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Clinical case

Christopher D Witiw, Fabrice Smieliauskas, John E O'Toole, Michael G Fehlings, Richard G Fessler
BACKGROUND: Surgery for cervical radiculopathy is often approached by either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). ACDF is more common; however, recent single center studies suggest comparable efficacy and significant cost savings with PCF in appropriately selected patients. OBJECTIVE: To compare utilization, adverse events, and costs for each approach from a national perspective. METHODS: Adults undergoing single level ACDF or PCF for cervical radiculopathy were included from a US commercial health insurance claims database spanning 2003 to 2014...
March 14, 2018: Neurosurgery
Alexander D Jobrack, Suman Goel, Alvin M Cotlar
Introduction: Granular cell tumors (GCTs) are of neuroectodermal origin and account for 0.5% of soft tissue tumors. They are most prevalent in African-Americans in the fourth to sixth decades, with a predilection for the head and neck regions. GCTs usually resemble more common lesions and hence are difficult to diagnose preoperatively. The tumor is readily identified on needle biopsy. Although usually benign with a malignancy rate of only 2-3%, the malignant form has a reported 3-yr mortality of 60%...
March 14, 2018: Military Medicine
Maxime Lamontagne, Jean-Christophe Bérubé, Ma'en Obeidat, Michael H Cho, Brian D Hobbs, Phuwanat Sakornsakolpat, Kim de Jong, H Marike Boezen, David Nickle, Ke Hao, Wim Timens, Maarten van den Berge, Philippe Joubert, Michel Laviolette, Don D Sin, Peter D Paré, Yohan Bossé
Causal genes of chronic obstructive pulmonary disease (COPD) remain elusive. The current study aims at integrating genome-wide association studies (GWAS) and lung expression quantitative loci (eQTL) data to map COPD candidate causal genes and gain biological insights into the recently discovered COPD susceptibility loci. Two complementary genomic datasets on COPD were studied. First, the lung eQTL dataset which included whole-genome gene expression and genotyping data from 1,038 individuals. Second, the largest COPD GWAS to date from the International COPD Genetics Consortium (ICGC) with 13,710 cases and 38,062 controls...
March 14, 2018: Human Molecular Genetics
Rodrigo Vargas, Lucas Beltrán, Rafael Lizama, Gabriela Reyes Valenzuela, Roberto Caraballo
PURPOSE: To present a retrospective study of 13 children with benign epilepsy with centrotemporal spikes (BECTS), also known as benign rolandic epilepsy (BRE), associated with generalized spikes and waves as the only EEG manifestation at onset. METHOD: Charts of children with typical clinical criteria of BRE electroclinically followed-up between February 2000 and February 2015 were reviewed. RESULTS: Among 309 patients who met the electroclinical criteria of BRE, we identified 13 children who presented with the typical clinical manifestations but who, on the EEG, only had generalized paroxysms at onset that continued along the course of the syndrome...
March 9, 2018: Seizure: the Journal of the British Epilepsy Association
Albena Vassileva, Dorien van Blooijs, Frans Leijten, Geertjan Huiskamp
The aim of this review is to evaluate whether open-loop or closed-loop neocortical electrical stimulation should be the preferred approach to manage seizures in intractable epilepsy. Twenty cases of open-loop neocortical stimulation with an implanted device have been reported, in 5 case studies. Closed-loop stimulation with an implanted device has been investigated in a larger number of patients in the RNS System clinical trials. With 230 patients enrolled at the start of the Long-term Treatment Trial, 115 remained at the last reported follow-up...
February 19, 2018: Epilepsy Research
Axel C Carlsson, Jan-Håkan Jansson, Stefan Söderberg, Toralph Ruge, Anders Larsson, Johan Ärnlöv
BACKGROUND AND AIMS: Soluble receptors for tumor necrosis factor alpha (sTNFR1 and sTNFR2) have been associated with cardiovascular diseases, and some evidence points towards a difference in associated risk between men and women. We aimed to study the association between sTNFR1 and sTNFR2 and incident myocardial infarctions (MI) and to explore the influence of established cardiovascular risk factors in men and women. METHODS: We conducted a nested case control study in three large Swedish cohorts, including 533 myocardial infarction cases, and 1003 age-, sex- and cohort-matched controls...
