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Type 1 chiari

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https://www.readbyqxmd.com/read/28437811/symptomatic-outcome-after-bone-only-suboccipital-decompression-in-adult-patients-with-chiari-type-i-malformations-in-the-absence-of-hydromyelia-or-hydrocephalus
#1
Nicolas Olmo Koechlin, Hazem J Abuhusain, Manuri Gunawardena, Tyler S Auschwitz, Charles Teo
Background Type I Chiari malformation presents without an associated hydromyelia in 30 to 70% of cases, yet there is no agreement regarding the optimal surgical treatment for these patients. We review our experience for treating symptomatic adult type I Chiari malformation without hydromyelia using a suboccipital bone decompression of the hindbrain and no duraplasty in 12 adult patients. Outcome was measured according to the Chicago Chiari Outcome Scale (CCOS). Results Nine of 12 patients were female; average age at surgery was 34...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28435116/chiari-malformation-type-1-a-systematic-review-of-natural-history-and-conservative-management
#2
REVIEW
Benjamin Langridge, Edward Phillips, David Choi
OBJECTIVE: Chiari type 1 malformations (CM-1) are variations of hind-brain development which can sometimes occur in asymptomatic individuals. Conventional treatment is surgical decompression, but little is known about the natural history of patients who do not undergo surgical management. Appreciation of this information is critical to determine how these patients should be managed. We conducted a systematic review of the literature to determine the natural history of CM-1 particularly in patients who did not undergo surgery, and in asymptomatic individuals, to help inform patients and doctors when surgery is likely to be beneficial...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427119/-genetic-analysis-of-posterior-cranial-fossa-morphology-in-families-of-chiari-malformation-type-%C3%A2
#3
X X Yuan, Y Li, S F Sha, W X Sun, Y Qiu, Z Liu, W G Zhu, Z Z Zhu
Objective: To explore genetic characteristic of posterior cranial fossa morphology in families of Chiari malformation type Ⅰ (CMI). Methods: From April 2010 to May 2016, a total of 47 cases of CMI families (CMI group) and their 94 parents (CMI-P group)collected were retrospectively reviewed in Department of Spinal Surgery, Drum Tower Hospital, School of Medicine, Nanjing University.Another cohort of 50 asymptomatic adults was enrolled to serve as the control group.Patients with skull fracture or other diseases which can lead to secondary CMI were excluded...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28416844/clinical-characteristics-of-neurogenic-dysphagia-in-adult-patients-with-chiari-malformation-type-i
#4
T Yu, J Li, K Wang, Y Ge, A C Jiang, L P Duan, Z Y Wang
OBJECTIVE: To investigate changes of swallowing function and associated symptoms in Chiari malformation typeI (CMI) patients with and without dysphagia by the analysis of their clinical and high-resolution manometry (HRM) parameters. METHODS: A total of 42 patients diagnosed with symptomatic CMI without atlantoaxial dislocations which were confirmed by clinical manifestations and magnetic resonance imaging (MRI) findings between January 2010 and July 2015 at Peking University Third Hospital were included in this study...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28409726/the-suboccipital-ligament
#5
Kelsey Alabaster, M Fred Bugg, Bruno Splavski, Frederick A Boop, Kenan I Arnautovic
OBJECTIVE A fibrous structure located dorsal to the dura at the posterior craniocervical junction stretches horizontally between the bilateral occipital condyles and the upper borders of the C-1 laminae. Partially covered by the occipital bone, this structure is always encountered when the bone is removed from the foramen magnum rim during approaches to the posterior cranial fossa. Although known to surgeons, this structure has not been defined, studied, or named. The most appropriate name for this structure is "the suboccipital ligament," and a detailed rationale for this name is provided...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28384788/neurologic-evaluation-in-children-with-laryngeal-cleft
#6
Ryan D Walker, Alexandria L Irace, Margaret A Kenna, David K Urion, Reza Rahbar
Importance: Referral to a neurologist and imaging play important roles in the management of laryngeal cleft. Swallowing involves a complex series of neuromuscular interactions, and aspiration can result from anatomical causes (eg, laryngeal cleft), neuromuscular disorders, or some combination thereof. To date, no protocols or guidelines exist to identify which patients with laryngeal cleft should undergo neuroimaging studies and/or consultation with a neurologist. Objective: To establish guidelines for neurologic evaluation and imaging techniques to identify or rule out neuromuscular dysfunction in children with laryngeal cleft...
April 6, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28384597/no-significant-difference-between-chiari-malformation-type-1-5-and-type-i
#7
Wei Liu, Hongxing Wu, Yalikun Aikebaier, Maoliti Wulabieke, Rexiti Paerhati, Xiaopeng Yang
OBJECTIVE: Chiari malformation Type 1.5 (CM 1.5) was defined as the association of Chiari malformation Type I (CM I) and brainstem herniation. The objective was to demonstrate the difference of clinical features and surgical outcomes between CM 1.5 and CM I. PATIENTS AND METHODS: All CM 1.5 and CM I adult patients who underwent posterior fossa decompression with duraplasty at our institution between 2006 and 2010 were retrospectively reviewed. Clinical characteristics, imaging features, and long-term outcomes were compared between CM 1...
