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inflammation and muscle weakness

Alon Abraham, Aaron Izenberg, Dubravka Dodig, Vera Bril, Ari Breiner
INTRODUCTION: Neuralgic amyotrophy (NA) is characterized by acute or subacute onset of shoulder and arm pain, followed by muscle atrophy and weakness, and variable sensory abnormalities. Historically, the site of inflammation has been localized to the brachial plexus, although involvement of individual nerve branches has been well recognized. METHODS: We describe ultrasound (US) findings in 2 cases with clinical presentation suggestive for NA, involving individual peripheral nerves, correlating with clinical and electrophysiological findings...
June 13, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Thomas Schwartz, Louise Pyndt Diederichsen, Ingrid E Lundberg, Ivar Sjaastad, Helga Sanner
Idiopathic inflammatory myopathies (IIM) include the main subgroups polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM) and juvenile DM (JDM). The mentioned subgroups are characterised by inflammation of skeletal muscles leading to muscle weakness and other organs can also be affected as well. Even though clinically significant heart involvement is uncommon, heart disease is one of the major causes of death in IIM. Recent studies show an increased prevalence of traditional cardiovascular risk factors in JDM and DM/PM, which need attention...
2016: RMD Open
Alon Abraham, Aaron Izenberg, Dubravka Dodig, Vera Bril, Ari Breiner
PURPOSE: Neuralgic amyotrophy is characterized by acute or subacute onset of shoulder and arm pain, followed by muscle atrophy and weakness, and variable sensory abnormalities. Historically, the site of inflammation has been localized to the brachial plexus, although the involvement of individual nerve branches has been well recognized. METHODS: We describe ultrasound findings in two cases with a clinical presentation suggestive of neuralgic amyotrophy, involving individual peripheral nerves, correlating with clinical and electrophysiological findings...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Magdalena Krajewska-Włodarczyk
The clinical picture of rheumatoid arthritis covers the condition of chronic inflammation connected to the increased concentration of inflammatory mediators, reduced physical activity, immobilization caused by pain, stiffness and joint destruction as well as accompanying hormonal and metabolic disorders. It all may lead to extra-articular complications, also to the loss of muscle mass with the weakness of muscle strength, adding to the disability and significantly lowering the patients' quality of life. Sarcopenia is an advanced form of muscle mass loss which constitutes an independent and vital threat for dexterity...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Xiaoxi Zhu, Melanie Kny, Franziska Schmidt, Alexander Hahn, Tobias Wollersheim, Christian Kleber, Steffen Weber-Carstens, Jens Fielitz
OBJECTIVE: In sepsis, the disease course of critically ill patients is often complicated by muscle failure leading to ICU-acquired weakness. The myokine transforming growth factor-β1 increases during inflammation and mediates muscle atrophy in vivo. We observed that the transforming growth factor-β1 inhibitor, secreted frizzled-related protein 2, was down-regulated in skeletal muscle of ICU-acquired weakness patients. We hypothesized that secreted frizzled-related protein 2 reduction enhances transforming growth factor-β1-mediated effects and investigated the interrelationship between transforming growth factor-β1 and secreted frizzled-related protein 2 in inflammation-induced atrophy...
September 21, 2016: Critical Care Medicine
Tomica Ambang, Joo-San Tan, Sheila Ong, Kum-Thong Wong, Khean-Jin Goh
Telbivudine, a thymidine nucleoside analog, is a common therapeutic option for chronic hepatitis B infection. While raised serum creatine kinase is common, myopathy associated with telbivudine is rare. Reports on its myopathological features are few and immunohistochemical analyses of inflammatory cell infiltrates have not been previously described. We describe the clinical, myopathological and immunohistochemical features of four patients who developed myopathy after telbivudine therapy for chronic hepatitis B infection...
2016: PloS One
Rahul Sehgal, Rafael Medina-Flores, Ralph Yachoui, Charles Kenney
Immune mediated necrotizing myopathy (IMNM) is a unique form of myositis that is characterized by distinct muscle biopsy features including abundant myofiber necrosis, degeneration, and regeneration with only minimal, if any, inflammation on muscle biopsy. IMNM is clinically similar to idiopathic inflammatory myopathy (IIM); hence, muscle biopsy is essential to diagnose IMNM. Herein we describe a case of neck extensor weakness due to necrotizing myopathy. Isolated weakness of the neck extensor muscles is uncommon in IIM and IMNM...
