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https://www.readbyqxmd.com/read/29901009/a-case-of-primary-sj%C3%A3-gren-s-syndrome-presenting-as-mass-like-encephalitis-with-progression-to-neuromyelitis-optica-spectrum-disorder
#1
Hyun-Jung Lee, Sung Hae Chang, Eun Ha Kang, Yun Jong Lee, Yeong Wook Song, You-Jung Ha
Neuromyelitis optica is an idiopathic inflammatory demyelinating disease of the central nervous system (CNS) that predominantly affects the optic nerves and spinal cord. With the discovery of the pathogenic anti-aquaporin-4 (AQP4) antibody, the disease was recognized as part of a spectrum of autoimmune diseases that target AQP4, collectively referred to as neuromyelitis optica spectrum disorder (NMOSD). NMOSD consists of conditions that affect various parts of the CNS with the AQP4 antibody. In this article, we report a 43-year-old female patient who was initially diagnosed with primary Sjögren's syndrome (pSS) with CNS involvement, but was later diagnosed with overlapping pSS and NMOSD, which required more intensive treatment...
December 2017: Archives of Rheumatology
https://www.readbyqxmd.com/read/29890458/local-muscle-flaps-minimize-post-operative-wound-morbidity-in-patients-with-neoplastic-disease-of-the-spine
#2
Philipp Franck, Jaime L Bernstein, Leslie E Cohen, Roger Härtl, Ali A Baaj, Jason A Spector
OBJECTIVES: Patients with neoplastic disease involving the spine either from primary or metastatic disease present a unique challenge given these patients' frequent poor nutritional status at the time of surgery, the delivery of early post-operative chemotherapy or radiation, and placement of large amounts of hardware and avascular bone graft into a wound bed that is atrophic, previously operated or irradiated. As a result, wound morbidity has traditionally been high in this cohort of patients...
May 29, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29890290/the-selective-glucocorticoid-receptor-modulator-cort-113176-reduces-neurodegeneration-and-neuroinflammation-in-wobbler-mice-spinal-cord
#3
Maria Meyer, Agustina Lara, Hazel Hunt, Joseph Belanoff, E Ronald de Kloet, Maria Claudia Gonzalez Deniselle, Alejandro F De Nicola
Wobbler mice are experimental models for amyotrophic lateral sclerosis. As such they show motoneuron degeneration, motor deficits, and astrogliosis and microgliosis of the spinal cord. Additionally, Wobbler mice show increased plasma, spinal cord and brain corticosterone levels and focal adrenocortical hyperplasia, suggesting a pathogenic role for glucocorticoids in this disorder. Considering this endocrine background, we examined whether the glucocorticoid receptor (GR) modulator CORT 113176 prevents spinal cord neuropathology of Wobblers...
June 8, 2018: Neuroscience
https://www.readbyqxmd.com/read/29885430/spinal-cord-ischemia-following-elective-endovascular-repair-of-infrarenal-aortic-aneurysms-a-systematic-review
#4
REVIEW
Konstantinos G Moulakakis, Vangelis G Alexiou, Georgios Karaolanis, George S Sfyroeras, George Theoharopoulos, Andreas Lazaris, John Kakisis, George Geroulakos
AIM: Spinal cord ischemia (SCI) following endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is a rare but devastating complication. The mechanism underlying the occurrence of SCI following EVAR seems to be multifactorial and is underreported and not fully elucidated. The aim of the study was to investigate the clinical outcomes in patients with this serious complication. MATERIAL-METHODS: A systematic review of the current literature, as per PRISMA statement guidelines, to evaluate the incidence of SCI following elective EVAR was performed...
June 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29883820/extensive-spinal-adhesive-arachnoiditis-after-extradural-spinal-infection-spinal-dura-mater-is-no-barrier-to-inflammation
#5
Theresa Krätzig, Marc Dreimann, Klaus Christian Mende, Ingo Königs, Manfred Westphal, Sven Oliver Eicker
BACKGROUND: Spinal adhesive arachnoiditis (SAA) is an inflammatory process of the meninges. Cystic changes and cicatrisation may lead to neurological deficits and immobilization. Therapy is difficult and often unsatisfactory. We describe eight cases of extensive SAA following extradural spinal infection. METHODS: 238 patients with epidural abscess or osteomyelitis were treated at our institution between 2011 and 2018. We identified eight patients who developed extensive SAA on follow-up...