March 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28382434/evaluation-of-the-central-sleep-apnea-in-asymptomatic-children-with-chiari-1-malformation-an-open-question
#8
Marco Zaffanello, Francesco Sala, Luca Sacchetto, Emma Gasperi, Giorgio Piacentini
INTRODUCTION: Type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to intermittent brain hypertension. In symptomatic children, central sleep apneas are shown in polysomnography evaluation. A central apnea index of 1/h or more is considered abnormal, but >5/h is clearly considered pathological. Therefore, central sleep apnea evaluation in pediatric age may show great age-related variability...
April 5, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28368217/long-acting-insulin-allergy-in-a-diabetic-child
#9
Carla Mastrorilli, Laura Rizzuti, Antonina Marta Cangelosi, Brunella Iovane, Giovanni Chiari, Carlo Caffarelli
Insulin allergy has been uncommon since the introduction of human recombinant insulin preparations; the prevalence is 2.4%. Insulin injection could elicit immediate reactions, which are usually induced by an IgE-mediated mechanism, within the first hour after drug administration. In the present study, we describe the case of a child who experienced immediate urticaria after long-acting insulin injection. A 9-year-old girl affected by type I diabetes mellitus referred a history of three episodes of urticaria 30 min after insulin subcutaneous injection...
April 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/28357166/spontaneous-intracranial-hypotension-presenting-as-a-pseudo-chiari-1
#10
Ali S Haider, Suraj Sulhan, Ian T Watson, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Spontaneous intracranial hypotension (SIH) is classified as a decrease in cerebrospinal fluid (CSF) pressure secondary to a CSF leakage and consequent descent of the brain into the foramen magnum. Diagnosing SIH can be difficult due to its overlapping findings with Arnold-Chiari type 1 Malformation (CM1) where the cerebellar tonsils herniate into the foramen magnum. The similarity of both conditions calls for a more reliable imaging technique to localize the CSF leak which could narrow the differential diagnosis and aid in choosing the correct treatment...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28291422/comparison-of-posterior-fossa-volumes-and-clinical-outcomes-after-decompression-of-chiari-malformation-type-i
#11
Siri Sahib S Khalsa, Alan Siu, Tiffani A DeFreitas, Justin M Cappuzzo, John S Myseros, Suresh N Magge, Chima O Oluigbo, Robert F Keating
OBJECTIVE Previous studies have indicated an association of Chiari malformation Type I (CM-I) and a small posterior fossa. Most of these studies have been limited by 2D quantitative methods, and more recent studies utilizing 3D methodologies are time-intensive with manual segmentation. The authors sought to develop a more automated tool to calculate the 3D posterior fossa volume, and correlate its changes after decompression with surgical outcomes. METHODS A semiautomated segmentation program was developed, and used to compare the pre- and postoperative volumes of the posterior cranial fossa (PCF) and the CSF spaces (cisterna magna, prepontine cistern, and fourth ventricle) in a cohort of pediatric patients with CM-I...
February 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28291403/a-rat-model-of-chronic-syringomyelia-induced-by-epidural-compression-of-the-lumbar-spinal-cord
#12
Ji Yeoun Lee, Shin Won Kim, Saet Pyoul Kim, Hyeonjin Kim, Jung-Eun Cheon, Seung-Ki Kim, Sun Ha Paek, Dachling Pang, Kyu-Chang Wang
OBJECTIVE There has been no established animal model of syringomyelia associated with lumbosacral spinal lipoma. The research on the pathophysiology of syringomyelia has been focused on Chiari malformation, trauma, and inflammation. To understand the pathophysiology of syringomyelia associated with occult spinal dysraphism, a novel animal model of syringomyelia induced by chronic mechanical compression of the lumbar spinal cord was created. METHODS The model was made by epidural injection of highly concentrated paste-like kaolin solution through windows created by partial laminectomy of L-1 and L-5 vertebrae...
February 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#13
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28171875/applicability-of-cone-beam-computed-tomography-to-the-assessment-of-the-vocal-tract-before-and-after-vocal-exercises-in-normal-subjects
#14
Elisângela Zacanti Garcia, Hélio Kiitiro Yamashita, Davi Sousa Garcia, Marina Martins Pereira Padovani, Renata Rangel Azevedo, Brasília Maria Chiari
BACKGROUND/AIMS: Cone beam computed tomography (CBCT), which represents an alternative to traditional computed tomography and magnetic resonance imaging, may be a useful instrument to study vocal tract physiology related to vocal exercises. This study aims to evaluate the applicability of CBCT to the assessment of variations in the vocal tract of healthy individuals before and after vocal exercises. METHODS: Voice recordings and CBCT images before and after vocal exercises performed by 3 speech-language pathologists without vocal complaints were collected and compared...
