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https://www.readbyqxmd.com/read/28687304/superior-shoulder-suspensory-complex-fracture-dislocation-case-report
#1
T Lidgett, E Bate, L Pittock
BACKGROUND: Acromioclavicular joint dislocation can be more complex than it first appears. The presented case had an unusual combination of injuries to the superior shoulder suspensory complex, which yielded some interesting learning points. CASE SUMMARY: The injuries were sustained after a fall from a push bike and included acromioclavicular dislocation with coracoid process, clavicle and acromion process fractures. These were identified on the initial X-ray examination, which was followed by computed tomography for surgical planning...
August 2017: Radiography
https://www.readbyqxmd.com/read/28642892/dacrystic-seizures-a-cry-for-help
#2
Avi Gadoth, Jaysingh Singh, Jeffrey W Britton, Eoin P Flanagan, Sean J Pittock
No abstract text is available yet for this article.
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28628235/expanded-phenotypes-and-outcomes-among-256-lgi1-caspr2-igg-positive-patients
#3
Avi Gadoth, Sean J Pittock, Divyanshu Dubey, Andrew McKeon, Jeff W Britton, John E Schmeling, Aurelia Smith, Amy L Kotsenas, Robert E Watson, Daniel H Lachance, Eoin P Flanagan, Vanda A Lennon, Christopher J Klein
OBJECTIVE: To describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1-IgG or CASPR2-IgG seropositive patients. METHODS: Patients were identified through service neural autoantibody evaluation. Ninety-five had longitudinal follow-up (7-456 months; median 35). RESULTS: Among 3,910 patients tested, 196 were LGI1-IgG-positive; 51 were CASPR2-IgG-positive and 9 were dual-positive. CSF-testing was less sensitive than serum-testing, detecting only 24/38 LGI1-IgG-positive (63%) and 5/6 CASPR2-IgG-positive (83%)...
June 19, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28570322/autoimmune-neurology-of-the-central-nervous-system
#4
W Oliver Tobin, Sean J Pittock
PURPOSE OF REVIEW: This article reviews the rapidly evolving spectrum of autoimmune neurologic disorders with a focus on those that involve the central nervous system, providing an understanding of how to approach the diagnostic workup of patients presenting with central nervous system symptoms or signs that could be immune mediated, either paraneoplastic or idiopathic, to guide therapeutic decision making. RECENT FINDINGS: The past decade has seen a dramatic increase in the discovery of novel neural antibodies and their targets...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28555833/predictive-models-in-the-diagnosis-and-treatment-of-autoimmune-epilepsy
#5
Divyanshu Dubey, Jaysingh Singh, Jeffrey W Britton, Sean J Pittock, Eoin P Flanagan, Vanda A Lennon, Jan-Mendelt Tillema, Elaine Wirrell, Cheolsu Shin, Elson So, Gregory D Cascino, Dean M Wingerchuk, Matthew T Hoerth, Jerry J Shih, Katherine C Nickels, Andrew McKeon
OBJECTIVE: To validate predictive models for neural antibody positivity and immunotherapy response in epilepsy. METHODS: We conducted a retrospective study of epilepsy cases at Mayo Clinic (Rochester-MN; Scottsdale-AZ, and Jacksonville-FL) in whom autoimmune encephalopathy/epilepsy/dementia autoantibody testing profiles were requested (06/30/2014-06/30/2016). An Antibody Prevalence in Epilepsy (APE) score, based on clinical characteristics, was assigned to each patient...
July 2017: Epilepsia
https://www.readbyqxmd.com/read/28451627/disruption-of-the-leptomeningeal-blood-barrier-in-neuromyelitis-optica-spectrum-disorder
#6
Nasrin Asgari, Eoin P Flanagan, Kazuo Fujihara, Ho Jin Kim, Hanne P Skejoe, Jens Wuerfel, Hiroshi Kuroda, Su Hyun Kim, Elisabeth Maillart, Romain Marignier, Sean J Pittock, Friedemann Paul, Brian G Weinshenker
OBJECTIVE: To describe leptomeningeal blood-barrier impairment reflected by MRI gadolinium-enhanced lesions in patients with aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD). METHODS: A retrospective case series of 11 AQP4-IgG-positive NMOSD patients with leptomeningeal enhancement (LME) were collected from 5 centers. External neuroradiologists, blinded to the clinical details, evaluated MRIs. RESULTS: LME was demonstrated on postcontrast T1-weighted and fluid-attenuated inversion recovery images as a sign of leptomeningeal blood-barrier disruption and transient leakage of contrast agent into the subarachnoid space in 11 patients, 6 in the brain and 6 in the spinal cord...
