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https://www.readbyqxmd.com/read/29667140/multidisciplinary-management-of-pyogenic-spondylodiscitis-epidemiological-and-clinical-features-prognostic-factors-and-long-term-outcomes-in-207-patients
#1
Enrico Pola, F Taccari, G Autore, F Giovannenze, V Pambianco, R Cauda, G Maccauro, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is a potentially life-threatening infection burdened by high morbidity rates. Despite the rising incidence, the proper management of PS is still controversial. Aim of this study was to describe the clinical features of PS and to evaluate the prognostic factors and the long-term outcomes of a large population of patients. METHODS: 207 cases of PS treated from 2008 to 2016 with a 2-year follow-up were enrolled. Clinical data from each patient were recorded...
April 17, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29666219/symptoms-at-lung-cancer-diagnosis-are-associated-with-major-differences-in-prognosis
#2
Victoria L Athey, Stephen J Walters, Trevor K Rogers
We report a cohort study of survival of patients with lung cancer presenting to a single multidisciplinary team between 1997 and 2011, according to symptoms at presentation. The overall median survival of the 3800 lung cases was 183 days (95% CI 171 to 195). There was a statistically significant difference in survival between the 12 symptom groups identified both without and with adjustment for the prognostic variables of age, gender and histology (P<0.001). Compared with the cough-alone symptom group, the risks of dying or HRs were significantly higher for the groups presenting with breathlessness (HR 1...
April 17, 2018: Thorax
https://www.readbyqxmd.com/read/29665426/human-papillomavirus-vaccine-and-demyelinating-diseases-a-systematic-review-and-meta-analysis
#3
Julie Mouchet, Francesco Salvo, Emanuel Raschi, Elisabetta Poluzzi, Ippazio Cosimo Antonazzo, Fabrizio De Ponti, Bernard Bégaud
BACKGROUND: Approved in 2006, human papillomavirus (HPV) vaccines were initially targeted for girls aged 9-14 years. Although the safety of these vaccines has been monitored through post-licensure surveillance programmes, cases of neurological events have been reported worldwide. PURPOSE: The present study aimed to assess the risk of developing demyelination after HPV immunization by meta-analysing risk estimates from pharmacoepidemiologic studies. DATA SOURCES: A systematic review was conducted in Medline, Embase, ISI Web of Science and the Cochrane Library from inception to 10 May 2017, without language restriction...
April 14, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29665080/clustering-of-motor-and-nonmotor-traits-in-leucine-rich-repeat-kinase-2-g2019s-parkinson-s-disease-nonparkinsonian-relatives-a-multicenter-family-study
#4
Tiago A Mestre, Claustre Pont-Sunyer, Farah Kausar, Naomi P Visanji, Taneera Ghate, Barbara S Connolly, Carmen Gasca-Salas, Drew S Kern, Jennifer Jain, Elizabeth J Slow, Achinoam Faust-Socher, Meike Kasten, Pettarusp M Wadia, Cindy Zadikoff, Prakash Kumar, Ronald M de Bie, Teri Thomsen, Anthony E Lang, Birgitt Schüle, Christine Klein, Eduardo Tolosa, Connie Marras
OBJECTIVES: The objective of this study was to determine phenotypic features that differentiate nonparkinsonian first-degree relatives of PD leucine-rich repeat kinase 2 (LRRK2) G2019S multiplex families, regardless of carrier status, from healthy controls because nonparkinsonian individuals in multiplex families seem to share a propensity to present neurological features. METHODS: We included nonparkinsonian first-degree relatives of LRRK2 G2019S familial PD cases and unrelated healthy controls participating in established multiplex family LRRK2 cohorts...
April 17, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29664878/c2-translaminar-screw-fixation-in-children
#5
Brian W Yang, Michael P Glotzbecker, Michael Troy, Mark R Proctor, Michael T Hresko, Daniel J Hedequist
BACKGROUND: Axis (C2) screw fixation has been shown to be effective in treating disorders that necessitate cervical stabilization. Although translaminar C2 screws have demonstrated clinical efficacy in adults, this technique has not yet been thoroughly investigated in children. This study describes the indications, technique, and results of translaminar C2 screw fixation in a case series of pediatric cervical spine disorders. METHODS: We searched the orthopaedic database at our institution for patients who had undergone a cervical spinal fusion that encompassed C2 between 2007 and 2017...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#6
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29663900/congenital-toxoplasmosis-in-tunisia-prenatal-and-neonatal-diagnosis-and-postnatal-follow-up-of-35-cases
#7
Boudaouara Yosr, Aoun Karim, Maatoug Rania, Souissi Olfa, Bouratbine Aïda, Ben Abdallah Rym
Congenital toxoplasmosis (CT) results from transplacental passage of Toxoplasma gondii to the fetus during acute maternal infection. Our study aims to report clinical and biological patterns of 35 cases of CT diagnosed at the department of the Parasitology of the Pasteur Institute of Tunis and to access the performance of prenatal and early postnatal diagnosis techniques. Serological screening of maternal infection was performed by Immunoglobulin (Ig) M and IgG detection and IgG avidity determination. Prenatal diagnosis was based on both Toxoplasma DNA detection in the amniotic fluid and monthly ultrasound examinations...
