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Eiichiro Amano, Kokoro Ozaki, Satoru Egawa, Motohiro Suzuki, Takashi Hirai, Satoru Ishibashi, Takuya Ohkubo, Toshitaka Yoshii, Atsushi Okawa, Takanori Yokota
RATIONALE: OSAM is a rare ventriculoperitoneal (VP) shunt complication where cervical spinal cord compression by epidural venous plexus engorgement is caused by cerebrospinal fluid (CSF) overdrainage. Symmetrically indented deformity of the upper cervical spinal cord and surrounding epidural venous engorgement are characteristic radiological findings. Both of them are typically detected on magnetic resonance imaging (MRI) and enhanced computed tomography (CT). PATIENT CONCERNS: The 77-year-old man who underwent the placement of a VP shunt without an antisiphon device to treat post-subarachnoid hemorrhage (SAH) hydrocephalus presented with progressive quadriplegia 10 years postoperatively...
March 2018: Medicine (Baltimore)
Mohammad M Zarshenas, Ramin Ansari, Amirhossein Dadbakhsh, Maryam Mohammadi
Among various neurological disorders, multiple sclerosis (MS) is an expanding global immune-related inflammatory disease with complex etiologies. There is increasing demand for the use and administration of natural medicaments for this disorder. Traditional Persian medicine (TPM) is a school of medicine and a medicinal plants-based resource for clinical studies put forward by Persian scholars. This paper aims to gather and study the effectiveness of all medicinal plants from the most popular Persian pharmacopeias...
March 5, 2018: Current Drug Metabolism
Syeda Saba Zaidi, Tahira Siddiqui, Sarwar Jamil Siddiqui
Acute onset of quadriplegia is a rare phenomenon seen with hypocalcemia due to hypoparathyroidism. We describe a 33-year gentleman who presented with weakness of all four limbs and areflexia. ECG showed QT abnormality. Nerve conduction study revealed normal sensory and significantly low motor CMAP amplitudes in both the upper and lower extremities. This nerve conduction study can be seen in acute motor neuropathy of various etiologies, among which GBS is the most worrisome. Our patient found to have low calcium and parathyroid hormone level...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Manoj Kamal, Geeta Singariya, Om Prakash Suthar, Ashwini S
Acute hypokalemic paralysis is a reversible but potentially lethal clinical condition. We report a case, who developed rapidonset quadriparesis in immediate postoperative period after undergoing right percutaneous nephrolithotomy for bilateral renal stones. On evaluation, she was found to have hypernatremic, hyperchloremic, hypokalemic acidosis. This severe hypokalemia-induced quadriparesis was precipitated by repeated furosemide injections, use of potassium-free fluid as maintenance, intracellular shift due to free water administration in this patient, who had pre-existing distal renal tubular acidosis...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Jae-Hyuk Yang, Jin Yong Shin, Si-Gyun Roh, Suk-Choo Chang, Nae-Ho Lee
RATIONALE: Xanthogranulomatous pyelonephritis (XGP) is a chronic destructive granulomatous inflammation that is characterized by urinary tract obstruction and invasion of the renal parenchyma. Although rare, XGP can lead to fatal complications, including perinephric inflammation, psoas abscess, and cutaneous fistula. PATIENT CONCERNS: A quadriplegic patient initially presented to the hospital with a chronic open wound and cutaneous fistula. DIAGNOSES: Abdominal computed tomography revealed a renal obstructing stone and enlarged right kidney with a perinephric fluid collection that communicated with the cutaneous fistula...
January 2018: Medicine (Baltimore)
Yinze Diao, Yu Sun, Shaobo Wang, Fengshan Zhang, Shengfa Pan, Zhongjun Liu
RATIONALE: The typical intraoperative presentation of vertebral artery injury (VAI) usually involves profuse bleeding and requires immediate treatment. However, an occult VAI may occur intraoperatively and result in delayed life-threatening epidural pseudoaneurysm several days postoperatively. PATIENT CONCERNS: A 21-year-old man with compressive cervical myelopathy resulting from canal stenosis of skeletal fluorosis underwent decompression of C1 to C7 and instrumentation from C2 to C7...
