conducted to give a better insight into the LOS synthesis genes in relation to the pathophysiology of C. jejuni. Firstly, a C. jejuni strain without GM1-like molecules was shown to be able to take up large DNA fragments, including LOS synthesis genes, from a strain expressing GM1-like molecules and consequently be transformed into a number of potential GBS-inducible transformants, which exhibited a high degree of genetic and phenotypic diversity. The ability of C. jejuni to take up and integrate foreign DNA explains the genome plasticity observed in this pathogen. Secondly, while attempting to analyse transcription of the LOS gene cluster, neither published methods nor any commercially available kits for RNA isolation could produce DNA-free RNA from C. jejuni. Combinations of these methods were trialled and only the combination of RNAzolB, TURBO DNase treatment, and acid phenol extraction was able to produce DNA-free RNA. The RNA isolated from most C. jejuni strains showed different RNA patterns to that of other bacteria. In addition the RNA from C. jejuni seemed closely associated with DNA compaired to RNA from other organisms. This might be caused by species-specific DNA conformation or chromatin structure. Thirdly, bidirectional transcription was observed in the LOS gene cluster. Both DNA strands were transcribed but transcription of the non-coding strands was at a lower rate, and both sense and antisense transcripts of each LOS gene tested were responsive to acid stress. This unusual transcription might have a potential effect on the expression of the GBS-inducing determinant. Finally, one of the LOS genes, the htrB gene, was further analysed. It was shown that expression of the htrB gene affects morphology, viability, growth ability, and sensitivity to stress environments. These results showed that the LOS molecule of C. jejuni is involved in many processes and is an important molecule for survival.
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Mori, Izumi. "Syndrome de Guillain-Barré et perturbations immunitaires." Paris 6, 2008. http://www.theses.fr/2008PA066343.
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Le syndrome de Guillain–Barré (SGB) consiste en une atteinte auto–immune aiguë du système nerveux périphérique. L’infection déclenchant l’atteinte neurologique est souvent détectée, et la date du début de la maladie est connue. Notre hypothèse était que le profil de la réponse immunitaire pourrait influencer non seulement l’évolution naturelle de la maladie, mais également la sensibilité au traitement par immunoglobulines intraveineuses (IgIv). Nous proposons ici le premier biomarqueur de l’efficacité du traitement par IgIv au cours du SGB. Une forte proportion de cellules B matures circulantes permettrait de prédire une bonne réponse aux IgIv. Par ailleurs, les traitements par IgIv entraînent une impressionnante mobilisation de plasmocytes, associée à une récupération rapide. Pour finir, nous montrons que les patients les plus sévères et les moins sensibles aux IgIv présentaient plus volontiers une expansion de cellules T cytomégalovirus–spécifiques. Il découle donc de ces observations que l’immunomonitorage au cours du SGB pourrait renseigner non seulement sur la physiopathologie de cette affection, mais également sur sa sensibilité aux IgIv.
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Sampaio, Pedro Henrique Marte de Arruda. "Assimetrias no exame neurológico de crianças com síndrome de Guillain-Barré." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17161/tde-25042018-150422/.
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A Síndrome de Guillain-Barré (SGB) é uma neuropatia periférica inflamatória aguda que tem sido definida pelo achado ou história de tetraparesia flácida arreflexa ascendente. Apresentações atípicas podem ser mais frequentes do que tem sido referido na literatura, particularmente na faixa etária infantil. Objetivo: Avaliar dados epidemiológicos e a prevalência de assimetria no exame neurológico em crianças com SGB. Métodos: Foram revisados 40 prontuários de crianças de 0 a 15 anos de idade com o diagnóstico de SGB, atendidas entre janeiro de 2000 e agosto de 2016. Avaliouse a presença de assimetrias no exame neurológico na admissão hospitalar, os desfechos clínicos e as características demográficas e clinico-laboratoriais. Resultados: Dois pacientes apresentaram assimetria no exame neurológico na admissão hospitalar e três pacientes admitidos com tetraparesia simétrica apresentaram um quadro motor assimétrico antes da internação. Uma criança evoluiu para assimetria após ter sido admitida com quadro simétrico. Outros oito casos tinham fraqueza segmentar. A presença de assimetria motora ou fraqueza segmentar se correlacionou com a progressão estática dos sintomas (p=0,004) e observou-se uma tendência desses pacientes serem mais jovens, mas essa diferença não foi significativa (p=0,08). Onze pacientes apresentavam reflexos miotáticos preservados e um paciente exibia hiperreflexia na admissão hospitalar. A maioria dos pacientes foi admitida sem conseguir deambular e, na alta, a maioria deambulava com ou sem apoio. Cinco crianças necessitaram de suporte ventilatório e nenhuma foi a óbito. Conclusão: Uma proporção significativa dos pacientes apresentava quadro motor assimétrico ou segmentar e reflexos miotáticos preservados. Os resultados obtidos delineiam aspectos clínicos atípicos na SGB em crianças e podem ajudar na definição diagnóstica e instituição de tratamento precoce.Guillain-Barré syndrome (GBS) is an acute, inflammatory, peripheral neuropathy that has been being defined as an ascending flaccid tetraparesis. Atypical presentations can be frequent, particularly in children, leading to greater challenges in the diagnosis. Objectives: To analyze the epidemiological data and the prevalence of motor asymmetries in the neurological examination of children with GBS. Methods: A total of 40 medical records were analyzed, of children aged 0 to 15 years old diagnosed with GBS, admitted from January 2000 to August 2016. We evaluated the presence of motor asymmetries at the hospital admission, the clinical outcomes and the demographic and clinic-laboratorial characteristics. Results: Two patients had motor asymmetries at hospital admission and three patients admitted with symmetric tetraparesis had an initial motor asymmetry before admission. One patient progressed to asymmetric tetraparesis after being initially admitted with symmetric weakness. Eight other cases had segmental weakness at admission. Motor asymmetry and segmental weakness correlated with a static progression of symptoms (p=0.004) and these patients tended to be younger, but this difference was not significant (p=0.08). Eleven patients had preserved deep tendon reflexes and one exhibited hyperreflexia at the hospital admission. Most patients were admitted on wheel-chair or bedridden, and at discharge the majority could walk with or without help. Five children required mechanical ventilation and no patient died. Conclusion: A significant proportion of patients had asymmetric or segmental weakness and preserved deep tendon reflexes. Those results show that the so-called atypical clinical findings in children with GBS are not uncommon, and needs to be kept in mind to allow an earlier diagnosis and treatment.
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Perez, Simone. "Fator neurotrófico ciliar e interleucina-6 na síndrome de Guillain-Barré." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/30980.
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A Síndrome de Guillain-Barré é uma polirradiculoneuropatia aguda imuno-mediada, clinicamente apresentando-se com envolvimento sensitivo e motor e curso progressivo, em muitos casos determinando grande incapacidade e morbimortalidade nos pacientes que a desenvolvem. Este projeto de pesquisa teve como objetivo o seguimento de uma coorte de 22 indivíduos portadores da Síndrome de Guillain-Barré admitidos no Hospital de Clínicas de Porto Alegre durante o período de Janeiro de 2008 a Dezembro de 2009 para a correlação dos achados clínicos com os níveis liquóricos de interleucina-6 (IL-6) e do fator neurotrófico ciliar do nervo (CNTF). Na admissão, foi coletado o líquido cefalorraquidiano dos pacientes para dosagem de IL-6 e CNTF e, após seis meses, os pacientes foram estratificados em dois grupos, de acordo com a escala de Hughes: bom e mau prognóstico. Não foi identificada associação entre esses níveis e os achados clínicos. Mesmo assim, acreditamos que o estudo dessas substâncias pode ajudar a esclarecer a fisiopatologia da Síndrome de Guillain-Barré.The Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy, which is usually immune-mediated. It is characterized by clinical features associated with a progressive motor and sensory involvement, leading often to major disability and morbidity in affected individuals. In this work, we investigate the correlation between clinical findings and cerebrospinal fluid levels of interleukine-6 (IL-6) and of ciliary neurotrophic factor (CNTF) in a cohort of patients with GBS during the period January 2008 - December 2009 at the Hospital de Clínicas in Porto Alegre. Interleukine-6 is an immune modulator produced in the immune system with the function of B-cells’ stimulation and antibody secretion. The CNTF is produced in the CNS and plays an important role in the survival of some types of neurons. In this regard, the clinical and prognostic correlation with cerebrospinal fluid may help to elucidate the physiopathology of the Guillain-Barré syndrome.
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Maire, Olivier. "Avenir fonctionnel et rééducation du syndrome de Guillain et Barré d'évolution prolongée." Montpellier 1, 1991. http://www.theses.fr/1991MON11176.
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Fok, Nga-yin Angel, and 霍雅妍. "Influenza vaccination and its association with Guillain-barréSyndrome." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45172043.
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Pontes, Tainá Madeira Barros. "Identificação etiológica de dengue em indivíduos com suspeita clínica da síndrome de Guillain Barré." Universidade de Fortaleza, 2017. http://dspace.unifor.br/handle/tede/108656.
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Previous issue date: 2017-09-27Guillain-Barré Syndrome is a polyneuropathy characterized by weakness, often started in an acute way, which bilaterally affects the limbs in a symmetrical manner, although there are some cases with asymmetry. In two-thirds of the patients, the start of the symptoms is preceded by an infectious disease of the upper respiratory or gastrointestinal tract. In literature, there are reports showing that the dengue virus is the causal agent of this syndrome; that way, this research was to identify a presence of the dengue virus as an etiological agent in participants suspected of Guillain-Barré Syndrome in the State of Ceará. The study was performed in a tertiary hospital in the period from April 2016 to March 2017 by means of an active search for participants with clinical suspicion of Guillain-Barré Syndrome. Data collection took place during the hospital stay of the individuals through structured interviews, analysis of medical charts and collection of serum and/or cerebrospinal fluid samples from the participants. In this study, serological diagnoses for dengue (IgG and IgM) and molecular diagnoses were accomplished by using the RT-PCR technique. Of the 23 individuals with clinical suspicion of Guillain-Barré Syndrome, 22 were analyzed according to the inclusion criteria of the research. Of these 22 participants, 11 were diagnosed with Guillain-Barré Syndrome. After performing an IgM and RT-PCR serological test for dengue, four individuals showed positive IgM for dengue, two of them with diagnosis of Guillain-Barré Syndrome and one of them showed positive RT-PCR. The individual who showed positivity for dengue through the RT-PCR method during hospital stay concomitantly with neurological symptoms evolved with severity of the clinical picture, and then died. Therefore, we conclude that, probably, the dengue virus infection seems to be present in a higher proportion than expected, thereby suggesting a possible neglect of this etiology in the investigation of the cases of Guillain-Barré Syndrome in the State of Ceará. KEYWORDS: Guillain-Barré Syndrome; Dengue fever.
A Síndrome de Guillain-Barré é uma polineuropatia que se caracteriza por fraqueza, geralmente, de início agudo, acometendo bilateralmente os membros de forma simétrica, embora alguns casos apresentem assimetria. Em dois terços dos pacientes, o início dos sintomas é precedido por uma doença infecciosa do trato respiratório superior ou gastrointestinal. Há relatos na literatura do vírus dengue ser o agente causador da síndrome, dessa forma, o objetivo desta pesquisa foi identificar a presença do vírus dengue como agente etiológico em participantes suspeitos da Síndrome de Guillain-Barré no Estado do Ceará. O estudo foi realizado em um hospital terciário, durante os meses de abril de 2016 a março de 2017, através de busca ativa de participantes com suspeita clínica da Síndrome de Guillain-Barré. A coleta de dados ocorreu durante a internação do indivíduo, através de entrevista estruturada, por meio de análise de prontuários e coleta de amostras de soro e/ou líquido cefalorraquidiano dos participantes. Neste estudo, foram realizados diagnóstico sorológicos para dengue (IgG e IgM) e diagnóstico molecular através da técnica de RT-PCR. Dos 23 indivíduos com suspeita clínica da Síndrome de Guillain-Barré, 22 foram analisados conforme os critérios de inclusão da pesquisa. Desses 22 participantes, 11 foram diagnosticados com a Síndrome de Guillain-Barré. Após realizar teste sorológico para dengue IgM e RT-PCR, 4 indivíduos apresentaram IgM positivo para dengue, 2 desses com diagnóstico da Síndrome de Guillain-Barré e um deles apresentou RT-PCR positivo. O indivíduo que apresentou positividade para dengue, através do método RT-PCR, durante o internamento hospitalar concomitante aos sintomas neurológicos, evoluiu com gravidade do quadro e óbito. Portanto, concluímos que, provavelmente a infecção pelo vírus dengue parece estar presente em uma proporção maior que esperada, sugerindo possível negligência desta etiologia na investigação dos casos de Síndrome de Guillain-Barré em nosso Estado. PALAVRAS-CHAVE: Síndrome de Guillain-Barré; Dengue.
