Shock is a life-threatening pathophysiologic state referring to inadequate organ perfusion, which can progress to end-organ dysfunction and eventually, multiple organ failure and death. The diagnosis of shock is clinical, necessitating good understanding of the underlying etiology, pathophysiology, as well as the clinical, biochemical, and hemodynamic manifestations of the various presentations of shock. This article describes an approach to shock, highlighting the important initial actions, pertinent clinical findings, and the four main types of shock, and offers an overview of the inotropes and vasopressors used in the intensive care setting. A case study and additional figures are included to supplement the presented concepts.
{"title":"Approach to Shock","authors":"Janet Chan","doi":"10.26443/mjm.v20i1.872","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.872","url":null,"abstract":"Shock is a life-threatening pathophysiologic state referring to inadequate organ perfusion, which can progress to end-organ dysfunction and eventually, multiple organ failure and death. The diagnosis of shock is clinical, necessitating good understanding of the underlying etiology, pathophysiology, as well as the clinical, biochemical, and hemodynamic manifestations of the various presentations of shock. This article describes an approach to shock, highlighting the important initial actions, pertinent clinical findings, and the four main types of shock, and offers an overview of the inotropes and vasopressors used in the intensive care setting. A case study and additional figures are included to supplement the presented concepts.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43198283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute kidney injury is defined as an abrupt decline in kidney function, which manifests as an increase in serum creatinine level or a decrease in urine output within a short period of time. It is a commonly encountered entity in the clinical setting and necessitates a systematic diagnostic approach. Acute kidney injury etiologies are classified as either prerenal, intrinsic renal, or postrenal. This article presents the key elements of history taking, physical examination, and laboratory investigations when assessing a patient for acute kidney injury to properly classify its etiology. The use of imaging modalities is also discussed. Common etiologies of acute kidney injury in each category are highlighted. Lastly, this article provides a brief overview of management principles for acute kidney injury with a particular emphasis on indications for initiation of dialysis.
{"title":"Approach to Acute Kidney Injury","authors":"Sophy Mo","doi":"10.26443/mjm.v20i1.943","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.943","url":null,"abstract":"Acute kidney injury is defined as an abrupt decline in kidney function, which manifests as an increase in serum creatinine level or a decrease in urine output within a short period of time. It is a commonly encountered entity in the clinical setting and necessitates a systematic diagnostic approach. Acute kidney injury etiologies are classified as either prerenal, intrinsic renal, or postrenal. This article presents the key elements of history taking, physical examination, and laboratory investigations when assessing a patient for acute kidney injury to properly classify its etiology. The use of imaging modalities is also discussed. Common etiologies of acute kidney injury in each category are highlighted. Lastly, this article provides a brief overview of management principles for acute kidney injury with a particular emphasis on indications for initiation of dialysis.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48216244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lately, the premier ateliers of contemporary architecture -- such as Herzog & de Meuron, or the Office of Metropolitan Architecture -- are showing increasing interest in hospital design, once the realm of highly specialized architectural firms. This trend towards reevaluating hospital design and architecture is most opportune, as the COVID-19 pandemic urges us all to rethink the ways in which our healthcare institutions can be better designed. This commentary is a discussion on the emerging issues of contemporary hospital architecture, especially as reinforced by the pandemic. For instance, while hospital architecture today focuses on individualized care, providing each patient with hotel-like rooms, the pandemic has reminded us of the issue of capacity and inequality in these limited and costly spaces. To what extent should hospitals be centralized or decentralized? Specialized or despecialized? This commentary discusses how COVID-19 has provided insight into some of contemporary hospital architecture’s greatest problems; specifically, it argues that the hospital of the future must exist on a more decentralized platform, both physically and digitally, and be more flexible in function.
