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https://www.readbyqxmd.com/read/28087505/2016-update-of-the-asas-eular-management-recommendations-for-axial-spondyloarthritis
#1
Désirée van der Heijde, Sofia Ramiro, Robert Landewé, Xenofon Baraliakos, Filip Van den Bosch, Alexandre Sepriano, Andrea Regel, Adrian Ciurea, Hanne Dagfinrud, Maxime Dougados, Floris van Gaalen, Pál Géher, Irene van der Horst-Bruinsma, Robert D Inman, Merryn Jongkees, Uta Kiltz, Tore K Kvien, Pedro M Machado, Helena Marzo-Ortega, Anna Molto, Victoria Navarro-Compàn, Salih Ozgocmen, Fernando M Pimentel-Santos, John Reveille, Martin Rudwaleit, Jochen Sieper, Percival Sampaio-Barros, Dieter Wiek, Jürgen Braun
To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009...
January 13, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28086758/toxoplasmosis-associated-iris-involving-the-cns-a-case-report-with-longitudinal-analysis-of-t-cell-subsets
#2
Rita Rb-Silva, Claudia Nobrega, Eugénia Reiriz, Soraia Almeida, Rui Sarmento-Castro, Margarida Correia-Neves, Ana Horta
BACKGROUND: HIV-infected patients may present an unforeseen clinical worsening after initiating antiretroviral therapy known as immune reconstitution inflammatory syndrome (IRIS). This syndrome is characterized by a heightened inflammatory response toward infectious or non-infectious triggers, and it may affect different organs. Diagnosis of IRIS involving the central nervous system (CNS-IRIS) is challenging due to heterogeneous manifestations, absence of biomarkers to identify this condition, risk of long-term sequelae and high mortality...
January 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28072809/optimal-angle-of-contralateral-oblique-view-in-cervical-interlaminar-epidural-injection-depending-on-the-needle-tip-position
#3
Jun Young Park, Myung-Hwan Karm, Doo Hwan Kim, Jae-Young Lee, Hye-Joo Yun, Jeong Hun Suh
BACKGROUND: Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury. OBJECTIVES: We aimed to determine the optimal needle tip visualization, in order to minimize CILESIs-induced complications. STUDY DESIGN: Retrospective observational study...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28062253/spinal-neuropeptide-expression-and-neuropathic-behavior-in-the-acute-and-chronic-phases-after-spinal-cord-injury-effects-of-progesterone-administration
#4
María F Coronel, Marcelo J Villar, Pablo R Brumovsky, Susana L González
Patients with spinal cord injury (SCI) develop chronic pain that severely compromises their quality of life. We have previously reported that progesterone (PG), a neuroprotective steroid, could offer a promising therapeutic strategy for neuropathic pain. In the present study, we explored temporal changes in the expression of the neuropeptides galanin and tyrosine (NPY) and their receptors (GalR1 and GalR2; Y1R and Y2R, respectively) in the injured spinal cord and evaluated the impact of PG administration on both neuropeptide systems and neuropathic behavior...
January 3, 2017: Peptides
https://www.readbyqxmd.com/read/28056870/anti-n-methyl-d-aspartate-receptor-nmdar-antibody-encephalitis-presents-in-atypical-types-and-coexists-with-neuromyelitis-optica-spectrum-disorder-or-neurosyphilis
#5
Kaiyu Qin, Wenqing Wu, Yuming Huang, Dongmei Xu, Lei Zhang, Bowen Zheng, Meijuan Jiang, Cheng Kou, Junhua Gao, Wurong Li, Jinglin Zhang, Sumei Wang, Yanfei Luan, Chaoling Yan, Dan Xu, Xinmei Zheng
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a clinically heterogeneous disorder characterized by epileptic seizures, psychosis, dyskinesia, consciousness impairments, and autonomic instability. Symptoms are always various. Sometimes it presents in milder or incomplete forms. We report 4 cases of anti-NMDAR encephalitis with incomplete forms, 3 cases of which were accompanied by neuromyelitis optica spectrum disorder or neurosyphilis respectively. CASE PRESENTATION: A 33-year-old man presented with dysarthria, movement disorder and occasional seizures...
January 5, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28053850/disseminated-coccidioidomycosis-presenting-with-intramedullary-spinal-cord-abscesses-management-challenges
#6
Kristina L Bajema, Mark F Dalesandro, David N Fredricks, Meena Ramchandani
Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses...
