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Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.
If you have multiple sclerosis (MS), you probably had several tests done before you received your diagnosis. There isn’t one test to diagnosis MS, so testing can vary. Doctors can use neurological exams, information about previous symptoms, blood tests, and spinal fluid tests. A magnetic resonance imaging (MRI) scan isn’t used to diagnose MS but rather to rule out other diseases. A diagnosis of MS requires more information than what a scan alone can give. By looking at more than one test or exam result, doctors can get a clearer picture of what’s going on in your body.
Most folks remember puberty – and not always in a good way. It can be an awkward stage of budding breasts, unwanted hair, acne and unexpected body odor. Puberty, when a child undergoes physical changes and becomes sexually mature, typically begins around age 8 in girls and age 9 in boys. But imagine, say, a 6- or 7-year-old undergoing such changes? Studies are showing that the onset of puberty for both boys and girls is occurring earlier and earlier, a phenomenon defined as precocious puberty. A study published in Pediatrics in 2010 found that among a population of 1,200 American girls, about 23 percent of African-Americans,15 percent of Latinas and 10 percent of Caucasian girls had begun puberty (marked by breast development) at age 7. In 2012, another study published in Pediatrics found that puberty in American boys – measured by testicular enlargement and pubic hair growth – was beginning six months to two years earlier than what research in previous decades had documented, particularly among African-American children.
Varicose veins are generally benign. The cause of this condition is not known. For many people, there are no symptoms and varicose veins are simply a cosmetic concern. In some cases, they cause aching pain and discomfort or signal an underlying circulatory problem. Treatment involves compression stockings, exercise, or procedures to close or remove the veins.
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✍️Dr. Matthew Harb talks about knee replacement surgery
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👨⚕️Orthopedic Hip and Knee Surgeon
📍Located in Washington DC, and Maryland
📚Education and Insight
🛠Minimally invasive, outpatient, hip and knee replacement surgery
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Dr. Matthew Harb specializes in minimally invasive, muscle sparing, hip and knee replacement surgery. Minimally invasive surgery allows patients to recover faster and have less pain post operatively. Implants are tailored and custom fit to each patient to allow for improved performance. Dr. Harb’s expertise in rapid recovery protocols allow for quick recovery after surgery and excellent outcomes in patients with hip and knee arthritis. With minimally invasive, muscle sparing surgery patients can return to their lifestyles and get back to doing the things they love sooner. Dr. Harb performs outpatient joint replacement surgery with many of his patients walking independently and going home the day of surgery.
“My focus is excellence in patient care, expedited recovery after surgery, and getting people back to the normal activities they love. Our team focused approach is committed to superb outcomes, improving lives, and returning patients to living pain free.”
Eric knew he needed help when an old knee injury began worsening over the course of time and was significantly affecting his quality of life. That’s when he turned to his hometown orthopedic experts at Mayo Clinic Health System in Mankato, who recommended a total knee replacement. After overcoming some initial fears, Eric decided it was time to have the operation — a fuller and more active life with his family depended on it.