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https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#1
Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28428927/limitations-of-personalized-medicine-and-gene-assays-for-breast-cancer
#2
David Tiberi, Laura Masucci, Daniel Shedid, Isabelle Roy, Toni Vu, Erica Patocskai, André Robidoux, Philip Wong
Adjuvant systemic treatments reduce the risk of breast cancer recurrence following the local treatment of primary stage I-III breast cancers. For patients with hormone-positive breast cancers receiving hormonal therapy, the risk of distant recurrence is under 20% and therefore, many patients may potentially be spared of chemotherapy. Consequently, several molecular signatures based on gene expression were developed to better determine which breast cancer patients would benefit from chemotherapy. We present the case of a 62-year-old woman diagnosed with an early stage hormone receptor-positive breast cancer that was treated with a partial mastectomy...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28428212/a-novel-mri-biomarker-of-spinal-cord-white-matter-injury-t2-weighted-white-matter-to-gray-matter-signal-intensity-ratio
#3
A R Martin, B De Leener, J Cohen-Adad, D W Cadotte, S Kalsi-Ryan, S F Lange, L Tetreault, A Nouri, A Crawley, D J Mikulis, H Ginsberg, M G Fehlings
BACKGROUND AND PURPOSE: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy. MATERIALS AND METHODS: Fifty-eight patients with degenerative cervical myelopathy and 40 healthy subjects underwent 3T MR imaging, covering C1-C7...
April 20, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28425069/a-prospective-serial-mri-study-following-acute-traumatic-cervical-spinal-cord-injury
#4
Joost P H J Rutges, Brian K Kwon, Manraj Heran, Tamir Ailon, John T Street, Marcel F Dvorak
PURPOSE: In acute traumatic cervical spinal cord injury (SCI) patients, we sought to characterize how objective MRI measures of injury change during the first 3 week post-injury. METHODS: Six MRI scans each were planned in 19 cervical SCI patients within the first 3 week post-injury. Length of cord edema, maximum spinal cord compression, maximum canal compromise, and presence and length of hematoma were measured. RESULTS: Length of spinal cord edema increased in the first 48 h after SCI, followed by a gradual decrease in the 3 weeks after injury...
April 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28421532/matrix-metalloproteinase-8-inhibition-prevents-disruption-of-blood-spinal-cord-barrier-and-attenuates-inflammation-in-rat-model-of-spinal-cord-injury
#5
Hemant Kumar, Min-Jae Jo, Hyemin Choi, Manjunatha S Muttigi, Seil Shon, Byung-Joo Kim, Soo-Hong Lee, In-Bo Han
After spinal cord injury (SCI), tight junction (TJ) protein degradation increases permeability and disrupts the blood-spinal cord barrier (BSCB). The BSCB is primarily formed of endothelial cell, which forms a specialized tight seal due to the presence of TJs. BSCB disruption after SCI allows neutrophil infiltration. Matrix metalloproteinase (MMP)-8 is believed to be mainly expressed by neutrophils and is quickly released upon neutrophil activation. Here, we determined whether MMP-8 is involved in the TJ protein degradation in endothelial cells and also determined its role in the neuroinflammation after SCI...
April 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28416437/the-ct-based-fractal-analysis-of-trabecular-bone-structure-may-help-in-detecting-decreased-quality-of-bone-prior-to-urgent-spinal-procedures
#6
Marcin Czyz, Arion Kapinas, James Holton, Renata Pyzik, Bronek M Boszczyk, Nasir A Quraishi
BACKGROUND CONTEXT: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. PURPOSE: To validate the hypothesis that the CT-based fractal analysis of the trabecular bone structure may help in detecting patients with poor quality of bone prior to urgent spinal procedures...
April 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28413533/persistent-l5-lumbosacral-radiculopathy-caused-by-lumbosacral-trunk-schwannoma
#7
Guive Sharifi, Amin Jahanbakhshi
Schwannomais, usually, benign tumor of nerve sheath that occurs evenly along the spinal cord. Intra-pelvic schwannoma is very rare entity that may arise from lumbosacral nerve roots or from sciatic nerve. Radicular pain of the lower limb as a presenting symptom of pelvic schwannoma is extremely rare. In the current report, the patient is presented with a right sided L5 radicular pain typical of lumbar discopathy. Interestingly, a herniated lumbar disc was noted on lumbosacral magnetic resonance imaging (MRI)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28413094/-pachymeningitis
#8
O Fain, A Mekinian
Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology...