March 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28048973/effect-of-physical-exercise-and-anabolic-steroid-treatment-on-spinal-motoneurons-and-surrounding-glia-of-wild-type-and-als-mice
#7
Roman M Kassa, Roberta Bonafede, Federico Boschi, Marina Bentivoglio, Raffaella Mariotti
Motoneuron degeneration is the hallmark of amyotrophic lateral sclerosis (ALS). The cause and predisposing factors for sporadic ALS are still unknown. Exposure to a specific environmental risk factors in subjects with a susceptibility genotype may increase the risk of the disease. The role of physical activity and the use of anabolic steroids are still debated in epidemiological studies on patients and murine models of ALS. To assess at the cellular level the role (beneficial or detrimental) of physical exercise and the use of anabolic steroid, we here investigated, in SOD1(G93A) (mSOD1) mice and wild-type littermates, changes in the ventral horn after regular exercise, treatment with the anabolic androgenic steroid 19-nortestosterone (nandrolone), and their combination, compared with matched control sedentary mice...
December 31, 2016: Brain Research
https://www.readbyqxmd.com/read/28025354/the-effectiveness-and-risks-of-non-image-guided-lumbar-interlaminar-epidural-steroid-injections-a-systematic-review-with-comprehensive-analysis-of-the-published-data
#8
REVIEW
Yakov Vorobeychik, Anil Sharma, Clark C Smith, David C Miller, Milan P Stojanovic, Steve M Lobel, Marc A Valley, Belinda Duszynski, David J Kennedy
OBJECTIVE: To determine the effectiveness and risks of non-image-guided lumbar interlaminar epidural steroid injections. DESIGN: Systematic review. INTERVENTIONS: Three reviewers with formal training and certification in evidence-based medicine searched the literature on non-image-guided lumbar interlaminar epidural steroid injections. A larger team of seven reviewers independently assessed the methodology of studies found and appraised the quality of the evidence presented...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28025351/immediate-adverse-events-in-interventional-pain-procedures-a-multi-institutional-study
#9
Carrie M Carr, Christopher T Plastaras, Matthew J Pingree, Matthew Smuck, Timothy P Maus, Jennifer R Geske, Christine A El-Yahchouchi, Zachary L McCormick, David J Kennedy
SETTING: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28017166/comparison-of-transforaminal-and-interlaminar-epidural-steroid-injections-for-the-treatment-of-chronic-lumbar-pain
#10
Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: We compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28007901/a-rat-model-of-ataxia-telangiectasia-evidence-for-a-neurodegenerative-phenotype
#11
Hazel Quek, John Luff, KaGeen Cheung, Sergei Kozlov, Magtouf Gatei, C Soon Lee, Mark C Bellingham, Peter G Noakes, Yi Chieh Lim, Nigel L Barnett, Steven Dingwall, Ernst Wolvetang, Tomoji Mashimo, Tara L Roberts, Martin F Lavin
Ataxia-telangiectasia (A-T), an autosomal recessive disease caused by mutations in the ATM gene is characterised by cerebellar atrophy and progressive neurodegeneration which has been poorly recapitulated in Atm mutant mice. Consequently, pathways leading to neurodegeneration in A-T are poorly understood. We describe here the generation of an Atm knockout rat model that does not display cerebellar atrophy but instead paralysis and spinal cord atrophy, reminiscent of that seen in older patients and milder forms of the disorder...
December 22, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/27999689/bradycardia-associated-with-steroid-use-for-laryngeal-edema-in-an-adult-a-case-report-and-literature-review
#12
Preeti R John, Ariana Khaladj-Ghom, Kimberly L Still
Steroids are used for specific indications in the perioperative period to reduce laryngeal or spinal cord edema, or for prophylaxis and treatment of postoperative nausea and vomiting. Given the other potential causes for hemodynamic alterations in the perioperative setting, it is important for physicians to be aware of cardiovascular side effects of short term steroids. Changes in blood pressure and heart rate, cardiac dysrhythmias, and even death have been described in patients receiving short term intravenous steroids...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27989984/anterior-cervical-discectomy-and-fusion-comparison-of-fusion-dysphagia-and-complication-rates-between-recombinant-human-bone-morphogenetic-protein-2-and-beta-tricalcium-phosphate
#13
Brendan P Lovasik, Christopher M Holland, Brian M Howard, Griffin R Baum, Gerald E Rodts, Daniel Refai
INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal procedures performed. A direct comparison of the fusion and complication rates between recombinant human bone morphogenetic protein-2 (rhBMP2) and beta-tricalcium phosphate (bTCP) has not been reported. METHODS: A retrospective study of 191 consecutive patients who underwent ACDF with PEEK (poly-ether-ether ketone plastic) fusion spacers over a 2-year period with either rhBMP2 (n=84, 46%) or bTCP (n=107, 56) was performed...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27977533/successful-management-of-fulminant-guillain-barr%C3%A3-syndrome-and-its-complications
#14
Atsushi Kamei, Manami Akasaka, Nami Araya, Ken Ishikawa, Akira Takada, Hiromi Furukawa, Sachiko Tanifuji, Maya Asami, Yurie Nasu, Kotaro Oyama, Shoichi Chida
A 3-year-old girl presented with muscle weakness of her limbs and trunk 6 days after developing symptoms of common cold. Two days later, she experienced respiratory arrest with a Glasgow Coma Scale score of 3, necessitating endotracheal intubation. Therefore, she was transferred to our hospital with suspected acute encephalopathy. Although no abnormalities were observed on brain and spinal magnetic resonance imaging and electroencephalography, peripheral nerve conduction velocity tests failed to evoke motor and sensory nerve action potentials...
