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Koushik Tripathy, Rohan Chawla, Kanhaiya Mittal, Rajni Farmania, Pradeep Venkatesh, Sheffali Gulati
BACKGROUND: Subacute sclerosing panencephalitis (SSPE) is a potentially fatal complication of measles. The authors report a case of recurrent myoclonic jerks under investigation, whose ophthalmic examination pointed to the diagnosis. CASE PRESENTATION: A 12-year-old boy with recurrent episodes of myoclonic jerks was found to have optic disc pallor and an irregular macular scar with pigmentation in the left eye. The retinal finding proved to be a strong diagnostic clue for SSPE...
2017: Eye and Vision (London, England)
Abi Manesh, Mahesh Moorthy, Rini Bandopadhyay, Priscilla Rupali
Earlier age of measles virus infection predisposes to development of sub-acute sclerosing panencephalitis (SSPE) and this risk is heightened in HIV-infected children. We describe a HIV-infected young adult on antiretroviral therapy, presenting with a non-classical, fulminant form of SSPE to highlight the unpredictable nature of measles presentation. The recent spate of measles outbreaks due to virus introduction in populations with sub-optimal vaccine coverage or waning immunity and co-existing paediatric HIV cohorts is a cause for concern...
January 1, 2017: International Journal of STD & AIDS
David Mountain, Gerben Keijzers, Kevin Chu, Anthony Joseph, Catherine Read, Gabriel Blecher, Jeremy Furyk, Chrianna Bharat, Karthik Velusamy, Andrew Munro, Kylie Baker, Frances Kinnear, Ahses Mukherjee, Gina Watkins, Paul Buntine, Georgia Livesay, Daniel Fatovich
INTRODUCTION: Overuse of CT Pulmonary Angiograms (CTPA) for diagnosing pulmonary embolism (PE), particularly in Emergency Departments (ED), is considered problematic. Marked variations in positive CTPA rates are reported, with American 4-10% yields driving most concerns. Higher resolution CTPA may increase sub-segmental PE (SSPE) diagnoses, which may be up to 40% false positive. Excessive use and false positives could increase harm vs. benefit. These issues have not been systematically examined outside America...
2016: PloS One
Sofia Morfopoulou, Edward T Mee, Sarah M Connaughton, Julianne R Brown, Kimberly Gilmour, W K 'Kling' Chong, W Paul Duprex, Deborah Ferguson, Mike Hubank, Ciaran Hutchinson, Marios Kaliakatsos, Stephen McQuaid, Simon Paine, Vincent Plagnol, Christopher Ruis, Alex Virasami, Hong Zhan, Thomas S Jacques, Silke Schepelmann, Waseem Qasim, Judith Breuer
Routine childhood vaccination against measles, mumps and rubella has virtually abolished virus-related morbidity and mortality. Notwithstanding this, we describe here devastating neurological complications associated with the detection of live-attenuated mumps virus Jeryl Lynn (MuV(JL5)) in the brain of a child who had undergone successful allogeneic transplantation for severe combined immunodeficiency (SCID). This is the first confirmed report of MuV(JL5) associated with chronic encephalitis and highlights the need to exclude immunodeficient individuals from immunisation with live-attenuated vaccines...
January 2017: Acta Neuropathologica
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) affects >600,000 patients per year in the United States. Evaluation includes clinical decision rules, laboratory tests, and several imaging modalities. The diagnosis of PE has risen in recent years, particularly subsegmental PE (SSPE). Controversy exists concerning the diagnosis and treatment of these lesions. OBJECTIVE: We sought to provide emergency physicians with a review of the controversies surrounding PE testing and the diagnosis and treatment of SSPE...
February 2017: Journal of Emergency Medicine
Rebecca L Holt, Dylan Kann, Caroline E Rassbach, Hayden T Schwenk, Jana M Ritter, Paul A Rota, Jorina Elbers
Subacute sclerosing panencephalitis (SSPE) is a fatal complication of measles infection. We present a case of a fully vaccinated 3-year-old boy who was diagnosed with and treated for autoimmune encephalitis before arriving at a diagnosis of SSPE. We discuss the challenges of diagnosing SSPE in developed countries.
September 12, 2016: Journal of Pediatrics
Masahiro Watanabe, Koichi Hashimoto, Yusaku Abe, Eiichi N Kodama, Ryota Nabika, Shinya Oishi, Shinichiro Ohara, Masatoki Sato, Yukihiko Kawasaki, Nobutaka Fujii, Mitsuaki Hosoya
Subacute sclerosing panencephalitis (SSPE) is a persistent, progressive, and fatal degenerative disease resulting from persistent measles virus (MV) infection of the central nervous system. Most drugs used to treat SSPE have been reported to have limited effects. Therefore, novel therapeutic strategies are urgently required. The SSPE virus, a variant MV strain, differs virologically from wild-type MV strain. One characteristic of the SSPE virus is its defective production of cell-free virus, which leaves cell-to-cell infection as the major mechanism of viral dissemination...
