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Dol C, Granel B, Resseguier N, Kaplanski G, Reynaud-Gaubert M, Schleinitz N, Grob JJ, Delaporte E, Lafforgue P, Rossi P, Bardin N, Benyamine A. [High anti-topoisomerase-1 autoantibodies levels are associated with the extension of skin fibrosis and vascular progression in patients with systemic sclerosis]. Rev Med Interne 2024; 45:126-131. [PMID: 38355359 DOI: 10.1016/j.revmed.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/29/2023] [Accepted: 11/04/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Anti-centromere antibodies, anti-topoisomerase-1 antibodies (ATA), and anti-RNA-polymerase III antibodies are three Systemic Sclerosis (SSc)-specific autoantibodies. Their detection is helpful in determining the prognosis. We aimed to evaluate whether ATA levels were associated with disease severity at diagnosis or disease progression during follow-up in ATA positive patients. METHODS We conducted a single-centre French retrospective observational study, between 2014 and 2021. ATA positive patients fulfilling the ACR/EULAR 2013 classification criteria for SSc with a minimal follow-up of 1 year and 2 ATA dosages were included. SSc patients with high IgG ATA levels at baseline (>240IU/mL) were compared with SSc patients with low levels (≤240IU/mL), at inclusion and at 1 and 3 years. A variation of at least 30 % of ATA levels was considered significant. RESULTS Fifty-nine SSc patients were included and analysed. There was a predominance of women and of patients with diffuse interstitial lung disease. Patients with high ATA levels exhibited a higher skin sclerosis assessed by the modified Rodnan skin score (P=0.0480). They had a lower carbon monoxide transfer coefficient (P=0.0457), a lower forced vital capacity (FVC) (P=0.0427) and more frequently had a FVC under 80 %, when compared to patients with low ATA levels (P=0.0423). Initial high ATA levels were associated with vascular progression at one year (21.95 % vs. 0 %; P=0.0495). CONCLUSION ATA levels are associated with skin sclerosis and vascular progression in SSc. Beyond the detection of ATA, quantifying this autoantibody might be of interest in predicting disease severity and prognosis in SSc.
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Affiliation(s)
- C Dol
- Service de médecine interne, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France
| | - B Granel
- Service de médecine interne, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France; Inserm, INRA, C2VN, Aix-Marseille université (AMU), 13005 Marseille, France
| | - N Resseguier
- Épidémiologie et économie de la santé, hôpital de la Timone, AP-HM, Aix-Marseille université (AMU), 13005 Marseille, France
| | - G Kaplanski
- Inserm, INRA, C2VN, Aix-Marseille université (AMU), 13005 Marseille, France; Service de médecine interne et immunologie clinique, hôpital de la Conception, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - M Reynaud-Gaubert
- Service de pneumologie, équipe de transplantation pulmonaire, centre de compétences des maladies pulmonaires rares, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), Aix-Marseille université (AMU), 13015 Marseille, France
| | - N Schleinitz
- Service de médecine interne, hôpital de la Timone, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - J-J Grob
- Service de dermatologie, hôpital de la Timone, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - E Delaporte
- Service de dermatologie, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), 13015 Marseille, France
| | - P Lafforgue
- Service de rhumatologie, hôpital Sainte-Marguerite, Assistance publique des Hôpitaux de Marseille (AP-HM), 13009 Marseille, France
| | - P Rossi
- Service de médecine interne, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France; Inserm, INRA, C2VN, Aix-Marseille université (AMU), 13005 Marseille, France
| | - N Bardin
- Inserm, INRA, C2VN, Aix-Marseille université (AMU), 13005 Marseille, France; Laboratoire d'immunologie, biogénopole, hôpital de la Timone, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - A Benyamine
- Service de médecine interne, hôpital Nord, Marseille, Assistance publique des Hôpitaux de Marseille (AP-HM), chemin des Bourrely, 13015 Marseille, France; Inserm, INRA, C2VN, Aix-Marseille université (AMU), 13005 Marseille, France.
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Chen HL, Hung CC, Tian YC, Chen KH. Weekly intraperitoneal steroid infusion to treat recurrent ascites in a patient with early stage of peritoneal dialysis-related encapsulating peritoneal sclerosis: A case report. Perit Dial Int 2024; 44:141-144. [PMID: 37905306 DOI: 10.1177/08968608231205851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Encapsulating peritoneal sclerosis (EPS) is a rare and potentially fatal complication of long-term peritoneal dialysis (PD). EPS-induced large volume and recurrent ascites represents a challenging condition. We report a 51-year-old man with kidney failure treated with PD for 13 years who eventually developed early stage of EPS accompanied with poor intake and recurrent ascites. After management including discontinuing PD and switching to haemodialysis, as well as oral steroids and tamoxifen administration, the patient had refractory ascites. An intervention of weekly intraperitoneal steroid infusion with methylprednisolone was implemented for a year. Gradually, we observed a reduction in ascites drainage, an improvement of clinical symptoms and the patient's nutritional status. The PD catheter was successfully removed as there was no recurrence of ascites. Intraperitoneal corticosteroid administration represents a new intervention for patients with early stage of EPS and recurrent ascites after PD cessation.
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Affiliation(s)
- Huai-Liang Chen
- Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan
| | - Cheng-Chieh Hung
- Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan
| | - Ya-Chung Tian
- Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan
| | - Kuan-Hsing Chen
- Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan
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Raina R, Jothi S, Haffner D, Somers M, Filler G, Vasistha P, Chakraborty R, Shapiro R, Randhawa PS, Parekh R, Licht C, Bunchman T, Sethi S, Mangat G, Zaritsky J, Schaefer F, Warady B, Bartosh S, McCulloch M, Alhasan K, Swiatecka-Urban A, Smoyer WE, Chandraker A, Yap HK, Jha V, Bagga A, Radhakrishnan J. Post-transplant recurrence of focal segmental glomerular sclerosis: consensus statements. Kidney Int 2024; 105:450-463. [PMID: 38142038 DOI: 10.1016/j.kint.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 12/25/2023]
Abstract
Focal segmental glomerular sclerosis (FSGS) is 1 of the primary causes of nephrotic syndrome in both pediatric and adult patients, which can lead to end-stage kidney disease. Recurrence of FSGS after kidney transplantation significantly increases allograft loss, leading to morbidity and mortality. Currently, there are no consensus guidelines for identifying those patients who are at risk for recurrence or for the management of recurrent FSGS. Our work group performed a literature search on PubMed/Medline, Embase, and Cochrane, and recommendations were proposed and graded for strength of evidence. Of the 614 initially identified studies, 221 were found suitable to formulate consensus guidelines for recurrent FSGS. These guidelines focus on the definition, epidemiology, risk factors, pathogenesis, and management of recurrent FSGS. We conclude that additional studies are required to strengthen the recommendations proposed in this review.
