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Muscle weakness, pain

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https://www.readbyqxmd.com/read/29343142/a-500%C3%A2-u-2%C3%A2-ml-dilution-of-abobotulinumtoxina-vs-placebo-randomized-study-in-cervical-dystonia
#1
Mark F Lew, Allison Brashear, Khashayar Dashtipour, Stuart Isaacson, Robert A Hauser, Pascal Maisonobe, Daniel Snyder, William Ondo
Purpose/aim: AbobotulinumtoxinA (Dysport®, Ipsen Biopharmaceuticals, Inc., Basking Ridge, NJ, USA) is an acetylcholine release inhibitor and a neuromuscular blocking agent. The United States prescribing information for abobotulinumtoxinA previously indicated only one dilution for cervical dystonia: 500 U/1 mL. Clinical trial data supporting a larger volume with a 500 U/2 mL dilution would offer clinicians flexibility with injection volume to better meet patient needs. MATERIALS AND METHODS: We conducted a 12-week, phase 3b, multicenter, randomized, double-blind, placebo-controlled trial (NCT01753310)...
January 17, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29340258/atypical-initial-presentation-of-painful-muscle-cramps-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report-and-brief-review-of-the-literature
#2
Aaron R Kuzel, Muhammad Uzair Lodhi, Intekhab Askari Syed, Mustafa Rahim
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized clinically by progressive muscle weakness that can occur proximally or distally in either the upper or lower extremities. It includes both upper motor neuron signs (spasticity, hyperreflexia, clonus, and Babinski sign) and lower motor neuron signs (atrophy, weakness, and muscle fasciculation). Initial presentation of progressively painful muscle cramps should lead the physician to screen for other signs of amyotrophic lateral sclerosis...
November 10, 2017: Curēus
https://www.readbyqxmd.com/read/29334327/migration-of-a-kirschner-wire-into-the-spinal-cord-a-case-report-and-literature-review
#3
Ryogo Furuhata, Mitsuhiro Nishida, Midori Morishita, Shigeru Yanagimoto, Masaki Tezuka, Eijiro Okada
CONTEXT: A Kirschner wire (K-wire) is a stainless steel pin with at least one sharpened tip that is mainly used for the internal fixation of bone fractures. While some cases of K-wire dislocation and migration have been reported as complications after fracture surgery, the intraspinal migration of a K-wire is rare. Herein, we report a case in which a K-wire used for sternal fixation 7 years earlier migrated into the spinal canal. FINDINGS: A 68-year-old male suddenly sustained severe radiating pain and numbness in his left upper extremity, and walked to our hospital...
January 15, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29331975/is-postoperative-bracing-after-pedicle-screw-fixation-of-spine-fractures-necessary-study-protocol-of-the-ornot-study-a-randomised-controlled-multicentre-trial
#4
Arjen Johannes Smits, Jaap Deunk, Agnita Stadhouder, Mark Cornelis Altena, Diederik Hendrik Ruth Kempen, Frank Willem Bloemers
INTRODUCTION: The most common surgical treatment of traumatic spine fractures is through a posterior approach using pedicle screws and rods. Postoperative treatment protocols including the use of postoperative orthoses however differ between hospitals and surgeons. A three-point hyperextension orthosis is designed to support proper posture and unload the anterior column. Some motion remains when wearing an orthosis, and its main value in postoperative treatment is therefore believed to be pain relief and patient confidence...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29327605/does-change-in-isolated-lumbar-extensor-muscle-function-correlate-with-good-clinical-outcome-a-secondary-analysis-of-data-on-change-in-isolated-lumbar-extension-strength-pain-and-disability-in-chronic-low-back-pain
#5
James Steele, James Fisher, Craig Perrin, Rebecca Conway, Stewart Bruce-Low, Dave Smith
PURPOSE: Secondary analysis of data from studies utilising isolated lumbar extension exercise interventions for correlations among changes in isolated lumbar extension strength, pain, and disability. MATERIALS AND METHODS: Studies reporting isolated lumbar extension strength changes were examined for inclusion criteria including: (1) participants with chronic low back pain, (2) intervention ≥ four weeks including isolated lumbar extension exercise, (3) outcome measures including isolated lumbar extension strength, pain (Visual Analogue Scale), and disability (Oswestry Disability Index)...