2016: PloS One
Tao Yi, Chuan Liu, Jiao Zhang, Fan Wang, Jirui Wang, Jifen Zhang
A new silybin nanocrystal self-stabilized Pickering emulsion (SN-SSPE) has been developed using a high pressure homogenization method to improve the oral bioavailability of silybin. Influences of homogenization pressure and drug content on the formation of SN-SSPE were studied. The morphology, structure and size of Pickering emulsion droplets were characterized using a scanning electron micrograph, confocal laser scanning microscopy and atomic force microscopy. The stability, in vitro release and in vivo oral bioavailability of SN-SSPE were investigated...
January 1, 2017: European Journal of Pharmaceutical Sciences
N Malek, M R Baker, C Mann, J Greene
Dementia is a global health problem with a huge impact on the lives of those afflicted. There are several distinct diseases that are classified under the umbrella term "dementia" ranging from neurodegenerative disorders such as Alzheimer's disease to chronic infections of the central nervous system such as subacute sclerosing panencephalitis (SSPE), a rare complication of measles virus infection in childhood. Clinical features, neuropsychological profiles and imaging characteristics of the various dementia syndromes can be sufficiently distinct to distinguish them from one another...
April 2017: Acta Neurologica Scandinavica
Biplab Das, Manoj Kumar Goyal, Manish Modi, Sahil Mehta, Sudheer Chakravarthi, Vivek Lal, Sameer Vyas
OBJECTIVES: Subacute sclerosing panencephalitis (SSPE) is rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection with measles virus. No cure for SSPE exists, but the condition can be managed by medication if treatment is started at an early stage. METHODS AND RESULTS: Heterogeneity of imaging findings in SSPE is not very uncommon. But pial and gyral enhancements are very rarely noticed. Significant asymmetric onset as well as pial-gyral enhancements is not reported...
April 2016: Annals of Indian Academy of Neurology
R Ghazvinian, A Gottsäter, J Elf
BACKGROUND: The need for anticoagulation therapy (AC) in patients with subsegmental pulmonary embolism (SSPE) diagnosed by computed tomography of the pulmonary arteries (CTPA) has been questioned, as these patients run low risk for recurrent venous thromboembolism (VTE) during 3 months of follow-up. Whether this applies also to patients with small PE diagnosed with pulmonary scintigraphy has not yet been evaluated, however. METHODS: We therefore retrospectively evaluated 54 patients (mean age 62 ± 19 years, 36 [67 %] women) with small PE diagnosed by ventilation/perfusion singe photon emission computed tomography (V/P SPECT) who did not receive conventional long-term AC...
2016: Thrombosis Journal
Virendra Chandrashekhar Patil, Harsha V Patil
BACKGROUND: AIDS has become chronic illness which is well treated with antiretroviral therapy and management of opportunistic infections (OIs). AIMS AND OBJECTIVES: The study clinical profile and outcome of human immunodeficiency virus (HIV) seropositive patients. MATERIALS AND METHODS: This was retrospective observational study carried out over a period of 1 year (January 2011-December 2011). All HIV patients admitted in medicine ward, and ICU were enrolled...
January 2016: Indian Journal of Sexually Transmitted Diseases
Nihal Olgac Dundar, Pinar Gencpinar, Nilgun Sallakci, Ozgur Duman, Senay Haspolat, Banu Anlar, Olcay Yegin
The two polymorphisms [IL-12 (-1188) A/C and the IFN-γ (+874) A/T)] are known to have functional consequences and henceforth were analyzed in subacute sclerosing panencephalitis (SSPE) patients to reveal a possible relation with these polymorphisms and this debilitating disease. For the IL-12 (-1188) A/C polymorphism, 78 patients and 90 healthy individuals were analyzed. An increase in the AA genotype was determined (p = 0.02, OR = 2.06). There was also a statistically significant difference between the control group and the patients with respect to the allele frequencies (p = 0...