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Torres, Vitor Félix. "Níveis séricos e liquóricos da proteína S100B, enolase específica do neurônio e neurotrofinas na síndrome de Guillain-Barré." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/26920.
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A Síndrome de Guillain-Barré é caracterizada por uma polirradiculoneuropatia de instalação aguda, usualmente imuno-mediada, com características clínicas associado a um envolvimento sensitivo e motor progressivo, muitas vezes determinando grande incapacidade e morbimortalidade nos indivíduos acometidos pela doença. Este projeto de pesquisa teve como objetivo o seguimento de uma coorte de indivíduos portadores da Síndrome de Guillain-Barré admitidos no Hospital de Clínicas de Porto Alegre durante o período de Janeiro de 2008 à Dezembro de 2009 para a correlação dos achados clínicos com os níveis plasmáticos e liquóricos da proteína S100B. A proteína S100B é basicamente encontrada nos astrócitos e tem tido grande importância para o melhor entendimento dos processos fisiopatológicos na injúria do Sistema nervoso central. Alguns autores relataram a correlação entre a Síndrome de Guillain-Barré e os níveis liquóricos da proteína S100B, baseado nestas descrições acreditamos que o melhor entendimento fisiopatológico da Síndrome de Guillain-Barré associado a determinação dos níveis plasmáticos e liquóricos da proteína S100B possam auxiliar e estabelecer uma importante ferramenta prognóstica precoce na determinação da gravidade dos portadores da Síndrome de Guillain-Barré.The Guillain-Barre syndrome is characterized by a polyradiculoneuropathy of acute onset, usually immune-mediated, with clinical features associated with a progressive motor and sensory involvement, often determining major disability and morbidity in individuals affected by this disease. This research Project was aimed at following a cohort of patients with Guillain-Barre syndrome admitted to the Hospital de Clinicas de Porto Alegre during the period of January 2008 to December 2009. We measured the sera and cerebrospinal fluid (CSF) concentrations of S100B protein, neuron-specific enolase, neurotrophins and interleukin 6 using enzyme immunoassay methods in 22 patients with Guillain- Barre syndrome and 32 controls. The clinical and laboratory findings observed in the cases were important for better understanding of the pathophysiology of this disease coupled with the outcome of disabilities among the cases.
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Gries, Manuela [Verfasser], and Tobias [Akademischer Betreuer] Hartmann. "Die Bedeutung angeborener Immunrezeptoren beim experimentellen Guillain-Barré-Syndrom / Manuela Gries. Betreuer: Tobias Hartmann." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2013. http://d-nb.info/1052904904/34.
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Greenshields, Kay. "Pathogenic potential of anti-ganglioside antibodies in a murine model of axonal Guillain-Barré syndrome." Thesis, University of Glasgow, 2007. http://theses.gla.ac.uk/3760/.
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Guillian-Barré Syndrome (GBS) is the world’s leading cause of neuromuscular paralysis occurring in serologically and pathogenically distinct forms. GBS is believed to have an autoimmune basis, where antibodies raised during antecedent infections (eg Campylobacter jejuni) cross-react with self antigens, exemplifying the process of molecular mimicry. These self-antigens are gangliosides, which are glycolipid structures enriched in peripheral nerve in specific membrane compartments termed lipid rafts. To date, successful murine models of anti-GD1a and anti-Gq1b ganglioside mediated neuropathy exist. Clinical evidence supports the involvement of anti-GM1 antibodies in nerve injury, however generation of anti-GM1 antibody mediated neuropathy models remain an enigma, and to date, the only successful model is based in Japanese rabbits. This thesis aims to address the controversies surrounding anti-GM1 antibody mediated neuropathy by utilising a panel of anti-GM1 antibodies of differing specificity, and explores how the stereometric interactions of GM1 with lipid raft species underpin the pathogenic potential of these antibodies.
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Krause, Julia [Verfasser]. "Therapie des Guillain Barré Syndroms: Unterschiede im Therapieansprechen unter Plasmapherese im Vergleich zur Immunglobulingabe / Julia Krause." Kiel : Universitätsbibliothek Kiel, 2016. http://d-nb.info/1122110995/34.
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Groß, Simone Ingrid [Verfasser], and Kaspar [Akademischer Betreuer] Matiasek. "Strategien zur Subklassifizierung Guillain-Barré-artiger Polyneuropathien bei Hund und Katze / Simone Ingrid Groß ; Betreuer: Kaspar Matiasek." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2017. http://d-nb.info/1139977997/34.
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Chavada, Govind. "Clinical heterogeneity, diagnostic features, outcomes of Guillain-Barré syndrome spectrum disorders : an analysis of IGOS UK data." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8497/.
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Introduction: GBS has a highly diverse clinical course and outcome. Currently available literature suggests that despite treatment about 20 % of patients remain disabled at one year and about 5 % patients die. These data come from clinical trials conducted between 1984 and 2006. Most of these studies included severe GBS cases. We conducted a multicentre prospective observational study looking at clinical and biological determinants of prognosis of GBS. As part of this study, I had an opportunity to analyse the data collected from 15 UK centres; looking at clinical and treatment patterns, various outcomes including ability to walk at 12 months, pain and quality of life. We also analysed Electrophysiological data from our local centre (Glasgow); compared newly published electrophysiological diagnostic criteria with existing criteria to determine whether serial studies are required for final electrophysiological diagnosis. Finally, to identify the patients with poor prognosis early in the disease course, we attempted to validate the currently available clinical prognostic models. Method: We conducted a multicentre prospective observational study named IGOS (International GBS Outcome Study) with a web-based entry system. It aimed to study at least 1000 patients over 3 years. The study included two modules: 1) core module which consist of a) acute clinical data collection at 0, 1, 2, 4 weeks and follow up data at 6 and 12 months b) serum samples collection at each clinical data entry point c) electrophysiology studies within 2 weeks 2) optional modules included additional electrophysiology studies at 4 weeks, CSF studies and long term outcome data at 2 and 3 years. As the study still ongoing, I analysed the data of 122 GBS patients recruited from 15 UK centres between May 2012 and Jan 2015. Results: In our cohort about 20 % patients remained disabled at 1 year, 18% required mechanical ventilation (MV), 5 % died. Pain continued to remain a major disabling symptom in more than half of the patients however unable to perform usual activity was the most disabling QoL domain affected at 12 months and was an important contributing factor affecting quality of life. Intravenous immunoglobulin was the most commonly prescribed treatment followed by plasma exchange. Immunotherapy was not beneficial in mildly affected GBS patients. Currently available electro diagnostic criteria are not very sensitive in identifying final EP subtypes and newly published Rajabally's criteria potentially addresses this issue and should be used in clinical practice to establish final EP diagnosis. Existing prognostic models EGOS and mEGOS performed well in our cohort and showed good discriminatory capacity. Discussion: Despite wider availability of immunotherapy prognosis of GBS has not changed in last 20years, which highlights the urgent need of more effective treatments in these patients. However new therapy can be expensive and can be only beneficial if the patients with poor prognosis are identified early in course. This can only be achieved by developing good prognostic models. Our results show that existing available models EGOS/MEGOS validates well and provides a proof of the concept that prognostic model can be used to identify patients with poor prognosis when the treatment is most beneficial. GBS continues to remain a clinical diagnosis. While there are drawbacks of existing EP criteria, newly developed Rajabally's criteria are sufficient to establish final EP diagnosis.
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Wachira, Virginia Kagure. "Etiologia da síndrome de Guillain-Barré : uma revisão sistemática de literatura : o que mudou em 10 anos?" reponame:Repositório Institucional da UnB, 2018. http://repositorio.unb.br/handle/10482/32205.
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Dissertação (mestrado)—Universidade de Brasília, Faculdade de Medicina, Pós-graduação em Medicina Tropical, 2018.Submitted by Raquel Viana (raquelviana@bce.unb.br) on 2018-07-03T20:52:33Z No. of bitstreams: 1 2018_VirginiaKagureWachira.pdf: 1224251 bytes, checksum: a3d6f560ea24acc2a898579963b67cdd (MD5)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
Introdução: A síndrome de Guillain-Barré é uma polirradiculoneuropatia desmielinizante inflamatória aguda, de natureza autoimune que afeta o sistema nervoso periférico e geralmente é desencadeada por um processo infeccioso agudo. Vários antecedentes etiológicos infecciosos e não infecciosos têm sido associados com a síndrome. A infecção por bactéria Campylobacter jejuni é a causa mais associada com a síndrome, entre outras infecções como citomegalovírus, vírus Epstein-Barr, sarampo, vírus de influenza A, Mycoplasma pneumoniae, enterovirus D68, hepatite A, B, C e o vírus Zika. Objetivo: Descrever os fatores associados ao desenvolvimento da síndrome de Guillain-Barré por meio de revisão da literatura científica e descrever as publicações com enfoque epidemiológico relacionadas à Sindrome de Guillain-Barré antes, durante e depois da epidemia do vírus Zika no Brasil e no mundo, com foco na sua etiologia. Método: Uma revisão sistemática de estudos epidemiológicos a respeito da etiologia da Síndrome de Guillain-Barré publicados no período de 2007 a 2017, antes, durante e depois da epidemia de Zika vírus. As bases de dados utilizados foram EBSCOhost Reseach Databases, Medical Literature Analysis and Retrieval System Online e Literatura Latino-Americana e do Caribe em Ciências da Saúde. A qualidade dos estudos foi avaliada utilizado Newcastle Ottawa Scale. Seguiu os passos da Preferred Reporting Items for Systematic Reviews and Meta-Analyses para o seu relato. Resultados: Um total de 224 artigos foi identificado após a busca nas bases de dados especificadas e após a aplicação dos critérios de inclusão 34 artigos foram selecionados para o estudo, após a leitura completa. Desses artigos, 17 usaram desenho de caso-controle, oito de coorte, cinco Self Controlled Case Series, dois de Self Controlled Risk Interval e dois com desenhos mistos. A qualidade global dos artigos foi considerada alta em relação à maioria dos itens avaliados. Vários agentes etiológicos tiveram resultados indicativos de associação com a síndrome de Guillain-Barré, entre eles: Campylobacter jejuni, vacina da influenza: pandêmica e sazonal, vírus Zika, Mycoplasma pneumoniae, infecção respiratória e gastrointestinal. No período estudado, não houve aumento anual importante no número de estudos que atenderam os critérios de inclusão apesar dos dois eventos de grande impacto na saúde coletiva: a pandemia do vírus da Influenza H1N1 em 2009 e a epidemia do vírus Zika, a partir de 2015 nas Américas. Os agentes encontrados são, na maioria, os mesmos relatados antes do período do estudo. A relação com cirurgias, vírus chikungunya, vírus Zika e a vacina quadrivalente do papilomavírus humano nas meninas (HPV 4 Gardasil) destacam-se como novidades na lista dos diversas possíveis agentes desencadeadores da síndrome de Guillain-Barré relatados no período estudado. Não foram identificados estudos realizados no Brasil nesse período. Conclusões: Os resultados dessa revisão sistemática podem contribuir para o conhecimento dos principais agentes etiológicos envolvidos no desenvolvimento da síndrome de Guillain-Barré e subsidiar a tomada de decisões em saúde, assim como guiar futuras pesquisas, especialmente no momento em que o Brasil vem vivenciando o aumento de casos da síndrome, chamando atenção da comunidade acadêmica, dos serviços de saúde, da comunidade e da imprensa.
Introduction: Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculoneuropathy, autoimmune in nature that affects the peripheral nervous system and usually triggered by an acute infectious process. Several background infectious and non-infectious etiological factors have been associated with the syndrome. Camplybocter jejuni infection is commonly associated with the syndrome among other infectious causes like citomegalovírus, Epstein-Barr virus, measles, influenza virus, Mycoplasma pneumoniae, enterovirus D68, hepatite A, B, C and Zika virus. Objective: Describe factors associated with the development of Guillain-Barré syndrome by reviewing scientific literature and describing publications with epidemiological approach related to Gullain-Barré Syndrome before, during and after the epidemic of Zika virus in Brazil and in the world with a focus on its etiology. Method: Systematic review of epidemiological studies about the etiology of Guillain-Barré syndrome published between 2007 and 2017, before, during and after Zika virus epidemic. The data bases used were EBSCOhost Reseach Databases, Medical Literature Analysis and Retrieval System Online and Literatura Latino-Americana e do Caribe em Ciências da Saúde. The quality of the studies was evaluated using the Newcastle Ottawa Scale. The study report followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results: 224 articles were identified after the search in the databases specified and the application of the inclusion criteria, 34 articles were selected for the study after their complete scan. Among the selected articles, 17 had case control design,eight had cohort, five self-controlled case series and two self-controlled risk interval. The quality of the studies was considered good in relation to most of the items evaluated. Many etiological agents had results indicative of association with Guillain-Barré syndrome, among them Campylobacter jejuni, influenza vaccine both pandemic and seasonal vaccines, respiratory infection, gastrointestinal infection among others. The etiological agents found are in most part the same reported prior to the study period. The association with surgeries, chikungunya virus, Zika virus and quadrivalent human papillomavirus vaccine (Gardasil in girls) stand out as new etiological agents in the list of the various possible agents that trigger Guillain-Barré syndrome reported in the study period. There were no Brazilian studies identified during this period. Conclusions: The results of this systematic review can contribute to the knowledge of the main etiological agents involved in the development of Guillain-Barré syndrome and aid in the decision-making process in the health sector, as well as to guide future research especially in Brazil at a time that the increase of cases of the syndrome is attracting the attention of the academic community, health services, the citizens and the press.