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Affiliation(s)
- Rupesh Raina
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA; Department of Nephrology, Akron Children's Hospital, Akron, Ohio, USA
| | - Swathi Jothi
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Michael Somers
- Division of Nephrology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Guido Filler
- Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Prabhav Vasistha
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA
| | - Ronith Chakraborty
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA; Department of Nephrology, Akron Children's Hospital, Akron, Ohio, USA
| | - Ron Shapiro
- Recanati/Miller Transplantation Institute, The Mount Sinai Medical Center, New York, New York, USA
| | - Parmjeet S Randhawa
- Department of Pathology, Thomas E Starzl Transplant Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rulan Parekh
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christopher Licht
- Division of Pediatric Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Timothy Bunchman
- Pediatric Nephrology and Transplantation, Children's Hospital of Richmond at Virginia Commonwealth University (VCU), Richmond, Virginia, USA
| | - Sidharth Sethi
- Pediatric Nephrology, Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India
| | - Guneive Mangat
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA
| | - Joshua Zaritsky
- Division of Pediatric Nephrology, Nemours, A.I. duPont Hospital for Children, Wilmington, Delaware, USA
| | - Franz Schaefer
- Department of Pediatric Nephrology, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Bradley Warady
- Division of Nephrology, University of Missouri-Kansas City School of Medicine, Children's Mercy, Kansas City, Missouri, USA
| | - Sharon Bartosh
- Department of Pediatrics, University of Wisconsin Medical School, Madison, Wisconsin, USA
| | - Mignon McCulloch
- Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Khalid Alhasan
- Nephrology Unit, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Kidney Transplant Division, Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Agnieszka Swiatecka-Urban
- University of Virginia Children's Hospital, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - William E Smoyer
- Center for Clinical and Translational Research and Division of Nephrology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Anil Chandraker
- Transplantation Research Center, Kidney and Pancreas Transplantation, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Hui Kim Yap
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales (UNSW), New Delhi, India; School of Public Health, Imperial College, London, UK; Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Arvind Bagga
- Division of Pediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Jai Radhakrishnan
- Department of Medicine (Nephrology), Columbia University Medical Center, New York, New York, USA.
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Murtas C, Guastini R, Cristi E, Ranalli TV, Feriozzi S. Cinacalcet in focal segmental glomerular sclerosis: a case report. Kidney Int 2024; 105:389-390. [PMID: 38245216 DOI: 10.1016/j.kint.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/12/2023] [Accepted: 10/20/2023] [Indexed: 01/22/2024]
Affiliation(s)
- Corrado Murtas
- Nephrology and Dialysis Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy.
| | - Roberta Guastini
- Nephrology and Dialysis Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy
| | - Emanuela Cristi
- Pathology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy
| | | | - Sandro Feriozzi
- Nephrology and Dialysis Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy
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Tuon FF, Mendonça CJA, Gasperin W, Zotto WL, Sarolli BMS, da Costa Manuel JA, Cruz JAW, Soni JF. Prevalence of radiographic findings in chronic osteomyelitis. BMC Musculoskelet Disord 2024; 25:75. [PMID: 38238672 PMCID: PMC10795221 DOI: 10.1186/s12891-023-07121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 12/14/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Simple radiography in conjunction with pertinent medical history and a comprehensive physical examination is typically adequate for diagnosing chronic osteomyelitis (CO). However, radiographic manifestations of CO lack specificity; therefore, the concordance among specialists in this regard has not been systematically assessed. This study aimed to compare and evaluate the proficiency of orthopedic surgeons and radiologists in identifying radiographic indicators present in simple radiographs for diagnosing CO. METHODS This cross-sectional study was a correlational investigation utilizing plain radiographs obtained from a cohort of 60 patients diagnosed with CO. Comprehensive assessments of the demographic and clinical characteristics, comorbidities, and microbiological parameters were conducted. Additional variables included the anatomical location of the CO, existence of fistulas, disease duration, and presence of pseudoarthrosis. This study meticulously documented the presence or absence of six specific findings: bone destruction, which incorporates erosion and radiolucencies around implants; bone sclerosis; cortical thinning concomitant with erosion; cortical thickening; sequestrum formation; and soft-tissue swelling. RESULTS Most patients were men (75%), with a mean age of 45.1 years. Hematogenous etiology of CO represented 23%. Bone sclerosis (71.3%) and cortical thickening (67.7%) were the most common radiographic findings, followed by soft-tissue swelling (51.3%), sequestration (47.3%), bone destruction (33.3%), and cortical erosion (30.3%). The mean agreement was 74.2%, showing a marked disagreement rate of 25.8% among all radiographic findings. The presence or absence of soft tissue edema, a prominent radiographic finding that was more important than the other findings, showed the greatest disagreement. CONCLUSIONS Radiographic findings in CO were universally observed in all patients, demonstrating a high degree of concordance among specialists, with the exception of soft tissue swelling.