{"title":"Rethinking Modern Hospital Architecture Through COVID-19","authors":"J. Park","doi":"10.26443/mjm.v20i1.906","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.906","url":null,"abstract":"Lately, the premier ateliers of contemporary architecture -- such as Herzog & de Meuron, or the Office of Metropolitan Architecture -- are showing increasing interest in hospital design, once the realm of highly specialized architectural firms. This trend towards reevaluating hospital design and architecture is most opportune, as the COVID-19 pandemic urges us all to rethink the ways in which our healthcare institutions can be better designed. This commentary is a discussion on the emerging issues of contemporary hospital architecture, especially as reinforced by the pandemic. For instance, while hospital architecture today focuses on individualized care, providing each patient with hotel-like rooms, the pandemic has reminded us of the issue of capacity and inequality in these limited and costly spaces. To what extent should hospitals be centralized or decentralized? Specialized or despecialized? This commentary discusses how COVID-19 has provided insight into some of contemporary hospital architecture’s greatest problems; specifically, it argues that the hospital of the future must exist on a more decentralized platform, both physically and digitally, and be more flexible in function.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":"147 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41284904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Modes of anatomical instruction (especially the need to dissect cadavers) have been contested for generations. The present narrative provides an opportunity to re-approach this age-old debate and contemplate the state of anatomical sciences education through a narrative reflection of an encounter with a donor in the cadaveric anatomy laboratory.
{"title":"A reflection on the role of anatomists in modern medical education: confronting meaning and mortality in the gross anatomy laboratory","authors":"Adam M R Groh","doi":"10.26443/mjm.v20i1.940","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.940","url":null,"abstract":"Modes of anatomical instruction (especially the need to dissect cadavers) have been contested for generations. The present narrative provides an opportunity to re-approach this age-old debate and contemplate the state of anatomical sciences education through a narrative reflection of an encounter with a donor in the cadaveric anatomy laboratory.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43783375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypercalcemia is a presentation commonly encountered in the clinical setting. Due to its vast differential diagnosis, a systematic approach is necessary when approaching patients with hypercalcemia. This article presents a simple, yet thorough approach to help clinicians determine the etiology of their patients' hypercalcemia. The main components of history taking, physical examination, and laboratory investigations for patients with hypercalcemia are highlighted. Emphasis is put on the importance of determining whether the hypercalcemia is associated with elevated or inappropriately normal parathyroid hormone (PTH) levels or not. The main etiologies of PTH-dependent hypercalcemia and PTH-independent hypercalcemia are explored. Primary hyperparathyroidism and hypercalcemia secondary to malignancy are highlighted as together, they make up 90% of hypercalcemia cases. A presentation of the management principles of hypercalcemia is also provided.
{"title":"Approach to hypercalcemia","authors":"Sophy Mo","doi":"10.26443/mjm.v20i1.941","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.941","url":null,"abstract":"Hypercalcemia is a presentation commonly encountered in the clinical setting. Due to its vast differential diagnosis, a systematic approach is necessary when approaching patients with hypercalcemia. This article presents a simple, yet thorough approach to help clinicians determine the etiology of their patients' hypercalcemia. The main components of history taking, physical examination, and laboratory investigations for patients with hypercalcemia are highlighted. Emphasis is put on the importance of determining whether the hypercalcemia is associated with elevated or inappropriately normal parathyroid hormone (PTH) levels or not. The main etiologies of PTH-dependent hypercalcemia and PTH-independent hypercalcemia are explored. Primary hyperparathyroidism and hypercalcemia secondary to malignancy are highlighted as together, they make up 90% of hypercalcemia cases. A presentation of the management principles of hypercalcemia is also provided.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49605524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Pulmonary hypertension is a devastating disease with a rapid progression of symptoms leading to high patient mortality. It is characterized by high blood pressure in the pulmonary vasculature and poor pulmonary perfusion, resulting in patient fatigue, dyspnea, and syncope, especially upon physical exertion. A sub-clinical form of pulmonary hypertension also exists which is referred to as exercise induced pulmonary hypertension, where patients display normal resting hemodynamic properties but abnormal pulmonary responses to exercise. Discussion Recent evidence suggests early intervention and treatment of pulmonary hypertension can improve patient outcomes. However, there is a lack of clinical evidence supporting effective treatments for exercise induced pulmonary hypertension (EIPH), arguably the earliest stage of pulmonary hypertension. This is due in part to the removal of EIPH from official guidelines such as the European Respiratory Society in 2008. EIPH was removed from clinical guidelines due to a lack of consensus on the definition and standardized testing procedures for diagnosing EIPH. Emerging evidence suggests that exercise testing following a standardized protocol of stress echocardiography or right heart catheterization of patients may allow for the classification of EIPH as a mean pulmonary artery pressure/cardiac output slope > 3 mmHg/L/min, and/or mean pulmonary artery pressure > 30 mmHg with a pulmonary vascular resistance > 3 Wood Units. Conclusion Providing evidence for a consensus definition of EIPH, along with a validated, standardized testing procedure, will hopefully foster the progression of research on EIPH and further the development of treatments and improve patient outcomes for people with pulmonary hypertension.