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#7
REVIEW
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28184993/pathogenic-implications-of-cerebrospinal-fluid-barrier-pathology-in-neuromyelitis-optica
#8
Yong Guo, Stephen D Weigand, Bogdan F Popescu, Vanda A Lennon, Joseph E Parisi, Sean J Pittock, Natalie E Parks, Stacey L Clardy, Charles L Howe, Claudia F Lucchinetti
Pathogenic autoantibodies associated with neuromyelitis optica (NMO) induce disease by targeting aquaporin-4 (AQP4) water channels enriched on astrocytic endfeet at blood-brain interfaces. AQP4 is also expressed at cerebrospinal fluid (CSF)-brain interfaces, such as the pial glia limitans and the ependyma and at the choroid plexus blood-CSF barrier. However, little is known regarding pathology at these sites in NMO. Therefore, we evaluated AQP4 expression, microglial reactivity, and complement deposition at pial and ependymal surfaces and in the fourth ventricle choroid plexus in 23 autopsy cases with clinically and/or pathologically confirmed NMO or NMO spectrum disorder...
April 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28120349/glial-fibrillary-acidic-protein-immunoglobulin-g-as-biomarker-of-autoimmune-astrocytopathy-analysis-of-102-patients
#9
Eoin P Flanagan, Shannon R Hinson, Vanda A Lennon, Boyan Fang, Allen J Aksamit, P Pearse Morris, Eati Basal, Josephe A Honorat, Nora B Alfugham, Jenny J Linnoila, Brian G Weinshenker, Sean J Pittock, Andrew McKeon
OBJECTIVE: A novel autoimmune central nervous system (CNS) disorder with glial fibrillary acidic protein (GFAP)-IgG as biomarker was recently characterized. Here, 102 patients with GFAP-IgG positivity are described. METHODS: The 102 included patients had: (1) serum, cerebrospinal fluid (CSF), or both that yielded a characteristic astrocytic pattern of mouse tissue immunostaining; (2) confirmation of IgG reactive with specific GFAP isoforms (α, ɛ, or κ) by cell-based assays; and (3) clinical data available...
February 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28097302/association-of-extension-of-cervical-cord-lesion-and-area-postrema-syndrome-with-neuromyelitis-optica-spectrum-disorder
#10
Divyanshu Dubey, Sean J Pittock, Karl N Krecke, Eoin P Flanagan
No abstract text is available yet for this article.
March 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28074593/microtubule-associated-protein-1b-novel-paraneoplastic-biomarker
#11
Avi Gadoth, Thomas J Kryzer, Jim Fryer, Andrew McKeon, Vanda A Lennon, Sean J Pittock
OBJECTIVE: To report the identification of microtubule-associated protein (MAP) 1B as the antigen of the previously described Purkinje cell cytoplasmic antibody type 2 (PCA-2) antibody, its frequency, and clinical, oncological, and serological associations. METHODS: Archival serum or cerebrospinal fluid (CSF) specimens were available from 96 of 118 consecutive PCA-2-IgG-seropositive patients identified during 1993-2016. The autoantigen, defined in mouse brain lysate by Western blot and mass spectrometry, was confirmed by dual immunohistochemical staining using commercial antibodies...
February 2017: Annals of Neurology
https://www.readbyqxmd.com/read/27913626/ring-enhancing-spinal-cord-lesions-in-neuromyelitis-optica-spectrum-disorders
#12
Nicholas L Zalewski, Padraig P Morris, Brian G Weinshenker, Claudia F Lucchinetti, Yong Guo, Sean J Pittock, Karl N Krecke, Timothy J Kaufmann, Dean M Wingerchuk, Neeraj Kumar, Eoin P Flanagan
OBJECTIVE: We assessed the frequency and characteristics of ring-enhancing spinal cord lesions in neuromyelitis optica spectrum disorder (NMOSD) myelitis and myelitis of other cause. METHODS: We reviewed spinal cord MRIs for ring-enhancing lesions from 284 aquaporin-4 (AQP4)-IgG seropositive patients at Mayo Clinic from 1996 to 2014. Inclusion criteria were as follows: (1) AQP4-IgG seropositivity, (2) myelitis attack and (3) MRI spinal cord demonstrating ring-enhancement...
March 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27844036/a-comparison-of-tissue-based-and-recombinant-protein-based-assays-for-detecting-pca-tr-dner-igg
#13
Nora Alfugham, Matthew Roforth, Lars Komorowski, Anthonina Ott, Wolfgang Meyer, Christian Probst, Vanda A Lennon, Sean J Pittock, Andrew McKeon
No abstract text is available yet for this article.