December 12, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27935769/fluoroscopically-guided-epidural-injections-of-the-cervical-and-lumbar-spine
#15
Euddeum Shim, Joon Woo Lee, Eugene Lee, Joong Mo Ahn, Yusuhn Kang, Heung Sik Kang
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications...
December 9, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27919862/spinal-cord-injury-assessing-tolerability-and-use-of-combined-rehabilitation-and-neuroaid-saturn-study-protocol-of-an-exploratory-study-in-assessing-the-safety-and-efficacy-of-neuroaid-amongst-people-who-sustain-severe-spinal-cord-injury
#16
Ramesh Kumar, Ohnmar Htwe, Azmi Baharudin, Mohammad Hisam Ariffin, Shaharuddin Abdul Rhani, Kamalnizat Ibrahim, Aishah Rustam, Robert Gan
BACKGROUND: Spinal cord injury (SCI) is a devastating condition with limited therapeutic options despite decades of research. Current treatment options include use of steroids, surgery, and rehabilitation. Nevertheless, many patients with SCI remain disabled. MLC601 (NeuroAiD), a combination of natural products, has been shown to be safe and to aid neurological recovery after brain injuries and may have a potential role in improving recovery after SCI. OBJECTIVE: The aim of this study is to evaluate the safety and efficacy of NeuroAiD amongst people who sustain SCI in the study setting...
December 5, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#17
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906934/can-unilateral-kyphoplasty-replace-bilateral-kyphoplasty-in-treatment-of-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analysis
#18
Han Sun, Pei-Pei Lu, Yi-Jie Liu, Xu Yang, Ping-Hui Zhou, Xiao-Feng Shen, Si-Wei Sun, Huilin Yang
BACKGROUND: Kyphoplasty has been proven to be an efficient method to relieve patient suffering from osteoporotic vertebral compression fractures (OVCFs). Because of its technological superiority, unilateral kyphoplasty consumes less operative time and bone cement than traditional bilateral kyphoplasty. However, there is controversy about which method is most efficient in the treatment of OVCFs. Thus, an overall analysis should be performed to shed light on the facts corroborating both procedures...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27861371/chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-clippers-with-intracranial-epstein-barr-virus-infection-a-case-report
#19
Yue Ma, Xiaolong Sun, Wen Li, Yi Li, Tao Kang, Xiai Yang, Wen Jiang
BACKGROUND: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder in the central nervous system (CNS) with distinct clinical, radiological, and pathological features. The pathophysiology of CLIPPERS still remains unclear and the reports are quite few. Although the radiological lesions were reported to be located predominantly in the pons, brachium pontis, and cerebellum, other adjacent structures such as the white matter and spinal cord were very recently reported as involved regions in CLIPPERS...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858240/return-of-motor-evoked-potentials-after-knee-flexion-in-the-setting-of-high-grade-spondylolisthesis
#20
Justin Tilan, Lindsay M Andras, Mark D Krieger, David L Skaggs
PURPOSE: To present a case of loss of motor-evoked potentials (MEPs) to the left foot in the supine position after a partial reduction and instrumented fusion from L4 to pelvis which was managed successfully without revision or removal of implants. METHODS: We report a patient with high-grade spondylolisthesis who demonstrated loss of motor-evoked potentials after posterior spinal fusion and transfer to supine position. The patient's knees were flexed to 90° and signals were immediately restored...
November 17, 2016: European Spine Journal
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