August 29, 2016: Clinical Medicine & Research
Ondřej Kubeček, Tomáš Soukup, Adam Paulík, Jindřich Kopecký
BACKGROUND: Dermatomyositis is an autoimmune myopathy characterized by proximal muscle weakness, muscle inflammation, and typical skin findings. It is a rare disease with an incidence of ~1/100 000. About 15-30 % of adult-onset cases are caused by underlying malignancy and dermatomyositis can be the first symptom of undiagnosed cancer, mainly in the case of anti-transcription intermediary factor 1γ (anti-TIF-1γ) antibodies presence. TIF-1γ is a transcriptional cofactor which is implicated in TGFβ signaling pathway that controls cell proliferation, differentiation, apoptosis, and tumorigenesis...
2016: BMC Cancer
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW...
2016: Frontiers in Pediatrics
Salyan Bhattarai, Khetam Ghannam, Sabine Krause, Olivier Benveniste, Andreas Marg, Gerjan de Bruin, Bo-Tao Xin, Hermen S Overkleeft, Simone Spuler, Werner Stenzel, Eugen Feist
Idiopathic inflammatory myopathies (IIMs) are diseases with muscle weakness, morphologically characterized by inflammatory infiltration and increased expression of MHC class I molecule on myofibers. Immunoproteasome, as a proteolytic complex that shapes the repertoire of antigenic peptides, has been previously demonstrated to be over-expressed in IIMs at mRNA level. In this study, we investigated the expression and the function of the immunoproteasome in IIMs in more detail. As shown by immunofluorescence staining, expression of relevant players of the immunoproteasome was detectable in the inflamed skeletal muscle tissue from IIM patients...
August 10, 2016: Journal of Autoimmunity
Christiane G Stäuble, Marc Helming, J A Jeevendra Martyn, Manfred Blobner, Heidrun Fink
OBJECTIVES: Recovery from ICU-acquired muscle weakness extends beyond hospital stay. We hypothesized that immobilization, more than inflammation, plays a prominent role in the delayed recovery from critical illness. DESIGN: Prospective, randomized, controlled, experimental study. SETTING: Animal laboratory, university hospital. SUBJECTS: Male Sprague-Dawley rats. INTERVENTIONS: Animals were divided to have one hind limb immobilized (n = 129) or sham-immobilized (n = 129) on day -12...
November 2016: Critical Care Medicine
James Lilleker, Sean Murphy, Robert Cooper
The idiopathic inflammatory myopathies (IIM) are a rare and heterogeneous group of acquired autoimmune muscle disorders, often referred to as 'myositis'. Clinical assessment, together with muscle biopsy findings and autoantibody status are key factors to consider when making a diagnosis of IIM, and in stratification of the 'IIM spectrum' into disease subgroups. Treatment stratified according to serotype (and in the future, likely also genotype) is increasingly being used to take account of the heterogeneity within the IIM spectrum...
August 2016: Therapeutic Advances in Musculoskeletal Disease
Nicolò Pipitone
PURPOSE OF REVIEW: This review aims at covering the role of muscle MRI in supporting the diagnosis of myositis, in aiding to differentiate it from other muscle disorders, and in monitoring myositis patients over time by assessing response to treatment and by discriminating between muscle inflammation and chronic damage. RECENT FINDINGS: MRI can assist in 'pattern recognition' of muscle involvement across numerous myopathies, including myositis. Novel applications of magnetic resonance such as cardiac MRI, MR elastography and blood oxigenation level-dependent magnetic resonance can shed light on different aspects of myositis and usefully complement conventional MRI in assessing patients with myositis...
November 2016: Current Opinion in Rheumatology
Andrea Váncsa, Katalin Dankó
Myositis, which means inflammation of the muscles, is a general term used for inflammatory myopathies. Myositis is a rare idiopathic autoimmune disease. It is believed that environmental factors such as virus, bacteria, parasites, direct injuries, drugs side effect can trigger the immune system of genetically susceptible individuals to act against muscle tissues. There are several types of myositis with the same systemic symptoms such as muscle weakness, fatigue, muscle pain and inflammation. These include dermatomyositis, juvenile dermatomyositis, inclusion-body myositis, polymyositis, orbital myositis and myositis ossificans...
