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Masateru Nagae, Yasuo Mikami, Kentaro Mizuno, Tomohisa Harada, Takumi Ikeda, Hitoshi Tonomura, Ryota Takatori, Hiroyoshi Fujiwara, Toshikazu Kubo
INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained...
October 2016: Medicine (Baltimore)
Xiaojing Wang, Fan Ping, Cuijuan Qi, Xinhua Xiao
BACKGROUND: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. METHODS: Here we reported a case of 38-year-old female patient who presented with 2 years' history of Hashimoto's thyroiditis and received levothyroxine replacement...
October 2016: Medicine (Baltimore)
Ru-Sen Zhu, Yi-Ming Ren, Jian-Jun Yuan, Zi-Jian Cui, Jun Wan, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Xue-Li Zhang
Lumbar disc herniation (LDH) is a common disease and lumbar discectomy is the most common surgical procedure carried out for patients with low back pain and leg symptoms. Although most researchers are focusing on the surgical techniques during operation, the aim of this study is to evaluate the effect of local intervertebral lavage during microdiscectomy.In this retrospective study, 410 patients were operated on by microdiscectomy for LDH during 2011 to 2014. Retrospectively, 213 of them (group A) accepted local intervertebral irrigation with saline water before wound closure and 197 patients (group B) only had their operative field irrigated with saline water...
October 2016: Medicine (Baltimore)
Sanka Amadoru, Kwang Lim, Mark Tacey, Craig Aboltins
AIMS: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. METHODS: Clinical, microbiological and radiological information was collected for patients at a single metropolitan hospital with spinal infections (spondylodiscitis, vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscess) between January 2008 and January 2015. Patients were excluded if under 18 years of age, or if clinical and imaging findings were inconsistent with the diagnosis...
October 18, 2016: Internal Medicine Journal
Xu Li, Zhi Li, Ke Li, Ya-Wei Zeng, Hai-Song Shi, Wen-Lan Xie, Zhuo-Ya Yang, Simon S Y Lui, Eric F C Cheung, Ada W S Leung, Raymond C K Chan
Anhedonia, the diminished ability to experience pleasure, is a challenging negative symptom in patients with schizophrenia and can be observed in at-risk individuals with schizotypy. Deficits in hedonic processing have been postulated to be related to decreased motivation to engage in potentially rewarding events. It remains unclear whether non-pharmacological interventions, such as cognitive training, could improve anhedonia. The present study aimed to examine the neural mechanism for alleviating hedonic deficits with working memory (WM) training in individuals with social anhedonia...
October 18, 2016: Scientific Reports
Max O Krucoff, Steven Cook, Owoicho Adogwa, Jessica Moreno, Siyun Yang, Jichun Xie, Alexander O Firempong, Nandan Lad, Carlos A Bagley
OBJECT: To examine the role of race, gender, and socioeconomics on presentations and outcomes of adult Chiari 1 malformations. METHODS: The charts of 638 adult patients with Chiari 1 malformations were reviewed, and 287 patients were included. Race, gender, insurance status, symptoms, depth of cerebellar tonsillar herniation, and presence of syringomyelia were examined as covariates in multivariate logistic regression models to identify independent predictors of presentation and outcome...
October 14, 2016: World Neurosurgery
Martina Hahn, Sibylle C Roll
A 50-year-old male patient with comorbid human immunodeficiency virus developed a relapse of bipolar disorder after a switch from oral aripiprazole 10 mg/day to intramuscular aripiprazole depot 200 mg every 28 days plus oral aripiprazole 5 mg/day. The patient was concomitantly taking lopinavir, saquinavir, ritonavir, silybum marianum extract, and omeprazole. Only 1 week after the switch, the patient developed mood swings, irritability, depressive mood, and lack of drive. The oral aripiprazole was increased again to stabilize the patient...