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Affiliation(s)
- Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica Do Paraná, Curitiba, PR, 80215-901, Brazil
| | | | - Wagner Gasperin
- Department of Orthopedics, Hospital de Clínicas da UFPR, Curitiba, PR, 80060-900, Brazil
| | | | | | | | - June Alisson Westarb Cruz
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica Do Paraná, Curitiba, PR, 80215-901, Brazil
| | - Jamil Faissal Soni
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica Do Paraná, Curitiba, PR, 80215-901, Brazil
- Department of Orthopedics, Hospital de Clínicas da UFPR, Curitiba, PR, 80060-900, Brazil
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Durak H, Çetin M, Emlek N, Ergül E, Özyıldız AG, Öztürk M, Duman H, Yılmaz AS, Şatıroğlu Ö. FIB-4 liver fibrosis index correlates with aortic valve sclerosis in non-alcoholic population. Echocardiography 2024; 41:e15732. [PMID: 38284663 DOI: 10.1111/echo.15732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
AIM Hepatic fibrosis, a progressive scarring of liver tissue, is commonly caused by non-alcoholic fatty liver disease (NAFLD), which increases the risk of cardiovascular disease. The Fibrosis-4 (FIB-4) index is a non-invasive tool used to assess liver fibrosis in patients with NAFLD. Aortic valve sclerosis (AVS), a degenerative disorder characterized by thickening and calcification of valve leaflets, is prevalent in the elderly and associated with increased cardiovascular morbidity and mortality. Recent studies have suggested that AVS may also be linked to other systemic diseases such as liver fibrosis. This study aimed to investigate the relationship between the FIB-4 index and AVS in a non-alcoholic population, with the hypothesis that the FIB-4 index could serve as a potential marker for AVS. METHOD A total of 92 patients were included in this study. AVS was detected using transthoracic echocardiography, and patients were divided into groups according to the presence of AVS. The FIB-4 index was calculated for all patients and compared between the groups. RESULTS A total of 17 (18.4%) patients were diagnosed AVS. Patients with AVS had higher rates of diabetes mellitus, older age, hypertension, angiotensin-converting enzyme inhibitor use, higher systolic blood pressure (BP) and diastolic BP in the office, coronary artery disease prevalence, left atrial volume index (LAVI), left ventricular mass index (LVMI), and late diastolic peak flow velocity (A) compared to those without AVS. Moreover, AVS patients had significantly higher creatinine levels and lower estimated glomerular filtration rate. Remarkably, the FIB-4 index was significantly higher in patients with AVS. In univariate and multivariate analyses, higher systolic BP in the office (OR, 1.044; 95% CI 1.002-1.080, p = .024) and higher FIB-4 index (1.46 ± .6 vs. .91 ± .46, p < .001) were independently associated with AVS. CONCLUSION Our findings suggest that the FIB-4 index is associated with AVS in non-alcoholic individuals. Our results highlight the potential utility of the FIB-4 index as a non-invasive tool for identifying individuals at an increased risk of developing AVS.
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Affiliation(s)
- Hüseyin Durak
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Mustafa Çetin
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Nadir Emlek
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Elif Ergül
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ali Gökhan Özyıldız
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Muhammet Öztürk
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Hakan Duman
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ahmet Seyda Yılmaz
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ömer Şatıroğlu
- Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Wang CJ, Chao YJ, Liu YS, Liao FT, Chang SS, Liao TK, Lu WH, Su PJ, Shan YS. Prediction of surgical outcomes in severe encapsulating peritoneal sclerosis using a computed tomography scoring system. J Formos Med Assoc 2024; 123:98-105. [PMID: 37365098 DOI: 10.1016/j.jfma.2023.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/27/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND/PURPOSE Encapsulating peritoneal sclerosis (EPS) is a rare and potential lethal complication of peritoneal dialysis characterized by bowel obstruction. Surgical enterolysis is the only curative therapy. Currently, there are no tools for predicting postsurgical prognosis. This study aimed to identify a computed tomography (CT) scoring system that could predict mortality after surgery in patients with severe EPS. METHODS This retrospective study enrolled patients with severe EPS who underwent surgical enterolysis in a tertiary referral medical center. The association of CT score with surgical outcomes including mortality, blood loss, and bowel perforation was analyzed. RESULTS Thirty-four patients who underwent 37 procedures were recruited and divided into a survivor and non-survivor group. The survivor group had higher body mass indices (BMIs, 18.1 vs. 16.7 kg/m2, p = 0.035) and lower CT scores (11 vs. 17, p < 0.001) than the non-survivor group. The receiver operating characteristic curve revealed that a CT score of ≥15 could be considered a cutoff point to predict surgical mortality, with an area under the curve of 0.93, sensitivity of 88.9%, and specificity of 82.1%. Compared with the group with CT scores of <15, the group with CT scores of ≥15 had a lower BMI (19.7 vs. 16.2 kg/m2, p = 0.004), higher mortality (4.2% vs. 61.5%, p < 0.001), greater blood loss (50 vs. 400 mL, p = 0.007), and higher incidence of bowel perforation (12.5% vs. 61.5%, p = 0.006). CONCLUSION The CT scoring system could be useful in predicting surgical risk in patients with severe EPS receiving enterolysis.
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Affiliation(s)
- Chih-Jung Wang
- Division of Trauma, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying Jui Chao
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Sheng Liu
- Department of Radiology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Fan-Ting Liao
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Shen-Shin Chang
- Division of Transplantation, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ting-Kai Liao
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Wei-Hsun Lu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ping-Jui Su
- Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yan-Shen Shan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of General Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
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Huang Y, Gu C, Xi H, Chen H, Gao F, Yuan X, Guo M, Mai J, Liu X, Du B. Sclerosis rim volume ratio and Japanese Investigation Committee classification as predictive factors for femoral head collapse progression after non-vascularized fibular grafting in osteonecrosis patients. Asian J Surg 2024; 47:250-255. [PMID: 37661477 DOI: 10.1016/j.asjsur.2023.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/22/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE The purpose of this retrospective cohort study was to determine the relationship between sclerosis rim volume ratio (SVR) and the progression of femoral head collapse after non-vascularized fibular grafting (NVFG) surgery in patients with osteonecrosis of the femoral head (ONFH), investigating risk factors associated with femoral head collapse progression and establishing a predictive model to enhance clinical decision-making. METHODS ONFH patients who underwent NVFG between January 2008 and December 2021 were analyzed retrospectively to assess the risk of post-operative collapse progression (collapse >2 mm). A logistic regression model was used to evaluate the independent risk factors associated with collapse progression, including age, sex, etiology, affected side, Japanese Investigation Committee classification (JIC), and the sclerosis rim volume ratio (SVR). SVR values was collected from three weight-bearing columns, namely SVR1, SVR2, and SVR3, respectively. RESULTS 57 patients with 64 hips who had undergone NVFG and were followed up for at least one year were included. During the follow-up, collapse>2 mm occurred in 30 hips (46.88%). Multivariable analysis revealed that JIC (p =0.037) and SVR1 (p = 0.04) were independent risk factors for collapse progression after NVFG. The results of the receiver operating characteristic (ROC) analysis indicated that the aforementioned indices provided a satisfactory prediction of early femoral head collapse progression in ONFH patients after NVFG. The regression model using the above two indicators as a composite index showed satisfactory performance in predicting early postoperative femoral head collapse progression, with an area under the curve (AUC) of 84.6%. CONCLUSIONS SVR is significant predictor of post-operative collapse progression following NVFG, and the composite index provides an optimal predictive value for femoral head collapse progression after surgery.