April 21, 2016: Journal of Neurovirology
Deniz Yılmaz, Deniz Yüksel, Didem Gökkurt, Hava Oguz, Banu Anlar
PURPOSE: Subacute sclerosing panencephalitis (SSPE) is a progressive, lethal disease. Brain histopathology in certain SSPE patients shows, neurofibrillary tangles composed of abnormally phosphorylated, microtubule-associated protein tau (PHF-tau). Because the, phosphorylation of tau is inhibited by insulin and insulin-like growth factor-1 (IGF-1), we investigated cerebrospinal fluid (CSF) insulin and IGF-1 levels in SSPE patients. METHODS AND RESULTS: In this study CSF IGF-1 and insulin levels of 45 SSPE and 25 age-matched control patients were investigated...
July 2016: European Journal of Paediatric Neurology: EJPN
J Velmurugan, Sanjib Sinha, Madhu Nagappa, N Mariyappa, P S Bindu, G S Ravi, Nandita Hazra, K Thennarasu, V Ravi, A B Taly, P Satishchandra
To study the genesis and propagation patterns of periodic complexes (PCs) associated with myoclonic jerks in sub-acute sclerosing pan-encephalitis (SSPE) using magnetoencephalography (MEG) and electroencephalography (EEG). Simultaneous recording of MEG (306 channels) and EEG (64 channels) in five patients of SSPE (M:F = 3:2; age 10.8 ± 3.2 years; symptom-duration 6.2 ± 10 months) was carried out using Elekta Neuromag(®) TRIUX™ system. Qualitative analysis of 80-160 PCs per patient was performed...
August 2016: Neurological Sciences
Arushi Gahlot Saini, Naveen Sankhyan, Hansashree Padmanabh, Jitendra Kumar Sahu, Sameer Vyas, Pratibha Singhi
BACKGROUND: Subacute sclerosing panencephalitis is a devastating neurodegenerative disease with a characteristic clinical course. Atypical presentations may be seen in 10% of the cases. AIMS: To describe the atypical clinical and radiological features of SSPE in a child form endemic country. METHODS: A 5-year-old boy presented with acute-onset cerebellar ataxia without associated encephalopathy, focal motor deficits, seizures or cognitive decline...
May 2016: European Journal of Paediatric Neurology: EJPN
Juventila Liko, Judith A Guzman-Cottrill, Paul R Cieslak
In 2015, the Oregon Health Authority was notified of the death of a boy with subacute sclerosing panencephalitis (SSPE), a rare and fatal complication of measles. The patient, aged 14 years, had reportedly been vaccinated against measles in the Philippines at age 8 months. However, the patient contracted measles at age 1 year while still in the Philippines. He had been well until 2012, when his neurodegenerative symptoms began. After the diagnosis of SSPE was made, the patient remained in home hospice care until his death...
January 15, 2016: MMWR. Morbidity and Mortality Weekly Report
Hugo H B Yoo, Thais H A T Queluz, Regina El Dib
BACKGROUND: Acute pulmonary embolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke.The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate of diagnosis. More cases of peripheral PEs, such as isolated subsegmental PE (SSPE) and incidental PE, have thereby been identified...
January 12, 2016: Cochrane Database of Systematic Reviews
Soheil Peiman, Mehrshad Abbasi, Seyed Farshad Allameh, Mehrnaz Asadi Gharabaghi, Hamidreza Abtahi, Enayat Safavi
Through the introduction of computed tomography pulmonary angiography (CTPA) for diagnosis of the pulmonary embolism (PE), the high sensitivity of this diagnostic tool led to detecting peripheral filling defects as small as 2-3mm, termed as subsegmental pulmonary embolism (SSPE). However, despite these substantial increases in diagnosis of small pulmonary embolism, there are minimal changes in mortality. Moreover, SSPE patients generally are hemodynamically stable with mild clinical presentation, lower serum level of biomarkers, lower incidence of associated proximal DVTs and less frequent echocardiographic changes compared to the patients with emboli located in more central pulmonary arteries...
February 2016: Thrombosis Research
Hasan Kweder, Michelle Ainouze, Joanna Brunel, Denis Gerlier, Evelyne Manet, Robin Buckland
Subacute Sclerosing Panencephalitis (SSPE), a rare lethal disease of children and young adults due to persistence of measles virus (MeV) in the brain, is caused by wild type (wt) MeV. Why MeV vaccine strains never cause SSPE is completely unknown. Hypothesizing that this phenotypic difference could potentially be represented by a molecular marker, we compared glycoprotein and matrix (M) genes from SSPE cases with those from the Moraten vaccine strain, searching for differential structural motifs. We observed that all known SSPE viruses have residues P64, E89, and A209 (PEA) in their M proteins whereas the equivalent residues for vaccine strains are either S64, K89, and T209 (SKT) as in Moraten or PKT...
2015: Advances in Virology
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