The Global Deterioration Scale (GDS) provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as Alzheimer’s disease. It is broken down into 7 different stages. Stages 1-3 are the pre-dementia stages. Stages 4-7 are the dementia stages. Biginning in stage 5, an individual can no longer survive without assistance. Within the GDS, each stage is numbered (1-7), given a short title (i.e., Forgetfulness, Early Confusional, etc. followed by a brief listing of the characteristics for that stage. Caregivers can get a rough idea of where an individual is at in the disease process by observing that individual’s behavioral characteristics and comparing them to the GDS. For more specific assessments, use Brief Cognitive Rating Scale (BCRS) and the Functional Assessment Staging (FAST) measures.
Continue reading “The Global Deterioration Scale for Primary Degenerative Dementia”
The esophageal motility disorders are categorized as secondary and primary disorders. The pathogenesis of secondary motility disorders is associated with systemic diseases.
Continue reading “Characteristics of Esophageal Motility Disorders”
Raynaud’s phenomenon (RP), is a disorder of the microvasculature that generally affects the fingers and toes but can present on other extremities such as the nose, ears and nipples. Continue reading “Diagnostic Criteria for Primary Raynaud’s Phenomenon (RP)”
Primary hypoparathyroidism is a condition characterized by hypocalcemia and hyperphosphatemia resulting from the primary absence or deficiency of parathyroid hormone (PTH) or from the secretion of biologically inactive PTH. Continue reading “Diagnosis of Primary Hypoparathyroidism”
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm (MPN) characterized by stem cell-derived clonal myeloproliferation that is often but not always accompanied by JAK2, CALR or MPL mutation, abnormal cytokine expression, bone marrow fibrosis, anemia, splenomegaly, extramedullary hematopoiesis (EMH), constitutional symptoms, cachexia, leukemic progression and shortened survival. Continue reading “Diagnostic Criteria for Primary Myelofibrosis (PMF)”
A diagnosis of primary Sjögren’s syndrome is often made on the basis of a classic triad of symptoms: dryness of the mouth and eyes, fatigue, and pain. Systemic complications, which are present in 30 to 40% of patients, may provide the first clues to the disease.
Continue reading “2017 ACR–EULAR Classification Criteria for Primary Sjögren’s Syndrome”
The American Academy of Sleep Medicine defines insomnia as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.
Continue reading “DSM-V Diagnostic Criteria for Insomnia”
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown cause that is characterized pathologically by an inflammatory and fibrotic process centered on the epithelium, leading to diffuse biliary stenosis and increased wall thickness throughout the intra- and extra-hepatic biliary trees.
Continue reading “Diagnostic Criteria of Primary Sclerosing Cholangitis (PSC)”
The autosomal recessive inherited primary hyperoxalurias types I, II and III are caused by defects in glyoxylate metabolism that lead to the endogenous overproduction of oxalate.
Continue reading “Features and Treatment of the Inherited Primary Hyperoxalurias”
The finding of hypercalcemia on routine biochemical testing or in the evaluation of postmenopausal women with osteoporosis is typically the initial clue to the diagnosis of primary hyperparathyroidism. The total serum calcium level, which combines both the free and albumin-bound components of circulating calcium, should be adjusted for the level of albumin. Measurement of ionized calcium may be useful in selected cases, such as in patients with hyperalbuminemia, thrombocytosis, Waldenström’s macroglobulinemia, and myeloma; these patients may have elevated levels of total serum calcium, but normal levels of ionized serum calcium (artifactual hypercalcemia).
Continue reading “Guidelines for the Treatment of Asymptomatic Primary Hyperparathyroidism”