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Flaccid paralysis

Yang Zhao, Hui Guo, Ying Zhao, Bingyin Shi
Ectopic adrenal adenoma causing chronic Cushing's syndrome (CS) is a rare phenomenon. Diagnosis is usually made years after disease onset because of the insidious nature of the ectopic adrenal gland and because it overlaps with common symptoms, such as overweight and hypertension, in the general population (Kreitschmann-Andermahr et al., 2015). Here, we report the case of a 46-year-old male with a 15-year history of severe hypertension, facial plethora, and centripetal obesity. During treatment for herpes zoster, the patient presented with severe hypokalemia and flaccid paralysis, characteristic changes associated with CS...
March 7, 2018: Annales D'endocrinologie
Jingjing Yuan, Li Shen, Jing Wu, Xinran Zou, Jiaqi Gu, Jianguo Chen, Lingxiang Mao
Enterovirus A71 (EV-A71) infection has grown to become a serious threat to global public health. It is one of the major causes of hand, foot, and mouth disease (HFMD) in infants and young children. EV-A71 can also infect the central nervous system (CNS) and induce diverse neurological complications, such as brainstem encephalitis, aseptic meningitis, and acute flaccid paralysis, or even death. Viral proteins play a crucial role in EV-A71 infection. Many recent studies have discussed the structure and function of EV-A71 proteins, and the findings reported will definitely aid the development of vaccines and therapeutic approaches...
2018: Frontiers in Microbiology
Chukwuma Mbaeyi, Abdinoor Mohamed, Brian Ogola Owino, Kumlachew F Mengistu, Derek Ehrhardt, Eltayeb Ahmed Elsayed
Background: Surveillance for cases of acute flaccid paralysis (AFP) is a key strategy adopted for the eradication of polio. Detection of poliovirus circulation is often predicated on the ability to identify AFP cases and test their stool specimens for poliovirus infection in a timely manner. The Village Polio Volunteers (VPV) program was established in 2013 in a bid to strengthen polio eradication activities in Somalia, including AFP surveillance, given the country's vulnerability to polio outbreaks...
March 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Kevin Messacar, Edwin J Asturias, Alison M Hixon, Coretta Van Leer-Buter, Hubert G M Niesters, Kenneth L Tyler, Mark J Abzug, Samuel R Dominguez
Increased circulation of enterovirus D68 in 2014 and 2016 temporally and geographically coincided with increases in cases of acute flaccid myelitis, an uncommon condition of paralysis due to lesions in the anterior horn of the spinal cord. The identification of enterovirus D68 in respiratory specimens from cases of acute flaccid myelitis worldwide further supports an association, yet the absence of direct virus isolation from affected tissues, infrequent detection in cerebrospinal fluid, and the absence, until recently, of an animal model has left the causal nature of the relationship unproven...
February 23, 2018: Lancet Infectious Diseases
Maximiliano A Hawkes, Ivan D Carabenciov, Eelco F M Wijdicks, Alejandro A Rabinstein
BACKGROUND: Data to guide neurointensivists seeing patients with West Nile Neuroinvasive disease (WNND) are lacking. We present a comparatively large series of patients with WNND admitted to the intensive care unit (ICU) and provide data on their early diagnosis, triage to the ICU and predictors of short-term outcomes. METHODS: We retrospectively identified patients aged ≥ 18 years old with WNND from January 1999 to November 2016. Demographic and clinical data, the modified Rankin Scale at discharge and disposition were collected...
February 12, 2018: Neurocritical Care
Ryutaro Kira
Acute flaccid myelitis (AFM) is a newly defined, rare, but clinically distinct syndrome of acute flaccid paralysis with spinal motor neuron involvement of unknown etiology. Clusters of AFM coincided with a nationwide outbreak of enterovirus D68 (EV-D68) in the United States during autumn to winter of 2014 and in Japan during the autumn of 2015. Although EV-D68 was detected in only 20% of the AFM patients, mainly from respiratory specimens without apparent viral detection from blood and cerebrospinal fluid (CSF) samples, strong temporal associations were noted...