December 2016: Drug Saf Case Rep
Rita Cardoso, Isabel Guimarães, Helena Santos, Rita Loureiro, Josefa Domingos, Daisy de Abreu, Nilza Gonçalves, Serge Pinto, Joaquim Ferreira
Hypokinetic dysarthria is a common symptom in those with Parkinson's disease (PD); there is currently no standardized or validated tool for assessing speech in this population. To translate into European Portuguese (EP) the FDA-2 and perform a cultural adaptation followed by an evaluation of its psychometric properties in PD in a sample of people with PD in different stages of disease progression. Translation, back-translation, experts' analysis, pre-test and final version test were performed. The EP version of the FDA-2 was administered to 80 people with PD (PwP) with dysarthria, feasibility and acceptability, reliability (internal consistency and inter-rater reliability) and validity (face and convergent) were measured...
October 17, 2016: Journal of Neurology
Roger A Lobo, J H Pickar, J C Stevenson, W J Mack, H N Hodis
In the late 1980s, several observational studies and meta-analyses suggested that hormone replacement therapy (HRT) was beneficial for prevention of osteoporosis, coronary heart disease, dementia and decreased all-cause mortality. In 1992, the American College of Physicians recommended HRT for prevention of coronary disease. In the late 1990s and early 2000s, several randomized trials in older women suggested coronary harm and that the risks, including breast cancer, outweighed any benefit. HRT stopped being prescribed at that time, even for women who had severe symptoms of menopause...
October 6, 2016: Atherosclerosis
Tyra Dark, Heather A Flynn, George Rust, Heidi Kinsell, Jeffrey S Harman
OBJECTIVE: The purpose of this study was to describe the epidemiology of anxiety-related emergency department (ED) visits in the United States and assess the care provided during those visits. METHODS: Data from the 2009-2011 National Hospital Ambulatory Medical Care Survey were used to identify all ED visits in which the patient received a primary anxiety diagnosis or declared anxiety as the reason for the visit (N=1,029). Patient characteristics, treatment provided, and dispositions of these nationally representative visits were assessed...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Carol Ann Flavell, Susan Gordon, Laurence Marshman
BACKGROUND: Physiotherapists use musculo-skeletal classification systems for patient assessment. Since its early development, the McKenzie lumbar spine assessment (MK) has been incorporated into examination algorithms and combined with a series of patho-anatomical diagnostic tests. No previous studies have used a MK and a combined examination (MK-C) to provide a detailed profile of patients, report and compare the classification characteristics of a chronic low back pain (CLBP) population...
October 5, 2016: Manual Therapy
Christopher J Sorensen, Molly B Johnson, Barbara J Norton, Jack P Callaghan, Linda R Van Dillen
An induced-pain paradigm has been used in back-healthy people to understand risk factors for developing low back pain (LBP) during prolonged standing. We examined asymmetry of lumbopelvic movement timing during a clinical test of active hip abduction in back-healthy people who developed LBP symptoms during standing (Pain Developers; PDs) compared to back-healthy people who did not develop LBP symptoms during standing (Non Pain Developers, NPDs). Participants completed the hip abduction test while movement was recorded with a motion capture system...
October 12, 2016: Human Movement Science
Sara J Morgan, Janna L Friedly, Dagmar Amtmann, Rana Salem, Brian J Hafner
OBJECTIVE: To determine relationships between pain site(s) and pain intensity/interference in people with lower limb amputations. DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS: Lower limb prosthesis users with unilateral or bilateral amputations (n=1296, mean time since amputation = 14.1 years). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity (1-item to assess average pain), PROMIS Pain Interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain, phantom limb pain, knee pain on the non-amputated side, back pain, and shoulder pain...
October 11, 2016: Archives of Physical Medicine and Rehabilitation
Yasunori Iida, Tsutomu Ito, Yu Inaba, Sachiko Hayashi, Takahiko Misumi, Hideyuki Shimizu
A 43-year-old woman with abdominal and back pain during childbirth consulted us 1 day postdelivery. Contrast-enhanced computed tomography (CT) revealed partially thrombosed type A aortic dissection with intimal tear in the proximal descending thoracic aorta. Conservative antihypertensive treatment was started. However, her abdominal pain progressively deteriorated. Repeat CT revealed narrowing of the descending aorta true lumen and progressive bowel malperfusion. Total arch replacement was urgently performed using the frozen elephant trunk technique...
