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Spinal steroid

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https://www.readbyqxmd.com/read/29195847/trochanteric-bursitis-following-primary-total-hip-arthroplasty-incidence-predictors-and-treatment
#1
Shai S Shemesh, Calin S Moucha, Aakash Keswani, Nolan A Maher, Darwin Chen, Michael J Bronson
BACKGROUND: Trochanteric bursitis (TB) remains a common complication after total hip arthroplasty (THA), with an incidence between 3% and 17%, depending on the surgical approach, with the posterior approach (PA) being relatively protective compared to the lateral approach. The purposes of this study were to determine the incidence of TB after primary THA, identify potential risk factors for TB, and examine the utility of different modes of treatment. METHODS: Retrospective cohort data of 990 primary THAs performed in a single institution, including 613 PAs and 377 direct anterior approaches (DAAs), were analyzed...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29187683/-efficacy-of-high-dose-steroid-pulse-therapy-for-anti-galactocerebroside-antibody-positive-combined-central-and-peripheral-demyelination
#2
Masashi Hoshino, Yu Suzuki, Hisanao Akiyama, Kouji Yamada, Sayuri Shima, Tatsuro Mutoh, Yasuhiro Hasegawa
A 59-year-old man had been admitted to another hospital because of diplopia and thirst at the beginning of March and was diagnosed with diabetic ketoacidosis. He was referred to our hospital because he had limb weakness, dysarthria, and bilateral sensory impairment of the upper limbs, which worsened rapidly from the middle of March, although plasma glucose had been well controlled after the initiation of insulin therapy in the previous hospital. Contrast spinal MRI in our hospital revealed hyperintense lesions at the level of C4 to C5 and T10...
November 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29184347/anti-myelin-oligodendrocyte-glycoprotein-associated-immunoglobulin-g-antimog-igg-associated-neuromyelitis-optica-spectrum-disorder-with-persistent-disease-activity-and-residual-cognitive-impairment
#3
Lekha Pandit, Ichiro Nakashima, Sharik Mustafa, Toshiyuki Takahashi, Kimhiko Kaneko
Antibodies targeting myelin oligodendrocyte glycoprotein (MOG) have been recently reported in association with idiopathic inflammatory central nervous system disorders. Initially believed to be a benign disorder, anti MOG-IgG was noted to cause steroid responsive recurrent optic neuritis and isolated longitudinally extensive myelitis. However, there is growing evidence that the disease may be predominantly relapsing, often producing severe visual loss and involving regions other than the spinal cord and optic nerve...
October 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29173662/image-and-contrast-flow-pattern-interpretation-for-attempted-epidural-steroid-injections
#4
REVIEW
Michael B Furman, Anthony A Cuneo
Fluoroscopically guided, contrast-enhanced epidural steroid injections (ESIs) are frequently performed for radicular symptoms. Interventionalists performing these procedures should have a thorough and detailed understanding of spinal anatomy to safely and effectively deliver the desired injectate to the targeted site. Being able to differentiate epidural from nonepidural contrast flow is vital as is recognizing flow to undesired locations. This article summarizes the characteristics that distinguish between ideal epidural flow patterns and nonideal subarachnoid, intradural, and other suboptimal contrast flow patterns...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29173656/cervical-epidural-steroid-injection-techniques-and-evidence
#5
REVIEW
Lawrence McLean House, Kevin Barrette, Ryan Mattie, Zachary L McCormick
Cervical epidural steroid injections are a common treatment of cervical radicular pain. Important safety considerations include attention to the possibility of spinal cord infarction and spinal epidural hematoma. When appropriate, radiographic, technical, and pharmacologic principals are used, these procedures are relatively safe. Cervical epidural steroid injections are effective for the short-term treatment of radicular pain. More rigorously designed clinical outcomes studies of both cervical interlaminar and transforaminal epidural steroid injections are needed...
February 2018: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29164025/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-use-of-methylprednisolone-sodium-succinate
#6
Michael G Fehlings, Jefferson R Wilson, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K Kwon, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Andrea C Skelly, Anoushka Singh, Eve C Tsai, Alexander Vaccaro, Albert Yee, James S Harrop
Introduction: The objective of this guideline is to outline the appropriate use of methylprednisolone sodium succinate (MPSS) in patients with acute spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions related to the use of MPSS in acute SCI. A multidisciplinary Guideline Development Group used this information, in combination with their clinical expertise, to develop recommendations for the use of MPSS...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29137141/steroid-and-xenobiotic-receptor-signalling-in-apoptosis-and-autophagy-of-the-nervous-system
#7
REVIEW
Agnieszka Wnuk, Małgorzata Kajta
Apoptosis and autophagy are involved in neural development and in the response of the nervous system to a variety of insults. Apoptosis is responsible for cell elimination, whereas autophagy can eliminate the cells or keep them alive, even in conditions lacking trophic factors. Therefore, both processes may function synergistically or antagonistically. Steroid and xenobiotic receptors are regulators of apoptosis and autophagy; however, their actions in various pathologies are complex. In general, the estrogen (ER), progesterone (PR), and mineralocorticoid (MR) receptors mediate anti-apoptotic signalling, whereas the androgen (AR) and glucocorticoid (GR) receptors participate in pro-apoptotic pathways...