July 2016: Orvosi Hetilap
Joe O Boison, Trisha Dowling, Ron Johnson, Jana Kinar
Phenylbutazone (PBZ) is permitted to be used for the treatment of musculoskeletal pain and inflammation in race horses but it is not approved for use in horses destined for human consumption. In a recent study initiated in our laboratory to study the disposition of PBZ and its oxyphenbutazone (OXPBZ) metabolite in equine tissues, we compared the effect of an additional enzymatic hydrolysis step with ß-glucuronidase on the results of the analysis for PBZ without enzymatic hydrolysis. Incurred tissue samples obtained from a female horse dosed with PBZ at 8...
May 2016: Drug Testing and Analysis
Andrés A Maldonado, Kimberly K Amrami, Michelle L Mauermann, Robert J Spinner
INTRODUCTION: Different hypotheses have been proposed for the pathophysiology of anterior interosseous nerve (AIN) palsy: compression, fascicular constriction or nerve inflammation (Parsonage-Turner Syndrome). We hypothesized that critical reinterpretation of electrodiagnostic studies (EDX) and MRIs of patients with a diagnosis of AIN palsy could provide insight into the pathophysiology and treatment. MATERIALS AND METHODS: A retrospective review was performed of all patients with a diagnosis of non-traumatic AIN palsy and an upper extremity MRI performed at our institution...
July 5, 2016: Plastic and Reconstructive Surgery
Claudia Barzago, Josephine Lum, Paola Cavalcante, Kandhadayar Gopalan Srinivasan, Elisa Faggiani, Giorgia Camera, Silvia Bonanno, Francesca Andreetta, Carlo Antozzi, Fulvio Baggi, Raffaele Adolfo Calogero, Pia Bernasconi, Renato Mantegazza, Lucia Mori, Francesca Zolezzi
Myasthenia gravis (MG) is a T-cell dependent autoimmune disorder of the neuromuscular junction, characterised by muscle weakness and fatigability. Autoimmunity is thought to initiate in the thymus of acetylcholine receptor (AChR)-positive MG patients; however, the molecular mechanisms linking intra-thymic MG pathogenesis with autoreactivity via the circulation to the muscle target organ are poorly understood. Using whole-transcriptome sequencing, we compared the transcriptional profile of peripheral blood mononuclear cells from AChR-early onset MG (AChR-EOMG) patients with healthy controls: 178 coding transcripts and 229 long non-coding RNAs, including 11 pre-miRNAs, were differentially expressed...
November 2016: Immunobiology
Richella Ryan, Anna Spathis, Angela Clow, Sara Booth
PURPOSE OF REVIEW: Breathlessness and chronic inflammation both span a wide range of disease contexts and hold prognostic significance. The possibility of a causal relationship between the two has been hypothesized. The aims of this article are to review the intersections between breathlessness and inflammation in the literature, describe potential mechanisms connecting the two phenomena, and discuss the potential clinical implications of a causal relationship. RECENT FINDINGS: There is a very limited literature exploring the relationship between systemic inflammation and breathlessness in chronic obstructive pulmonary disease, heart failure, and cancer...
September 2016: Current Opinion in Supportive and Palliative Care
Pinelopi Katsiveli, Maria Sfakiotaki, Nikolaos Voulgaris, Labrini Papanastasiou, Theodora Kounadi, Konstantinos Lymperopoulos, George Piaditis
UNLABELLED: Primary hypophysitis (PH) is a rare clinical entity characterized by inflammatory infiltration of the pituitary gland with various degrees of pituitary dysfunction. OBJECTIVE: To present a complicated case of aggressive PH with bilateral cavernous sinuses infiltration, successfully treated with azathioprine after failure of corticosteroid treatment. METHODS AND RESULTS: A 48-year-old woman presented with episodes of recurrent headache and progressively worsening muscle weakness...
April 2016: Hormones: International Journal of Endocrinology and Metabolism
Vijay Kumar, Asimul Islam, Md Imtaiyaz Hassan, Faizan Ahmad
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease associated with motor neuron degeneration, muscle weakness, paralysis and finally death. The proposed mechanisms of ALS include glutamate excitotoxicity, oxidative stress, inflammation, mitochondrial dysfunction, apoptosis and proteasomal dysfunction. Although numerous pathological mechanisms have been explained, ALS remains incurable disease because of failure of clinical trials and lack of any effective therapy. The rapid advancement in genetic discoveries in ALS emphasizes the point that ALS is a multi-subtype syndrome rather than a single disease...
October 4, 2016: European Journal of Medicinal Chemistry
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