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Rink, Claudia [Verfasser]. "Autoantikörper gegen Proteine monaminerger Systeme beim Guillain-Barré Syndrom - mögliche Beteiligung an der Pathophysiologie des Psychosyndroms? / Claudia Rink." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2011. http://d-nb.info/1026265029/34.
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Harrison, Catherine Victoria. "A mixed method investigation into the psychological well-being of individuals who have suffered from Guillain-Barré Syndrome." Thesis, University of Leicester, 2010. http://hdl.handle.net/2381/8604.
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The needs of patients who are nursed on the ICU are becoming more widely recognised and services are beginning to reflect this. However there is little research into how patients who have suffered from a severe and progressive muscular paralysis called Guillain-Barré Syndrome (GBS) experience the disease and subsequent hospitalisation. The purpose of this study was to explore how these patients experience the different aspects of the illness, including an extended period of paralysis and treatment on an ICU. This is intended to expand upon the limited research in this area and identify how the findings can inform clinical practice and future studies. Method: A systematic literature search identified research in relation to the experiences of individuals who had GBS which was utilised to form the basis of the understanding for this study. Very little systematic research has looked at individuals‟ experiences of Guillain-Barré Syndrome whilst ill and their subsequent recovery. A mixed methods study was carried out with the aim of adding to this research. Interpretative Phenomenological Analysis was selected as the method of analysis for Study 1, which involved interviews with seven participants who had experienced GBS severe enough to need treatment on an ICU. This then enabled quantitative questionnaires to be disseminated which asked about individuals‟ levels of anxiety, depression and Post Traumatic Stress symptomatology both retrospectively and following recovery in Study 2. Results: Study1 found that participants experienced GBS as either a slow and frustrating, or as a rapid and scary onset. The main themes that were developed included: the paralysis being viewed as multiple losses, frustration, difficulties associated with communication loss, vulnerability and frightening hallucinations. Study 2 utilised non-parametric analyses of the data and found that participants experienced high levels of anxiety and depression at the onset of GBS and that some continued to experience anxiety, depression and post traumatic symptoms after recovery from GBS. Generally the profile suggests predominantly anxiety problems during the acute onset phase and then predominantly depression at the time of follow-up. Aspects of post traumatic stress were positively correlated with duration of mechanical ventilation which in turn was related to duration of paralysis. This challenged the hypothesis that GBS patients habituate to the experience of paralysis. Conclusion: For some individuals, GBS was experienced as a frightening event, but one that they could draw positive things from. However, for others, GBS was experienced as a traumatic event and some of these people continued to exhibit signs of psychological distress even after recovery. It remains important for staff to feel able to speak about distressing situations with their patients and to signpost them to other psychological services if appropriate.
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Apaza, Nina Littman. "Características clínicas y electrofisiológicas del síndrome de Guillain Barré en el Instituto Nacional de Ciencias Neurológicas, 2008-2012." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/12920.
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Objetivo: Describir las características clínicas y electrofisiológicas de los pacientes con el diagnóstico del SGB en el INCN, 2008-2012.
Introducción: El SGB, es una causa común de parálisis flácida aguda de distribución mundial. Existen varios subtipos que se definen con los estudios neurofisiológicos. Son pocos los estudios en el Perú que describen clínica y electrofisiológicamente el SGB. Se ha observado el incremento de las variantes axonales, asociado a mayor severidad y peor pronóstico.
Pacientes y métodos: Estudio descriptivo, retrospectivo, en los pacientes con SGB hospitalizados en el INCN desde el 2008 al 2012, en los que se estudiarán las características clínicas, electrofisiológicas.
Resultados: De 32 pacientes evaluados la mayoría fueron varones (59.4%), y en edad media de la vida, la mayoría correspondió a PDIA (PDIA=75%, NAMA=18.8%, MF=6.3%), con antecedente de infección previa, (16.7%-33.3%), la cuadriparesia fue más intensa (WH-IV) y más frecuente en NAMA (83.3%) que en PDIA (54.2%), en aproximadamente una semana, sin mayor compromiso sensitivo y de ROT, el NC-VII fue el más afectado. Electrofisiológicamente de los nervios evaluados en el PDIA se evidenció latencia prolongada del PAMC (66.7%) con VC disminuida (53.8%), y ausencia de respuestas tardías (F-92.3%, H-91.2%). En la NAMA se evidenció amplitud disminuida del PAMC (83.3%) y ausencia de respuestas tardías (F-100%, F-33.3%). La denervación y la reinervación fueron los hallazgos más frecuentes en NAMA (en hasta el 100% y 72% de los segmentos evaluados). En el MF la conducción nerviosa resultó normal, con denervación y reinervación en rostro. Conclusiones: El subtipo PDIA es la más frecuente cuyo compromiso motor (WH-IV) está en relación con los hallazgos electrofisiológicos que evidencian desmielinización, el NAMA es el segundo subtipo que evidencia mayor daño axonal en el estudio electrofisiológico y mayor compromiso clínico.Trabajo académico
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Berdaï, Driss. "La maladie de Guillain-Barré et les échanges plasmatiques : à propos de trente cinq cas relevant de techniques de réanimation." Bordeaux 2, 1990. http://www.theses.fr/1990BOR25121.
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Velásquez, Rimachi Victor Andrés. "Características clínico-epidemiológicas asociadas con resultados al alta hospitalaria en pacientes con síndrome de Guillain-Barré en el Hospital Nacional Dos de Mayo, 2011-2015, Lima-Perú." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2020. https://hdl.handle.net/20.500.12672/11708.
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El síndrome de Guillain-Barré (SGB) es una enfermedad autoinmune que
afecta el sistema nervioso periférico. El déficit motor severo, el compromiso respiratorio,
el compromiso de nervios craneales, la disfunción del sistema nervioso autónomo y
alteración de conciencia al comienzo de la enfermedad se asociaron con un mal
pronóstico. El objetivo es determinar características clínico-epidemiológicas asociadas a
resultados al alta hospitalaria en pacientes con SGB mediante un estudio
observacional retrospectivo que incluyó pacientes con diagnóstico de SGB en el Hospital
Nacional Dos de Mayo desde el 1 de enero de 2011 hasta el 31 de diciembre de 2015. Se
evaluaron edad, sexo, fecha de inicio de enfermedad (verano, otoño, invierno y
primavera), manifestaciones clínicas, severidad (al ingreso, al nadir y al alta),
antecedentes infecciosos (gastrointestinales y respiratorios), terapia con recambio
plasmático terapéutico (RPT) y días de hospitalización. Según la escala de severidad de
Hughes, un grado mayor a 2 se catalogó como déficit severo. Se evaluaron
92 historias clínicas, de las cuales un 70,7% fue de sexo masculino y la mediana de edad
fue de 44 años. Encuentra que la cuadriparesia fue la característica clínica más frecuente (81,1%). Un
77,1% recibió terapia específica con RPT. Durante las temporadas de verano e invierno,
se presentaron más de la mitad de casos. La mayoría de casos con antecedentes
gastrointestinales (17,86%) y antecedentes respiratorios (33,3%) ocurrieron en agosto y
febrero/ septiembre, respectivamente. Se evidenciaron asociaciones entre la prevalencia
más alta de tener una estadía prolongada en pacientes en los que usó RPT. Además, la
prevalencia de mejoría fue menor en pacientes que tenían un déficit severo al alta
hospitalaria. En el análisis multivariado, la prevalencia de una estadía prolongada fue
mayor en pacientes con antecedentes infecciosos gastrointestinales. Se
evidenció una asociación entre el usó de RPT, déficit severo y infección gastrointestinal
con la prevalencia de los resultados al alta hospitalaria. Se observó un mayor número de
casos en pacientes varones y las temporadas de verano e invierno.Tesis
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Britto, Alexandre Paulo Machado de. "Custo-efetividade do uso de imunoglobulina intravenosa e de plasmaferese no tratamento da síndrome de Guillain-Barré no Hospital de Clínicas de Porto Alegre." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/148859.
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Objetivo: Comparar as relações de custo-efetividade de duas terapias, Imunoglubulina Intravenosa (IgIV) e Plasmaferese (PE), no tratamento da Síndrome de Guillain-Barré sob a perspectiva do sistema público (SUS). O objetivo secundário foi avaliar a adesão às recomendações da Comissão de Medicamentos do HCPA Métodos: estudo transversal com análise econômica de pacientes tratados por Síndrome de Guillain-Barré no período de junho de 2003 a junho de 2008 no Hospital de Clínicas de Porto Alegre (HCPA). Foi realizada análise de custo-efetividade do emprego de IgIV e de PE nestes pacientes, pelo método de minimização de custos, considerando-se somente os custos diretos sanitários, fornecidos pelo sistema gerencial da instituição . Foram excluídos os pacientes que usaram outro tipo de tratamento associado ou isolado. Coletaram-se os dados através da revisão dos prontuários. A gravidade da doença na internação foi classificada como: doença leve, quando caminhar foi possível; doença moderada, quando caminhar foi impossível; doença grave, quando os pacientes necessitaram de ventilação assistida. A incapacidade na alta foi estabelecida pela escala de sete pontos de Hughes. A adesão às recomendações da Comissão de Medicamentos do HCPA, objetivo secundário, foi avaliada através da dose e o esquema de prescrição da IgIV. Resultados: Vinte e cinco participantes (2 a 70 anos) foram incluídos no estudo, cinco tratados com PE, empregando-se Albumina Humana como substituto do plasma, e 20 tratados com IgIV. O custo total do tratamento de um paciente com PE foi R$10.603,88 (± 2.978,12) e o de um que recebeu IgIV foi R$ 32.103,00 (± 21.454,24). O custo total da internação foi de R$45.027,14 (± 32.750,45) para os tratados com PE e de R$ 60.844,28 (±48.590,52) para os que receberam IgIV. Em relação ao desfecho clínico principal, melhora na escala de incapacidade de sete pontos, após o tratamento com uma das alternativas escolhida, a mediana dos pacientes que internaram com grau de gravidade 3 e que foram tratados com PE foi igual a dos que receberam IgIV. Em relação à permanência hospitalar, permanência em UTI e dias de Ventilação Mecânica, não houve diferença estatisticamente significativa entre os dois tratamentos. Conclusões: Quando comparados os custos médios das duas opções terapêuticas, uma delas aparece claramente com menor custo. Quando comparados os desfechos, após o emprego de cada opção terapêutica, estes não revelam diferença. Concluímos que, no HCPA, a opção pelo procedimento Plasmaferese é mais custo efetiva do que o emprego da IgIV.Objectives: To compare the cost-effectiveness of two distinct therapies, Intravenous Immunoglobulin (IVIg) and Plasma Exchange (PE) in the treatment of Guillain-Barré Syndrome, concerning the public health care system. Compliance to the guidelines of the Pharmacy and Therapeutics Committee of the Hospital de Clínicas de Porto Alegre was a secondary objective. Methods: A cross-sectional, economical analysis was conducted, including patients treated for GBS in the period from June, 2003 through June, 2008 in Hospital de Clínicas de Porto Alegre (HCPA). The cost-effectiveness of the use of IVIg and PE in such patients was studied through the cost minimization method, considering direct medical costs only (2008 currency), yield by the management of the institution. Patients receiving treatments other than PE or IVIg were excluded. Data were collected by chart reviews. Severity of disease on admittance was classified as follows: mild disease, when the patient was able to walk; moderate disease, when the patient was unable to walk, and severe disease, when assisted ventilation was required. Disability on discharge was established by the 7-point scale of Hughes. Compliance to the guidelines of the Pharmacy and Therapeutics Committee was evaluated through the dose and prescription scheme of IVIg. Results: Twenty-five participants (2 to 70 years of age) were included in the study, 5 were submitted to treatment with PE, using human albumin as replacement for plasma, and 20 were treated with IVIg. The total treatment cost for PE in a single patient was US$6,058.85 (±1,701.78 SD), and the same expense for IVIg was US$18,344.57 (± 12,259.56 SD) (p = 0.035). Total inpatient cost was US$25,729.79 (± 18,714.54 SD) in the PE group, and US$34,768.16 (±27,766.01 SD) (p=0.530) in the IVIg group. The main clinical outcome was improvement in the 7-point disability grade scale. The median of that measure in patients admitted with a severity grade 3 treated either with PE and IVIg was the same. Secondary outcomes, such as in-hospital stay, ICU stay, and number of days on mechanical ventilation revealed no statistically significant difference between treatments. Conclusions: As the mean expenses of both therapeutic options are compared, one clearly stands-out as less onerous. Clinical outcomes, when compared, reveal no statistical difference after each treatment. We concluded that, in HCPA, plasma exchange is more cost-effective than intravenous immunoglobulin.