June 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29879075/atypical-spinal-cord-infarction-a-case-report
#6
Koshi Ota, Ryo Iida, Kanna Ota, Masahide Sakaue, Shogo Takashima, Kohei Taniguchi, Masao Tomioka, Masahiko Nitta, Akira Takasu
INTRODUCTION: The abrupt onset of sensorimotor deficits is a neurologic emergency that requires immediate management. Acute spontaneous spinal cord infarction (SCI) is rare, but can cause the sudden onset of quadriplegia or quadriparesis. Magnetic resonance imaging (MRI) is an essential imaging modality to diagnose SCI. CASE PRESENTATION: A 75-year-old man with a history of diabetes mellitus type 2, hypertension, and dyslipidemia was transferred to our facility for further workup of the sudden onset of quadriplegia...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29871371/comparison-of-epidural-spreading-patterns-and-clinical-outcomes-of-transforaminal-epidural-steroid-injection-with-high-volume-injectate-via-the-subpedicular-versus-the-retrodiscal-approach
#7
Won-Joong Kim, Hwa-Yong Shin, Seung Hee Yoo, Hahck Soo Park
BACKGROUND: The effect of transforaminal epidural steroid injection (TFESI) appears to be influenced by the volume of the injected material because there is a positive correlation between injection volume and extent of pain relief. OBJECTIVES: The purpose of this study was to examine how many vertebral segments are covered by the subpedicular (SP) approach and the retrodiscal (RD) approach and to compare the clinical outcomes of the 2 approaches in TFESI with high-volume injectates...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29867498/the-somatostatin-receptor-4-agonist-j-2156-alleviates-mechanical-hypersensitivity-in-a-rat-model-of-breast-cancer-induced-bone-pain
#8
Priyank A Shenoy, Andy Kuo, Nemat Khan, Louise Gorham, Janet R Nicholson, Laura Corradini, Irina Vetter, Maree T Smith
In the majority of patients with breast cancer in the advanced stages, skeletal metastases are common, which may cause excruciating pain. Currently available drug treatments for relief of breast cancer-induced bone pain (BCIBP) include non-steroidal anti-inflammatory drugs and strong opioid analgesics along with inhibitors of osteoclast activity such as bisphosphonates and monoclonal antibodies such as denosumab. However, these medications often lack efficacy and/or they may produce serious dose-limiting side effects...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29804214/pseudoprogression-successfully-treated-with-bevacizumab-in-a-child-with-spinal-pilocytic-astrocytoma
#9
Kenji Miyata, Toshinori Hori, Yasuto Shimomura, Masahiro Joko, Masakazu Takayasu, Akihisa Okumura
CLINICAL CASE: We report on a 7-year-old female with spinal pilocytic astrocytoma complicated by pseudoprogression 1 month after completion of radiation therapy. Although she was initially treated with high-dose steroids, her clinical symptoms did not completely resolve, and magnetic resonance imaging (MRI) revealed extension of the lesions into the medulla oblongata. Treatment with bevacizumab was commenced, followed by rapid resolution of the clinical symptoms and improvements in the MRI findings...
May 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29804078/spinal-tophaceous-gout-presenting-in-a-young-adult-without-pain
#10
Zaid Al-Jebaje, John Mellon Elibol, Jonathan Peters, Ali Alameri
A 26-year-old man with a medical history of gout and morbid obesity presented with a 7-day history of decreased sensation to light touch and temperature from the feet to the level of the nipples. He also noted incomplete voiding. Laboratory investigations showed an elevated serum uric acid level (10.4 mg/dL, reference range: 3.8-8.7 mg/dL) as well as negative rapid plasma reagin and rheumatoid factor. MRI showed inflammatory changes on multiple spinal levels. Laminectomy was performed, with follow-up biopsy revealing multiple multinucleated giant cells and monosodium urate (MSU) crystals...