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Affiliation(s)
- Yixuan Huang
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Changyuan Gu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Hongzhong Xi
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Hao Chen
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Feifei Gao
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Xinwei Yuan
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Mingbin Guo
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Jianbin Mai
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Xin Liu
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China.
| | - Bin Du
- The Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Orthopedics, Nanjing, 210029, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, 210029, China.
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9
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Castro‐Lima H, Passarelli V, Ribeiro ES, Adda CC, Preturlon‐Santos APP, Jorge CL, Valério R, Tzu WH, Boa‐Sorte N, Pipek LZ, Castro LHM. Bilateral ictal EEG is associated with better memory outcome after hippocampal sclerosis surgery. Epilepsia Open 2023; 8:1532-1540. [PMID: 37750472 PMCID: PMC10690677 DOI: 10.1002/epi4.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/17/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE To compare memory outcomes after surgery for unilateral hippocampal sclerosis (HS)-associated epilepsy in patients with unilateral and bilateral ictal electrographic involvement. METHODS We prospectively evaluated HS patients, aged 18-55 years and IQ ≥70. Left (L) and right (R) surgical groups underwent noninvasive video-EEG monitoring and Wada test. We classified patients as Ipsilateral if ictal EEG was restricted to the HS side, or Bilateral, if at least one seizure onset occurred contralaterally to the HS, or if ictal discharge evolved to the opposite temporal region. Patients who declined surgery served as controls. Memory was evaluated on two occasions with Rey Auditory-Verbal Learning Test and Rey Visual-Design Learning Test. Baseline neuropsychological test scores were compared between groups. Pre- and postoperative scores were compared within each group. Reliable change index Z-scores (RCI) were obtained using controls as references, and compared between surgical groups. RESULTS We evaluated 64 patients. Patients were classified as: L-Ipsilateral (9), L-Bilateral (15), L-Control (9), R-Ipsilateral (10), R-Bilateral (9), and R-Control (12). On preoperative evaluation, memory performance did not differ among surgical groups. Right HS patients did not present postoperative memory decline. L-Ipsilateral group presented postoperative decline on immediate (P = 0.036) and delayed verbal recall (P = 0.011), while L-Bilateral did not decline. L-Ipsilateral had lower RCI Z-scores, indicating delayed verbal memory decline compared to L-Bilateral (P = 0.012). SIGNIFICANCE Dominant HS patients with bilateral ictal involvement presented less pronounced postoperative verbal memory decline compared to patients with exclusive ipsilateral ictal activity. Surgery was indicated in these patients regardless of memory impairment on neuropsychological testing, since resection of the left sclerotic hippocampus could result in cessation of contralateral epileptiform activity, and, therefore, improved memory function.
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Affiliation(s)
| | - Valmir Passarelli
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Elyse S Ribeiro
- Division of Psychology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Carla C Adda
- Division of Psychology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Ana Paula P Preturlon‐Santos
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Carmen L Jorge
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Rosa Valério
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Wen Hung Tzu
- Department of Neurosurgery, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Ney Boa‐Sorte
- Bahiana School of Medicine and Public HealthSalvadorBrazil
| | - Leonardo Zumerkorn Pipek
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
| | - Luiz Henrique M Castro
- Department of Neurology, Hospital das Clínicas HCFMUSP, Faculdade de MedicinaUniversity of Sao PauloSão PauloBrazil
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10
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Kamalov A A, Sorokin N I, Kadrev A V, Shaparov B M, Afanasevskaya E V, Sindeeva O A, Sukhorukov G B, Kritsky A A, Pyataev N A, Abdurashitov A S, Kulikov O A, Proshin P I. [The use of a urethral catheter with an ultrasound-induced biopolymer drug coating for the prevention of recurrent bladder neck sclerosis in patients after endoscopic treatment of benign prostate hyperplasia]. Urologiia 2023:145-150. [PMID: 38156699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Recurrent bladder neck sclerosis is one of the common complications of endoscopic treatment of benign prostate hyperplasia, which often leads to multiple re-operations, including complex open and laparoscopic reconstructive procedures. One of the most promising minimally invasive methods for preventing recurrence of bladder neck sclerosis is balloon dilatation under transrectal ultrasound guidance. To improve the results of using this technique, a urethral catheter with a biopolymer coating, capable of depositing a drug and eluting it under the influence of diagnostic ultrasound, was proposed.
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Affiliation(s)
- A Kamalov A
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - I Sorokin N
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - V Kadrev A
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - M Shaparov B
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - V Afanasevskaya E
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - A Sindeeva O
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - B Sukhorukov G
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - A Kritsky A
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - A Pyataev N
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - S Abdurashitov A
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - A Kulikov O
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
| | - I Proshin P
- Urology and Andrology Branch, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
- Department of Urology and Andrology, Lomonosov MSU Medical Research and Educational Center, Moscow, Russia
- A.V. Zelmann Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, Russia
- Institute of Medicine, National Research Ogarev Mordovia State University, Saransk, Russia
- Moscow City Clinical Hospital No. 17, Moscow, Russia
- Istra Regional Clinical Hospital, Istra, Russia
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11
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Nabata K, Watanabe A, Stuart H. Sclerosing encapsulating peritonitis causing fatal bowel obstruction. BMJ Case Rep 2023; 16:e255625. [PMID: 37923337 PMCID: PMC10626900 DOI: 10.1136/bcr-2023-255625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Sclerosing encapsulating peritonitis (SEP) is a rare condition characterised by a fibrotic peritoneal membrane encasing loops of bowel often resulting in obstruction. We present a case of SEP complicated by non-resolving small bowel obstruction in the context of prior malignancies and surgical complications. A literature review on SEP was performed to outline potential aetiologies, diagnostic investigations and treatment strategies that may be considered in the management of this disease.