2016: Folia Phoniatrica et Logopaedica
https://www.readbyqxmd.com/read/28156254/population-based-description-of-familial-clustering-of-chiari-malformation-type-i
#15
Diana Abbott, Douglas Brockmeyer, Deborah W Neklason, Craig Teerlink, Lisa A Cannon-Albright
OBJECTIVE A population-based genealogical resource with linked medical data was used to define the observed familial clustering of Chiari malformation Type I (CM-I). METHODS All patients with CM-I were identified from the 2 largest health care providers in Utah; those patients with linked genealogical data were used to test hypotheses regarding familial clustering. Relative risks (RRs) in first-, second-, and third-degree relatives were estimated using internal cohort-specific CM-I rates; the Genealogical Index of Familiality (GIF) test was used to test for an excess of relationships between all patients with CM-I compared with the expected distribution of relationships for matched control sets randomly selected from the resource...
February 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28052881/headache-outcomes-in-children-undergoing-foramen-magnum-decompression-for-chiari-i-malformation
#16
Saba Raza-Knight, Kshitij Mankad, Prab Prabhakar, Dominic Thompson
OBJECTIVE: A common symptom of Chiari I malformation (CIM) is headache, which is diagnosed using non-validated criteria from the International Headache Society (IHS). CIM-associated headaches should resolve following neurosurgical treatment of the malformation by foramen magnum decompression (FMD). We aimed to validate the IHS criteria and determine (1) the efficacy of FMD in treating headache and (2) whether duraplasty confers an advantage over simple bony decompression in the treatment of this symptom...
March 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27991500/high-frequency-of-diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-in-italian-children-a-nationwide-longitudinal-study-2004-2013
#17
Valentino Cherubini, Edlira Skrami, Lucia Ferrito, Stefano Zucchini, Andrea Scaramuzza, Riccardo Bonfanti, Pietro Buono, Francesca Cardella, Vittoria Cauvin, Giovanni Chiari, Giuseppe D Annunzio, Anna Paola Frongia, Dario Iafusco, Ippolita Patrizia Patera, Sonia Toni, Stefano Tumini, Ivana Rabbone, Fortunato Lombardo, Flavia Carle, Rosaria Gesuita
This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004-2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH < 7.30) and severe (pH < 7.1). Two multiple logistic regression models were used to evaluate the time trend of DKA frequency considered as present versus absent and severe versus absent, adjusted for gender, age group and geographical area of residence at diagnosis...
December 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27921214/external-validity-of-the-chiari-severity-index-and-outcomes-among-pediatric-chiari-i-patients-treated-with-intra-or-extra-dural-decompression
#18
Jared M Pisapia, Maxwell B Merkow, Danielle Brewington, Rosemary E Henn, Leslie N Sutton, Phillip B Storm, Gregory G Heuer
INTRODUCTION: Chiari malformation type-1 (CM-1) may be treated by intradural (ID) or extradural (ED) posterior fossa decompression, although the optimal approach is debated. The Chiari Severity Index (CSI) is a pre-operative metric to predict patient-defined improvement after CM-1 surgery. In this study, we evaluate the results of ID versus ED decompression and assess the external validity of the CSI. METHODS: We performed a retrospective cohort study of pediatric CM-1 patients undergoing decompression at a single academic children's hospital...
February 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27910704/the-safety-of-nivolumab-for-the-treatment-of-advanced-non-small-cell-lung-cancer
#19
REVIEW
Giulio Metro, Biagio Ricciuti, Marta Brambilla, Sara Baglivo, Irene Soli, Elisa Minenza, Giulia Costanza Leonardi, Alessandro D'arpino, Daniela Colabrese, Marco Tazza, Daniela Zicari, Vincenzo Minotti, Rita Chiari
Immune checkpoint blockaders (ICBs) act by unbalancing the immune system, thus favoring the development of an immune-mediated antitumor effect. ICBs targeting the programmed cell death receptor-1 (PD-1) have recently been investigated in a number of advanced tumors, including non-small cell lung cancer (NSCLC). Nivolumab, a fully human IgG4 kappa directed against PD-1, has been the first ICB to be approved for second-line treatment of advanced NSCLC. Areas covered: In this review we focus on the clinical development of nivolumab for the treatment of advanced NSCLC, with an emphasis on its safety profile...
January 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27863925/number-and-function-of-circulating-endothelial-progenitor-cells-in-patients-with-primary-budd-chiari-syndrome
#20
Rui Huang, Qingqiao Zhang, Qianxin Huang, Maoheng Zu, Hao Xu, Lingyu Zeng
BACKGROUND AND AIM: Primary Budd-Chiari syndrome (BCS) is associated with vascular endothelial injury. Circulating endothelial progenitor cells (EPCs) provide an endogenous mechanism to repair endothelial injury. This study investigated the levels and functionality of EPCs in patients with primary BCS. METHODS: EPCs (CD34(+)/CD133(+)/KDR(+)) were quantified in 82 patients with primary BCS (inferior vena cava type: n=19; hepatic vein type: n=22; and mixed type: n=41), 10 cirrhosis controls (CC group) and 10 age-matched healthy controls (HC group), using flow cytometry...
November 15, 2016: Clinics and Research in Hepatology and Gastroenterology
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