December 2016: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/27643908/autoantibody-associated-central-nervous-system-neurologic-disorders
#14
Jenny Linnoila, Sean J Pittock
Autoimmune neurology is a rapidly evolving new subspecialty driven by the discovery of novel neural- (neuronal- or glial-) specific autoantibodies and their target antigens. The neurologic manifestations affecting the central nervous system include encephalitis, dementia, epilepsy, and movement and sleep disorders. Laboratory testing is now available for most of these neural-specific autoantibodies, which serve as diagnostic markers, in some instances directing the physician toward specific cancer types (e...
August 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27618707/autoimmune-glial-fibrillary-acidic-protein-astrocytopathy-a-novel-meningoencephalomyelitis
#15
Boyan Fang, Andrew McKeon, Shannon R Hinson, Thomas J Kryzer, Sean J Pittock, Allen J Aksamit, Vanda A Lennon
Importance: A novel astrocytic autoantibody has been identified as a biomarker of a relapsing autoimmune meningoencephalomyelitis that is immunotherapy responsive. Seropositivity distinguishes autoimmune glial fibrillary acidic protein (GFAP) meningoencephalomyelitis from disorders commonly considered in the differential diagnosis. Objective: To describe a novel IgG autoantibody found in serum or cerebrospinal fluid that is specific for a cytosolic intermediate filament protein of astrocytes...
November 1, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27511450/clinical-pathologic-correlations-in-voltage-gated-kv1-potassium-channel-complex-subtyped-autoimmune-painful-polyneuropathy
#16
Rajat Lahoria, Sean J Pittock, Avi Gadoth, Janean K Engelstad, Vanda A Lennon, Christopher J Klein
INTRODUCTION: Voltage-gated Kv1 potassium channel complex (VGKC) autoantibodies subtyped for leucine-rich glioma-inactivated 1 (LGI1), contactin-associated-proteinlike 2 (CASPR2), and Kv IgGs have a spectrum of neurological presentations. Painful polyneuropathy is seen in some patients, but nerve pathology descriptions are lacking. METHODS: Clinicopathologic features were studied in subtyped VGKC-autoantibody-seropositive patients who had undergone nerve biopsies...
April 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/27376483/increased-expression-of-gm1-detected-by-electrospray-mass-spectrometry-in-rat-primary-embryonic-cortical-neurons-exposed-to-glutamate-toxicity
#17
Dae Hee Park, Lynn Wang, Paula Pittock, Gilles Lajoie, Shawn Narain Whitehead
Neurons within different brain regions have varying levels of vulnerability to external stress and respond differently to injury. A potential reason to explain this may lie within a key lipid class of the cell's plasma membrane called gangliosides. These glycosphingolipid species have been shown to play various roles in the maintenance of neuronal viability. The purpose of this study is to use electrospray ionization mass spectrometry (ESI-MS) and immunohistochemistry to evaluate the temporal expression profiles of gangliosides during the course of neurodegeneration in rat primary cortical neurons exposed to glutamate toxicity...
August 2, 2016: Analytical Chemistry
https://www.readbyqxmd.com/read/27144221/clinical-utility-of-testing-aqp4-igg-in-csf-guidance-for-physicians
#18
Masoud Majed, James P Fryer, Andrew McKeon, Vanda A Lennon, Sean J Pittock
OBJECTIVE: To define, using assays of optimized sensitivity and specificity, the most informative specimen type for aquaporin-4 immunoglobulin G (AQP4-IgG) detection. METHODS: Results were reviewed from longitudinal service testing for AQP4-IgG among specimens submitted to the Mayo Clinic Neuroimmunology Laboratory from 101,065 individual patients. Paired samples of serum/CSF were tested from 616 patients, using M1-AQP4-transfected cell-based assays (both fixed AQP4-CBA Euroimmun kit [commercial CBA] and live in-house flow cytometry [FACS])...
June 2016: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/27112695/preface
#19
EDITORIAL
Sean J Pittock, Angela Vincent
No abstract text is available yet for this article.
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27112694/current-and-future-immunotherapy-targets-in-autoimmune-neurology
#20
REVIEW
Melody Y Hu, Panos Stathopoulos, Kevin C O'connor, Sean J Pittock, Richard J Nowak
Randomized controlled treatment trials of autoimmune neurologic disorders are generally lacking and data pertaining to treatment are mostly derived from expert opinion, large case series, and anecdotal reports. The treatment of autoimmune neurologic disorders comprises oncologic therapy (where appropriate) and immunotherapy. In this chapter, we first describe the standard acute and chronic immunotherapies and provide a practical overview of their use in the clinic (mechanisms of action, dosing, monitoring, and side effects)...
2016: Handbook of Clinical Neurology
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