Uploaded byTruong Anh Bui Show 0% found this document useful (2 votes) 9K views 411 pages Copyright© © All Rights Reserved Available FormatsPDF, TXT or read online from Scribd Share this documentDid you find this document useful?Is this content inappropriate?0% found this document useful (2 votes) 9K views411 pages 45 Đề Thi Thử Tiếng Anh THPT Quốc Gia 2023 Giống Đề Thi Chính ThứcUploaded byTruong Anh Bui Jump to Page You are on page 1of 411 Search inside document Reward Your CuriosityEverything you want to read. Anytime. Anywhere. Any device. No Commitment. Cancel anytime.  Các tổn thương ở ruột non xuất hiện dưới dạng niêm mạc dạng hạt và nốt, niêm mạc bị bong tróc và xuất huyết ăn mòn. To visualize the total amount of amyloid in the body, the serum amyloid P component labeled 123 is injected into the circulation. It binds to amyloid fibers in the body. The diagnostic sensitivity of this scan is 90% for AA and AL amyloidosis. Liver on ultrasound or computed tomography is enlarged with uniform density or echogenicity. Computed tomography may show diffuse or focal areas of hypoattenuation and lack of parenchymal enhancement of the spleen. On magnetic resonance imaging, there is also a uniform intensity with T1 increasing and T2 not changing significantly. Nhuộm màu đỏ tươi nhanh trực tiếp tạo ra màu đỏ cam đặc trưng trong ánh sáng bình thường (a) và lưỡng chiết màu xanh lá cây táo trong ánh sáng phân cực cho thấy sự lắng đọng amyloid ở niêm mạc nổi bật (b). Nhuộm đỏ nhanh trực tiếp cho thấy nền ít không đặc hiệu hơn so với đỏ Congo. 3. TreatmentPrinciples of amyloidosis treatment should be directed at the underlying cause and aimed at preventing amyloid accumulation and formation by reducing the abundance of the fibril precursor protein. This approach can help stabilize or improve the function of the affected organ. The goal of primary amyloidosis treatment is to block the synthesis of immunoglobulin light chains by controlling the underlying plasma cell disorder with chemotherapy. Role of high-dose chemotherapy in combination with hematopoietic stem cell transplantation Recently, high-dose chemotherapy in combination with hematopoietic stem cell transplantation is being performed for AL amyloidosis with encouraging results. More recently, a patient with severe intestinal amyloidosis secondary to active rheumatoid arthritis was treated with tocilizumab, a humanized anti-interleukin 6 receptor antibody. The treatment resulted in improvement in gastrointestinal symptoms as well as systemic joint pain. Furthermore, her serum AA protein levels returned to normal and repeat endoscopic biopsies revealed no colon amyloid accumulation. Tocilizumab may be a treatment of choice for AA amyloidosis associated with inflammatory arthritis, potentially interfering with the biosynthesis of amyloidogenic precursors induced by the representative proinflammatory cytokine, intereukin 6 New drugs under investigation Again, a new small molecule inhibitor, R1[6[(R)2carboxypyrrolidin1yl]6oxohexanoyl]pyrrolidine2 carboxylic acid (CPHPC) has been developed to specifically target Serum amyloid P is a common constituent of amyloid deposits and contributes to their formation. CPHPC reduces serum amyloid P levels and prevents amyloid deposition in an open-label proof-of-principle study in systemic amyloidosis. However, such promising specific agents have so far not been available in the clinical setting of systemic amyloidosis. In fact, the treatment of AA amyloidosis involves controlling the primary disease. For example, long-term anti-tuberculosis therapy has been reported to reduce established amyloidosis. Chlorambucil and tumor necrosis factorα inhibitors against amyloid deposition-induced arthritis. However, the therapeutic effect is anecdotal and inconclusive as shown in sporadic cases or a limited series. Role of Colchicine Colchicine, an alkaloid extracted from Colchicum autumnale of the rose family, is prescribed for the treatment of diseases as diverse as gout, Behçet's disease and primary biliary cirrhosis. This drug inhibits microtubule formation, thereby affecting cell mitosis, and may interfere with the phagocytic properties of polymorphonuclear leukemic cells. First, there was an observational case that it was an effective remedy for the prevention of attacks of FMF, an inherited disease characterized by short fevers of serosa, and this was confirmed. by controlled studies. Colchicine is today an effective drug in the prevention and treatment of amyloidosis secondary to FMF. Cases of nephrotic syndrome that resolved after prolonged use of colchicine have been reported not only with FMF but also with ulcerative colitis and ankylosing spondylitis. In a preliminary trial, colchicine (1.5 mg/day) was administered for amyloid nephropathy in patients with hereditary dystrophy epidermolysis bullosa (EB). More recently, we report that gastrointestinal amyloidosis secondary to EB was cured by colchicine at a similar dose 2 months later. Treatment of gastrointestinal symptoms Gastrointestinal symptoms are managed with symptom control. It is important to ensure adequate nutrition and enough water. Symptoms of gastroparesis have been effectively treated with metoclopramide or domperidone. Neostigmine may be helpful in alleviating acute colonic obstruction; it can be used as an alternative to colon decompression in patients with various acute pathologies. Diarrhea has been successfully treated with loperamide or octreotide. Total parenteral nutrition is used if the movement disorder-related symptoms are disabling and the patient is malnourished. Antibiotics can be used for bacterial overgrowth. Patients should be supplemented, especially with fat-soluble vitamins. The treatment for gastrointestinal bleeding can be similar to that in other diseases. Để đặt lịch khám tại viện, Quý khách vui lòng bấm số hoặc đặt lịch trực tiếp . Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng. XEM THÊM:
Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng. |