{"title":"Exercise-Induced Pulmonary Hypertension: How to Define, Diagnose, and Treat At-Risk Patients","authors":"Brandon Shokoples, Kevin Comeau","doi":"10.26443/mjm.v20i1.900","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.900","url":null,"abstract":"Introduction Pulmonary hypertension is a devastating disease with a rapid progression of symptoms leading to high patient mortality. It is characterized by high blood pressure in the pulmonary vasculature and poor pulmonary perfusion, resulting in patient fatigue, dyspnea, and syncope, especially upon physical exertion. A sub-clinical form of pulmonary hypertension also exists which is referred to as exercise induced pulmonary hypertension, where patients display normal resting hemodynamic properties but abnormal pulmonary responses to exercise.\u0000Discussion Recent evidence suggests early intervention and treatment of pulmonary hypertension can improve patient outcomes. However, there is a lack of clinical evidence supporting effective treatments for exercise induced pulmonary hypertension (EIPH), arguably the earliest stage of pulmonary hypertension. This is due in part to the removal of EIPH from official guidelines such as the European Respiratory Society in 2008. EIPH was removed from clinical guidelines due to a lack of consensus on the definition and standardized testing procedures for diagnosing EIPH. Emerging evidence suggests that exercise testing following a standardized protocol of stress echocardiography or right heart catheterization of patients may allow for the classification of EIPH as a mean pulmonary artery pressure/cardiac output slope > 3 mmHg/L/min, and/or mean pulmonary artery pressure > 30 mmHg with a pulmonary vascular resistance > 3 Wood Units.\u0000Conclusion Providing evidence for a consensus definition of EIPH, along with a validated, standardized testing procedure, will hopefully foster the progression of research on EIPH and further the development of treatments and improve patient outcomes for people with pulmonary hypertension.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45675327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James Lee, Ahmed A. Aoude, Becher Alhalabi, Ayden Watt, L. Lessard
Background: Operating room efficiency is invaluable. Particularly in public health systems, where resources are limited and patient loads are high, efficient systems underpin the continued delivery of high quality care. In addition to impacting patients, the implementation of efficient healthcare tools has the potential to improve staff quality of life. In the face of growing surgical resident attrition and healthcare worker burnout, developments in standard practice, such as the implementation of the 80-hour work week, are necessary to improve quality of life. Materials and methods: A new online scheduling software (ORNET.CA) was created, installed, and piloted in a Level I Trauma Center after instructing users (physicians and nurses) on its use. A 20-item survey was then distributed to all users to assess the effect implementation of the software had on their quality of life. Results: ORnet was shown to improve communication between hospital staff and physicians, reduce workflow interruptions, and improve the quality of the working environment. The survey showed that 60% of residents and 50% of attending staff believed that ORNET.CA improved their quality of life. Conclusions: We present data from a novel emergency operating room scheduling system that allowed surgical residents and attending physicians to better plan their on-call shifts. Staff (resident and physician) reported survey results suggest that implementation of this system resulted in an improved quality of life and a decrease in stress and anxiety levels.