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Affiliation(s)
- Kylie Nabata
- General Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Akie Watanabe
- General Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Heather Stuart
- General Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
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12
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Li Y, Liu P, Lin Q, Zhou D, An D. Postoperative seizure and memory outcome of temporal lobe epilepsy with hippocampal sclerosis: A systematic review. Epilepsia 2023; 64:2845-2860. [PMID: 37611927 DOI: 10.1111/epi.17757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
We conducted a systematic review and meta-analysis to evaluate postoperative seizure and memory outcomes of temporal lobe epilepsy with different hippocampal sclerosis (HS) subtypes classified by International League Against Epilepsy (ILAE) Consensus Guidelines in 2013. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-Analysis of Observational Studies in Epidemiology) guidelines, we searched PubMed, Embase, Web of Science, and Cochrane Library from January 1, 2013 to August 6, 2023. Observational studies reporting seizure and memory outcomes among different HS subtypes were included. We used the Newcastle-Ottawa scale to assess the risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to grade the quality of evidence. Seizure freedom and improved outcome (Engel 1 or ILAE class 1-2) ≥1 year after surgery were defined as the primary and secondary seizure outcome. A random-effects meta-analysis by DerSimonian and Laird method was performed to obtain pooled risk ratio (RRs) with 95% confidence interval (CIs). The memory impairment was narratively reviewed because of various evaluation tools. Fifteen cohort studies with 2485 patients were eligible for the meta-analysis of seizure outcome. Six cohorts with detailed information on postoperative memory outcome were included. The pooled RRs of seizure freedom, with moderate to substantial heterogeneity, were .98 (95% CI = .84-1.15) between HS type 2 and type 1, 1.11 (95% CI = .82-1.52) between type 3 and type 1, and .80 (95% CI = .62-1.03) between the no-HS and HS groups. No significant difference of improved outcome was found between different subtypes (p > .05). The quality of evidence was deemed to be low to very low according to GRADE. The long-term seizure outcome (≥5 years after surgery) and memory impairment remained controversial.
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Affiliation(s)
- Yuming Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Peiwen Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuxing Lin
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Dongmei An
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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13
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Ghosh S, Baker L, Chen F, Khera Z, Vain A, Zhang K, Hood A, Smith H, Chen H, Jagasia M, Tkaczyk E. Interrater reproducibility of the Myoton and durometer devices to quantify sclerotic chronic graft-versus-host disease. Arch Dermatol Res 2023; 315:2545-2554. [PMID: 37227518 DOI: 10.1007/s00403-023-02626-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 05/26/2023]
Abstract
Chronic graft-versus-host disease (cGVHD) is a severe complication in long-term survivors of allogeneic hematopoietic stem cell transplantation. This disease is challenging to manage clinically due to a lack of validated tools to quantitatively measure skin sclerosis. The current gold standard for measuring skin sclerosis is the NIH Skin Score which has only moderate agreement among clinicians and experts. To more accurately assess skin sclerosis in cGVHD, the Myoton and durometer devices can be used to directly measure biomechanical parameters of the skin. However, the reproducibility of these devices is not known in patients with cGVHD. To determine this reproducibility, three observers independently measured 10 anatomic sites in each of seven patients with sclerotic cGVHD using the Myoton and durometer. Clinical reproducibility was measured by mean pairwise differences (U-statistic) and intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs). Mean pairwise differences, expressed in true physical units, were used to report typical errors for each anatomic site and device. Mean pairwise differences were less than 11% of the average overall values for all five Myoton parameters and durometer hardness. These were lower for Myoton creep (4.1%), relaxation time (4.7%), and frequency (5.1%) than decrement (9.0%), stiffness (10.4%), and durometer hardness (9.0%). Myoton parameters creep, relaxation time, and frequency showed promise for capturing skin biomechanics more accurately than Myoton stiffness, decrement, or durometer hardness. Mean pairwise differences trended highest in the shin and volar forearm and lowest in the dorsal forearm. The interobserver ICC for overall (averaged across all measured body sites of a patient) creep (0.94; 95% CI 0.87-1.00), relaxation time (0.96; 95% CI 0.90-1.00), and frequency (0.95; 95% CI 0.88-1.00), trended higher than that for decrement (0.43; 95% CI 0.00-0.88), stiffness (0.92; 95% CI 0.81-1.00), and durometer hardness (0.82; 95% CI 0.61-1.00). Similar trends were observed in healthy participants. These findings can help clinicians design better studies to assess therapeutic response to new cGVHD treatments and support the interpretation of future measurements.
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Affiliation(s)
- Shramana Ghosh
- Dermatology and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Laura Baker
- Dermatology and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Fuyao Chen
- Dermatology and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Medical Scientist Training Program, Yale School of Medicine, New Haven, CT, USA
| | - Zain Khera
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Arved Vain
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
- University of Tartu Institute of Physics, Tartu, Estonia
| | - Kathy Zhang
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Alexis Hood
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Hayden Smith
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Heidi Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | | | - Eric Tkaczyk
- Dermatology and Research Services, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA.
- Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, TN, Nashville, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
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14
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Arcidiacono GP, Poci C, Sella S, Torres MO, Zanchetta F, Cecchinato A, Diogo M, Peleg Falb M, Giannini S. Hepatitis C-associated Osteosclerosis (HCAO): Long-Term Follow-Up of a New Case Recovered After Antiviral Treatment. Calcif Tissue Int 2023; 113:571-577. [PMID: 37718324 DOI: 10.1007/s00223-023-01135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
Hepatitis C-associated osteosclerosis (HCAO) is a very rare condition that can be observed in a small number of patients with Hepatitis C Virus (HCV) infection. HCAO is usually characterized by widespread bone sclerosis, associated with severe bone pain, and increased levels of bone turnover markers, especially alkaline phosphatase (ALP). In this report, we present the case of a 55-year-old woman who was affected by HCV and came to our attention for severe and diffuse bone pain. Radiological studies showed bone sclerosis, and bone mineral density (BMD) was markedly increased, as well as serum ALP levels. The patient was initially treated with intravenous pamidronate, which provided only a transient benefit on clinical symptoms. Then antiviral therapy for HCV (interferon-alfa and ribavirin) was started and it was effective in making the viral load undetectable. After a long follow-up period, we observed a persistent remission of bone pain, a reduction in BMD together with a progressive trend toward the normalization of bone turnover markers. In conclusion, HCAO, although rare, should be considered among the potential causes of increased bone mass in patients with HCV infection, and treatment for the underlying infection may be effective in controlling the manifestations of this disease.