February 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Hafsa Imran, Dania Raja, Nicholas C Grassly, M Zubair Wadood, Rana M Safdar, Kathleen M O'Reilly
Background: Within Pakistan, estimates of vaccination coverage with the pentavalent vaccine, oral polio vaccine (OPV) and measles vaccine (MV) in 2011 were reported to be 74%, 75% and 53%, respectively. These national estimates may mask regional variation. The reasons for this variation have not been explored. Methods: Data from the Multiple Indicator Cluster Surveys (MICS) for Balochistan and Punjab (2010-2011) are analysed to examine factors associated with receiving three or more doses of the pentavalent vaccine and one or more MVs using regression modelling...
February 8, 2018: International Health
Manli Guo, Guowen Zhang, Shaogang Ma, Tie Xu, Yigen Peng
OBJECTIVE To screen for mutations in a Chinese pedigree affected with hypokalemic periodic paralysis. METHODS The proband and nine family members were enrolled for the analysis of CACNA1S and SCN4A gene mutations. Genomic DNA was extracted from peripheral blood samples. The coding regions of the two genes were amplified with PCR and subjected to Sanger sequencing. Potential impact of suspected mutations was predicted with Bioinformatics software. The mutations were also verified among 100 healthy controls. RESULTS The proband and 5 family members (including 5 males and 1 female) had presented with episodes of flaccid paralysis accompanied by low serum potassium...
February 10, 2018: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
Maria Dolores Fernandez-Garcia, Manasi Majumdar, Ousmane Kebe, Kader Ndiaye, Javier Martin
Enterovirus B69 (EV-B69) is a rarely reported type and till date, only the full-length genome sequence of the prototype strain is available. Besides the prototype strain, only limited VP1 sequences of this virus from Africa and India are available in GenBank. In this study, we analyzed the full-length genome sequence of an EV-B69 strain recovered from a patient with acute flaccid paralysis in Niger. Compared with the EV-B69 prototype strain, it had 79.6% and 76.3% nucleotide identity in the complete genome and VP1 coding region, respectively...
February 1, 2018: Scientific Reports
Hassan El Khatib, Amal Naous, Soha Ghanem, Ghassan Dbaibo, Mariam Rajab
Guillain-Barre Syndrome, an acute flaccid paralysis known to be caused by recent Gastro-intestinal infections mainly campylobacter, and Respiratory infections mainly mycoplasma pneumoniae and influenza. One reported case of severe invasive pneumococcal disease in a 68 year old female, that presented with Austrian's triad of meningitis, pneumonia and endocarditis, and progressed to develop Guillain Barre syndrome, an association never been documented before. We present a case of 13 year old male, presented with hypoactivity and inability to bare his own weight, developed septic shock due to pneumococcus with Acute Respiratory Distress Syndrome, and was found to have neurological findings of Guillain-Barre Syndrome...
2018: IDCases
Chao Zhang, Xueyang Zhang, Wenlong Dai, Qingwei Liu, Pei Xiong, Shuxia Wang, Lanlan Geng, Sitang Gong, Zhong Huang
In recent years, enterovirus D68 (EVD68) has been reported increasingly to be associated with severe respiratory tract infections and acute flaccid myelitis (AFM) in children all over the world. Yet, no effective vaccines or antiviral drugs are currently available for EVD68. Although several experimental animal models have been developed, immunogenicity and protective efficacy of inactivated EVD68 vaccines has not been fully evaluated. To promote the development of vaccines, we established an Institute of Cancer Research (ICR) suckling mouse model of EVD68 infection in this study...
January 30, 2018: Viruses
Takafumi Togashi, Hironori Baba, Meiko Kitazawa, Nao Takahashi, Yasuhiro Samejima, Eiji Yumoto, Arata Horii
Cluster of acute flaccid paralysis and cranial nerve dysfunction was associated with a 2014 outbreak of enterovirus D68 (EV-D68) respiratory illness in US. We describe a 33 year-old male patient of refractory dysphagia due to EV-D68-induced brainstem encephalitis successfully treated by surgery. Following acute upper respiratory tract infection, he developed dysphagia and bilateral facial paralysis. A coughing reflex was readily produced when the laryngopharyngeal fiberscope touched the epiglottis, however, water infusion induced only very weak and slow swallowing reflex, suggesting that only motor component was impaired but sensory function was preserved during swallowing...