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Calle, Vilca María Luzmila del Carmen. "Influencia de la plasmaféresis en la evolución clínica de los pacientes con síndrome de Guillain Barré en el Hospital Nacional Dos de Mayo, enero 2005 - mayo 2010." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2015. https://hdl.handle.net/20.500.12672/13479.
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El documento digital no refiere asesorObjetivos: Determinar si los pacientes con síndrome de Guillain Barré que han recibido plasmaféresis tienen mejor evolución clínica respecto a los que no han recibido plasmaféresis. Material y métodos: Se realizó un estudio observacional, analítico, de casos. Se revisaron 97 historias clínicas de pacientes con diagnóstico de síndrome de Guillain Barré que fueron atendidos en el Hospital Nacional Dos de Mayo desde enero del 2005 a mayo del 2010, y que tuvieran sus datos completos consignados en la historia clínica. Se usó la escala de discapacidad de Hughes, considerando los grados 0 y I como buena evolución y grados II, III, IV y V como mala evolución. Resultados: La media de edad fue 45 años, desde 16 hasta 70 años, 78.4% fueron varones. 17.5% tuvo antecedente de infección gastrointestinal y 29.9% respiratoria. Predominó la debilidad distal (86.6%), 20.6% tuvo hiporreflexia y 78.4% arreflexia. Hubo alteración en la sensibilidad táctil (21,6%), dolorosa (25.8%) y palestésica (29.9%). El 50.5% tuvo alteración del nervio facial, 20.6% en los oculomotores y 14.4% en el glosofaríngeo y vago. El 72.2% presentó signo de Lasegue. El 20.6% ingresó con dificultad respiratoria, 21.6% requirió ventilación mecánica y 15.5% fue traqueostomizado. Hubo disociación albuminocitológica en 60.8%. La electromiografía mostró 44.3% con patrón desmielinizante, con afectación sensitivo-motora en el 53.6%. La escala de Hughes al ingreso y al alta fue grado IV en el 69,1 y 61.9%; a los 6 meses predominó el grado II y al año el grado I con 36.1%. De los 97 pacientes, 64 (66%) recibieron plasmaféresis y 33 (34%) no la recibieron. Al alta (29 días promedio) ningún paciente tuvo buena evolución (Hugues 0 ó I), a los 6 meses 18.8% tuvo buena evolución en el grupo tratado y 18.2% en el que no; al año incrementó a 64.1% en los tratados y 48.5% en los que no. Los pacientes con ventilación mecánica que recibieron plasmaféresis tuvieron buena evolución al año en 44.5%, mientras el 100% de los pacientes que no la recibieron quedaron con secuela grave (Hughes IV). La duración de ventilación mecánica fue 12.7 días en promedio en el grupo tratado y 30 en el no tratado, la traqueostomía duró 113.2 días en los tratados y 156.3 días en los no tratados. Conclusiones: Los pacientes con síndrome de Guillain Barré que han recibido plasmaféresis tienen menor tiempo de ventilación mecánica y traqueostomía, además tienen mejor evolución clínica al año respecto a los que no han recibido plasmaféresis.
Trabajo académico
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Easton, Alistair Scott. "The role of lipo-oligosaccharide ganglioside mimicry on the interaction of Guillain-Barré syndrome associated strains of Campylobacter jejuni with the immune system." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/2019/.
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The post infectious paralytic autoimmune disease, Guillain-Barré syndrome (GBS), has been associated with the generation of cross-reactive auto-antibodies after Campylobacter jejuni infection. These auto-antibodies interact with both the ganglioside mimicking C. jejuni lipo-oligosaccharides (LOS) and endogenous gangliosides. This study sought to investigate novel interactions of the ganglioside mimicking LOS with immune system ganglioside specific receptors. In addition, studies investigated if such receptor recognition affects antigen trafficking or the immunostimulatory potency of the LOS, which could participate in auto-antibody generation. Results presented in this thesis demonstrate for the first time that certain members of the siglec receptor family are capable of recognising LOS from a GBS associated strain of C. jejuni. This interaction did not definitively result in enhanced, or altered, potency of ganglioside mimicking LOS in stimulating immune cells. Interestingly, ganglioside mimicry was shown to enhance phagocytosis of C. jejuni, however, in vivo differences in bacterial trafficking were not observed.
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Becker, Anne [Verfasser], and Klaus [Akademischer Betreuer] Fassbender. "Vergleichende Analyse von Autoantikörperprofilen bei Patienten mit Myasthenia gravis, Guillain-Barré-Syndrom und gesunden Kontrollen an Hand von Proteinmacroarrays / Anne Becker. Betreuer: Klaus Fassbender." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2011. http://d-nb.info/1051434777/34.
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Palma, García Luis. "Eficacia del recambio plasmático terapéutico en el tratamiento del síndrome de Guillain Barre en el Hospital Nacional Dos de Mayo." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2013. https://hdl.handle.net/20.500.12672/14144.
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Publicación a texto completo no autorizada por el autorDetermina la eficacia del recambio plasmático terapéutico en el tratamiento del Síndrome de Guillain Barré. El diseño de la investigación es analítico experimental, prospectivo y longitudinal. La muestra fue de 56 pacientes con Sd de Guillain Barré, a quienes se les realizó 208 sesiones de RPT, durante el período comprendido de mayo 2012 a abril 2013, teniendo como criterios de exclusión a aquellas otras polirradiculopatías, así como un tiempo de enfermedad mayor a 15 días. Este estudio demostró que los pacientes que ingresaron al Hospital Nacional Dos de Mayo durante el periodo de un año y que presentaron un cuadro clínico compatible con síndrome de Guillain- Barré y a quienes se les practicó un Recambio Plasmático Terapeutico, tienen una evolución favorable y el iniciar la plasmaféresis durante los primeros quince días de evolución acorta el periodo crítico de la enfermedad y el tiempo de recuperación de la función motora. Asimismo, el principal factor que lleva al mayor porcentaje de eventos secundarios, es el uso del plasma fresco congelado, asimismo esta enfermedad, no distingue sexo, y el grupo de mayor riesgo a padecer esta enfermedad oscila entre los 20 y 60 años de edad. La mortalidad en nuestro estudio fue de 0 %.
Trabajo académico
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Mace, Janet-Lee. "An inquiry into the meaning of Guillain-Barré syndrome : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts." Massey University, 2001. http://hdl.handle.net/10179/1180.
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Guillain-Barré Syndrome (GBS) is an autoimmune syndrome characterized by a severe and rapid onset of paralysis that ascends without warning. It has an unknown aetiology and is generally unknown by most people, including medical professionals. When a person who has had GBS is asked to speak about their experience, they are likely to talk about aspects of it that are personally meaningful. Their account can be likened to a story in that it collates seemingly unconnected facts, episodes of activity and emotional attributions into a sequence that provides knowledge and understanding. A story is a powerful form for expressing suffering and experiences and so is particularly suitable for the study of trauma and illness. The actual process of creating the story, plus its presentational and organisational forms, provides sources for uncovering the identities authors choose to create and present of themselves. Six people who have had GBS were interviewed about their experience, and their stories were analysed using a narrative inquiry to discern the meanings attributed to GBS from the participants’ own understandings and perspectives. The intended focus of the research was holistic and content based. The result of the narrative inquiry was a plot common to all six narratives. Namely, GBS is an inexplicable condition, during which horrendous things happen, but people do recover with time and it is likely their life view will be changed in the process. Four fundamental issues, identity, meaning, making sense and meaningfulness were drawn from the stories and configured into a narrative of the researcher’s making. What the participants chose to speak about became the meanings, or themes, major and minor, of their stories. No event has meaning in itself, however traumatic events can precipitate crises of meaning. When these crises are viewed within the context of other events, and are perceived to add value to life, then they have meaningfulness. In the telling of meanings and meaningfulness, the purpose for storying and the audience to whom the story is directed are the criteria for which the storylines are chosen. Both the story and the storying provide opportunities for the authors to create and offer images of themselves, that are then open to interpretation by an audience. As a traumatic experience, GBS enabled six people to tell their stories. In doing so they were able to make sense of important issues for themselves, and re-examine the way they saw themselves and the world.
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Leitzen, Eva [Verfasser]. "Theiler’s Murine Encephalomyelitis Virus Infection: a Model for Spinal Cord Lesions in Progressive Multiple Sclerosis and a Peripheral Neuropathy Resembling Guillain-Barré Syndrome / Eva Leitzen." Gießen : DVG, 2019. http://d-nb.info/1189654717/34.
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Polo, Castro Julio Cesar, and Castro Julio Cesar Polo. "Sistema de visión artificial basado en la detección de los movimientos del ojo, para mejorar la atención de los pacientes con síndrome de Guillain Barré." Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2015. http://tesis.usat.edu.pe/handle/usat/524.
Full textAbstract:
El síndrome de Guillain Barré es una polirradiculoneuropatía de evolución aguda o sub aguda que ataca progresivamente el sistema nervioso central impidiendo el movimiento de una persona progresivamente, empieza en los brazos y piernas y se extiende hasta el cuello, en el 50% de los casos se requiere de un ventilador mecánico, por lo que se considera una enfermedad critica, el problema de la enfermedad es que dificulta la comunicación entre los pacientes y su entorno, esto hace que durante el ciclo de la enfermedad, 1 año aproximadamente, este paciente presente complicaciones por la falta de comunicación. El presente proyecto de tesis está enfocado a desarrollar un Sistema de Visión artificial, basado en la detección de los movimientos del ojo que permitió solucionar el problema de la falta de comunicación de los pacientes con síndrome de Guillain Barre del Hospital Nacional Almanzor Aguinaga Asenjo. El SVA presenta una interfaz con algunos mensajes predefinidos, así como un teclado para escribir un mensaje propio, dirigiendo la mirada hacia el lugar que quieren realizar el “click”, referenciándose por un puntero que le permitirá asegurar el lugar exacto donde quiere clickear, para esto se usara la técnica de “tracking eye” o técnica de seguimiento de los ojos, mediante el uso de una cámara para captar los movimientos del ojo y poder usarlo en el sistema de visión artificial, que se desarrollara en base a la metodología propuesta por Kong y Nilson (2005), que consta de 3 etapas, la representación de la imagen, el procesamiento de la imagen y el análisis de la misma. La población de esta tesis es no probabilística por lo que se realiza en los 5 pacientes con SGB que se encontraban hospitalizados durante la realización de esta tesis.Tesis
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Polo, Castro Julio Cesar. "Sistema de visión artificial basado en la detección de los movimientos del ojo, para mejorar la atención de los pacientes con síndrome de Guillain Barré." Bachelor's thesis, Chiclayo, 2015. http://tesis.usat.edu.pe/jspui/handle/123456789/544.
Full textAbstract:
El síndrome de Guillain Barré es una polirradiculoneuropatía de evolución aguda o sub aguda que ataca progresivamente el sistema nervioso central impidiendo el movimiento de una persona progresivamente, empieza en los brazos y piernas y se extiende hasta el cuello, en el 50% de los casos se requiere de un ventilador mecánico, por lo que se considera una enfermedad critica, el problema de la enfermedad es que dificulta la comunicación entre los pacientes y su entorno, esto hace que durante el ciclo de la enfermedad, 1 año aproximadamente, este paciente presente complicaciones por la falta de comunicación. El presente proyecto de tesis está enfocado a desarrollar un Sistema de Visión artificial, basado en la detección de los movimientos del ojo que permitió solucionar el problema de la falta de comunicación de los pacientes con síndrome de Guillain Barre del Hospital Nacional Almanzor Aguinaga Asenjo. El SVA presenta una interfaz con algunos mensajes predefinidos, así como un teclado para escribir un mensaje propio, dirigiendo la mirada hacia el lugar que quieren realizar el “click”, referenciándose por un puntero que le permitirá asegurar el lugar exacto donde quiere clickear, para esto se usara la técnica de “tracking eye” o técnica de seguimiento de los ojos, mediante el uso de una cámara para captar los movimientos del ojo y poder usarlo en el sistema de visión artificial, que se desarrollara en base a la metodología propuesta por Kong y Nilson (2005), que consta de 3 etapas, la representación de la imagen, el procesamiento de la imagen y el análisis de la misma. La población de esta tesis es no probabilística por lo que se realiza en los 5 pacientes con SGB que se encontraban hospitalizados durante la realización de esta tesis.