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Affiliation(s)
| | - Carlo Poci
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Stefania Sella
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Marco Onofrio Torres
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Francesca Zanchetta
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Alberta Cecchinato
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Martin Diogo
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Mor Peleg Falb
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Sandro Giannini
- Department of Medicine, Clinica Medica 1, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
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15
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Lecourtois C, Baudin-Tréhiou C, Blond L. Lumbosacral endplate contour defect is frequently observed concurrent with other lumbosacral abnormalities on spinal CT of French Bulldogs. Vet Radiol Ultrasound 2023; 64:813-822. [PMID: 37366604 DOI: 10.1111/vru.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 06/28/2023] Open
Abstract
Lumbosacral osteochondrosis has been previously described in large breed dogs with variable clinical signs. Its CT features are a contour defect at the dorsal aspect of either vertebral endplate, commonly with an adjacent fragment. Descriptions of this condition have not been previously published in an increasingly popular breed, French Bulldogs. Aims of this retrospective, descriptive, single center study were to evaluate CT lumbosacral abnormalities and the frequency of lumbosacral endplate contour defect in a large sample of French Bulldogs. The presence and location of lumbosacral endplate contour defect and the presence of a concurrent osseous fragment were recorded. Other abnormal CT findings such as L7-S1 disc herniation, cauda equina nerve roots compression or thickening, disc mineralization, endplate sclerosis, spondylosis deformans, S1 articular processes hypertrophy, transitional vertebrae, hemivertebrae, spina bifida, and block vertebrae were recorded. Lumbosacral CT abnormalities were present in 91.8% of dogs (168/183). The most common abnormality was an L7-S1 dorsal disc herniation (77.4%, 130/168). Among dogs with lumbosacral abnormalities, the frequency of a lumbosacral endplate contour defect was 47% (79/168). It mostly involved L7 (78.5%, 62/79) at its dorsolateral aspect (61.3%, 38/62). A mineralized fragment was identified in 62% of the defects (49/79). Endplate contour defects were most frequently seen with a concurrent disc herniation (93.7%, 74/79) causing nerve root compression in 63.3% (50/79) and with sclerosis (65.8%, 52/79). There was no definitive evidence of a relationship with clinical presentation in this sample of French Bulldogs; therefore, this finding should be interpreted with caution. The etiology remains unclear.
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Affiliation(s)
- Camille Lecourtois
- Department of Diagnostic Imaging, Centre Hospitalier Vétérinaire Languedocia, Montpellier, France
| | - Clément Baudin-Tréhiou
- Department of Diagnostic Imaging, Centre Hospitalier Vétérinaire Languedocia, Montpellier, France
| | - Laurent Blond
- Department of Diagnostic Imaging, Centre Hospitalier Vétérinaire Languedocia, Montpellier, France
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16
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Nakayama M, Miyazaki M, Hamada C, Ito Y, Honda K. Pathophysiology of encapsulating peritoneal sclerosis: lessons from findings of the past three decades in Japan. Clin Exp Nephrol 2023; 27:717-727. [PMID: 37278945 PMCID: PMC10432343 DOI: 10.1007/s10157-023-02360-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/10/2023] [Indexed: 06/07/2023]
Abstract
Encapsulating peritoneal sclerosis (EPS), a condition with a high mortality rate, is a serious complication of peritoneal dialysis (PD). In Japan, EPS became a central issue in the clinical setting during the mid-90s and the beginning of this century. However, following the introduction of biocompatible neutral PD solutions containing lower levels of glucose degradation products, the incidence and clinical severity of EPS has been greatly lessened. During the past three decades, the etiology of EPS has been elucidated by findings obtained by peritoneal biopsy, laparoscopy, and surgical intervention. Accumulating findings suggest the need for a paradigm change on the nature of EPS pathophysiology; notably, EPS appears not to reflect peritoneal sclerosis per se, but rather the formation of a neo-membrane as a biological reaction to peritoneal injury. This narrative review looks back on the history of EPS in Japan, and discusses EPS pathophysiology, the impact of neutral PD solution on peritoneal protection, and a future novel diagnostic approach, ultra-fine endoscope, for the identification of patients at high risk of EPS.
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Affiliation(s)
- Masaaki Nakayama
- St Luke's International Hospital, Kidney Center, Akashi-cho 9-1, Chuo-ku, Tokyo, Japan.
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17
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Samudra N, Armour E, Gonzalez H, Mattingly D, Haas K, Singh P, Sonmezturk H, Gallagher M, Crudele A, Nobis W, Reddy S, Jacobs M, Aulino JM, Bick S, Morgan V, Englot D, Abou-Khalil B. Epilepsy with anterior temporal encephaloceles: Baseline characteristics, post-surgical outcomes, and comparison to mesial temporal sclerosis. Epilepsy Behav 2023; 139:109061. [PMID: 36587487 DOI: 10.1016/j.yebeh.2022.109061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/18/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To review clinical and neuropsychological characteristics and natural history of a series of patients with temporal lobe epilepsy (TLE) and anterior temporal encephaloceles (ATE) and compare them to a similar series of TLE patients with mesial temporal sclerosis (MTS) to identify characteristics suggestive of ATE-related epilepsy. METHODS Patients with epilepsy and ATE were identified via clinic encounters and consensus epilepsy surgery conference at a Level 4 epilepsy center. The drug-resistant subset of these patients who underwent epilepsy surgery (twenty-two of thirty-five) were compared to age- and laterality-matched patients with MTS. Clinical, neuropsychological, electrophysiologic, and surgical data were abstracted through chart review. RESULTS In comparison with MTS, ATE patients were more often female, had significantly later onset of epilepsy, and did not have prior febrile seizures. In addition, ATE patients were more likely to have chronic headaches and other historical features consistent with idiopathic intracranial hypertension (IIH). Failure to identify ATE on initial imaging was common. Most patients had limited temporal cortical resections sparing mesial structures. Of the twenty ATE patients who had a long-term postsurgical follow-up, seventeen (85%) had International League Against Epilepsy (ILAE) Class 1 or 2 outcomes. SIGNIFICANCE A shorter duration of epilepsy, female gender, and lack of history of febrile seizures may suggest ATE as an etiology of refractory TLE in adults. Targeted encephalocele resections can result in seizure freedom, underscoring the importance of encephalocele identification.