January 12, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29322711/high-prevalence-of-hypovitaminosis-d-in-patients-presenting-with-proximal-muscle-weakness-a-sub-himalayan-study
#6
Jatinder Mokta, Balraj, Kiran Mokta, Asha Ranjan, Ivan Joshi, Mahak Garg
Background: Hypovitaminosis D has emerged as a major public health problem and 25-50% of patients encountered in clinical practice are deficient in vitamin D. This study was conducted to estimate the prevalence of hypovitaminosis D among patients presenting with proximal muscle weakness. Study Design: It was a cross-sectional study done on patients ≥18 years presenting in outdoor clinic from May 2008 to April 2013, with difficulty in standing and going up stairs/ diffuse musculoskeletal pains...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29321467/importance-of-regular-and-maintenance-therapy-adherence-in-neuromyelitis-optica-nmo-lessons-from-a-repeating-relapse-case
#7
Jing Miao, Doreen E Aboagye, Boris Chulpayev, Lin Liu, Gary Ishkanian, Bangaruraju Kolanuvada, Dariush Alaie, Richard L Petrillo
BACKGROUND Neuromyelitis optica (NMO) is a rare demyelinating disease of the central nervous system; NMO predominantly affects the spinal cord and optic nerves. The diagnosis is based on history, clinical presentation, seropositive NMO-IgG antibody, and notably, exclusion of other diseases. Despite the absence of definitive therapeutic strategies for NMO, methylprednisolone pulse therapy and plasma exchange are used for acute phase treatment, while immunosuppressive agent(s) are recommended to prevent relapses and improve prognosis...
January 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29320842/carpal-tunnel-syndrome-in-hiv-positive-patients-coinfected-with-hcv
#8
A Mastroianni, F Allegrini, S Nardi, D Donatucci, F Girelli, C Guidi
A wide range of rheumatic and peripheral nervous system disorders may develop in patients with HIV infection, leading to pain, sensory symptoms, and muscle weakness. Over the past three decades, the progress in management of HIV disease with anti-retroviral therapy (ART) has resulted in increased life expectancy for people living with HIV disease. With this new chronicity of the disease has a constellation of chronic musculoskeletal, orthopaedic and rheumatic manifestations has emerged, as potential complications of the disease itself and/or the results of ART treatment regimen and/or because of expected age-related symptoms/manifestations...
December 21, 2017: Reumatismo
https://www.readbyqxmd.com/read/29320549/assessing-adverse-effects-of-intra-articular-botulinum-toxin-a-in-healthy-beagle-dogs-a-placebo-controlled-blinded-randomized-trial
#9
Helka M Heikkilä, Tarja S Jokinen, Pernilla Syrjä, Jouni Junnila, Anna Hielm-Björkman, Outi Laitinen-Vapaavuori
OBJECTIVE: To investigate the clinical, cytological, and histopathological adverse effects of intra-articularly injected botulinum toxin A in dogs and to study whether the toxin spreads from the joint after the injection. METHODS: A longitudinal, placebo-controlled, randomized clinical trial was conducted with six healthy laboratory Beagle dogs. Stifle joints were randomized to receive either 30 IU of onabotulinum toxin A or placebo in a 1:1 ratio. Adverse effects and spread of the toxin were examined by evaluating dynamic and static weight-bearing of the injected limbs, by assessing painless range of motion and pain on palpation of joints, and by performing synovial fluid analysis, neurological examination, and electrophysiological recordings at different examination time-points in a 12-week period after the injections...