2016: Annals of Vascular Diseases
Takamichi Yoshizaki, Naoyuki Kimura, Tomoyasu Hirano, Atsushi Yamaguchi, Hideo Adachi
We investigated the clinical picture of non-traumatic acute aortic dissection (AAD) occurring behind the wheel. Between 1990 and 2014, AAD had occurred in 11 patients while driving (nine men, mean age; 58.3 years, seven commercial drivers). The symptoms included chest and/or back pain (n = 9) and syncope (n = 2). One patient with syncope caused a traffic accident. Ten patients had type A dissection (DeBakey type I) and 1 type B dissection. In-hospital mortality was 9.9% (1/11). Our data showed if affected drivers are transported to a hospital in a timely fashion, a good surgical outcome can be expected...
2016: Annals of Vascular Diseases
Pedro Shiozawa, July Silveira Gomes, Daniella Valverde Ducos, Henrique Teruo Akiba, Álvaro Machado Dias, Alisson Paulino Trevizol, Ricardo R Uchida, Natasza Orlov, Quirino Cordeiro
Introduction: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia. Method: We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods...
July 2016: Trends in Psychiatry and Psychotherapy
Sudie E Back, Jenna L McCauley, Kristina J Korte, Daniel F Gros, Virginia Leavitt, Kevin M Gray, Mark B Hamner, Stacia M DeSantis, Robert Malcolm, Kathleen T Brady, Peter W Kalivas
OBJECTIVE: The antioxidant N-acetylcysteine is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders (SUDs). This study explored the efficacy of N-acetylcysteine in the treatment of posttraumatic stress disorder (PTSD), which frequently co-occurs with SUD and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. METHODS: Veterans with PTSD and SUD per DSM-IV criteria (N = 35) were randomly assigned to receive a double-blind, 8-week course of N-acetylcysteine (2,400 mg/d) or placebo plus cognitive-behavioral therapy for SUD (between March 2013 and April 2014)...
October 11, 2016: Journal of Clinical Psychiatry
Win Wah, Pin Pin Pek, Andrew Fu Wah Ho, Stephanie Fook-Chong, Huili Zheng, En Yun Loy, Terrance Siang Jin Chua, Tian Hai Koh, Khuan Yew Chow, Arul Earnest, Junxiong Pang, Marcus Eng Hock Ong
OBJECTIVES: Symptom-to-door time (S2D) is one of the important components of ischaemic time, which might affect the infarct size and outcomes of acute myocardial infarction. The aim of the present study was to identify patients' characteristics associated with delayed symptom-onset-to-arrival at EDs in ST-segment elevation myocardial infarction (STEMI) patients in Singapore. METHODS: Retrospective data of STEMI patients presenting to the ED of all public hospitals with onsite primary percutaneous coronary intervention facilities between 2010 and 2012 were obtained from the Singapore Myocardial Infarction Registry...
October 11, 2016: Emergency Medicine Australasia: EMA
C Schmidt
Background: The role of psychological comorbidities as a risk factor associated with a further chronification in low back pain is evident. In this paper we explore, whether psychological comorbidities recorded in the discharge letters have a time-stable and from other risk factors independent impact on a pension for reduced earning capacity. Methods: A sample of 10% is drawn from a routine data set provided by the German Pension Fund. Several risk factors are defined and presented descriptively. The survival analysis will be accomplished by cox regressions...
October 2016: Die Rehabilitation
Shin-Ichi Nureki, Koji Ishii, Hideaki Fujisaki, Masataka Torigoe, Keisuke Maeshima, Hirotaka Shibata, Eishi Miyazaki, Jun-Ichi Kadota
A 42-year-old woman presented with an intermittent fever and chest and back pain, and an abnormal chest shadow was detected. She was diagnosed with paragonimiasis caused by Paragonimus westermani. Praziquantel therapy improved the abnormal chest shadow, but did not relieve her symptoms. She was also diagnosed with familial Mediterranean fever (FMF), and colchicine therapy resolved her symptoms. She subsequently developed arthralgia and morning stiffness in her hands. We also diagnosed the patient with rheumatoid arthritis (RA), and corticosteroid and salazosulfapyridine therapy improved her symptoms...
2016: Internal Medicine
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