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Affiliation(s)
- Niyatee Samudra
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric Armour
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hernan Gonzalez
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Danielle Mattingly
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kevin Haas
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pradumna Singh
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hasan Sonmezturk
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Martin Gallagher
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela Crudele
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William Nobis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilpa Reddy
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Monica Jacobs
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph M Aulino
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah Bick
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victoria Morgan
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dario Englot
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bassel Abou-Khalil
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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18
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Barasch E, Gottdiener JS, Tressel W, Bartz TM, Buzkova P, Massera D, deFilippi C, Biggs ML, Psaty BM, Kizer JR, Owens D. The Associations of Aortic Valve Sclerosis, Aortic Annular Increased Reflectivity, and Mitral Annular Calcification with Subsequent Aortic Stenosis in Older Individuals: Findings from the Cardiovascular Health Study. J Am Soc Echocardiogr 2023; 36:41-49.e1. [PMID: 36096340 PMCID: PMC9822849 DOI: 10.1016/j.echo.2022.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although aortic valve sclerosis (AVS) is well described as preceding aortic stenosis (AS), the associations of AS with antecedent mitral annular calcification (MAC) and aortic annular increased reflectivity (AAIR) have not been characterized. In a population-based prospective study, the authors evaluated whether MAC, AAIR, and AVS are associated with the risk for incident AS. METHODS Among participants of the Cardiovascular Health Study free of AS at the 1994-1995 visit, the presence of MAC, AAIR, AVS, and the combination of all three was evaluated in 3,041 participants. Cox proportional-hazards regression was used to assess the association between the presence of calcification and the incidence of moderate or severe AS in three nested models adjusting for factors associated with atherosclerosis and inflammation both relevant to the pathogenesis of AS. RESULTS Over a median follow-up period of 11.5 years (interquartile range, 6.7-17.0 years), 110 cases of incident moderate or severe AS were ascertained. Strong positive associations with incident moderate or severe AS were found for all calcification sites after adjustment for the main model covariates: AAIR (hazard ratio [HR], 2.90; 95% CI, 1.95-4.32; P < .0005), AVS (HR, 2.20; 95% CI, 1.44-3.37; P < .0005), MAC (HR, 1.67; 95% CI, 1.14-2.45; P = .008), and the combination of all three (HR, 2.50; 95% CI, 1.65-3.78; P < .0005). In a secondary analysis, the risk for AS increased with the number of sites at which calcification was present. CONCLUSIONS In a large cohort of community-dwelling elderly individuals, there were strong associations between each of AAIR, AVS, MAC, and the combination of the three and incident moderate or severe AS. The novel finding that AAIR had a particularly strong association with incident AS, even after adjusting for other calcification sites, suggests its value in identifying individuals at risk for AS and potential inclusion in routine assessment by transthoracic echocardiography.
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Affiliation(s)
- Eddy Barasch
- Department of Research and Education, St. Francis Hospital/SUNY at Stony Brook, Roslyn, New York.
| | - John S Gottdiener
- Department of Medicine (Cardiology), University of Maryland School of Medicine, Baltimore, Maryland
| | - William Tressel
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Traci M Bartz
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Petra Buzkova
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Daniele Massera
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York
| | | | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Bruce M Psaty
- Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington and Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Jorge R Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System and Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco, San Francisco, California
| | - David Owens
- Division of Cardiology, University of Washington, Seattle, Washington
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19
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Zhao T, Yu X, Wang S, Yang L, Su T. Hypercalciuria may predict better response to immunosuppressive therapy in renal sarcoidosis: a case series. J Nephrol 2023; 36:69-82. [PMID: 35696042 DOI: 10.1007/s40620-022-01360-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/18/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Renal sarcoidosis is a rare cause of tubulointerstitial nephritits (TIN). The clinical and pathological characteristics, as well as outcomes, of renal sarcoidosis remain unclear. METHODS This single-center study retrospectively analyzed 18 patients affected by sarcoidosis with tubulointerstitial nephritis (TIN) and 53 patients with tubulointerstitial nephritis not related to sarcoidosis. Patients were further stratified into the granulomatous (12 sarcoidosis and 6 non-sarcoidosis) and non-granulomatous (6 sarcoidosis and 47 non-sarcoidosis) TIN groups. RESULTS Half of the patients with renal sarcoidosis had signs of acute kidney injury at kidney biopsy, 94% of whom presented with extra-renal involvement. The prevalence of hypercalcemia, hypercalciuria, and elevated serum angiotensin-converting enzyme levels was 27.6%, 33.3%, and 31.3%, respectively. Renal sarcoidosis patients with eGFR < 30 mL/min/1.73 m2 scored higher for total chronic tubulointerstitial injury (p = 0.044) and glomerular sclerosis (p = 0.027). Compared to non-sarcoidosis patients, higher urinary calcium levels (for patients with GFR [Formula: see text] 40 mL/min/1.73 m2, p = 0.034), lower scores of acute tubular injury (p = 0.008), and more prominent glomerular sclerosis were observed in renal sarcoidosis. Similar characteristics of chronicity and hypercalciuria were also identified in granulomatous interstitial nephritis; however, interstitial inflammation was obvious (p = 0.001). Patients with renal sarcoidosis were initially treated with corticosteroids. Five patients receiving immunosuppressive agents showed better long-term renal recovery. High 24-h urine calcium (adjusted by weight) was identified as a factor associated with long-term remission. CONCLUSION Renal sarcoidosis is a systemic disease of insidious onset and chronic progression, sharing similar features of chronicity and hypercalciuria with granulomatous interstitial nephritis of other cause. Hypercalciuria may predict a better response to immunosuppressive therapy, presumably indicating active interstitial inflammation; thus, strengthened immunosuppression might be considered.