{"title":"Can an Emergency Surgery Scheduling Software Improve Residents’ Time Management and Quality of Life?","authors":"James Lee, Ahmed A. Aoude, Becher Alhalabi, Ayden Watt, L. Lessard","doi":"10.26443/mjm.v20i1.893","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.893","url":null,"abstract":"Background: Operating room efficiency is invaluable. Particularly in public health systems, where resources are limited and patient loads are high, efficient systems underpin the continued delivery of high quality care. In addition to impacting patients, the implementation of efficient healthcare tools has the potential to improve staff quality of life. In the face of growing surgical resident attrition and healthcare worker burnout, developments in standard practice, such as the implementation of the 80-hour work week, are necessary to improve quality of life.\u0000Materials and methods: A new online scheduling software (ORNET.CA) was created, installed, and piloted in a Level I Trauma Center after instructing users (physicians and nurses) on its use. A 20-item survey was then distributed to all users to assess the effect implementation of the software had on their quality of life.\u0000Results: ORnet was shown to improve communication between hospital staff and physicians, reduce workflow interruptions, and improve the quality of the working environment. The survey showed that 60% of residents and 50% of attending staff believed that ORNET.CA improved their quality of life.\u0000Conclusions: We present data from a novel emergency operating room scheduling system that allowed surgical residents and attending physicians to better plan their on-call shifts. Staff (resident and physician) reported survey results suggest that implementation of this system resulted in an improved quality of life and a decrease in stress and anxiety levels.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42342600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The emergence of the global COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus, SARS-CoV-2, has created a substantial burden on healthcare systems worldwide. The systemic impacts of COVID-19 infection are severe and broad in their implications, and the cardiovascular system is no exception. Discussion: Patients with a history of cardiovascular disease are at an increased risk for hospitalization and mortality, and COVID-19 infection has now been demonstrated to initiate acute, but serious, episodes of cardiovascular events such as stroke. Considering the rapid spread of COVID-19 across the globe and the inability of healthcare systems to address and adequately respond to the pandemic, therein lies an increased need for understanding the interplay between COVID-19 infection and cardiovascular disease. SARS-CoV-2 relies on binding the angiotensin-converting enzyme-2 (ACE2) receptor to infect host cells, with ACE2 representing a critical regulator of blood pressure homeostasis and proper cardiovascular functioning. Conclusion: Identifying the exact role of ACE2 in COVID-19 infection will have major implications for understanding the disease; therefore, here we have reviewed ACE2’s involvement in the pathogenesis of COVID-19 infection and the resulting end-organ damage. In addition, we have summarized how COVID-19 affects cardiovascular physiology, and how COVID-19 infection can manifest in acute cardiovascular events. Finally, we examine why patients with cardiovascular disease are at an increased risk of succumbing to COVID-19 and what the long-term cardiovascular implications of COVID-19 infection could mean. Relevance: This paper discusses the cardiovascular consequences of the global COVID-19 pandemic.
{"title":"The Interplay Between COVID-19 and Cardiovascular Disease","authors":"Brandon Shokoples, N. Ferreira, Kevin Comeau","doi":"10.26443/mjm.v20i1.880","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.880","url":null,"abstract":"Introduction: The emergence of the global COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus, SARS-CoV-2, has created a substantial burden on healthcare systems worldwide. The systemic impacts of COVID-19 infection are severe and broad in their implications, and the cardiovascular system is no exception. Discussion: Patients with a history of cardiovascular disease are at an increased risk for hospitalization and mortality, and COVID-19 infection has now been demonstrated to initiate acute, but serious, episodes of cardiovascular events such as stroke. Considering the rapid spread of COVID-19 across the globe and the inability of healthcare systems to address and adequately respond to the pandemic, therein lies an increased need for understanding the interplay between COVID-19 infection and cardiovascular disease. SARS-CoV-2 relies on binding the angiotensin-converting enzyme-2 (ACE2) receptor to infect host cells, with ACE2 representing a critical regulator of blood pressure homeostasis and proper cardiovascular functioning. Conclusion: Identifying the exact role of ACE2 in COVID-19 infection will have major implications for understanding the disease; therefore, here we have reviewed ACE2’s involvement in the pathogenesis of COVID-19 infection and the resulting end-organ damage. In addition, we have summarized how COVID-19 affects cardiovascular physiology, and how COVID-19 infection can manifest in acute cardiovascular events. Finally, we examine why patients with cardiovascular disease are at an increased risk of succumbing to COVID-19 and what the long-term cardiovascular implications of COVID-19 infection could mean. Relevance: This paper discusses the cardiovascular consequences of the global COVID-19 pandemic.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48245539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delirium is a common and serious geriatric syndrome with core features of acute onset and inattention. It is often underdiagnosed and is associated with many adverse outcomes, such as prolonged hospitalization, institutionalization, functional impairment and death. This review summarizes an approach to the recognition, work-up, management and prevention of delirium.