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Pezo, Pezo Armando Martin. "Asociación entre compromiso de reflejos osteotendinosos y grado de severidad del síndrome de Guillain Barré en el Hospital Nacional Dos de Mayo, Perú 2011-2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2021. https://hdl.handle.net/20.500.12672/16625.
Full textAbstract:
El Síndrome de Guillain-Barré (SGB) exhibe un amplio rango de
severidad. Aproximadamente, el 10% de pacientes con SGB presentan reflejos
osteotendinosos profundos (ROP) normales o aumentados en etapas iniciales;
sobre ello, algunos estudios refieren que estos pacientes presentan un menor
porcentaje de cuadros severos de la enfermedad, pero la evidencia es limitada.
Busca determinar el nivel de asociación entre ROP al ingreso hospitalario y
severidad del SGB al nadir y al alta en pacientes del Hospital Nacional Dos de Mayo
durante el 2011-2015. Realiza un análisis secundario de base de
datos. Desarrolla un estudio observacional, analítico, tipo cohorte retrospectiva de adultos
diagnosticados con SGB excluyéndose a aquellos con alguna otra neuropatía. Se
realizó un análisis mediante modelo lineal generalizado de familia Poisson y link log
con varianzas robustas. Se presentan RR crudos y ajustados. Encuentra que
ingresaron 76 participantes, con media de edad 47.3 años (±14.1),
predominantemente varones (82.9%). El 13.2% presentó ROP normales al ingreso,
el 80.3% y 25.0% presentó SGB moderado a severo al nadir y alta, respectivamente.
Los pacientes con ROP normales al ingreso presentaron 54% menos riesgo de
desarrollar cuadros moderados a severos al nadir (IC95% 1%-79%) en comparación
a aquellos con ROP disminuidos/abolidos considerando constante edad y tiempo
hasta primera evaluación (p=0.048). Concluye que los pacientes con ROP
normales al ingreso al hospital Dos de Mayo en el periodo de estudio presentaron
cerca de la mitad del riesgo de desarrollar cuadros moderados a severos de SGB
durante el nadir en comparación a los pacientes con ROP disminuidos/abolidos.
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Bellodas, Ramos Karla Geraldine. "Grados de fuerza muscular y su relación con los subtipos del síndrome de guillain barré en los pacientes afectados entre los años 2009 al 2013." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2015. https://hdl.handle.net/20.500.12672/4235.
Full textAbstract:
OBJETIVOS: Determinar los grados de fuerza muscular y la relación que tienen con los subtipos del síndrome de Guillain Barré en los pacientes afectados desde el año 2009 al 2013 del Instituto Nacional de Ciencias Neurológicas.
MATERIALES Y MÉTODOS: Estudio de tipo descriptivo, correlacional, retroprospectivo, transversal; se estudio a 31 pacientes que fueron afectados con el Síndrome del Guillain Barré entre los años 2009 al 2013 del Instituto Nacional de Ciencias Neurológicas entre los 20 a los 79 años de edad; se utilizó como instrumentos el test manual de exploración muscular o test de fuerza muscular manual y se relacionó la variable con el subtipo del Síndrome de Guillain Barré extraída de los datos de la historia clínica de los pacientes.
RESULTADOS: Los resultados del cruce de las variables subtipo de Síndrome de Guillain Barré y los grados de Fuerza muscular (divididas en dos grupos: con alteración funcional o sin alteración funcional) por medio de tablas de contingencia con la utilización de las pruebas de Chi –cuadrado el grado de los significancia de p > 0,05, con lo cual no se p grados de Fuerza Muscular no podrán ser probadas. Se observaron que las alteraciones de los grados de fuerza muscular a nivel funcional están presenten a predominio de los grupos musculares de los segmentos distales, tanto de miembros superiores como miembros inferiores.
CONCLUSIONES: No se pudo demostrar la relación entre los subtipos del Síndrome de Guillain Barré, las posibles causas de los resultados aún se mantienen en discusión para futuras investigaciones. Las alteraciones de los grados de fuerza muscular funcional son predominantes en los segmentos distales.OBJECTIVES: To determine the degree of muscle strength and the relationship they have with the subtypes of Guillain Barre syndrome in patients affected from 2009 to 2013 of the Instituto Nacional de Ciencias Neurológicas. MATERIALS AND METHODS: Descriptive, correlational, retroprospective, transversal; 31 patients who were affected with Guillain Barre Syndrome from 2009 to 2013 of the Instituto Nacional de Ciencias Neurológicas, the age range is 20 to 79 years old; Manual muscle test was used as instruments and it was related with the subtype of Guillain Barré syndrome, that data was extracted from medical records of patients. RESULTS: The results from the intersection of variables subtype of Guillain Barré and degrees of muscular strength (divided into two groups: those with functional impairment or without functional impairment ) using contingency tables and using Chi -square test the significance level of p> 0.05 , I was not found a significant difference between between subtypes of Guillain Barre syndrome and degrees of muscle strength. It was found degrees of muscle strenght alteration at the functional level a of the distal muscle groups in the upper limbs and lower limbs. CONCLUSIONS: it was not found a significant correlation between between subtypes of Guillain Barré and degrees of muscle strength. The possible causes of the results still are found under discussion for future studies. Alterations in the levels of functional muscle strength are predominant in the distal segments. KEYBOARDS: Subtype Guillain Barre Syndrome, Muscular Strength, degree of functional muscle strength, muscle strength degree of functional impairment.
Tesis
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Cochen-de, Cock Valérie. "Mécanismes des états dissociés du sommeil paradoxal : comportements oniriques, hallucinations." Paris 6, 2007. http://www.theses.fr/2007PA066319.
Full textAbstract:
La dissociation du sommeil paradoxal peut induire hallucinations et comportements oniriques. Les troubles de la pensée au cours du syndrome de Guillain et Barré ne sont pas propre aux conditions réanimatoires mais liés à une atteinte du système nerveux central. Ils correspondent à des rêves éveillés secondaires à une dissociation majeure du sommeil, par atteinte auto-immune réversible de l’hypothalamus, associant dysautonomie et diminution de la transmission hypocrétinergique-1. La plupart des patients présentant un syndrome parkinsonien de la Guadeloupe, une tauopathie, ont des comportements oniriques. La localisation des lésions plus que leur nature (alpha-synucléine versus protéine tau) conditionnerait la survenue de comportements oniriques. Les patients parkinsoniens ne sont plus akinétiques pendant leurs comportements oniriques. Cette restauration du contrôle moteur suggère un rétablissement transitoire « levodopa-like » de la boucle des ganglions de la base pendant le sommeil paradoxal. Le syndrome parkinsonien pourrait aussi disparaître par un débrayage entre les systèmes pyramidal et extra pyramidal en sommeil paradoxal.
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Karnam, Anupama. "Role of Wnt/β-catenin pathway in the anti-inflammatory mechanism of therapeutic normal immunoglobulins Wuchereria bancrofti filaria activates human dendritic cells and polarizes T helper 1 and regulatory T cells via toll-like receptor 4 Regulatory T cells induce activation rather than suppression of human basophils." Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS642.
Full textAbstract:
Les immunoglobulines polyclonales intraveineuses (IVIG) sont préparées à partir de plasmas provenant de plusieurs milliers de donneurs sains et utilisées comme traitement dans de nombreuses maladies inflammatoires et autoimmunes. Lors de ma thèse, j’ai investigué si cette thérapie pouvait interférer avec la détection sérique du virus Zika chez des patients atteints du syndrome de Guillain-Barré (GBS). J’ai démontré que la thérapie par IVIG n’interférait pas avec la détection sérique du virus dans le plasma des patients atteints de GBS suivant un traitement aux IVIG. Contrairement aux souris, les IVIG peuvent activer les basophiles humains par une voie différente que celle de l’IL-33. Les IVIG induisent la sécrétion d’Il-4, IL-6 et IL-8 par interaction directe avec les IgE à la surface des basophiles. Cette fonction est dépendante de la fraction F(ab’)2 et implique l’activation de Syk. Ces résultats montrent un nouveau mécanisme dans l’activation des basophiles humains par les IVIG. La dernière partie de ma thèse m’a permis d’étudier le rôle de la voie de signalisation β-caténine sur les effets anti-inflammatoires médiées pars les IVIG. La β-caténine, composante de la voie Wnt, joue un rôle important dans la tolérogénicité des cellules dendritiques (DC) et dans la protection contre l’encéphalomyélite auto-immune expérimentale (EAE). Les données générées montrent que les IVIG activent la voie β-caténine chez les DC humains en plus de la production de Wnt 5a nécessitant une IgG complète ainsi que les co-récepteurs LRP5/6. En dépit de l’induction de β-caténine par les IVIG, cette voie est dispensable pour ses actions anti-inflammatoires in vitro et in vivo dans le modèle EAEIntravenous immunoglobulin (IVIG) is a therapeutic preparation of pooled normal IgG obtained from the several thousand healthy donors. It is established as first-line therapy for many autoimmune and inflammatory diseases. In the first part of my thesis, I have investigated if IVIG therapy interferes with the serological detection of Zika virus infection in Guillain–Barré syndrome (GBS) patients. By analyzing the plasma of GBS patients treated with IVIG for anti-Zika IgG, I have demonstrated that IVIG therapy in GBS patients does not interfere with the serological Zika detection. The second part addresses the immunoregulatory role of IVIG on human basophil function. Unlike in mice, IVIG does not require DC-SIGN-dependent IL-33 for the activation of human basophils. IVIG directly induces the activation of IL-3-primed human basophils and secretion of IL-4, IL-6, and IL-8 by directly interacting with the basophil surface-bound IgE. This function was F(ab’)2-dependent and involves Syk activation. These results demonstrate a novel mechanism of human basophil activation by IVIG. The last part unravels the signaling pathways associated with IVIG-mediated anti-inflammatory effects specifically the Wnt/β-catenin pathway, which imparts tolerogenic properties to dendritic cells (DCs) and protection against experimental autoimmune encephalomyelitis (EAE). My data shows that IVIG activates β-catenin in human DC along with upregulation of Wnt 5a. Activation of β-catenin requires intact IgG and LRP5/6 co-receptors. However, despite the activation of β-catenin by IVIG, this pathway is dispensable for its anti-inflammatory actions both in vitro and in vivo in the EAE model
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Carvalho, Inês Sequeira Peixoto Araújo. "Síndrome de Guillain-Barré." Master's thesis, 2015. http://hdl.handle.net/10400.6/5120.
Full textAbstract:
A Síndrome de Guillain-Barré (SGB) é uma polineuropatia desmielinizante aguda do Sistema Nervoso Periférico (SNP) mediada imunologicamente. Caracteriza-se pelo início agudo e rapidamente progressivo de uma tetraparésia ascendente, acompanhada frequentemente por arreflexia e, ocasionalmente, por anomalias sensoriais e do Sistema Nervoso Autónomo (SNA).
Esta doença divide-se em variantes clínicas, e, como tal, apresenta uma ampla diversidade de manifestações. Apesar destes subtipos diferirem na sua fisiopatologia, pensa-se que o “mimetismo molecular” possa constituir um dos mecanismos-chave envolvidos na patogénese desta doença. Através deste processo, os agentes agressores produzem autoanticorpos contra determinados componentes dos nervos periféricos do hospedeiro, levando à sua destruição e consequente aparecimento da clínica.
A resposta imune depende tanto de fatores do hospedeiro como de fatores relacionados com o agente agressor. Os eventos precedentes mais comuns são as infeções, principalmente as respiratórias e gastrointestinais. Atualmente investiga-se o papel de outros possíveis fatores menos comuns, como as imunizações e as cirurgias. No entanto, são ainda necessários mais estudos para comprovar totalmente estes fatores como causadores da doença. É ainda de realçar a existência de fatores genéticos que assumem um papel igualmente importante. Assim, há um conjunto de genes candidatos que têm vindo a ser estudados para a SGB.
Existem diversos mecanismos imunológicos subjacentes à SGB. A imunidade celular e a imunidade humoral, associadas respetivamente aos linfócitos T ativados e aos autoanticorpos, contribuem, em conjunto, para a doença. Como resultado final desta cascata inflamatória vamos ter, entre outros, desmielinização, lesão axonal e bloqueio da condução nervosa.
