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https://www.readbyqxmd.com/read/27922503/myasthenia-gravis-and-lambert-eaton-myasthenic-syndrome
#1
Michael W Nicolle
PURPOSE OF REVIEW: This article discusses the pathogenesis, diagnosis, and management of autoimmune myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS). RECENT FINDINGS: Recognition of new antigenic targets and improved diagnostic methods promise to improve the diagnosis of MG, although the clinical phenotypes associated with newer antibodies have not yet been defined. Future therapies might specifically target the aberrant immune response. The apparent increase in the prevalence of MG is not fully explained...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27908939/l-shaped-mini-sternotomy-combined-with-videoscopic-approach-for-thymoma-with-invasion-of-major-veins
#2
Atsushi Suga, Shunsuke Yamada, Haruka Takeichi, Yusuke Nakamura, Masayuki Iwazaki
It might be possible to remove thymic tumors with minimal invasion of the left brachiocephalic vein (BCV) using an advanced videoscopic technique; simple resection of this vessel can be achieved via such an approach. However, tumor invasion of the superior vena cava or right  BCV requires angioplasty or reconstruction, both of which are difficult to perform in videoscopic procedures. We report a case of invasive thymoma with localized invasion of the great vessels at the junction of the left BCV and superior vena cava...
December 1, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#3
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27900082/successful-treatment-of-advanced-thymic-carcinoma-with-lymph-node-and-pleural-metastases-a-case-report
#4
Yoko Yamamoto, Ken Kodama, Tomohiro Maniwa, Hiroki Kishima
Thymic carcinoma is a rare type of cancer that is more aggressive and is associated with a poorer prognosis compared with thymoma. No definitive clinical management of this disease has been established to date. This report describes the 20-year clinical course of a 50-year-old male patient who was successfully treated for initially diagnosed stage IVb thymic carcinoma. Thymo-thymectomy combined with resection of the surrounding organs was performed on December 1995 with curative intent (R0) after neoadjuvant chemoradiotherapy...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27890878/prevalence-of-electrocardiographic-abnormalities-in-patients-with-myasthenia-gravis
#5
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/27887977/direct-and-indirect-cost-of-myasthenia-gravis-a-prospective-study-from-a-tertiary-care-teaching-hospital-in-india
#6
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/27876071/bilateral-single-port-thoracoscopic-extended-thymectomy-for-management-of-thymoma-and-myasthenia-gravis-case-report
#7
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/27867646/commentary-on-randomized-trial-of-thymectomy-in-myasthenia-gravis
#8
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
#9
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/27861229/what-s-in-the-literature
#10
Nicholas J Silvestri, Gil I Wolfe, David Lacomis
In this edition, we focus on neuromuscular junction disorders and myopathy. The newly published international consensus guidelines for the management of myasthenia gravis are reviewed. In addition, various emerging treatment options for myasthenia, including the use of methotrexate, rituximab, subcutaneous immunoglobulin, and thymectomy, are discussed. Recent studies examining the clinical and genetic features of several forms of congenital myasthenia gravis are also highlighted. The clinical features and treatment of late-onset Pompe disease are reviewed, as are studies in facioscapulohumeral dystrophy, idiopathic inflammatory myopathies, and calpainopathy...
December 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27861217/low-dose-medication-and-long-term-outcome-in-myasthenia-gravis
#11
Salomi Salins, Barbara Teter, Katelyn Kavak, Gil I Wolfe, Nicholas J Silvestri
OBJECTIVES: Many advances have been made in the diagnosis, treatment, and management of myasthenia gravis (MG) and most patients will eventually progress to experience minimal manifestations (MM) of the disease or remission. However, there is a paucity of literature on medication dosing needed to achieve such a favorable clinical status in the long term. The objective of this article was to (1) study the course of MG and identify clinical predictors of maintenance of eventual disease remission or minimal manifestations and (2) determine if patients on low-dose medications have comparable MG Foundation of America (MGFA) scores and postintervention statuses (PIS) with those on conventional therapeutic dosing...
December 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27856933/predictors-of-extubation-outcomes-following-myasthenic-crisis
#12
Zhenguo Liu, Shiyuan Yao, Qian Zhou, Zhensheng Deng, Jianyong Zou, Huiyu Feng, Hua Zhu, Chao Cheng
OBJECTIVE: Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. METHODS: The medical charts of 33 patients (19 women, 14 men) with 76 MC attacks from 2002 to 2014 were retrospectively reviewed. Early extubation (≤7 days) and prolonged ventilation (>15 days) during the MC were used to assess patient outcomes...
November 17, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27837196/abnormal-thymic-maturation-and-lymphoproliferation-in-mrl-faslpr-lpr-mice-can-be-partially-reversed-by-synthetic-oligonucleotides-implications-for-systemic-lupus-erythematosus-and-autoimmune-lymphoproliferative-syndrome
#13
R F Ashman, N Singh, P S Lenert
MRL-Fas (lpr/lpr) mice represent an excellent animal model for studying non-malignant lymphoproliferation, regeneration and systemic autoimmunity. Retro-transposon insertion into the second intron of the pro-apoptotic Fas gene appears to be responsible for both lymphoproliferation and autoimmunity, while other genes are more likely to contribute to the regenerative healing characteristic of this mouse strain. Previous studies have shown that neonatal thymectomy can halt the development of abnormal lymphoproliferation...