February 2018: Medicine (Baltimore)
M Welborn, S Farrell, P Knott, E Mayekar, S Mardjetko
Purpose: Little is known about the natural history of spinal deformities in Coffin-Lowry syndrome (CLS). Our goal was to evaluate the spinal deformity progression and clinical impact. Methods: In this institutional review board-approved study, we performed a multinational retrospective review of six male CLS patients, aged 13 to 22 years at final follow-up, for a mean of 7.25 years (3 to 13). Results: All showed delayed skeletal maturity. Three had calcifications of their lower cervical ligamentum flavum, all experienced neural axis abnormalities, including lower extremity weakness, numbness and tingling and in one, quadriparesis...
February 1, 2018: Journal of Children's Orthopaedics
Peng-Rong Ouyang, Xi-Jing He, Xuan Cai
Upper cervical fracture-dislocations are series of pathological injuries occurred in occipital, atlas and axis caused by traumatic impact, which often results in severe clinical consequences, such as paraplegia, quadriplegia, and even death. In light of the potential severe clinical outcomes, it is important to define the type of upper cervical fracture-dislocations depending on which the clinician can deal with the disease properly. Owing to its specific anatomical structures, the upper cervical fractures occurr to the unique osseous structures or ligamentous connections always present in predictable patterns...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Angelina Cistaro, Giuliano Lo Bianco, Piercarlo Fania, Simone Margotti, Simone Vigneri, Cristina Geraci, Natale Quartuccio
We report the case of a 59-year-old male patient suffering from locked-in syndrome (LIS) following basilar artery thrombosis despite an attempt of thrombolysis. Neurological examination showed quadriplegia and aphonia and a state of coma requiring mechanical ventilation was diagnosed. The use of 18F-fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET) allowed to detect a normal 18F-FDG uptake in the main cerebral cortical areas and a significant reduction of 18F-FDG uptake in both cerebellar hemispheres, compatible with a functional deafferentation, helping confirming the clinical suspicion of LIS...
January 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Anne-Sophie Smilga, Jarred Garfinkle, Pamela Ng, John Andersen, David Buckley, Darcy Fehlings, Adam Kirton, Ellen Wood, Esias van Rensburg, Michael Shevell, Maryam Oskoui
BACKGROUND: The goal of this study was to explore the association between neonatal infection and outcomes in children with cerebral palsy. METHODS: We conducted a retrospective cohort study using the Canadian CP Registry. Neonatal infection was defined as meeting one of the following criteria: (1) septicemia, (2) septic shock, or (3) administration of antibiotics for ≥10 days. Phenotypic profiles of children with cerebral palsy with and without an antecedent neonatal infection were compared...
December 13, 2017: Pediatric Neurology
Xinjie Song, Shruti Shukla, Myunghee Kim
Cronobacter species are foodborne pathogens that can affect the human central nervous system. Survivors of Cronobacter infections often suffer from severe neurological impairments, including hydrocephalus, quadriplegia, and developmental delays in all ages, especially in infants and the immunocompromised. Moreover, Cronobacter species pose a high risk in powdered infant formula (PIF) because PIF is a major source of nutrition for infants worldwide. To develop a rapid and sensitive detection method for Cronobacter species in PIF, immunoliposomes and immunomagnetic nanoparticles were synthesized, after which an immunoliposome-based immunomagnetic concentration and separation assay was developed and applied to PIF for the detection of Cronobacter species...
June 2018: Food Microbiology
Kyle Raasck, Jason Khoury, Ahmed Aoude, Fahad Abduljabbar, Peter Jarzem
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord, and leading to acute neurological deficits. The disease's cloudy etiology and rarity contribute to dangerously suboptimal therapeutic principles. These neural deficits can be permanent, even fatal, if the SSEH is not treated in a timely and appropriate manner. Standard therapy is decompressive laminectomy, though nonsurgical management is a viable course of action for patients who meet a criterion that is continuously being refined...