A SGB ainda é uma doença potencialmente fatal e que encerra um mau prognóstico em pelo menos 20% dos casos. Assim, é fundamental salientar a necessidade de melhores tratamentos para esta doença, com o objetivo de reduzir o número de pessoas que persistem com défices residuais. O conhecimento da sua fisiopatologia e dos processos imunes envolvidos assume repercussões terapêuticas relevantes, ao permitir a investigação de novos fármacos que vão atuar sobre as principais moléculas envolvidas na patogénese da SGB.The Guillain-Barré Syndrome (GBS) is an acute demyelinating polyneuropathy of the Peripheral Nervous System (PNS) which is immunologically mediated. It is characterized by an acute and rapidly progressive onset of an upward tetraparesis, often accompanied by areflexia and occasionally by sensory and Autonomic Nervous System anomalies (ANS). This disease can be divided into clinical variants, and as such, has a wide variety of manifestations. Although these subtypes differ in their pathophysiology, it is believed that the "molecular mimicry" may be one of the key mechanisms involved in the pathogenesis of this disease. Through this process, the aggressors produce autoantibodies against certain components of the peripheral nerves of the host, leading to its destruction and the consequent presentation of the clinic. The immune response depends on both host factors as factors related to the offending agent. The most common previous events are infections, especially respiratory and gastrointestinal. The potential role of other less common factors, such as the immunizations or surgery is currently under investigation. However, more studies are still needed to fully verify these factors as causes of the disease. It is also worth noting the existence of genetic factors that assume an equally important role. Thus, there is a set of candidate genes that have been studied for GBS. There are several immunological mechanisms underlying the GBS. The cellular immunity and humoral immunity, respectively associated with activated T lymphocytes and autoantibodies, contribute altogether to the disease. As an end result of the inflammatory cascade we have, among others, demyelination, axonal damage and blockage of nerve conduction. GBS is still a life threatening condition and determines a poor prognosis by at least 20% of cases. Thus, it is essential to emphasize the need for better treatments for this disease, in order to reduce the number of people who persist with residual deficits. The knowledge of the pathophysiology and immune processes involved assumes relevant therapeutic effects, by allowing the development of new drugs which act on the key molecules involved in the pathogenesis of GBS.
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Norling, Maja. "Neurophysiological findings in Guillain-Barré syndrome at different stages, a retrospective study." Thesis, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-445356.
Full textAbstract:
Introduction: Guillain-Barré syndrome (GBS) is a neurological disease caused by an autoimmune attack on the peripheral nerves. The main symptoms are loss of motor and sensory skills in the upper and lower extremities. Autonomic dysfunction also occurs.Aim: To identify which parameters in neurography examination that are showing pathology at three different stages from the onset of symptoms. To practically perform and evaluate different electrode placements at RR-intervals.Materials and methods: The first part of this study was a retrospective study with results from 58 patients which were diagnosed with GBS in 2010-2020 at the University Hospital in Uppsala. The second part of this study included measurement of the heart rate variation with RR-intervals at different electrode placement in ten healthy volunteers. Results: In part 1 of the project, there were no significant differences between the groups at distal latency in the ulnar nerve, F-latency in the tibial nerve and in the conduction velocity in the sural nerve. However, there were significant differences in the amplitude of the radial nerve. In part 2 of the project, there were significant differences between the electrode placements, and most artifacts were found with electrodes placed on the shoulders.Conclusion: Examination with neurography and RR-intervals plays an important role in the diagnosis of GBS. As the amplitude in the radial nerve was the only one that showed significant differences between the groups, the nerve is recommended to be examined bilaterally. With a high presence of artifacts in RR-intervals with electrodes placed on the shoulders and wrists, placement on the chest is to be recommended.
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Forster, Eva. "Psychische Veränderungen und Liquorparameter bei intensivbehandelten Patienten mit akutem Guillain-Barré-Syndrom." Doctoral thesis, 2005. https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-20619.
Full textAbstract:
Das akute Guillain-Barré-Syndrom (GBS) ist eine akute Erkrankung des peripheren Nervensystems, bei der es aufgrund komplexer immunologischer Prozesse häufig im Anschluss an einen bakteriellen Infekt zu Sensibilitätsstörungen und aufsteigenden Paresen bis hin zur Panplegie mit Beatmungspflichtigkeit kommt. Die Hirnnerven und das autonome Nervensystem sind oft mitbetroffen. Aufgrund der Paresen ist die Kommunikationsfähigkeit bei erhaltenem Bewusstsein zum Teil erheblich eingeschränkt. Bei intensivmedizinisch behandelten Patienten mit schwerer Verlaufsform werden häufig psychische Veränderungen beobachtet. Die vorliegende Arbeit beschreibt Ergebnisse einer Untersuchung an 54 Patienten mit einem akuten Guillain-Barré-Syndrom, die im Zeitraum von April 1989 bis Juni 1996 in der Neurologischen Universitätsklinik Würzburg behandelt wurden. Ziel dieser Arbeit war es, mögliche Korrelationen zwischen Liquorparametern, somatischen Befunden und Psychopathologie bei manifestem Guillain-Barré-Syndrom zu untersuchen, um Hinweise für mögliche diagnostisch und ätiologisch bedeutsame Zusammenhänge dieser in der Regel sowohl in Forschung als auch Patientenversorgung getrennt betrachteter Krankheitsparameter zu erhalten. Annähernd ein Viertel der Patienten entwickelte während der akuten Krankheitsphase produktiv-psychotische Symptome wie Halluzinationen, Wahnvorstellungen oder oneiroides Erleben (24,1%). Mit dem Auftreten einer psychotischen Symptomatik korrelierten neben der Höhe des Gesamteiweißes im Liquor auch der Ausprägungsgrad der somatischen Befunde (multiple Hirnnervendysfunktion, ausgeprägte Tetraparese) sowie die Beatmungspflichtigkeit. Signifikante Korrelationen ergaben sich des weiteren für das Auftreten der psychotischen Symptome Halluzinationen, wahnhaftes Verhalten und oneiroides Erleben mit der Konzentration einiger Immunglobuline im Liquor. Hinweise für das Vorliegen einer Depression fanden sich bei 67,9% der untersuchten Patienten. Das Vorhandensein depressiver Symptome korrelierte mit der Konzentration von Gesamteiweiß und IgG im Liquor, wie auch mit dem Auftreten von Beatmungspflichtigkeit und ausgeprägter Tetraparese signifikant. Als häufigster psychopathologischer Befund wurde das Auftreten einer Angstsymptomatik beobachtet, welche bei fast allen Patienten evident war (88,7%). Das Vorhandensein von Angst korrelierte weder mit der Höhe der Liquorwerte noch mit dem neurologischen Status. Auch für den Ausprägungsgrad einiger somatischen Befunde ließen sich statistisch signifikante Zusammenhänge mit der Höhe der Liquorparameter Gesamtprotein, Albumin, Albuminquotient und IgM nachweisen. Aus der vorliegenden Untersuchung geht hervor, dass psychische Symptome bei GBS-Patienten häufig vorkommen. Als Ursache der psychischen Veränderungen werden eine Reihe psychodynamisch-somatischer Interaktionstheorien angeführt, welche die Entstehung psychopathologischer Befunde vornehmlich durch die gestörte Kommunikations- und Wahrnehmungsfähigkeit der Patienten in der akuten Krankheitsphase erklären. Die hier vorgelegte Arbeit stützt im Kontext mit Ergebnissen anderer Autoren darüber hinaus die These, dass immunologische und pathologische Veränderungen im ZNS möglicherweise als zusätzliche Faktoren bei der Entstehung und Vermittlung der psychischen Krankheitssymptome in Betracht kommen. Inwiefern die hier vorgelegten Ergebnisse auch prädiktiv-diagnostisch nutzbar gemacht werden können sollte in nachfolgenden prospektiv-randomisierten Studien untersucht werden. Zusammenfassend betont die vorliegende Arbeit, dass beim akuten Guillain-Barré-Syndrom, wie bei vielen weiteren Krankheitsentitäten, eine komplexe Interaktion zwischen somatischen und psychischen Alterationen besteht. Daraus folgert, dass zum Verständnis und zur Weiterentwicklung der Behandlung der Erkrankung die Entwicklung eines integrativen Gesamtkonzeptes unter Berücksichtigung aller Parameter und ihrer komplexen Wechselwirkungen anzustreben istGuillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculo-neuropathy, which often manifests after an acute infective illness. It is characterized by ascending acute flaccid paralysis and in severe cases leads to tetraplegia with the need of artificial ventilation. Mild sensory symptoms, as well as cranial nerve involvement and autonomic dysfunctions are frequent. Beside somatic symptoms, psychological disturbances are often found in GBS patients. While the reasons and consequences of the somatic alterations in the course of the illness have been the focus of intense investigative efforts during the last decade, data on the accompanying psychological symptoms are still sparse. Goal of this work was to investigate possible interactions and correlations between somatic symptoms, cerebral spinal fluid (CSF) parameters and the incidence and type of psychological disturbances in GBS. In this prospective study, 54 severely compromised patients with GBS were included between the years 1989 and 1996. CSF parameters, psychological disturbances and neurological deficits were thoroughly investigated for all patients and statistical correlation analyses were performed. Psychotic symptoms including hallucinations, delusions and oneiroid states were found in 24,1% of the patients. The frequency of psychotic symptoms was associated with the concentration of total CSF protein and the concentration of specific CSF immune globulines and correlated with the severity of the overall neurological deficits (severe tetraparesis, artificial respiration, multiple cranial nerve dysfunction). Depression was found in 67,9% of the patients and its presence/absence correlated with the concentration of CSF protein and IgG, artificial respiration and severe tetraparesis. Anxiety was present in the vast majority of patients (88,7%) investigated, however no associations of the concentration of CSF proteins or neurological deficits with this psychopathological symptom was apparent. The severity of some neurological deficits was associated with the concentration of total CSF protein, CSF albumine, albumine quotient and CSF IgM. In summary, this study emphasized the fact that psychopathological symptoms are frequent in GBS. As a reason for the occurrence of these symptoms psychodynamic-somatic interactions have been proposed. However, apart from a possible psychodynamic pathogenesis, psychotic symptoms may also originate from immunological and pathological CNS changes. The present work provides some support for this theory as associations between CSF parameters and psychopathology were clearly evident for some parameters. Furthermore the results of this study point on a potential use of CSF parameters for the prediction of the development of psychological disturbances in this disease entity. The results hint on the fact that there is an complex interaction between somatic and psychological disturbances in acute GBS. To understand the disease and to improve therapy, an integrative overall approach which takes all parameters and their complex interactions into account must be applied
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Kirchberger, André Philipp Konstantin [Verfasser]. "Beeinträchtigungen der Atemmuskelkraft bei Guillain-Barré-Syndrom / vorgelegt von André Philipp Konstantin Kirchberger." 2009. http://d-nb.info/1008985392/34.
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Möller-Schmidt, Franziska. "Retrospektive Untersuchung über psychische und körperliche Langzeitbeeinträchtigungen bei Patienten nach Guillain-Barré-Syndrom." Doctoral thesis, 2002. https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-4308.
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Um die psychischen, physischen und psychosozialen Langzeitbeeinträchtigungen bei Patienten nach schwerem Guillain-Barré-Syndrom erheben und zu beschreiben wurden 1994 41 Patienten in der Neurologischen Universitätsklinik Würzburg nachuntersucht. 1 bis 12 Jahre nach der akuten Erkrankung wurden die Patienten mittels eines halbstrukturierten Interviews befragt und neurologisch nachuntersucht. 17% der Patienten zeigten zum Zeitpunkt der Nachuntersuchung keinerlei neurologische Ausfälle mehr. 76% wiesen leichte sensible Ausfälle auf. An motorischen Ausfällen litten 37% der Patienten. Als Folge der motorischen Deprivation und des Verlustes von Kommunikationsfähigkeiten litten 17% der Patienten an depressiven Symptomen, 32% an vermehrten Stimmungsschwankungen und 34% an einer verminderten seelischen Belastbarkeit. Ein Zusammenhang zwischen vermehrten Stimmungsschwankungen und motorischen Ausfällen zum Zeitpunkt der Nachuntersuchung (p<0,05) und einer Beatmungsnotwendigkeit zum Zeitpunkt der stärksten Ausprägung (p<0,01) konnte nachgewiesen werden. 44% der Patienten waren beruflich eingeschränkt, 29% beschrieben Änderungen in ihrer Partnerschaft und 29% änderten ihre Freizeitgestaltung. Zwei Drittel der Befragten (66%) beschrieben positive Veränderungen ihrer Lebenseinstellung. Das GBS zeigt langfristige, komplexe psychische und psychosoziale Beeinträchtigungen, so dass eine langfristige Betreuung der GBS-Patienten, zum Erkennen und Behandeln psychischer Beschwerden wünschenswert und sinnvoll erscheintTo describe and determine the psychological, physical and psychosocial long-term-outcome of patients after severe Guillain-Barré-Syndrome (GBS), 41 patients were retrospectively studied in 1994 in the Department of Neurology, University Hospital Würzburg, Germany. 1 to 12 years after the onset of GBS the patients received a semistructured interview and were neurologically examined. 17 % of the patients had recovered completely at the time of the follow-up examination. 76% had minimal sensory signs. Motor signs were presented in 37% of the patients. As a result of motor deprivation and loss of communication 17 % showed depressive symptoms; 32% increased changes of mood and 34% emotional inconveniences. Increased changes of mood were associated with residual motor signs at the time of the follow-up examination (p<0,05) and with the necessity of artificial ventilation (p<0,01) during the acute GBS. 44% of the patients had to work less or change work, 29% described changes in their partnership and 29% altered their leisure activities. Two thirds of the patients (66%) described a positive change of their mental attitude. GBS has a long-term impact on the patients` psychosocial life, so a continuous psychosocial support would be desirable
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Van, der Merwe Hermanus Daniel. "A resonant mirror biosensor approach to understand antibody-antigen interactions in Guillain Barré Syndrome." Diss., 2007. http://hdl.handle.net/2263/23995.