November 10, 2016: Lupus
https://www.readbyqxmd.com/read/27822454/report-on-first-international-workshop-on-robotic-surgery-in-thoracic-oncology
#14
Giulia Veronesi, Robert Cerfolio, Roberto Cingolani, Jens C Rueckert, Luc Soler, Alper Toker, Umberto Cariboni, Edoardo Bottoni, Uberto Fumagalli, Franca Melfi, Carlo Milli, Pierluigi Novellis, Emanuele Voulaz, Marco Alloisio
A workshop of experts from France, Germany, Italy, and the United States took place at Humanitas Research Hospital Milan, Italy, on February 10 and 11, 2016, to examine techniques for and applications of robotic surgery to thoracic oncology. The main topics of presentation and discussion were robotic surgery for lung resection; robot-assisted thymectomy; minimally invasive surgery for esophageal cancer; new developments in computer-assisted surgery and medical applications of robots; the challenge of costs; and future clinical research in robotic thoracic surgery...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27819773/prognosis-of-thymectomy-in-myasthenia-gravis-patients-with-thymus-hyperplasia
#15
Jing Yang, Chanchan Liu, Tao Li, Chengyan Li
PURPOSE: To compare the post-thymectomy prognosis in different conditions of myasthenia gravis (MG) patients with thymus hyperplasia. MATERIALS AND METHODS: Collecting medical record and carrying out the follow-up study of one hundred and twenty three myasthenia gravis patients with thymus hyperplasia who have underwent thymectomy during the period between 2003 and 2013. Dividing into different groups based on gender, age of onset, duration of disease and Myasthenia Gravis Association of America (MGFA) clinical classification to analyze different prognosis in different groups...
November 7, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27815619/-thymectomy-in-myasthenia-gravis
#16
K Hekmat, C Bruns
No abstract text is available yet for this article.
December 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27810167/comparative-clinical-outcomes-after-thymectomy-for-myasthenia-gravis-thoracoscopic-versus-trans-sternal-approach
#17
Sophon Siwachat, Apichat Tantraworasin, Worakitti Lapisatepun, Chidchanok Ruengorn, Emanuela Taioli, Somcharoen Saeteng
BACKGROUND: Thymectomy is an effective treatment option for long-term remission of myasthenia gravis. The superiority of the trans-sternal and thoracoscopic surgical approaches is still being debated. The aims of this study are to compare postoperative outcomes and neurologic outcomes between the two approaches and to identify prognostic factors for complete stable remission (CSR). METHODS: Myasthenia gravis patients who underwent thymectomy with trans-sternal or thoracoscopic approach in MahaRaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between January1, 2006 and December 31, 2013 were retrospectively reviewed...
November 1, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27807708/the-subxiphoid-approach-leads-to-less-invasive-thoracoscopic-thymectomy-than-the-lateral-approach
#18
Motoki Yano, Satoru Moriyama, Hiroshi Haneda, Katsuhiro Okuda, Osamu Kawano, Risa Oda, Ayumi Suzuki, Ryoichi Nakanishi, Hiroki Numanami, Masayuki Haniuda
OBJECTIVE: Video-assisted thoracic surgery (VATS) is widely used in thoracic surgery. This study investigated the usefulness of the subxiphoid approach in thymectomy using VATS techniques. METHODS: Sixty operations were performed using the lateral approach (n = 46) and subxiphoid approach (n = 14). Using the lateral approach, 39 partial thymectomies (PT), 5 total or subtotal thymectomies (TT), and 2 total or subtotal thymectomies with combined resection of the surrounding organs (or tissues) (CR) were performed...
November 2, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27794404/limited-thymectomy-as-a-potential-alternative-treatment-option-for-early-stage-thymoma-a-multi-institutional-propensity-matched-study
#19
Kyoung Shik Narm, Chang Young Lee, Young Woo Do, Hee Suk Jung, Go Eun Byun, Jin Gu Lee, Dae Joon Kim, Yoohwa Hwang, In Kyu Park, Chang Hyun Kang, Young Tae Kim, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Yong Mog Shim, Su Kyung Hwang, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Kyung Young Chung
OBJECTIVES: For early-stage thymoma, complete thymectomy has classically been regarded as the standard treatment protocol. However, several studies have shown that limited thymectomy may be an alternative treatment option for thymoma. This study compared perioperative outcomes, survival, and recurrence rates between patients undergoing limited thymectomy and complete thymectomy. MATERIALS AND METHODS: Between January 2000 and December 2013, a total of 762 patients underwent thymectomy for stage I or II thymomas at four institutions participating in the Korean Association for Research on the Thymus...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/27785065/invasive-atypical-thymic-carcinoid-three-case-reports-and-literature-review
#20
Shan Zhu, Zhong-Tang Wang, Wen-Zhi Liu, Shi-Xiang Zong, Bao-Sheng Li
Atypical thymic carcinoid is an extremely rare thymic neuroendocrine tumor derived from the neuroendocrine system. The aims of this paper were to investigate the clinical features of atypical thymic carcinoid and collate information and experience to improve the diagnosis and treatment of this disease. We describe three cases of atypical carcinoid of the thymus; clinical features, pathological data, treatment modalities, and short-term patient outcomes were summarized and analyzed. The initial clinical symptoms and signs of all three patients were nonspecific and an anterior mediastinal mass was found in each patient on chest computed tomography scan...
2016: OncoTargets and Therapy
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