April 16, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29663869/the-effect-of-self-assessed-fatigue-and-subjective-cognitive-impairment-on-work-capacity-the-case-of-multiple-sclerosis
#8
Gisela Kobelt, Dawn Langdon, Linus Jönsson
OBJECTIVES: The impact of physical disability in multiple sclerosis on employment is well documented but the effect of neurological symptoms has been less well studied. We investigated the independent effect of self-reported fatigue and cognitive difficulties on work. METHODS: In a large European cost of illness survey, self-reported fatigue, subjective cognitive impairment (SCI), and productivity at work were assessed with visual analogue scales (VAS 0-10). The analysis controlled for country, age, age at diagnosis, gender, education, and physical disability...
April 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/29663026/ct-guided-biopsy-in-suspected-spondylodiscitis-microbiological-yield-impact-on-antimicrobial-treatment-and-relationship-with-outcome
#9
Ömer Kasalak, Marjan Wouthuyzen-Bakker, Hugo J A Adams, Jelle Overbosch, Rudi A J O Dierckx, Paul C Jutte, Thomas C Kwee
PURPOSE: To investigate the clinical impact of CT-guided biopsy, as performed in routine clinical practice, in patients with suspected spondylodiscitis on MRI in terms of culture yield, impact on antimicrobial treatment, and outcome. METHODS: This study included 64 patients with MRI findings compatible with spondylodiscitis who underwent CT-guided biopsy. RESULTS: Initial CT-guided biopsies were culture-positive in 20/64 (31.3%, 95% confidence interval [CI] 21...
April 16, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29662290/extra-intestinal-manifestations-of-non-celiac-gluten-sensitivity-an-expanding-paradigm
#10
REVIEW
Giuseppe Losurdo, Mariabeatrice Principi, Andrea Iannone, Annacinzia Amoruso, Enzo Ierardi, Alfredo Di Leo, Michele Barone
Non celiac gluten sensitivity (NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease (CD) or wheat allergy. The possibility of systemic manifestations in this condition has been suggested by some reports. In most cases they are characterized by vague symptoms such as 'foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness even if more specific complaints have been described. NCGS has an immune-related background...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29661205/comparison-between-minimally-invasive-spine-stabilization-with-and-without-posterior-decompression-for-the-management-of-spinal-metastases-a-retrospective-cohort-study
#11
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Enshi Nakayama, Hirotoki Soma
BACKGROUND: Posterior decompression and stabilization plays significant roles in palliative surgery for metastatic spinal tumor. However, the indication for addition of posterior decompression have not been examined. The purpose of this study was to investigate a retrospective cohort of outcomes of metastatic spinal tumor treated with minimally invasive spine stabilization (MISt) with or without posterior decompression. METHODS: The subjects were 40 patients who underwent MISt using percutaneous pedicle screws for metastatic spinal tumor, including 20 patients treated with stabilization alone (group A) and 20 patients with added posterior decompression (group B)...
April 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29659838/comparative-methylome-analysis-of-icf-patients-identifies-heterochromatin-loci-that-require-zbtb24-cdca7-and-hells-for-their-methylated-state
#12
Guillaume Velasco, Giacomo Grillo, Nizar Touleimat, Laure Ferry, Ivana Ivkovic, Florence Ribierre, Jean-François Deleuze, Sophie Chantalat, Capucine Picard, Claire Francastel
Alterations of DNA methylation landscapes and machinery are a hallmark of many human diseases. A prominent case is the ICF syndrome, a rare autosomal recessive immunological/neurological disorder diagnosed by the loss of DNA methylation at (peri)centromeric repeats and its associated chromosomal instability. It is caused by mutations in the de novo DNA methyltransferase DNMT3B in about half of the patients (ICF1). In the remainder, the striking identification of mutations in factors devoid of DNA methyltransferase activity, ZBTB24 (ICF2), CDCA7 (ICF3) or HELLS (ICF4), raised key questions about common or distinguishing DNA methylation alterations downstream of these mutations and hence, about the functional link between the four factors...
April 12, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29659200/atypical-tuberous-sclerosis-complex-presenting-as-familial-renal-cell-carcinoma-with-leiomyomatous-stroma
#13
Ismaël Bah, Somayyeh Fahiminiya, Louis R Bégin, Nancy Hamel, Maria Daniela D'Agostino, Simon Tanguay, William D Foulkes
We report an atypical tuberous sclerosis complex phenotype presenting as familial multiple renal cell carcinomas with (angio)leiomyomatous stroma (5/7 familial renal cell carcinomas) on a background of multiple angiomyolipomas, hypopigmented skin macules and absence of neurological anomalies. In the index case and 3 relatives, germline genetic testing identified a heterozygous TSC2 missense pathogenic variant [c.2714 G>A, (p.Arg905Gln)], a rare TSC-associated alteration which has previously been associated with a milder TSC phenotype...