{"title":"Approach To: Delirium","authors":"Alfiya Mukharyamova","doi":"10.26443/mjm.v20i1.813","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.813","url":null,"abstract":"Delirium is a common and serious geriatric syndrome with core features of acute onset and inattention. It is often underdiagnosed and is associated with many adverse outcomes, such as prolonged hospitalization, institutionalization, functional impairment and death. This review summarizes an approach to the recognition, work-up, management and prevention of delirium.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43453458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Cytomegalovirus (CMV) is a linear, dsDNA virus that is regarded as the prototype of the Betaherpesvirinae subfamily of viruses. It has an established endemic status in certain locations around the globe, and is also reported to be the most prevalently occurring congenital infection in humans. Furthermore, Cytomegalovirus is notorious for being a persistent lifelong pathogen that poses a threat of reactivation as well. Discussion: Congenital cytomegalovirus infection causes numerous ophthalmologic, and neurologic sequelae, and is also known for being the principal reason behind sensorineural hearing loss of non-genetic etiology in neonates. These symptoms, if present, may give rise to a premonition of congenital Cytomegalovirus disease, and so, a diagnosis can be established through serology, radiology, and PCR of salivary, urinary, or dried blood spot samples. Timely administration of ganciclovir or valganciclovir has proven to be effective in managing symptomatic cases of congenital CMV. Conclusion: A well-timed delivery of pharmacological and non-pharmacological interventions is necessary to achieve healthy developmental outcomes for the neonate. Moreover, there is still a need to study the role of antiviral therapy in silent cases since asymptomatic patients are at a risk of developing long-term clinical sequelae as well. Relevance: An estimated 60-90% of women of child-bearing age get infected with Cytomegalovirus, and Congenital CMV disease is reported in 0.2-2.4% of all live births. Therefore, in order to develop effective screening and management protocols, it is vital to educate healthcare professionals regarding the various aspects of this congenital infection.
{"title":"Congenital Cytomegalovirus Infection: Transmission, Diagnosis and Treatment.","authors":"M. R. Manan, H. Manan","doi":"10.26443/mjm.v20i1.876","DOIUrl":"https://doi.org/10.26443/mjm.v20i1.876","url":null,"abstract":"Introduction: Cytomegalovirus (CMV) is a linear, dsDNA virus that is regarded as the prototype of the Betaherpesvirinae subfamily of viruses. It has an established endemic status in certain locations around the globe, and is also reported to be the most prevalently occurring congenital infection in humans. Furthermore, Cytomegalovirus is notorious for being a persistent lifelong pathogen that poses a threat of reactivation as well.\u0000Discussion: Congenital cytomegalovirus infection causes numerous ophthalmologic, and neurologic sequelae, and is also known for being the principal reason behind sensorineural hearing loss of non-genetic etiology in neonates. These symptoms, if present, may give rise to a premonition of congenital Cytomegalovirus disease, and so, a diagnosis can be established through serology, radiology, and PCR of salivary, urinary, or dried blood spot samples. Timely administration of ganciclovir or valganciclovir has proven to be effective in managing symptomatic cases of congenital CMV.\u0000Conclusion: A well-timed delivery of pharmacological and non-pharmacological interventions is necessary to achieve healthy developmental outcomes for the neonate. Moreover, there is still a need to study the role of antiviral therapy in silent cases since asymptomatic patients are at a risk of developing long-term clinical sequelae as well.\u0000Relevance: An estimated 60-90% of women of child-bearing age get infected with Cytomegalovirus, and Congenital CMV disease is reported in 0.2-2.4% of all live births. Therefore, in order to develop effective screening and management protocols, it is vital to educate healthcare professionals regarding the various aspects of this congenital infection.","PeriodicalId":18292,"journal":{"name":"McGill Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47355595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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