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Guillain Barré Syndrome in humans is characterised by ascending paralysis. It is often associated with preceding infections two to four weeks prior to nadir and is fatal in five percent of cases. Antibodies specific to several nerve components are frequently associated with clinical symptoms in GBS. These antibodies were found to be specific to various gangliosides and ganglioside complexes. It was also found that antibody reactivity to gangliosides is affected by membrane components. The most prevalent (20-30%) immunoglobulin in GBS is anti-GM1 (20-30%), which also binds to the LPS of the PEN O:19 Campylobacter jejuni serotype. This is the most common infectious agent associated with GBS and emphasizes the importance of infection and anti-ganglioside antibodies in disease development. Intravenous infusion of pooled immunoglobulin from healthy donors, also called intravenous immunoglobulin (IVIg), halves the severity of disease manifestation. The action mechanism of IVIg in curing GBS is not clear, but intravenous immunoglobulin was shown to neutralize anti-ganglioside binding activity and its pathogenic effects. It was further found that anti-idiotypic antibodies in IVIg inhibit anti-ganglioside antibody activity. Treatment with IVIg is not equally effective in all GBS cases, which might be due to the inability of IVIg to neutralize anti-ganglioside antibodies in all patients adequately. Therefore, the treatment of GBS with IVIg needs to be better understood in order to improve its use as a cure for GBS. This study confirmed previous findings that the interaction of patient serum anti-GM1 antibodies and ganglioside auto-antigens is greatly impaired by components in healthy serum. Bound anti-GM1 antibodies could be displaced by (presumably) anti-idiotypic antibodies from healthy donor serum. This study found that the displacement potential between donor sera differs. Anti-GM1 antibody displacement was found to be dependent on the character of both anti-GM1 and anti-idiotypic antibody. This demonstrated the feasibility of improving the efficiency of treatment by IVIg by sourcing it from only those sera that test best for displacing auto-antibodies from their ganglioside antigens in ELISA. IVIg selection may therefore greatly benefit from the use of recombinant phage display antibodies to distinguish between the various types of GBS for treatment. To develop a method to characterize anti-ganglioside antibodies sensitively, an evanescent field biosensor was employed in which gangliosides were presented in a liposome environment. This provided a more physiological way of antibody antigen recognition. The optimized method determined the ganglioside binding specificity of purified IgG from a GBS patient, and mouse monoclonal anti-GM1 and anti-GD1a antibodies accurately. The results compared well with those from ELISA. The results obtained with purified IgG were far better than that obtained with whole serum analysis. This could be due to non-specific binding or the presence of inhibiting anti-idiotypic antibodies in patient sera. The biosensor method for antibody detection in GBS may allow the detection of anti-idiotypic antibodies in patients in future, because it requires no prior labelling of antibodies. Anti-idiotypic interaction may be detected by displacement of Ab1 from antigen, or by capturing Ab2 on Ab1 immobilized on the biosensor surface.Dissertation (MSc (Biochemistry))--University of Pretoria, 2008.
Biochemistry
MSc
unrestricted
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Resina, Eduarda Filipa de Almeida. ""Vírus Zika - um problema de saúde pública"." Master's thesis, 2017. http://hdl.handle.net/10316/83641.
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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de FarmáciaO vírus Zika é um arbovírus, pertencente à família flaviviridae e ao género flavivírus. O seugenoma é constituído por uma molécula de RNA de cadeia simples e polaridade positiva,possui cápside icosaédrica e envelope. O genoma contém aproximadamente 11 kb quecodifica uma poliproteina que origina três proteínas estruturais- C, prM e E e sete proteínasnão estruturais – NS1, NS2a, NS2b, NS3, NS4a, NS4b, NS5. Este vírus surgiu pela primeiravez em Uganda em 1947 e foi-se disseminando para outras regiões do planeta ao longo dosanos. A transmissão ao ser humano ocorre maioritariamente por picadas de mosquitos dogénero Aedes, principalmente aegypti e albopictus, mas também por via sexual, vertical etransfusão sanguínea. Os sintomas mais comuns são febre baixa, erupção maculopapular,artralgia e conjuntivite. Para além disso está associado a microcefalia e a síndrome deGuillain-Barré. A confirmação de infeção por vírus Zika baseia-se na pesquisa do genomaviral em diversas amostras tais como o sangue, urina, saliva, sémen e líquido amniótico e emexames serológicos para a deteção de anticorpos do tipo IgM. A reatividade cruzadaexistente entre os diferentes flavivírus dificulta o seu diagnóstico, sendo importante aexecução do Teste de neutralização de redução em placa. A prevenção da transmissão dovírus inclui várias medidas, como usar repelente, roupas que cubram o máximo de pelepossível, usar telas em janelas e portas, ar-condicionado, eliminar águas, usar inseticidas paramatar larvas e mosquitos e uso de métodos contracetivos de barreira, são alguns exemplos.Ainda não há vacina nem nenhum medicamento anti-viral, pelo que o tratamento é baseadono alívio dos sintomas.
Zika virus is an arthropod-born virus (arbovirus) belong from flaviviridae family and flavivirusgenus. It is an icosahedral and enveloped virus with a single and positive RNA molecule.Your genome have 11kb that encodes a polyprotein that originates three structural proteins– C, prM and E and seven non-structural proteins - NS1, NS2a, NS2b, NS3, NS4a, NS4b,NS5. Zika virus (ZIKV) was first identified in Uganda in 1947 and it spread for others regionsof the planet along the years. ZIKV is transmitted mainly by Aedes mosquitos´ bites,principally aegypti and albopictus, but also by sexual, vertical and blood transfusion. Mostcommon symptoms are low-grade fever, rash, arthralgia and conjunctivitis. The virus wasassociated at some diseases like microcephaly and Guillain-Barré syndrome. Theconfirmation of Zika virus infection is based on viral genome screening in different samplessuch as blood, urine, saliva, semen and amniotic fluid, and serological tests for detecting IgMantibodies. Serological diagnosis is complicated by cross-reactivity between the members offlavivirus genus, so it is important to do a plaque reduction neutralization test. Theimportant task of prevention of transmission can be done in manners such as using repellent,wearing appropriated clothes, use of screens for windows and doors, air-conditioner, usinginsecticides to kill larvae and mosquitos and the use preservative. There aren´t any vaccinesor antiviral medicaments so the treatment is based on supporting care.
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Silvestre, Miguel Alexandre Piedade. "Zika : o paradigma atual." Master's thesis, 2017. http://hdl.handle.net/10400.26/20184.
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Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas MonizO Zika é um vírus que faz parte da família Flaviviridae, mais especificamente do género flavivírus. Este foi descoberto em 1947, no Uganda, na floresta Zika, sendo que em 1952, na Nigéria, ocorreu o primeiro caso de infeção humana. Perante isto, a sua disseminação perpetuou-se por todo o continente Africano e Asiático. Em 2007 registou-se, pela primeira vez, um surto em larga escala. Porém, em 2013 aquando do surto na Polinésia francesa, foi pela primeira vez descrita a síndrome de Guillain-Barré como uma complicação neurológica nos doentes infetados por Zika. Verificaram-se também surtos nas Ilhas Cook, Nova Caledónia e Ilha da Páscoa, em 2014. Em 2015, este vírus atingiu o Brasil, ocorrendo milhares de casos de infeção, onde se pôde verificar uma associação entre a microcefalia e as malformações fetais com a infeção por Zika. Atualmente, este vírus continua a circular provocando novos casos que se reportam a setenta e nove países, por todo o mundo. O vírus Zika pode propagar-se por duas vias: a vetorial e a não vetorial. Sendo que a primeira se transmite através dos mosquitos do género Aedes. A segunda via, corresponde à transmissão por via sexual, via vertical (mãe-filho), por transfusões de sangue e outras possíveis vias, ainda não confirmadas. No que respeita ao tratamento, não existe ainda um fármaco antiviral aprovado e disponível que seja eficaz contra este vírus, da mesma forma como, face à prevenção, não existe uma vacina disponível. Em contrapartida, existem medidas de prevenção que podem ser tomadas para evitar a sua propagação e transmissão, nomeadamente educação das populações, sexo protegido e controlo vetor.
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Janse, van Rensburg Anna Catharina. "Die belewenis van Guillain Barre-pasiente tydens verpleging in intensiewesorgeenhede." Thesis, 2012. http://hdl.handle.net/10210/6925.
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M.Cur.The purpose of this study is to explore and describe the experiences of patients with Guillain-Barré syndrome whilst being nursed in intensive care units, in order to set guidelines for nursing. The researcher made use of the phenomenological approach within the paradigm of qualitative research. The target population consisted of 70 patients of which seven complied with the selection criteria: In-depth interviews, which were taped, were conducted with the patients. Validity and reliability were ensured by using measures as stated by Woods and Catanzaro (1988). Data-analysis was executed by means of Giorgi's method (Omery,1983) and after clearance with an external decoder, it was categorized according to the patients' internal and external environment. The Nursing Theory for the Wholeperson had been used to this purpose. The conclusions of this study indicate that patients with Guillain-Barré syndrome in intensive care units experience deprivation of sleep, pain and fear. Limited communication and loss of autonomy create frustration. Patients become lonely and bored and have a need for constant support from their family and others. Consequent upon the conclusions the researcher developed nine guidelines for the nursing of patients with Guillain-Barré syndrome. These guidelines are in support of the functional approach of the researcher and may be considered an attempt to provide research findings that are applicable to the practice of nursing.
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Forster, Eva [Verfasser]. "Psychische Veränderungen und Liquorparameter bei intensivbehandelten Patienten mit akutem Guillain-Barré-Syndrom / vorgelegt von Eva Forster." 2006. http://d-nb.info/982204426/34.
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Casal, Jessica Filipa de Sa. "Relatórios de Estágio e Monografia intitulada “Infeção pelo Vírus Zika e a Síndrome de Guillain-Barré”." Master's thesis, 2019. http://hdl.handle.net/10316/88337.
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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de FarmáciaDurante os cinco anos que constituem o Mestrado Integrado em Ciências Farmacêuticas da Faculdade de Farmácia da Universidade de Coimbra, os alunos são formados e preparados para exercerem a profissão farmacêutica. O ciclo de estudos culmina no estágio curricular, que além da Farmácia Comunitária pode incluir várias áreas das Ciências Farmacêuticas, acompanhado de uma monografia realizada no âmbito de um assunto relevante para a comunidade farmacêutica. Como tal, o presente Documento Único compreende três partes: o Relatório de Estágio em Indústria Farmacêutica, realizado na Farmalabor de 7 de janeiro a 29 de março de 2019, orientado pela Dra. Dália Gonçalves; o Relatório de Estágio em Farmácia Comunitária, realizado na Farmácia Passos Carneiro de 1 de abril a 30 de julho de 2019, orientado pelo Dr. Pedro Carneiro; e uma monografia intitulada “Infeção pelo Vírus Zika e a Síndrome de Guillain- Barré”, orientada pela Professora Doutora Cristina Luxo. Em março de 2016, a Organização Mundial de Saúde confirmou a existência de consenso científico de que a Síndrome de Guillain-Barré é causada pelo vírus Zika, e apelou ao desenvolvimento de vacinas e novas terapias antivirais, após ter decretado emergência de saúde pública a nível internacional. Este trabalho pretende elaborar uma revisão bibliográfica da informação que existe atualmente acerca do vírus Zika, da Síndrome de Guillain-Barré associada à infeção por este vírus, assim como das características desta doença quando associada (ou não) à infeção pelo Zika e repercussões que a disseminação do vírus pode ter a nível mundial.