March 9, 2018: Atherosclerosis
S Sengottuvel, Pathan Fayaz Khan, N Mariyappa, Rajesh Patel, S Saipriya, K Gireesan
Cutaneous measurements of electrogastrogram (EGG) signals are heavily contaminated by artifacts due to cardiac activity, breathing, motion artifacts, and electrode drifts whose effective elimination remains an open problem. A common methodology is proposed by combining independent component analysis (ICA) and ensemble empirical mode decomposition (EEMD) to denoise gastric slow-wave signals in multichannel EGG data. Sixteen electrodes are fixed over the upper abdomen to measure the EGG signals under three gastric conditions, namely, preprandial, postprandial immediately, and postprandial 2 h after food for three healthy subjects and a subject with a gastric disorder...
March 1, 2018: SLAS Technology
Brenda Deliz, Kathya Ramos, Cynthia M Pérez
OBJECTIVE: To evaluate the sociodemographic characteristics and clinical and functional profile of amyotrophic lateral sclerosis (ALS) patients evaluated at Puerto Rico's Muscular Dystrophy Association-supported (MDA) clinics. METHODS: A retrospective review of 76 medical records of ALS patients evaluated at any of four MDA-sponsored clinics in Puerto Rico. RESULTS: The mean age of diagnosis was 57.4 ± 11.1 yrs. Most of the patients (52.3%) were women...
March 2018: Puerto Rico Health Sciences Journal
Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Babita Saigal, Laura Guerra
BACKGROUND: A common class-specific toxicity of mammalian target of rapamycin (mTOR) inhibitors is stomatitis. Some patients experience a severe form of mTOR inhibitor-associated stomatitis (mIAS) that can have a negative effect on nutritional status, compromise quality of life, and potentially lead to nonadherence, reducing the efficacy of cancer therapy. OBJECTIVES: This article aims to address an unmet need for education about mIAS among oncology nurses and patients and to share findings about everolimus-related stomatitis from the SWISH trial...
April 1, 2018: Clinical Journal of Oncology Nursing
Enrico Ravagli, Stefano Severi
During hemodialysis (HD), blood is circulated through an extracorporeal tubing system (bloodline) made of medical-grade polymeric material. Sensors of various types that do not come into contact with blood (optical, electromagnetic, etc.) are applied directly across the bloodline for clinical purposes and for therapy customization. Thus, a detailed knowledge of the bloodline's physical properties is useful for the development of next-generation HD sensors. In this work, we performed a novel comparative analysis of the materials used by the manufacturers of the bloodlines...
March 16, 2018: Materials
Carey L Holleran, Patrick W Hennessey, Abigail L Leddy, Gordhan B Mahtani, Gabrielle Brazg, Brian D Schmit, T George Hornby
BACKGROUND AND PURPOSE: Previous data suggest that large amounts of high-intensity stepping training in variable contexts (tasks and environments) may improve locomotor function, aerobic capacity, and treadmill gait kinematics in individuals poststroke. Whether similar training strategies are tolerated and efficacious for patients with other acute-onset neurological diagnoses, such as motor incomplete spinal cord injury (iSCI), is unknown. Individuals with iSCI potentially have greater bilateral impairments...
April 2018: Journal of Neurologic Physical Therapy: JNPT
Bonita Sasnett, Susie T Harris, Shelly White
Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators...
March 16, 2018: Health Care Manager
Leonardo R C Mesquita, Maria L G da Fonseca, Rodrigo M da Silva, Eduardo H Morizot
PURPOSE: To report a case involving a patient with presumed panretinal ritonavir-induced retinopathy. METHODS: A 52-year-old, HIV-positive patient, with no criteria for AIDS associated with the use of ritonavir for more than 10 years, underwent clinical examination, fundus photography, spectral domain optical coherence tomography, and fundus autofluorescence imaging. RESULTS: Fundus examination revealed areas of atrophy and hypertrophy in the retinal pigment epithelium throughout the retina...