December 2017: Medicine (Baltimore)
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Medicine (Baltimore)
Shital Poojary, Mrunal Shah
Sjögren-Larsson syndrome (SLS) is a rare autosomal-recessive neurocutaneous disorder comprising a triad of ichthyosis, mental retardation, and spastic diplegia or quadriplegia. It has rarely been reported in Asian and Indian populations. We report the case of an Indian patient with SLS who presented with the classical clinical triad and demonstrated characteristic findings on magnetic resonance spectroscopy. In resource-restricted settings where enzymatic and genetic analyses are not available, magnetic resonance spectroscopy serves as a useful adjunct in confirming the diagnosis of SLS...
December 2017: Cutis; Cutaneous Medicine for the Practitioner
Monica L Koncicki, Philip Zachariah, Adam R Lucas, Jeffrey D Edwards
OBJECTIVES: To characterize a multi-institutional cohort of children with chronic respiratory failure that use long-term, non-invasive respiratory support, perform a time-to-event analysis of transitions to transtracheal ventilation and identify factors associated with earlier transition to transtracheal ventilation. STUDY DESIGN: A retrospective cohort study of patients less than 21 years of age with diagnoses associated with chronic respiratory failure and discharged on non-invasive respiratory support was performed using data from the Pediatric Health Information System (PHIS) between 2007 and 2015...
January 17, 2018: Pediatric Pulmonology
Pragathi Balakrishna, Augusto Villegas
Introduction of immune checkpoint inhibitors (ICIs) has led to significant improvements in the treatment of multiple malignancies. Anti-programmed cell death protein 1 (PD-1) and anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) are two essential ICIs that have been FDA approved since 2011. As the use of immunotherapy in melanoma and other malignancies increases, the potential of adverse events also increases. Overall, anti-PD-1 agents are well tolerated. In rare instances, colitis, endocrinopathies, skin, and renal toxicities have been observed...
2017: Case Reports in Oncological Medicine
Mikako Hirakawa, Tasuku Nishihara, Kazuo Nakanishi, Sakiko Kitamura, Sonoko Fujii, Keizo Ikemune, Kentaro Dote, Yasushi Takasaki, Toshihiro Yorozuya
RATIONALE: Coffin-Lowry syndrome (CLS) is a rare inherited disease with specific clinical features, such as mental retardation, facial dysmorphism, and cardiac abnormality. In particular, the characteristic facial features of CLS, including retrognathia and large tongue, are associated with difficult ventilation and/or intubation, which is a serious problem of anesthesia management. However, case reports on anesthesia management of CLS are very limited as there are only two published English reports till date...
December 2017: Medicine (Baltimore)
Chuqiao Li, Rui He, Xiaoqiang Li, Yulan Zhong, Li Ling, Fangming Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a rare but highly disabling neurological emergency. The initial presentations are variable. Most patients of SSEH present with paraplegia or tetraplegia clinically, but recurrent hemiparesis with complete spontaneous recovery, mimicking transient ischemic attack (TIA), is a very rare initial presentation of SSEH. PATIENT CONCERNS: A 71-year-old female presented to the emergency department with 2 episodes of transient right hemiparesis in 5 hours...
December 2017: Medicine (Baltimore)
Guan-Chyuan Wang, Sheng-Wen Wu
RATIONALE: Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis. We presented a case with pulmonary tuberculosis and concurrent IMTB at C3 to C5 level and reviewed the recent case series and discussed the diagnosis, treatment, and outcome. PATIENT CONCERNS: A 33-year-old male had concurrent pulmonary TB and IMTB at the C3 to C5 level. He had quadriplegia (muscle power 0 at 4 limbs) and sensory loss below C5 level...
December 2017: Medicine (Baltimore)
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