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https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#1
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27901257/brazilian-portuguese-translation-cross-cultural-adaptation-and-validation-of-the-myasthenia-gravis-composite-scale-a-multicentric-study
#2
Ezequiel Fernandes Oliveira, Valéria Cavalcante Lima, Eduardo Araujo Perez, Melissa Nunes Polaro, Berenice Cataldo Oliveira Valério, João R Pereiro, Sergio Roberto Nacif, Claudia Santos Oliveira, Acary Souza Bulle Oliveira, Luis Vicente Franco Oliveira
Objective: To perform the translation, cultural adaptation and validation of the Myasthenia Gravis Composite (MGC) scale in Brazil. Methods: The study was conducted at three neuromuscular disease research centers in accordance with the international ethical standards, following a multi-modal approach and was conducted in three steps consisting of translation, cultural adaptation, and validation according to international guidelines. The final version of the MGC was applied in a sample of 27 MG patients and the total score was compared to a Portuguese version of the MG-QOL-15...
November 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27900773/systematic-review-of-immunoglobulin-use-in-paediatric-neurological-and-neurodevelopmental-disorders
#3
REVIEW
Jonathan Gadian, Emma Kirk, Kate Holliday, Ming Lim, Michael Absoud
AIM: A systematic literature review of intravenous immunoglobulin (IVIG) treatment of paediatric neurological conditions was performed to summarize the evidence, provide recommendations, and suggest future research. METHOD: A MEDLINE search for articles reporting on IVIG treatment of paediatric neuroinflammatory, neurodevelopmental, and neurodegenerative conditions published before September 2015, excluding single case reports and those not in English. Owing to heterogeneous outcome measures, meta-analysis was not possible...
November 30, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27900731/the-validity-and-reliability-of-the-korean-version-of-the-stigma-scale-for-chronic-illness-8-items-ssci-8-in-patients-with-neurological-disorders
#4
Sung-Hee Yoo, Sung Reul Kim, Hyang Sook So, Hyang-In Cho Chung, Duck Hee Chae, Myeong-Kyu Kim, Byeong C Kim, Man-Seok Park, Seung-Han Lee, Tai-Seung Nam, Helena Correia, David Cella
PURPOSE: The aim of this study was to develop a Korean version of the Stigma Scale for Chronic Illness 8-items (SSCI-8) and then assess its reliability and construct validity among patients with neurological conditions. METHOD: Patients diagnosed with stroke, Parkinson's disease, epilepsy, multiple sclerosis, myasthenia gravis, and amyotrophic lateral sclerosis were recruited. Reliability was assessed for internal consistency with Cronbach's alpha coefficient. Exploratory factor analysis (EFA) was used to extract potential factors of Korean SSCI-8...
November 29, 2016: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/27896329/myasthenia-gravis-with-acute-respiratory-failure-in-the-emergency-department
#5
Hasan Huseyin Kozak, Ali Ulvi Uca, Turgut Teke, Mustafa Altas, Emine Karatas
Acute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto-immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27893014/durability-of-the-rituximab-response-in-acetylcholine-receptor-autoantibody-positive-myasthenia-gravis
#6
Kimberly R Robeson, Aditya Kumar, Benison Keung, Daniel B DiCapua, Emily Grodinsky, Huned S Patwa, Panos A Stathopoulos, Jonathan M Goldstein, Kevin C O'Connor, Richard J Nowak
Importance: Myasthenia gravis (MG), an autoimmune disorder of neuromuscular transmission, is treated by an array of immunotherapeutics, many of which are nonspecific. Even with current therapies, a subset of patients has medically refractory MG. The benefits of B-cell-targeted therapy with rituximab have been observed in MG; however, the duration of these benefits after treatment is unclear. Objective: To evaluate the durability of response to rituximab in the treatment of acetylcholine receptor autoantibody-positive (AChR+) generalized MG...
November 21, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27892981/rituximab-in-treatment-refractory-myasthenia-gravis
#7
Nicholas J Silvestri, Gil I Wolfe
No abstract text is available yet for this article.