November 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29132243/protective-effects-of-estradiol-and-dihydrotestosterone-following-spinal-cord-injury
#8
Dale R Sengelaub, Qi Han, Nai-Kui Liu, Melissa Maczuga, Violetta Szalavari, Stephanie Valencia, Xiao-Ming Xu
Spinal cord injury (SCI) results in lesions that destroy tissue and disrupt spinal tracts, producing deficits in locomotor and autonomic function. We previously demonstrated that motoneurons, and the muscles they innervate, show pronounced atrophy after SCI, and these changes are prevented by treatment with testosterone. Here we assessed if the testosterone active metabolites, estradiol and dihydrotestosterone, have similar protective effects after SCI. Young adult female rats received either sham or T9 spinal cord contusion injuries and were treated with estradiol, dihydrotestosterone, both, or nothing via Silastic capsules...
November 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#9
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29116946/spinal-cord-injury-by-direct-damage-during-ct-guided-c7-transforaminal-epidural-steroid-injection-a-case-report
#10
Min Cheol Chang
Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury (SCI) during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt...
November 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29112802/consensus-treatment-plans-for-chronic-nonbacterial-osteomyelitis-refractory-to-nonsteroidal-anti-inflammatory-drugs-and-or-with-active-spinal-lesions
#11
Yongdong Zhao, Eveline Y Wu, Melissa S Oliver, Ashley M Cooper, Matthew L Basiaga, Sheetal S Vora, Tzielan C Lee, Emily Fox, Gil Amarilyo, Sara M Stern, Jeffrey A Dvergsten, Kathleen A Haines, Kelly A Rouster-Stevens, Karen B Onel, Julie Cherian, Jonathan S Hausmann, Paivi Miettunen, Tania Cellucci, Farzana Nuruzzaman, Angela Taneja, Karyl S Barron, Matthew C Hollander, Sivia K Lapidus, Suzanne C Li, Seza Ozen, Hermann Girschick, Ronald M Laxer, Fatma Dedeoglu, Christian M Hedrich, Polly J Ferguson
OBJECTIVE: To develop standardized treatment regimens for chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO) to enable comparative effectiveness treatment studies. METHODS: Virtual and face-to-face discussions and meetings were held within the CNO subgroup of the Childhood Arthritis and Rheumatology Research Alliance (CARRA). A literature search was conducted, and CARRA membership was surveyed to evaluate available treatment data and identify current treatment practices...
November 7, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29110994/spinal-cord-involvement-in-primary-cns-lymphoma
#12
Arunmozhi Maran Elavarasi, Deepa Dash, Anand R Warrier, Rohit Bhatia, Lalit Kumar, Deepali Jain, Manjari Tripathi
LETM is a common syndrome and the diagnosis of CNS lymphoma is not usually considered in the list of differentials. Primary CNS lymphoma can present as longitudinally extensive transverse myelopathy. Failure to suspect and evaluate leads to delay in diagnosis and treatment. PCNSL may be non contrast enhancing on gadolinium enhanced MRI. CSF analysis should be done preferably before starting corticosteroids as it is usual practice in treatment of transverse myelitis, as steroids may lead to transient improvement and mask the correct diagnosis...
October 27, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29102751/epidural-steroids-at-closure-post-microdiscectomy-laminectomy-for-reduction-of-post-operative-analgesia-systematic-review-and-meta-analysis
#13
Ash Wilson-Smith, Nicholas Chang, Victor M Lu, Ralph J Mobbs, Matthew Fadhil, Declan Lloyd, Sara Kim, Kevin Phan
BACKGROUND: This review assessed the efficacy of epidural steroid administration on the reduction of pain, hospital stay time and use of opioid analgesics postoperatively. METHODS: We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CCRCT) and Cochrane Database of Systematic Reviews (CDSR) for studies utilizing epidural steroids through any route following lumbar surgery. The primary study outcomes included pre- and postoperative pain as assessed through the use of a Visual Analogue Scale (VAS), length of hospital stay and postoperative use of opioid analgesics...
November 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29095327/cerebral-venous-sinus-thrombosis-due-to-low-molecular-weight-heparin-induced-thrombocytopenia
#14
Ezequiel Gleichgerrcht, Ming Y Lim, Tanya N Turan
INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin exposure. A limited number of studies have reported cerebral venous sinus thrombosis (CVST) as the presenting thrombotic event induced by HIT, only one of which occurred with exposure to low-molecular-weight heparin (LMWH), with death as outcome. Here, we present a unique case of LMWH-induced HIT leading to CVST but resulting in good clinical outcome. CASE REPORT: A 52-year-old woman received subcutaneous LMWH for deep vein thrombosis prophylaxis while in rehabilitation following kyphoplasty for spinal fracture related to recent trauma...