May 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29796379/worldwide-steroid-prescription-for-acute-spinal-cord-injury
#11
REVIEW
Asdrubal Falavigna, Francine W Quadros, Alisson R Teles, Chung Chek Wong, Giuseppe Barbagallo, Darrel Brodke, Abdulaziz Al-Mutair, K Daniel Riew
Study Design: Cross-sectional study. Objectives: To continue the line of a previous publication using steroid for acute spinal cord injury (SCI) by spine surgeons from Latin America (LA) and assess the current status of methylprednisolone (MP) prescription in Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine targets for educational activities suitable for each region. Methods: The English version of a previously published questionnaire was used to evaluate opinions about MP administration in acute SCI in LA, EU, AP, NA, and ME...
May 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29786884/bone-morbidity-and-recovery-in-children-with-acute-lymphoblastic-leukemia-results-of-a-six-year-prospective-cohort-study
#12
Leanne M Ward, Jinhui Ma, Bianca Lang, Josephine Ho, Nathalie Alos, Mary Ann Matzinger, Nazih Shenouda, Brian Lentle, Jacob L Jaremko, Beverly Wilson, David Stephure, Robert Stein, Anne Marie Sbrocchi, Celia Rodd, Victor Lewis, Sara Israels, Ronald M Grant, Conrad V Fernandez, David B Dix, Elizabeth A Cummings, Robert Couch, Elizabeth Cairney, Ronald Barr, Sharon Abish, Stephanie A Atkinson, John Hay, Frank Rauch, David Moher, Kerry Siminoski, Jacqueline Halton
Osteoporotic fractures are a significant cause of morbidity in acute lymphoblastic leukemia (ALL). Our objective was to determine the incidence and predictors of fractures and recovery from osteoporosis in pediatric ALL over 6 years following glucocorticoid initiation. Vertebral fractures (VF) and vertebral body reshaping were assessed on annual spine radiographs, low-trauma non-VF were recorded at regular intervals and spine bone mineral density (BMD) was captured every 6 months for 4 years and then annually...
May 22, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29773485/pregnancy-after-heterotopic-heart-transplant-removal
#13
S Churchill, L de Lloyd, H C Francis, H Wallis
Heterotopic heart transplants were introduced in 1974. The technique allows the patient's native heart to be preserved in situ, alongside the transplanted heterotopic donor heart (Newcomb et al., 2004). We present the case of a nulliparous woman who underwent heterotopic heart transplant in infancy, and subsequent explantation of the donor heart eleven years later, when her native heart function recovered. In adulthood the patient attended pre-pregnancy counselling and was awaiting cardiac magnetic resonance imaging when she presented pregnant at 6 weeks-of-gestation...