March 15, 2018: Retinal Cases & Brief Reports
V C Ruschel, M V Martins, J K Bernardon, H P Maia
Rehydration of the tooth remnant and complete polymerization of the composite resin are aspects that should be considered in shade selection of composite resin. This article presents a case series of Class IV restorations performed to evaluate the color match between the composite resin and the tooth remnant. Thirteen Class IV restorations were performed in maxillary central incisors and evaluated according to the period following the restorative procedure: 10 minutes (baseline), 48 hours before and after finishing and polishing, and seven, 14, and 28 days...
March 16, 2018: Operative Dentistry
Kirti Gupta, Chirag K Ahuja, Awadh K Pandit, Manisha Biswal, M R Shivaprakash
While neurological manifestations in scrub typhus have been well described both in clinical and radiological reports in the literature, neuropathological features are rarely reported. They range from subtle "typhus nodules" to more widespread capillaritis. Familiarity with pathological features is essential for correct interpretation. We describe the clinical, imaging, and histological findings in an autopsy case of scrub typhus, which was pre-terminally superimposed by fungal meningoencephalitis...
March 2018: Neurology India
Manas Panigrahi, Manoranjitha Kumari, Sudhindra Vooturi
Background: The diagnosis of lymphocytic hypophysitis (LYH) is a clinical challenge. Medical management with steroids may result in complete resolution of the symptoms and radiological features. We report our approach to the diagnosis and treatment of LYH. Materials and Methods: Retrospective analysis of data of nine consecutive patients of LYH from August 2013 to August 2015 was done. The average age of the study population was 38.4 ± 19.8 years, with five (55...
March 2018: Neurology India
Levente Molnár, Béla Fülesdi, Norbert Németh, Csilla Molnár
Sepsis is a leading cause of death in medical and surgical intensive care units (ICUs). Disturbance of consciousness of varying severity is an early warning sign of developing sepsis in the majority of cases. Sepsis-associated encephalopathy (SAE) is the most frequent type of encephalopathy in the ICU and is defined as a state of diffuse cerebral dysfunction caused by the inflammatory response of the body to various infections, where the inflammatory process does not affect the central nervous system (CNS) directly and the primary symptom is a disturbed level of consciousness...
March 2018: Neurology India
Michael Karsy, Jian Guan, L Eric Huang
OBJECTIVE Gliomas are one of the most common types of primary brain tumors. Recent studies have supported the importance of key genetic alterations, including isocitrate dehydrogenase (IDH) mutations and 1p19q codeletion, in glioma prognosis. Mutant IDH produces 2-hydroxyglutarate from α-ketoglutarate, a key metabolite of the Krebs cycle. The mitochondrial pyruvate carrier (MPC) is composed of MPC1 and MPC2 subunits and is functionally essential for the Krebs cycle. The authors sought to explore the impact of MPC1 and MPC2 expression on patient prognosis...
March 16, 2018: Journal of Neurosurgery
Daniel A Tonetti, Bradley A Gross, Brian T Jankowitz, Hideyuki Kano, Edward A Monaco, Ajay Niranjan, John C Flickinger, L Dade Lunsford
OBJECTIVE Aggressive dural arteriovenous fistulas (dAVFs) with cortical venous drainage (CVD) are known for their relatively high risk of recurrent neurological events or hemorrhage. However, recent natural history literature has indicated that nonaggressive dAVFs with CVD have a significantly lower prospective risk of hemorrhage. These nonaggressive dAVFs are typically diagnosed because of symptomatic headache, pulsatile tinnitus, or ocular symptoms, as in low-risk dAVFs. Therefore, the viability of stereotactic radiosurgery (SRS) as a treatment for this lesion subclass should be investigated...
March 16, 2018: Journal of Neurosurgery
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