PEPID's December Newsletter
In This Issue
The Role of NOTCH3 Mutations in Cerebral Vascular Disease
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare inherited disorder caused by mutations in the NOTCH3 gene on chromosome 19. It is characterized by the thickening of small and medium-sized cerebral arteries, leading to ischemic damage in the brain. Symptoms typically begin around age 30 and include migraines with aura, transient ischemic attacks (TIAs), lacunar infarcts, cognitive impairment, and psychiatric disorders such as depression and apathy, with some cases progressing to vascular dementia. Diagnosis is confirmed through genetic testing or skin biopsy, with MRI findings showing white matter hyperintensities in the anterior temporal lobes and external capsule. While there is no cure for CADASIL, management focuses on symptom control, including migraine treatment (avoiding vasoconstrictors), antihypertensives, antiplatelet therapy, and lifestyle modifications such as smoking cessation. For a more detailed overview of CADASIL, consult PEPID's full CADASIL monograph.
A Parasitic Infection Linked to Meat Consumption
Trichinellosis, also known as trichinosis, is a parasitic infection caused by roundworms (nematodes) of the genus Trichinella. The disease results from the consumption of undercooked or raw meat, particularly pork or wild game such as bear meat, containing encysted larvae. After ingestion, larvae are released in the stomach and invade the small intestine, maturing into adults and producing more larvae. Symptoms typically begin with gastrointestinal complaints (nausea, vomiting, diarrhea, abdominal pain) 1–2 days after infection, followed by systemic manifestations like fever, periorbital edema, myalgia, and eosinophilia within 1–2 weeks. Severe cases may involve myocarditis, encephalitis, or death. Diagnosis relies on history of undercooked meat consumption, clinical presentation, eosinophilia, serological tests (e.g., ELISA), and imaging (muscle calcifications). Treatment for mild cases includes supportive care with antipyretics and anti-inflammatory agents, while severe infections require antiparasitic agents like albendazole or mebendazole, sometimes combined with corticosteroids. Prevention involves cooking meat to an internal temperature of at least 77°C, freezing pork for 20 days at ?15°C, and ensuring proper hygiene when handling raw meat. Recent cases in North Carolina highlight the risk of consuming undercooked bear meat, emphasizing the need for food safety awareness. For a comprehensive overview, refer to PEPID's monograph on trichinellosis.
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A Tool for Informed Decision-Making in Cancer Patients
The Prognostic Index for Cancer Outcomes is a medical calculator designed to predict cancer mortality using serum biomarkers, specifically C-Reactive Protein (CRP) and white blood cell count (WBC). Intended for use in patients with known cancer, an elevated score on the index is associated with a poorer prognosis. However, survival outcomes can vary significantly depending on factors such as cancer type, stage, and individual patient characteristics, highlighting the importance of clinical context in interpretation. Access the Prognostic Index for Cancer Outcomes calculator in the PEPID app or by visiting pepidconnect.com now.
New & Updated PEPID Content?
Clinical Topics?
New/Updated Drugs
Updated Medical Calculators
Top Winter Wellness Tips for Healthcare Providers and Patients
Winter brings unique wellness challenges, from seasonal illnesses and dry skin to stress and the winter blues, making it crucial for healthcare providers and patients alike to prioritize their health. Our latest blog offers practical tips to boost immunity with nutrient-rich foods, stay active with indoor and outdoor exercise ideas, manage stress through self-care and mindfulness, and protect skin from winter’s harsh conditions. These simple, effective strategies will help you stay energized, healthy, and mentally strong all season long. Don’t let winter slow you down - read the full blog on PEPID Pulse now!