Throughout the five years that compose the Integrated Master's degree in Pharmaceutical Sciences at Faculty of Pharmacy of University of Coimbra, students are trained and prepared to practice the pharmaceutical profession. The course of studies culminates in the curricular internship, which in addition to Community Pharmacy may include several areas of Pharmaceutical Sciences, followed by a monograph conducted within a subject relevant to the pharmaceutical community. As such, this Single Document comprises three parts: the Internship Report in Pharmaceutical Industry, held at Farmalabor from January 7th to March 29th 2019, oriented by Dr. Dália Gonçalves; the Internship Report in Community Pharmacy, held at Farmácia Passos Carneiro from April 1st to July 30th 2019, oriented by Dr. Pedro Carneiro; and a monograph titled “Zika Virus Infection and Guillain-Barré Syndrome”, oriented by professor doctor Cristina Luxo. In March 2016, the World Health Organization confirmed the scientific consensus that Guillain-Barré Syndrome is caused by Zika virus, and called for the development of vaccines and new antiviral therapies, after declaring international public health emergency. This monograph's intention is to elaborate a bibliographic review of the current information about Zika virus, Guillain-Barré Syndrome associated with Zika virus infection, as well as the characteristics of this disease when associated (or not) with Zika infection and the repercussions that the spread of the virus may have worldwide.
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Carvalho, Ana Carolina Gonçalves de. "Zika: avanços e perspetivas futuras." Master's thesis, 2018. http://hdl.handle.net/10316/84469.
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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de FarmáciaZika é uma doença infeciosa causada pelo vírus zika que pertence à família Flaviviridae. Este vírus é transmitido maioritariamente pela picada de um mosquito, sendo o mosquito Aedes o vetor primário. Ao contrário dos outros flavivírus, o zika tem a particularidade de poder ser transmitido por via sexual.O vírus zika permaneceu relativamente desconhecido até 2007, quando ocorreu o primeiro surto na ilha de Yap, na Micronésia, mas na altura foi associado a uma doença suave, uma vez que a maior parte da população não apresentava sintomas. Porém, o reaparecimento da infeção por este vírus e a sua associação com anomalias neurológicas e malformações no sistema nervoso central (SNC), como microcefalia e Síndrome de Guillain-Barré (SGB) e suspeitas de microcefalia congénita devido à infeção durante a gravidez,alertaram as autoridades de saúde pública. Em 2016 a World Health Organization (WHO)declarou zika como uma emergência de saúde pública.Desde o recente surto do vírus zika ocorrido no Brasil, com o primeiro caso confirmado em maio de 2015, que se tem investigado incessantemente para desenvolver métodos de diagnóstico sensíveis bem como fármacos e moléculas eficazes além de medidas adequadas de prevenção e controlo para evitar a propagação de zika e os seus efeitos. O desenvolvimento de testes de diagnóstico fiáveis tem-se revelado difícil devido à reatividade cruzada do vírus com outros flavivírus e devido à baixa especificidade destes testes em pessoas anteriormente expostas a um flavivírus. Os métodos disponíveis neste momento são os métodos serológicos e os métodos moleculares, sendo os métodos moleculares baseados na deteção do RNA viral os mais utilizados para fazer diagnóstico na fase aguda. Os métodos serológicos apenas devem ser realizados após a seroconversão. As principais medidas de prevenção da infeção por zika incluem o controlo de vetores,terapêuticas e vacinação. O controlo de vetores engloba várias medidas físicas de proteção individual da picada do mosquito e também medidas químicas e biológicas com o objetivo de reduzir a população de vetores. Face à falta de medicamentos aprovados para a prevenção da infeção, encontra-se em investigação a possibilidade de reutilização de certos compostos já existentes para ser em usados como antivirais e o uso de Anticorpos (Ac) monoclonais como potencial terapêutica para flavivírus. Estes Ac são muito específicos e apresentam menos imunogenicidade e toxicidade fora do alvo que as moléculas antivirais. Como não é possível uma quimioprofilaxia constante e devido à agressividade e propagação do vírus, é urgente uma vacina segura e eficaz. Devido ao conhecimento da estrutura do vírus e conhecimento dos antigénios alvo e tendo como base o desenvolvimento de vacinas bem sucedidas para outros flavivírus, foi possível criar várias plataformas de vacinas que estão atualmente em ensaios clínicos.O objetivo desta monografia é observar a evolução do conhecimento sobre o vírus zika,abordar os vários modos de transmissão e de infeção básica, adquirir novos conhecimentos sobre os métodos de diagnóstico, assim como perspetivar algumas medidas preventivas em estudo.
Zika is an infectious disease caused by the zika virus that belongs to the Flaviviridae family.The zika virus is mainly transmitted by a mosquito bite, being the primary vector the mosquito Aedes. Unlike the other flaviviruses, zika has the particularity of being capable of sexual transmission.The virus remained relatively unknown until 2007, when its firs outbreak occurred on the Yap island, in Micronesia, but at the time it was associated with a mild disease since most ofthe population showed no symptoms. However the resurgence of the virus and its association with neurological abnormalities and central nervous system malformations, such as microcephaly and Guillain-Barré Syndrome and suspicions of congenital microcephaly due to infection during pregnancy, alerted the authorities of public health. In 2016, World Health Organization (WHO) declared zika as a Public Health Emergency.Since its most recent outbreak in Brazil, with its first confirmed case in May 2015, it has been unceasingly investigated the development sensitive diagnostic methods as well as drugs and molecules effective besides suitable measures of prevention and control in order to avoid the spread of zika and its effects. The development of reliable diagnostic testing has revealed to be hard work due to cross reactivity of the virus with other flaviviruses and due to the low specificity of these test in persons previously exposed to a flavivirus. The currently available assays are serological assays and molecular assays, and the molecular assays, that detect viral RNA, are the most used to make diagnosis in acute phases. The serological assays should only be used after seroconversion. The main measures of prevention of zika infection include vector control, therapeutics and vaccination. Vector control encompasses several physical measures of individual protection of the mosquito bite and also chemical and biological measures with the goal of reducing vector population. In view of the lack of approved medicines for the prevention of infection, it is under investigation the possibility of the reuse of certain compounds already existing to be used as antivirals and the use of monoclonal antibodies as potential therapy to flavivirus. These antibodies are highly specific and show less immunogenicity and toxicity outside the target than small antiviral molecules.As it is not possible permanent prophylaxis and due to the aggressive nature of the virus and its spread, it is urgent a safe and effective vaccine. The knowledge of the virus structure and its target antigens, and having as base the development of successful vaccines to other flavivirus, permitted the creation of several vaccine platforms that are currently in clinical trials. The goal for this monograph is to observe the evolution of the knowledge of the zika virus, approach the several routes of transmission and basic infection, acquire new awareness about diagnostic methods as well as prospect some prevention measures currently in study.
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Duckstein, Ulrike [Verfasser]. "Die prognostische Wertigkeit von klinischen und elektrophysiologischen Parametern für den Langzeitverlauf des Guillain-Barré-Syndroms / von Ulrike Duckstein." 2007. http://d-nb.info/987941798/34.
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Möller-Schmidt, Franziska [Verfasser]. "Retrospektive Untersuchung über psychische und körperliche Langzeitbeeinträchtigungen bei Patienten nach Guillain-Barré-Syndrom / vorgelegt von Franziska Möller-Schmidt." 2003. http://d-nb.info/969665547/34.
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"Das Guillain-Barré-Syndrom : Untersuchungen zur Klinik, Nosologie und Prognose anhand von 39 Fällen aus den Jahren 1972-1981." Norderstedt : Books on Demand, 2003. http://d-nb.info/1013240766/34.
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Pésinho, Inês Vaz. "Multiple Sclerosis vs. Guillain-Barré syndrome: differences in two autoimmune disorders with a common target in two different regions." Master's thesis, 2019. http://hdl.handle.net/10451/43421.
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Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2019A Esclerose Múltipla (EM) e o Síndrome Guillain-Barré (SGB) são ambos doenças autoimunes e desmielinizantes que afetam, respetivamente, o Sistema Nervoso Central (SNC) e o Sistema Nervoso Periférico (SNP), pertencendo ainda a um grupo de doenças neurodegenerativas que envolvem lesões inflamatórias associadas a desmielinização, induzindo dano no axónio e consequente neurodegeneração, o que leva a uma perda de função progressiva. A EM é uma doença inflamatória crónica do SNC sendo a causa mais frequente de distúrbios neurológicos em jovens adultos. É uma doença que consiste na inflamação, desmielinização e uma variável perda axonal. A sua etiologia ainda não é completamente conhecida, mas presume-se que envolva a interação entre fatores genéticos e ambientais, estimulando um ataque autoimune e consequentes danos na mielina e nos axónios. Clinicamente, a maior parte dos doentes tem uma fase recidivante-remitente, caracterizada pela presença de surtos seguida de recuperação. Destes doentes, a maioria progride para uma doença secundária progressiva e os restantes doentes desenvolvem uma Esclerose Múltipla primária progressiva. Alguns doentes têm ainda um síndrome clinicamente isolado que corresponde a um primeiro episódio de sintomas neurológicos no SNC, sendo que estes podem ou não evoluir para Esclerose Múltipla. Em termos de tratamento, estão aprovados os medicamentos modificadores de doença, especialmente no caso de doença recidivante-remitente. A SGB é uma doença inflamatória, mas do SNP, sendo a causa mais frequente de paralisia flácida aguda. Esta doença autoimune é antecedida por uma infeção viral ou bacteriana, como vírus Influenza ou Campilobacter jejuni, que são capazes de desencadear uma resposta imune anormal direcionada contra os componentes dos nervos periféricos, por mimetismo molecular. As formas mais frequentes são polineuropatia desmielinizante inflamatória aguda e neuropatia motora axonal aguda, existindo ainda a neuropatia motora sensorial axonal aguda e a síndrome de Miller Fisher. Os doentes com SGB têm insuficiência respiratória e disfunção autónoma como complicações associadas. O tratamento é composto por uma abordagem multidisciplinar que inclui cuidados médicos gerais e imunoterapia. As prioridades na investigação da EM e da SGB incluem o desenvolvimento de biomarcadores e um melhor conhecimento da imunopatogénese, para que haja medicina personalizada.
Multiple Sclerosis (MS) and Guillain-Barré Syndrome (GBS) are both demyelinating and autoimmune disorders affecting, respectively, the central nervous system (CNS) and the peripheral nervous system (PNS), which means they belong to a group of neurodegenerative diseases that involve inflammatory lesions associated with demyelination, inducing axonal damage and consequent neurodegeneration, leading to progressive loss of function. MS is a chronic inflammatory disorder of the CNS and is assumed to be the most frequent cause of neurological disability in young adults. This disorder consists in inflammation, demyelination and variable levels of axonal loss. The etiology is still unknown but it is presumed to involve interaction between genetic and environmental factors that triggers an autoimmune attack, resulting in damaged myelin and axons. Clinically, most of the patients experience a relapsing-remitting phase, characterized by relapses followed by recovery. The majority of them, late on enter in a progressive phase called secondary progressive MS. The remaining patients pursue a progressive course that is called primary progressive MS. There is also clinically isolated syndrome corresponding to a first episode of neurologic symptoms in the CNS, and people who experience it may or may not develop MS. In terms of therapeutic options, disease-modifying treatments are approved specially to treat relapsing remitting form of the disease. GBS is also an inflammatory demyelinating disease of the PNS and it is the most frequent cause of acute flaccid paralysis. This autoimmune disorder is, in most cases, preceded by viral or bacterial infections, such as Campylobacter jejuni or Influenza virus, that are capable of triggering an abnormal immune responses directed against components of the peripheral nerves by molecular mimicry. Clinically, the most frequent forms of GBS is acute inflammatory demyelinating polyradiculoneuropathy and acute motor axonal neuropathy, but there is also acute motor-sensory axonal neuropathy and Miller-Fischer syndrome. Patients with GBS commonly have respiratory insufficiency and autonomic dysfunction as associated complications. The treatment of this syndrome is composed by a multidisciplinary approach that includes general medical care and immunotherapies. The priorities for MS and GBS investigation include establishment of biomarkers and an improved knowledge of the immunopathogenesis, to go towards personalized medicine.
Farmácia Lisboa; Hospital de Santo António dos Capuchos
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Silva, Rui Pedro Alves da. "Síndrome de Guillain-Barré - Revisão retrospetiva da casuística dos casos hospitalizados no Centro Hospitalar do Porto - Artigo de investigação médica." Dissertação, 2015. https://repositorio-aberto.up.pt/handle/10216/81939.
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Silva, Rui Pedro Alves da. "Síndrome de Guillain-Barré - Revisão retrospetiva da casuística dos casos hospitalizados no Centro Hospitalar do Porto - Artigo de investigação médica." Master's thesis, 2015. https://repositorio-aberto.up.pt/handle/10216/81939.
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