November 21, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27891095/differential-rna-expression-profile-of-skeletal-muscle-induced-by-experimental-autoimmune-myasthenia-gravis-in-rats
#8
Henry J Kaminski, Keiichi Himuro, Jumana Alshaikh, Bendi Gong, Georgiana Cheng, Linda L Kusner
The differential susceptibility of skeletal muscle by myasthenia gravis (MG) is not well understood. We utilized RNA expression profiling of extraocular muscle (EOM), diaphragm (DIA), and extensor digitorum (EDL) of rats with experimental autoimmune MG (EAMG) to evaluate the hypothesis that muscles respond differentially to injury produced by EAMG. EAMG was induced in female Lewis rats by immunization with acetylcholine receptor purified from the electric organ of the Torpedo. Six weeks later after rats had developed weakness and serum antibodies directed against the AChR, animals underwent euthanasia and RNA profiling performed on DIA, EDL, and EOM...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27890878/prevalence-of-electrocardiographic-abnormalities-in-patients-with-myasthenia-gravis
#9
Jun Tsugawa, Masahiro Ogawa, Shinji Ouma, Jiro Fukae, Yoshio Tsuboi
OBJECTIVE: Myasthenia gravis (MG) is an immunological disorder of the neuromuscular junction, characterized by easy fatigability and weakness of the skeletal muscles. However, it has sometimes been reported that heart diseases including cardiomyopathies leading to sudden death have been observed in patients with MG. We studied the prevalence of electrocardiographic (ECG) abnormalities and heart disease in patients newly diagnosed with MG who had not received immunotherapy. METHODS: Fifty-three patients with MG were enrolled in our study...
November 25, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27888814/diaphragmatic-dysfunction-after-thoracic-operations
#10
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
November 26, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27887977/direct-and-indirect-cost-of-myasthenia-gravis-a-prospective-study-from-a-tertiary-care-teaching-hospital-in-india
#11
Kamlesh Kumar Sonkar, Sanjeev Kumar Bhoi, Deepanshu Dubey, Jayantee Kalita, Usha Kant Misra
Myasthenia gravis (MG) requires lifelong treatment. The cost of management MG is very high in developed countries but there is no information on the cost of management of MG in the developing countries. This study reports the direct and indirect cost and predictors of cost of MG in a tertiary care teaching hospital in India. In a prospective hospital based study, from a tertiary hospital in India 66 consecutive patient during 2014-2015 were included. The age of the patients ranged between 6 and 75years. The severity of MG was assessed by myasthenia gravis foundation association (MGFA) class (MGFA) I-V...
November 23, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27886889/update-on-ocular-myasthenia-gravis
#12
REVIEW
Stacy V Smith, Andrew G Lee
Ocular myasthenia gravis (OMG) is a localized form of myasthenia gravis in which autoantibodies directed against acetylcholine receptors block or destroy these receptors at the postsynaptic neuromuscular junction. The hallmark of OMG is a history of painless weakness or fatigability of the extraocular muscles and ptosis with normal pupillary function and visual acuity. Clinical, laboratory, electrophysiologic, and pharmacologic tests are available for diagnosis. Treatment can begin with symptom management; there is no cure...
February 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/27878274/regulatory-t-cells-exhibit-neuroprotective-effect-in-a-mouse-model-of-traumatic-brain-injury
#13
Yunhu Yu, Fang Cao, Qishan Ran, Xiaochuan Sun
Traumatic brain injury (TBI) is a major health and socioeconomic problem as it is associated with high rates of mortality and morbidity worldwide. Regulatory T cells (Tregs) have been reported to reduce inflammatory response in several diseases, including myasthenia gravis, viral myocarditis and cerebral infarction. The present study investigated the role of Tregs in mediating neuro‑protective effects in a mouse model of TBI. Initially, Treg levels were determined, and compared between the controlled cortical impact (CCI) model for moderate TBI and the sham group, by using flow cytometry and ELISA...
