Polly, Neurologic Diseases, Dana Farber Cancer Institute discussed on NEJM This Week - Audio Summaries

Automatic TRANSCRIPT

Disagreements can go in both directions, sometimes doctors recommend treatments and parents refuse. Sometimes parents request continue treatment that doctors think inappropriate such conflicts have occurred in cases of hypotheses encephalopathy, degenerative neurologic diseases and even brain death these disagreements can cause moral distress among doctors, and nurses and debates about the ethical justifiability. Of unilateral decisions that treatment is futile. And should be withdrawn. Usually disagreements are resolved by ongoing discussion between doctors and parents by bringing in other family members, or by consulting an ethics committee. Most intensive ists. Learn how to negotiate with families in these situations occasionally disagreements become intractable and cases end up in court attention to the process by which decisions are made rather than to the result of the decision. Making process has changed the way we think about Neo Natal bioethics recognition of the role that doctors play as choice architects suggest that there might be new ways to think about the ethical responsibilities that go along with that role. A fifty eight year old woman with Paris, thea and weakness of the left foot and domino wall. A case record of the Massachusetts General Hospital by Tim Reta and colleagues a fifty eight year old woman from New England presented to the outpatient neurology clinic in early autumn because of Hypo Sesia Paris, these ya and weakness ten weeks earlier back pain developed between the shoulder blades. The pain resolved without an intervention six weeks before this presentation, numbness developed in a band like distribution around her trunk one week later, the numbness extended to the upper abdomen. Paris Thenia developed in the third fourth and fifth fingers of the left hand and the fourth and fifth fingers of the right hand. M R I of the spine was scheduled, however, two weeks before this presentation the numbness extent. Ended to the genital area. And urinary incontinence developed prompting the patient to present to the emergency department overall, this patient syndrome was most consistent with a sub acute. Polly ridiculous Pathy or poly ridiculous neuropathy. There are several disorders that can cause or mimic sub acute Polly ridiculous Pathy or poly ridiculous neuropathy patients who have Lima ninja ridiculous typically present to eighteen weeks after infection during the early disseminated phase with pain sensory loss and a reflexive weakness over half of patients with Lima ninja ridiculous present with seventh cranial nerve palsy a manifestation of Lyme disease that many recognize, but any cranial or spinal nerve root may be involved. Inhibition of casing kind as one alpha in acute myeloid leukemia. A clinical implications of basic research article by Benjamin Ebert from the Dana Farber Cancer Institute, Boston acute myeloid leukemia. AM L is genetically heterogeneous cancer that arises in Hamadeh poetic stem cells for the past forty years standard treatment for AM L has consisted of a combination of two chemo therapeutic agents site, Tara bean and an anthracite Clint this regimen results in high rates of remission. But in the majority of cases fails to Aratu, Kate, the residual lewke MC stem cells that are the reason for relapse and poor outcomes. In patients with AM L, the comprehensive genetic analysis of AM L in the past ten years has revealed recurrent, somatic Lee MU. -tated genes leading to the development of new targeted therapies, including inhibitors of FMS like tyrosine kinase three an.

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