November 2017: Neurologist
https://www.readbyqxmd.com/read/29079733/analgesic-effects-and-pharmacologic-mechanisms-of-the-gelsemium-alkaloid-koumine-on-a-rat-model-of-postoperative-pain
#15
Bo-Jun Xiong, Ying Xu, Gui-Lin Jin, Ming Liu, Jian Yang, Chang-Xi Yu
Postoperative pain (POP) of various durations is a common complication of surgical procedures. POP is caused by nerve damage and inflammatory responses that are difficult to treat. The neuroinflammation-glia-steroid network is known to be important in POP. It has been reported that the Gelsemium alkaloid koumine possesses analgesic, anti-inflammatory and neurosteroid modulating activities. This study was undertaken to test the analgesic effects of koumine against POP and explore the underlying pharmacologic mechanisms...
October 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29067449/diosgenin-attenuates-neuropathic-pain-in-a-rat-model-of-chronic-constriction-injury
#16
Wei-Xin Zhao, Peng-Fei Wang, Hui-Gang Song, Nai Sun
Diosgenin is a steroidal saponin extract from numerous plants, including Solanum and Dioscorea species, and has been reported to possess neuroprotective activity. However, the role of diosgenin in neuropathic pain remains unclear. The present study examined the effects of diosgenin on allodynia and the levels of inflammatory mediators in rats following neuropathic pain evoked by chronic constriction injury (CCI). In addition, the underlying molecular mechanisms involved in diosgenin‑induced suppression of neuropathic pain were examined...
August 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29055484/chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-clippers-a-pediatric-case-report-with-six-year-follow-up
#17
Aravindhan Veerapandiyan, Amit Chaudhari, Prabhav Deo, Xue Ming
BACKGROUND: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is an inflammatory disorder involving brainstem, pons in particular, characterized by a predominant T-cell pathology and responsiveness to glucocorticosteroids. We describe a difficult 6 year course of this rare syndrome in a 10-year-old girl. CASE REPORT: Our patient presented with diplopia, spastic paraparesis, and unsteady gait. MRI showed characteristic punctate hyper-intensities with enhancement in the brain stem, cerebellar peduncles, and optic chiasm and diffuse nodular enhancement throughout the cervical and thoracic spinal cord...
October 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29055448/a-case-of-mog-antibody-positive-bilateral-optic-neuritis-and-meningoganglionitis-following-a-genital-herpes-simplex-virus-infection
#18
Masataka Nakamura, Yuko Iwasaki, Toshiyuki Takahashi, Kimihiko Kaneko, Ichiro Nakashima, Takenobu Kunieda, Satoshi Kaneko, Hirofumi Kusaka
BACKGROUND: Myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis (ON) and myelitis are recognized as important differential diagnosis of aquaporin-4 (AQP4) antibody-positive neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD). Similar to NMO/NMOSD associated with AQP4 antibodies, preceding infections have been reported in patients with MOG antibody-positive ON. This is the first report of bilateral ON following a herpes simplex virus (HSV) infection associated with a positive MOG antibody...
October 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29050399/diagnostic-criteria-for-chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-clippers
#19
W Oliver Tobin, Yong Guo, Karl N Krecke, Joseph E Parisi, Claudia F Lucchinetti, Sean J Pittock, Jay Mandrekar, Divyanshu Dubey, Jan Debruyne, B Mark Keegan
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a central nervous system inflammatory syndrome predominantly affecting the brainstem, cerebellum, and spinal cord. Following its initial description, the salient features of CLIPPERS have been confirmed and expanded upon, but the lack of formalized diagnostic criteria has led to reports of patients with dissimilar features purported to have CLIPPERS. We evaluated clinical, radiological and pathological features of patients referred for suspected CLIPPERS and propose diagnostic criteria to discriminate CLIPPERS from non-CLIPPERS aetiologies...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29034173/mycobacteria-bovis-osteomyelitis-following-intravesical-bcg-for-bladder-cancer
#20
Karan Seegobin, Satish Maharaj, Cherisse Baldeo, Carmen Isache, Bharatsinh Gharia, Lara Zuberi
Mycobacteria Bovis osteomyelitis is a rare adverse effect after Bacillus Calmette-Guerin (BCG) intravesical therapy. A 62-year-old male presented with acute spinal cord compression three months after completing his second course of therapy for bladder cancer. The first course with intravesical BCG was complicated with an episode of hematuria. He reported intermittent subjective fever for 3 weeks thereafter which resolved with Tylenol. Interferon-α2 B was added to the second cycle of intravesical BCG with the indication here being residual tumor, and was tolerated well...
2017: IDCases
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