November 18, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27876071/bilateral-single-port-thoracoscopic-extended-thymectomy-for-management-of-thymoma-and-myasthenia-gravis-case-report
#14
Francesco Paolo Caronia, Alfonso Fiorelli, Ettore Arrigo, Sebastiano Trovato, Mario Santini, Attilio Ignazio Lo Monte
BACKGROUND: Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. CASE PRESENTATION: A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3...
November 22, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27873026/long-term-efficacy-and-side-effects-of-low-dose-tacrolimus-for-the-treatment-of-myasthenia-gravis
#15
Xiaoyong Tao, Wei Wang, Feng Jing, Zhongkui Wang, Yuping Chen, Dongning Wei, Xusheng Huang
The study evaluated the efficacy of low-dose tacrolimus for treating Myasthenia Gravis (MG). Data were collected from 97 patients treated with low-dose tacrolimus from February 2011 to April 2015. Metabolic analysis was performed to determine more accurate tacrolimus dosing and patients were followed-up within clinic every 6 months for up to 4 years. The myasthenia gravis-specific activities of daily living scale was used to assess MG symptoms and their effects on patients' daily activities. All side effects and adverse reactions were thoroughly documented...
November 21, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27867646/commentary-on-randomized-trial-of-thymectomy-in-myasthenia-gravis
#16
COMMENT
Alexandar Tzankov
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867633/a-crucial-first-randomized-controlled-trial-of-thymectomy-in-non-thymomatous-myasthenia-gravis
#17
COMMENT
Pierre R Bourque, Jodi Warman Chardon
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27864473/a-recommendation-for-timing-of-repeat-chlamydia-trachomatis-test-following-infection-and-treatment-in-pregnant-and-nonpregnant-women
#18
Gweneth B Lazenby, Jeffrey E Korte, Sarah Tillman, Florence K Brown, David E Soper
The objective of this study was to describe the time required to obtain a negative chlamydia test in pregnant and nonpregnant women following treatment to inform test-of-cure collection and recommend an abstinence period to avoid reinfection. Seventy-two women with Chlamydia trachomatis infection, 36 pregnant and 36 nonpregnant, were enrolled in a prospective cohort study. Women were excluded less than 18 years of age, if they had been treated for chlamydia, reported an allergy to macrolide antibiotics, or if they had Myasthenia Gravis...
November 18, 2016: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/27863874/successful-autologous-haematopoietic-stem-cell-transplantation-for-refractory-myasthenia-gravis-a-case-report
#19
Irene Håkansson, Anna Sandstedt, Fredrik Lundin, Håkan Askmark, Ritva Pirskanen, Kristina Carlson, Fredrik Piehl, Hans Hägglund
Myasthenia gravis (MG) is an autoimmune disease, with immune reactivity against the post-synaptic endplate of the neuromuscular junction. Apart from symptomatic treatment with choline esterase blockers, many patients also require immunomodulatory treatment. Despite existing treatment options, some patients are treatment refractory. We describe a patient with severe MG refractory to corticosteroids, four oral immunosuppressants, cyclophosphamide, rituximab and bortezomib who was treated with autologous haematopoietic stem cell transplantation...
September 28, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27863830/caveolin-3-is-aberrantly-expressed-in-skeletal-muscle-cells-in-myasthenia-gravis
#20
Kazuo Iwasa, Yutaka Furukawa, Hiroaki Yoshikawa, Masahito Yamada
Caveolin-3 is a muscle-specific membrane protein that localizes to the sarcolemma and T-tubule system. Caveolin-3 is needed for muscle repair and skeletal muscle development. The objective of this study was to compare caveolin-3 expression in myasthenia gravis (MG) and control muscles. Caveolin-3 was abnormally expressed in the MG muscle membrane, with partial loss of expression and overexpression in 5/15 and 10/15 patients, respectively. Caveolin-3 mRNA and protein levels were higher in MG than in control muscles, suggesting that partial deficiency of caveolin-3 is occasionally detected in MG muscle and that caveolin-3 overexpression may be required after MG muscle damage...
November 9, 2016: Journal of Neuroimmunology
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