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guide

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A mechanical aid or device that assists in setting a course or directing the motion either of one's hand or of an instrument one holds.

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guideline

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An instructional guide or reference to indicate a course of action in a specified situation, e.g., critical care guideline.

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guidewire, guide wire

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(gīd′wī″ĕr) A device used to enter tight spaces, e.g., obstructed valves or channels, within the body, or to assist in inserting, positioning, and moving a catheter. Guidewires vary in size, length, stiffness, composition, and shape of the tip. SEE: illus.

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GUIDEWIRE

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guiding

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In osteopathic medicine the movement of a body part gently along its normal axis through its normal range of motion.

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guile

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The use of deception, cunning, or trickery in order to accomplish something.

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Guillain-Barré syndrome

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(gē-yan′bar-ā′) [Georges Guillain, Fr. neurologist, 1876–1961; J.A. Barré, Fr. neurologist, 1880–1967] ABBR: GBS. A rare autoimmune illness characterized by progressive, potentially fatal ascending paralysis, with loss of motor reflexes, ataxia, and paresthesias. There are three types: acute inflammatory demyelinating polyradiculoneuropathy (90% of cases), acute motor axonal neuropathy (AMAN), or motor and sensory axonal neuropathy (AMSAN). SYN: acute inflammatory demyelinating polyneuropathy.

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INCIDENCE: GBS affects about 1 or 2 people per 100,000 population

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CAUSES: Destruction of myelin in peripheral nerves is the proximate cause. The disease typically occurs a few weeks after an upper respiratory infection, a bout of gastroenteritis, or in some instances, a vaccine. AMAN and AMSAN are more likely to occur after gastrointestinal infection with Campylobacter jejuni and may result from antibodies against gangliosides (anti-GM 1 antibodies). Other infections that sometimes precede GBS are cytomegalovirus, Epstein-Barr virus, Zika virus, or Mycoplasma pneumoniae infection. Some cases have occurred after other traumatic events, including snake bite, cardiac surgery, or antiviral therapy for hepatitis C virus infection.

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DIAGNOSIS: Any patient with a bilateral, ascending paralysis should be considered as having GBS; other illnesses (such as tick-borne paralysis) may mimic the disease.

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TREATMENT: Plasma exchange and/or intravenous immunoglobulin infusions help manage GBS.

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IMPACT ON HEALTH: Recovery is spontaneous and complete in the vast majority of patients in several weeks or months, but it may take as long as several years. However, nearly a fifth of all patients have difficulty walking without assistance 6 months after infection.

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PATIENT CARE: The patient is carefully assessed for evidence of impending respiratory failure, through the use of bedside spirometry. If the inspiratory force, vital capacity, or arterial blood gases deteriorate respiratory support is provided. Testing for thoracic sensation and monitoring and marking ...

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