2018: PloS One
https://www.readbyqxmd.com/read/29316888/the-preventive-effect-of-sensorimotor-and-vibration-exercises-on-the-onset-of-oxaliplatin-or-vinca-alkaloid-induced-peripheral-neuropathies-stop
#10
Fiona Streckmann, Maryam Balke, Helmar C Lehmann, Vanessa Rustler, Christina Koliamitra, Thomas Elter, Michael Hallek, Michael Leitzmann, Tilman Steinmetz, Petra Heinen, Freerk T Baumann, Wilhelm Bloch
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and clinically relevant side effect of chemotherapy. Approximately 50% of all leukemia, lymphoma, colorectal- and breast cancer patients are affected. CIPN is induced by neurotoxic chemotherapeutic agents and can manifest with sensory and/or motor deficits. It is associated with significant disability and poor recovery. Common symptoms include pain, altered sensation, reduced or absent reflexes, muscle weakness, reduced balance control and insecure gait...
January 10, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29315708/neuralgic-amyotrophy-in-children
#11
Fouad Al-Ghamdi, Partha S Ghosh
INTRODUCTION: Neuralgic amyotrophy (NA) is characterized by the clinical triad of pain, muscle weakness/atrophy and sensory symptoms. METHODS: We retrospectively identified children (≤18 years) over 15 years (2002-2017) from a single pediatric center. RESULTS: We had 22 patients (8 female; 6-18 years); pain was the presenting manifestation in all of them. Clinical weakness involving periscapular muscles was observed in 16 patients, scapular winging in 13...
January 9, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29301801/clinically-amyopathic-dermatomyositis-associated-with-anti-mda5-antibody
#12
Konstantinos Parperis, Amirali Kiyani
Clinically amyopathic dermatomyositis (CADM) is a rare entity that presents with cutaneous manifestations of classic dermatomyositis but without muscle weakness or abnormal muscle enzymes. It is more common in young white and Asian females. A subset of patients with CADM has a specific antibody known as anti-MDA5. These patients have a more aggressive course with distinct cutaneous features, pulmonary involvement and early death. Here, we present the case of a 64-year-old Caucasian male with no significant medical history who was admitted with marked weight loss and a painful rash for 6 months...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29299474/improvement-in-hamstring-and-quadriceps-muscle-strength-following-cruciate-retaining-single-radius-total-knee-arthroplasty
#13
Jennifer Kurowicki, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Linsen T Samuel, Morad Chughtai, Martin Roche, Peter M Bonutti, Michael A Mont
Background: The ability to reach full functional capacity following total knee arthroplasty (TKA) is reliant on the strength of the quadriceps and hamstring muscles. Weakness of these muscles can persist anywhere from 1 to 3 years post-operatively. There remains considerable controversy as to what factors influence restoration of muscle strength after TKA. Implant designs have been implicated in the ability of patients to recover. Currently there is a paucity of literature available describing the influence of patient characteristics, surgical factors, and clinical outcomes on quadriceps and hamstring muscle strength following TKA with a cruciate-retaining, single radius (SR) implant...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29279515/anti-neutrophil-cytoplasmic-antibody-associated-vasculitis-aav-restricted-to-the-limbs-a-case-report
#14
Yoshie Ojima, Kinya Sawada, Hiroshi Fujii, Tsuyoshi Shirai, Ayako Saito, Saeko Kagaya, Satoshi Aoki, Yoichi Takeuchi, Tomonori Ishii, Tasuku Nagasawa
A previously healthy 58-year-old man was admitted for muscle pain and weakness (manual muscle testing [MMT] of 4/4 for upper and lower limbs). We detected elevated levels of inflammatory makers and PR3-anti-neutrophil cytoplasmic antibody (ANCA). Subsequently, the muscle weakness rapidly progressed to an MMT of 2 for all limbs. Magnetic resonance imaging indicated muscle edema, and the CK level increased to 29,998 U/L. mPSL and cyclophosphamide pulse therapy improved the patient symptoms. MMT recovered to 4 for all limbs...
December 27, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29277966/role-of-inflammatory-biomarker-in-diabetic-peripheral-neuropathy
#15
Heung Yong Jin, Tae Sun Park
Diabetic peripheral neuropathy (DPN) is the most common chronic neurological complication of diabetes1 . Small and large peripheral nerve fibers may be involved in DPN. Large nerve fiber damage causes paresthesia, sensory loss, and muscle weakness and small nerve fiber damage is associated with pain, anesthesia, foot ulcer, and autonomic symptoms. However, the exact pathogenic mechanisms and diagnostic criteria for DPN are not firmly established currently. The present DPN prevention, diagnosis, and treatment strategies are incomplete and unsuccessful due to the various pathogenesis of systemic and cellular disturbance in glucose and lipid metabolism...