April 13, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#9
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28407704/delayed-epidural-mucin-collection-after-surgery-for-spinal-metastatic-pancreatic-adenocarcinoma
#10
Dong Ha Kim, Dong Hwan Kim, Hwan Soo Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
A rare case of delayed large epidural mucin collection causing neurologic deficit after surgery for metastatic pancreatic cancer is reported. A 65-year-old man presented with intractable upper-thoracic back pain radiating to the chest and gait disturbance. He had a history of subtotal pancreatectomy due to intraductal papillary mucinous neoplasm (IPMN) of the pancreas and concurrent chemotherapy. Eight months after pancreatectomy, multiple thoracic spinal metastasis was diagnosed with routine up positron emission tomography-computed tomography...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28404935/outcomes-of-metastatic-spinal-cord-compression-secondary-to-primary-hepatocellular-carcinoma-with-multidisciplinary-treatments
#11
Shaohui He, Haifeng Wei, Yifei Ma, Jian Zhao, Wei Xu, Jianru Xiao
Few studies have reported progression-free survival (PFS) and overall survival (OS) of Metastatic spinal cord compression (MSCC) patients with primary hepatocellular carcinoma (HCC) following surgery and adjuvant therapies. Enrolled in this study were 155 MSCC patients with primary HCC who received surgery and adjuvant therapies between 2000 and 2015. Kaplan-Meier methods and Cox's proportional hazards regression mode were performed to investigate the clinical features and prognostic factors affecting PFS and OS...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#12
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28402031/evaluation-of-osseous-associated-cervical-spondylomyelopathy-in-dogs-using-kinematic-magnetic-resonance-imaging
#13
Michele Provencher, Amy Habing, Sarah A Moore, Laurie Cook, Gary Phillips, Ronaldo C da Costa
Osseous-associated cervical spondylomyelopathy in dogs is characterized by both static and dynamic spinal cord compression; however, standard MRI methods only assess static compression. In humans with cervical spondylotic myelopathy, kinematic MRI is commonly used to diagnose dynamic spinal cord compressions. The purpose of this prospective, analytical study was to evaluate kinematic MRI as a method for characterizing the dynamic component of osseous-associated cervical spondylomyelopathy in dogs. We hypothesized that kinematic MRI would allow visualization of spinal cord compressions that were not identified with standard imaging...
April 12, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28394776/correlation-analysis-between-modic-change-of-cervical-vertebrae-and-intramedullary-high-signal-intensity
#14
Hao Zhou, Jin Fan, Peng Sun, Wei Zhou, Qingqing Li, Lipeng Yu, Guoyong Yin
PURPOSE: Clinical studies have shown that endplate Modic change in the cervical spine and intramedullary high signal intensity often occurs simultaneously. We aimed to investigate whether there is a correlation between Modic change and intramedullary high signal intensity, and to explore the possible risk factors. MATERIALS AND METHODS: In total, 133 patients with cervical spondylotic myelopathy treated at the First Affiliated Hospital of Nanjing Medical University between May 2009 and March 2013 were enrolled in the study...
April 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28393590/feasibility-of-extended-dosing-intervals-of-denosumab
#15
Jacob K Kettle, Puja B Patel
Purpose Denosumab is a crucial supportive care agent for patients with advanced cancers affecting the bone. Despite the importance of treatment, logistical and financial obstacles hinder the ability to maintain long-term adherence. This analysis was designed to provide preliminary data regarding the feasibility of extended denosumab dosing intervals. Methods This retrospective, case cohort study was conducted on patients receiving treatment with denosumab for malignancies with bone involvement. A total of 60 patients were identified for analysis and were divided into cohorts according to the average number of days between denosumab doses...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28386545/residual-spinal-cord-compression-following-hemilaminectomy-and-mini-hemilaminectomy-in-dogs-a-prospective-randomized-study
#16
Gustaf Svensson, Ulrika S H Simonsson, Fredrik Danielsson, Tobias Schwarz
The aim of this study was to compare the reduction of spinal cord compression after surgical treatment of dogs with acute thoracolumbar intervertebral disc (IVD) extrusion achieved using hemilaminectomy versus mini-hemilaminectomy techniques. This was a prospective randomized study with client-owned dogs presented with acute IVD extrusion that were allocated to surgical treatment using hemilaminectomy (n = 15) or mini-hemilaminectomy (n = 15) techniques. Plain and intravenous-contrast computed tomography was performed pre- and postoperatively...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#17
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
RATIONALE AND OBJECTIVES: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28383432/atypical-spinal-tuberculosis-involved-noncontiguous-multiple-segments-case-series-report-with-literature-review
#18
Lin-Nan Wang, Lei Wang, Li-Min Liu, Yue-Ming Song, Yue Li, Hao Liu
In its typical form, spinal tuberculosis (TB) presents as destroyed contiguous vertebral bodies with involvement of intervertebral discs and paravertebral or psoas abscesses. Atypical forms are uncommonly reported. Here, we describe 8 patients with noncontiguous multisegmental spinal TB with no intervertebral disc involvement. From 2013 to 2014, we surgically treated 384 patients with spinal TB to relieve spinal cord compression, re-establish spinal stability, confirm the diagnosis, and debride the TB foci...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28382214/spontaneous-spinal-epidural-hematoma-management-a-case-series-and-literature-review
#19
Kyle Raasck, Ahmed A Habis, Ahmed Aoude, Leonardo Simões, Fernando Barros, Rudy Reindl, Peter Jarzem
OBJECTIVE: Spontaneous spinal epidural hematoma (SSEH) manifests from blood accumulating in the epidural space, compressing the spinal cord and leading to acute neurological deficits. Standard therapy is decompressive laminectomy, although spontaneous recoveries have been reported. Sub-optimal therapeutic principles contribute to SSEH's 5.7% mortality-which patient will benefit from surgery remains unclear. This study aims to investigate parameters that affect SSEH's progression, outlining a best-practice therapeutic approach...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28381439/tumor-stroma-interactions-in-bone-metastasis-molecular-mechanisms-and-therapeutic-implications
#20
Hanqiu Zheng, Wenyang Li, Yibin Kang
Metastasis and associated complications are the major cause of death for cancer patients. The incidence of bone metastasis is among the highest in cancers arising from breast, prostate, and lung. Common skeletal-related events caused by bone metastasis include aberrant bone remodeling (osteolytic, osteoblastic, and mixed), bone pain, fracture, spinal cord compression, and life-threatening hypercalcemia. It is now known that interactions between tumor cells and bone stroma lie at the core of major steps of bone-metastasis progression...
April 5, 2017: Cold Spring Harbor Symposia on Quantitative Biology
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