April 16, 2018: Journal of Pathology. Clinical Research
https://www.readbyqxmd.com/read/29657936/cellular-therapy-for-chronic-traumatic-brachial-plexus-injury
#14
Alok Sharma, Hemangi Sane, Nandini Gokulchandran, Prerna Badhe, Suhasini Pai, Pooja Kulkarni, Jayanti Yadav, Sanket Inamdar
Cellular therapy is being actively pursued as a therapeutic modality in many of the neurological diseases. A variety of stem cells from diverse sources have been studied in detail and have been shown to exhibit angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Published clinical data have shown bone marrow mononuclear cell (BMMNC) injection in neurological disorders is safe and possesses regenerative potential. We illustrate a case of 27-year-old male with traumatic brachial plexus injury, administered with autologous BMMNCs intrathecally and intramuscularly, followed by multidisciplinary rehabilitation...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29657732/two-cases-of-spontaneous-cervical-epidural-hematoma-without-back-or-neck-pain-in-elderly-japanese-men
#15
Takashi Hongo, Kenichi Iseda, Midori Tsuchiya, Mototaka Inaba, Satoshi Nozaki, Kenji Takahashi, Masaaki Nakajima, Toshifumi Fujiwara
Cases: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain. Outcomes: This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657181/a-personal-narrative-on-living-and-dealing-with-psychiatric-symptoms-after-dbs-surgery
#16
Frédéricand Gilbert, John Noel Viaña
Although deep brain stimulation (DBS) may result in dramatic motor improvement in people with Parkinson's disease (PD), it has been correlated with a number of postoperative psychiatric side effects. We report a case of a person with PD experiencing depression and hypomania following DBS surgery. We provide a detailed report of the patient's personal experiences dealing with and managing these psychiatric side effects for three years. Providing a personal narrative focusing on detailed patient subjective experiences complements reports that give insight into the short- and long-term effects of DBS on established psychiatric measures and neurologic activity...
2018: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29656628/cerebral-thromboembolic-events-during-anterior-cervical-spine-surgery-retrospective-case-series-study-with-diffusion-weighted-magnetic-resonance-imaging-follow-up-in-the-immediate-postoperative-period
#17
Seok-Won Chung, Min-Soo Kang, Sang-Ho Lee, Shin-Young Lee, Yong-Hwan Shin, Chan-Hong Park
OBJECTIVE: We evaluated the efficacy of diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting perioperative cerebral thromboembolic events after anterior cervical discectomy and fusion (ACDF). METHODS: This retrospective case series included 51 consecutive patients that underwent ACDF. To assess baseline presence of plaque or stenosis, all patients were assessed for risk factors of cerebrovascular events and underwent carotid ultrasound preoperatively and cerebral DW-MRI was performed in all patients postoperatively, with areas of high signal intensity interpreted as a cerebral thromboembolic event...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29656532/of-lamp-posts-keys-and-fabled-drunkards-a-perspectival-tale-of-4-guidelines
#18
Trisha Greenhalgh
BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...
April 15, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29656294/gray-matter-heterotopia-mental-retardation-developmental-delay-microcephaly-and-facial-dysmorphisms-in-a-boy-with-ring-chromosome-6-a-10-year-follow-up-and-literature-review
#19
Shu Liu, Zhiqing Wang, Sisi Wei, Jinqun Liang, Nuan Chen, Haimei OuYang, Weihong Zeng, Liying Chen, Xunjie Xie, Jianhui Jiang
Ring chromosome 6, r(6), is an extremely rare cytogenetic abnormality with clinical heterogeneity which arises typically de novo. The phenotypes of r(6) can be highly variable, ranging from almost normal to severe malformations and neurological defects. Up to now, only 33 cases have been reported in the literature. In this 10-year follow-up study, we report a case presenting distinctive facial features, severe developmental delay, and gray matter heterotopia with r(6) and terminal deletions of 6p25.3 (115426-384174, 268 kb) and 6q26-27 (168697778-170732033, 2...
April 14, 2018: Cytogenetic and Genome Research
https://www.readbyqxmd.com/read/29653270/decompressive-craniotomy-for-malignant-middle-cerebral-artery-infarction-optimal-timing-and-literature-review
#20
Ahmed Elsawaf, Ayman Galhom
OBJECT: To compare the results of early or delayed decompressive craniotomy (DC) for cases of malignant middle cerebral artery (MCA) infarction. STUDY DESIGN: Prospective comparative study METHODS: Prospective randomized study on consecutive series of a 46 patients with malignant MCA territory infarction. Patients were divided randomly into two groups: Group I; 27 patients who were followed till obvious deterioration of conscious level happened, Group II; 19 patients who were operated prophylactically in 6 hours of presentation even with no clear deterioration of conscious level or radiology's findings...
April 10, 2018: World Neurosurgery
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