December 26, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29258992/late-diagnosis-of-a-truncating-wisp3-mutation-results-in-a-severe-phenotype-of-progressive-pseudorheumatoid-dysplasia
#16
Salem Alawbathani, Amit Kawalia, Mert Karakaya, Janine Altmueller, Peter Nuernberg, Sebahattin Cirak
Rare diseases are often misdiagnosed or receive a delayed diagnosis and thus unfortunately affected individuals may not receive optimal medical management. Here, we report a case of two siblings with a severe phenotype of progressive pseudorheumatoid dysplasia (PPD). Their onset of symptoms began at the age of 3 years. Both were neglected in the past and the patients presented with a very severe phenotype and unmitigated natural history. PPD is a rare autosomal recessive skeletal dysplasia characterized by progressive joint stiffness, swelling and pain...
December 19, 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29249499/spontaneous-ventilation-thoracoscopic-thymectomy-without-muscle-relaxant-for-myasthenia-gravis-comparison-with-standard-thoracoscopic-thymectomy
#17
Long Jiang, Lieven Depypere, Gaetano Rocco, Jin-Shing Chen, Jun Liu, Wenlong Shao, Hanyu Yang, Jianxing He
OBJECTIVES: Myasthenia gravis (MG) benefits from thymectomy. However, its unpredictable response to muscle relaxants and volatile anesthetic agents may result in muscle weakness and subsequently in postoperative myasthenic crisis. The aim of this study was to determine the surgical outcomes after spontaneous ventilation compared with conventional intubated video-assisted thoracoscopic thymectomy (spontaneous-ventilation video-assisted thoracic thymectomy [SV-VATT] vs intubated video-assisted thoracic thymectomy) in patients with MG...
November 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29249454/biomechanical-consequences-of-running-with-deep-core-muscle-weakness
#18
Margaret E Raabe, Ajit M W Chaudhari
The deep core muscles are often neglected or improperly trained in athletes. Improper function of this musculature may lead to abnormal spinal loading, muscle strain, or injury to spinal structures, all of which have been associated with increased low back pain (LBP) risk. The purpose of this study was to identify potential strategies used to compensate for weakness of the deep core musculature during running and to identify accompanying changes in compressive and shear spinal loads. Kinematically-driven simulations of overground running were created for eight healthy young adults in OpenSim at increasing levels of deep core muscle weakness...
December 6, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29245264/repeated-recurrent-epidermoid-cyst-with-atypical-hyperplasia-a-case-report-and-literature-review
#19
Jialin Li, Ming Qian, Xiaoyi Huang, Li Zhao, Xinghai Yang, Jianru Xiao
RATIONALE: Epidermoid cysts are slow-growing, benign tumor which account for less than 1% of all intraspinal tumors and epidermoid cyst with Atypical Hyperplasia is very rare. Surgical resection is the standard treatment of the tumor, but recurrence is not uncommon after incomplete resection. Inappropriate treatment can lead to repeated recurrent. Here, we reported a case of repeated recurrent epidermoid cyst with atypical hyperplasia treated with radiotherapy after surgery. PRESENTING CONCERNS: A 40-year-old female presenting with intraspinal epidermoid cyst showed incomplete paraplegia in lower limbs...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29245259/efficacy-of-pudendal-nerve-block-for-alleviation-of-catheter-related-bladder-discomfort-in-male-patients-undergoing-lower-urinary-tract-surgeries-a-randomized-controlled-double-blind-trial
#20
Li Xiaoqiang, Zhang Xuerong, Liu Juan, Bechu Shelley Mathew, Yin Xiaorong, Wan Qin, Luo Lili, Zhu Yingying, Luo Jun
BACKGROUND: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle...
December 2017: Medicine (Baltimore)
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