January 20, 2018: Auris, Nasus, Larynx
Hua-Hui Hu, Xiao-Long Huang, Ren-Fu Quan, Zong-Bao Yang, Jing-Jing Xu
OBJECTIVE: To establish the rat model of acute spinal cord injury, followed by aprimary study on this model with ¹H NMR based on metabonomics and to explore the metabonomics and biomarkers of spinal cord injury rat. METHODS: Twenty eight-week-old adult male SD rats of clean grade, with body weight of (200±10) g, were divided into sham operation group and model group in accordance with the law of random numbers, and every group had 10 rats. The rats of sham operation group were operated without damaging the spinal cord, and rats of model group were made an animal model of spinal cord incomplete injury according to the modified Allen's method...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hsin-Yi Wei, Ting-Kai Yeh, Juo-Yu Hsieh, I-Ping Lin, Jyh-Yuan Yang
In respond to acute flaccid paralysis (AFP) in association with Enterovirus D68 (EV-D68) infection, Taiwan Centers for Disease Control began to screen EV-D68 infection among each AFP patient since July 2015 and detected the first case in August 2016. This article updated the molecular epidemiology trends of EV-D68 from the national surveillance data.
January 3, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
John D Morrey, Hong Wang, Brett L Hurst, Katherine Zukor, Venkatraman Siddharthan, Arnaud J Van Wettere, Donal G Sinex, E Bart Tarbet
Enterovirus D68 (EV-D68) caused a large outbreak in the summer and fall of 2014 in the United States. It causes serious respiratory disease, but causation of associated paralysis is controversial, because the virus is not routinely identified in cerebrospinal fluid. To establish clinical correlates with human disease, we evaluated EV-D68 infection in non-lethal paralysis mouse models. Ten-day-old mice lacking interferon responses were injected intraperitoneally with the virus. Paralysis developed in hindlimbs...
January 12, 2018: Viruses
Alexis Burakoff, Jennifer Lehman, Marc Fischer, J Erin Staples, Nicole P Lindsey
Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the continental United States (1,2). Other arboviruses, including La Crosse, Powassan, Jamestown Canyon, St. Louis encephalitis, and eastern equine encephalitis viruses, cause sporadic cases of disease and occasional outbreaks. This report summarizes surveillance data reported to CDC for 2016 for nationally notifiable arboviruses...
January 12, 2018: MMWR. Morbidity and Mortality Weekly Report
Bipin Amin, Himanshu Meghnathi, M D Gajjar, Tarak Patel, Jignesh Vanani, Nidhi Gupta, Anil Chauhan
Introduction: Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy causing acute flaccid paralysis and it is known to improve with plasmapheresis. Objective: To study effects of electrophysiological type of GBS, clinical variant of GBS and time taken for initiation of plasmapheresis on outcome of disease. Methods: 50 consecutive patients of GBS attending tertiary care hospital underwent clinical examination and electrophysiological studies...
November 2017: Journal of the Association of Physicians of India
Mohan Rudrappa, Laxmi Kokatnur, Oleg Chernyshev
West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy...
January 10, 2018: Diseases (Basel)
Cyntia O Souza, Marcelo A C S Vieira, Francisca M A Batista, Kelsen D Eulálio, Jéssica M M Neves, Laís C Sá, Leni C R Monteiro, Walfrido S Almeida-Neto, Raimunda S S Azevedo, Dorcas L Costa, Ana C R Cruz
In countries where poliomyelitis has been eradicated, Guillain-Barré syndrome (GBS) is the leading cause of acute flaccid paralysis. The range of infections that precede GBS in Brazil is unknown. Campylobacter jejuni infection is the most frequent trigger of GBS worldwide. Given the lack of systematic surveillance of diarrheal diseases, particularly in adults, the incidence of enteritis caused by C. jejuni in developing countries is unknown. From 2014 to 2016, pretreatment serum samples from 63 GBS patients were tested by immunoglobulin M (IgM) enzyme-linked immunosorbent assay for C...
January 8, 2018: American Journal of Tropical Medicine and Hygiene
Ayesheshem Ademe Tegegne, Fiona Braka, Meseret Eshetu Shebeshi, Aron Kassahun Aregay, Berhane Beyene, Amare Mengistu Mersha, Mohammed Ademe, Abdulahi Muhyadin, Dadi Jima, Abyot Bekele Wyessa
BACKGROUND: Ethiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004-2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned. METHOD: The data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP)...
January 5, 2018: BMC Infectious Diseases
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