April 24, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29770929/two-cases-of-sarcoidosis-presenting-as-longitudinally-extensive-transverse-myelitis
#14
REVIEW
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29768373/acute-myelitis-of-children-with-positive-anti-gm1-antibody-case-series-and-literature-review
#15
Zhiling Wang, Di Qie, Hui Zhou, Xiao Tang Cai
RATIONALE: To explore the clinical features, treatment, and prognosis of acute myelitis (AM) of children with positive blood anti- ganglioside (GM1) antibodies. PATIENT CONCERNS: Two cases of AM of children with positive anti-GM1 antibody were retrospectively collected and followed up for 6 months. Two cases had positive helicobacter pylori IgG antibody, and Case 2 also had positive mycoplasma IgM antibody. DIAGNOSES: Two cases had typical symptoms of myelitis, abnormal spinal magnetic resonance imaging (MRI), and positive serum anti-GM1 IgM...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764185/management-of-metastatic-spinal-cord-compression-among-veterans-health-administration-radiation-oncologists
#16
Ruchika Gutt, Sheeta Malhotra, Shruti Jolly, Drew Moghanaki, Alice V Cheuk, Helen Fosmire, Maria Kelly, Lori Hoffman-Hogg, Stephen Lutz, Mitchell Anscher, George Dawson
BACKGROUND: Optimal management of metastatic spinal cord compression (MSCC) improves functional outcomes in patients with metastatic disease. This survey study evaluated management of MSCC by Veterans Health Administration (VHA) radiation oncologists (ROs), to determine whether management of MSCC correlates with American College of Radiology (ACR) guidelines, and to compare times to initiation of treatment between surgery and radiotherapy (RT). METHODS: Surveys emailed to 79 VHA ROs included questions on steroid use, surgical care, palliative care, fractionation of irradiation, re-irradiation, and management of common MSCC case scenarios...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29755242/spinal-schistosomiasis-cases-in-egyptian-population
#17
Ahmed M Ashour, Tarek H Elserry, Mohamed S Nosser, Zeyad Y Fayed, Mohamed Wael Samir, Alaa Fakher, Maamoun M Ashour, Mamdouh M Salama
Background: Spinal cord involvement by schistosomiasis is considered to be rare. Clinical presentation of spinal schistosomiasis ranges from radicular pain to myelopathy causing flaccid paraplegia, bladder incontinence, and dysesthesia. We reported six cases with spinal schistosomiasis. Methodology: We did a retrospective analysis of the records in our department from March 1995 to March 2015, and we found that six cases of proved spinal schistosomiasis were documented, with follow-up period more than a year, aiming to find an assumption for a guideline for this ambiguous issue...
January 2018: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29745624/current-evidence-for-central-analgesic-effects-of-nsaids-an-overview-of-the-literature
#18
Pascal H Vuilleumier, Juerg Schliessbach, Michele Curatolo
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for a variety of painful conditions. Their peripheral anti-inflammatory effect due to inhibition of prostaglandin synthesis is well documented. In the late 1980ies, animal data suggested for the first time that NSAIDs might have central effects as well. Since that time, central inflammatory and nociceptive pathways that are potential targets of NSAIDs have been extensively studied in both animal and human models. This review provides an overview of the relevant literature implicated in the central effects of NSAIDs...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29742711/pituitary-apoplexy-following-lumbar-fusion-surgery-in-prone-position-a-case-report
#19
Chunghee Joo, Geol Ha, Yeon Jang
RATIONALE: Pituitary apoplexy (PA) is a syndrome caused by acute hemorrhage or infarction of the pituitary gland, generally within a pituitary adenoma. PA following spinal surgery is a very rare complication and may be difficult to diagnose. However, early diagnosis of PA is essential for the timely treatment of pan-hypopituitarism and prevention of severe neurologic complications. PATIENT CONCERNS: A 73-year-old man had a posterior lumbar fusion surgery over a period of 8 hours on prone position...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29742708/the-effectiveness-and-safety-of-nonsurgical-integrative-interventions-for-symptomatic-lumbar-spinal-spondylolisthesis-a-randomized-controlled-multinational-multicenter-trial-protocol
#20
RANDOMIZED CONTROLLED TRIAL
Kiok Kim, Yousuk Youn, Sang Ho Lee, Jung Chul Choi, Jae Eun Jung, Jaehong Kim, Wenchun Qu, Jason Eldrige, Tae-Hun Kim
BACKGROUND: Surgery is generally accepted as the main therapeutic option for symptomatic lumbar spondylolisthesis. However, new nonsurgical therapeutic options need to be explored for this population. OBJECTIVES: The objective of this study is to assess the effectiveness and safety of a 5-week Mokhuri treatment program compared with conventional nonsurgical treatments for symptomatic lumbar spondylolisthesis. METHODS: This is a study protocol for a multinational, multicenter clinical randomized controlled trial comparing the effectiveness and safety of 5 weeks of nonsurgical integrative treatments (a Mokhuri treatment program consisting of Chuna, acupuncture, and patient education) with nonsurgical conventional treatments (drugs for pain relief, epidural steroid injections, and physical therapy)...
May 2018: Medicine (Baltimore)
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