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Affiliation(s)
- Tao Zhao
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, No.8 Xishiku Street, Xicheng District, Beijing, China
| | - Xiaojuan Yu
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, No.8 Xishiku Street, Xicheng District, Beijing, China
| | - Suxia Wang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, No.8 Xishiku Street, Xicheng District, Beijing, China
| | - Li Yang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, No.8 Xishiku Street, Xicheng District, Beijing, China
| | - Tao Su
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, No.8 Xishiku Street, Xicheng District, Beijing, China.
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20
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Voronetsky AN, Gulenko AV. [Histological evaluation of esophageal stricture in children with caustic burn]. Khirurgiia (Mosk) 2023:43-51. [PMID: 38088840 DOI: 10.17116/hirurgia202312143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To analyze histological features of esophageal strictures in children with chemical burn following ingestion of household products containing sodium (potassium) hypochlorite, sodium (potassium) hydroxide. MATERIAL AND METHODS We analyzed 3 children with complicated caustic esophageal burns. Children at the time of swallowing the caustic were 26.3±4.1 months. Multiple dilatations of esophageal stricture were ineffective. Therefore, extirpation or subtotal resection of the esophagus and esophagocoloplasty were performed. We stained specimens using hematoxylin and eosin, as well as Masson's trichrome. RESULTS Severe esophageal burns caused by sodium (potassium) hydroxide and/or sodium hypochlorite are followed by irreversible tissue lesions and non-dilatable stricture. Strictures are localized in the areas of physiological narrowing of the esophagus. The longest stricture follows ingestion of liquid substance. Histological properties include atrophy of glands and mucous membrane, muscle layer substitution by connective tissue and diffuse sclerosis of esophageal wall. CONCLUSION Non-dilatable esophageal stricture following caustic burn in children is due to irreversible morphological lesion of esophageal wall with mucous layer atrophy and sclerosis of all layers.
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Affiliation(s)
| | - A V Gulenko
- Alexandrov National Center of Oncology and Medical Radiology, Minsk, Belarus
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21
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郭 玉, 张 建, 王 佃, 郭 传. [Analysis of pathological characteristics of medication-related osteonecrosis of the jaw and discussion of clinical treatment strategies based on the pathological analysis results]. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54:1190-1195. [PMID: 36533354 PMCID: PMC9761830 DOI: 10.19723/j.issn.1671-167x.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To summarize the pathological characteristics of medication-related osteonecrosis of the jaw (MRONJ) specimens after jaw curettage or jaw osteotomy treatment and to comprehensively analyze the relationship between the different pathological features, treatment methods, and treatment effects to provide new ideas for effective treatment of MRONJ in clinical work. METHODS The clinical and pathological data were collected from 23 patients with MRONJ who were treated with curettage (18 patients) and jaw osteotomy (5 patients) at the Department of Oral and Maxillofacial Surgery of Peking University Hospital of Stomatology between June 2014 and December 2015. The pathological characteristics of MRONJ were summarized and analyzed with treatment effects based on various surgical treatment methods. The diagnostic criteria and disease staging of MRONJ were determined according to the 2014 American Association of Oral and Maxillofacial Surgeon's Position Paper. RESULTS In this study, 5 patients have treated with jaw segmental osteotomy, and all of them were in stage Ⅲ; the other 18 patients were treated with jaw curettage, including 5 patients in stage Ⅱ and 13 patients in stage Ⅲ. The pathological features of MRONJ in five cases of jaw segmental osteotomy were divided into three adjacent regions from shallow to deep: inflammation region (IR), sclerosis region (SR), and bone remodeling layer (BRL). Moreover, three types of pathological features of specimens from traditional curettage were defined as type 1 (IR), type 2 (IR + SR), and type 3 (IR + SR + BRL). The pathological features of the patients treated with jaw curettage were: type Ⅰ, 38.9% (7/18); type Ⅱ, 44.4% (8/18); type Ⅲ, 16.7% (3/18). Complete healing was achieved in 5 patients treated with jaw segmental osteo-tomy. Moreover, 2 cases with type Ⅰ, 1 case with type Ⅱ, and 1 with type Ⅲ completely healed after jaw curettage, while 5 cases with type Ⅰ, 7 cases with type Ⅱ, and 2 cases with type Ⅲ experienced recurrence after surgery. CONCLUSION Pathological features of continuous regions of inflammation, sclerosis, and bone remodeling layer were identified from shallow to deep, based on the microscopic observation of jaw segmental osteotomy samples. Insufficient removal of the sclerotic region during jaw curettage that blocks the required blood, nutritional factors, and mesenchymal stem cells seems to be a common cause for failed treatment of MRONJ after curettage surgery.
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Affiliation(s)
- 玉兴 郭
- 北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 建运 张
- 北京大学口腔医学院·口腔医院口腔病理科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 佃灿 王
- 北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 传瑸 郭
- 北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Liu L, Zhan Y, Shi Y, Zeng Z, Yu J, Zou P, Qiu X, Zhou Y, Zhang G, Ding Y, Xiao R. Bullous lichen sclerosus-generalized morphea overlap syndrome improved by tofacitinib. Dermatol Ther 2022; 35:e15942. [PMID: 36254686 DOI: 10.1111/dth.15942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 11/28/2022]
Abstract
We here report a case of a middle-aged man with an unusual case of bullous lichen sclerosus complicated with generalized morphea. He showed initial recurrent flaccid bullae, followed by ivory-white sclerotic plaques and extensive skin sclerosis, with additional walking disorder caused by knee-joint contracture, and ulcers on the lower extremities and back. The patient had no visceral involvement. After oral hydroxychloroquine and oral corticosteroids failed, the patient was given tofacitinib, which resolved his ulcers after 4 weeks and ameliorated his knee-joint contracture and skin sclerosis within 4 months. Owing to the occurrence of diffuse large B-cell lymphoma, he stopped using tofacitinib, and the ulcer and walking disorder reappeared. This is rare case of bullous lichen sclerosus-generalized morphea overlap syndrome. The patient recovered well after treatment with tofacitinib. His symptoms recurred after discontinuation of tofacitinib.
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Affiliation(s)
- Licong Liu
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Yi Zhan
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Yaqian Shi
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Zhuotong Zeng
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Jiangfan Yu
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Puyu Zou
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Xiangning Qiu
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Ying Zhou
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Guiying Zhang
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
| | - Yan Ding
- Department of Dermatology, Hainan Provincial Hospital of Skin Disease, Haikou, China
- Department of Dermatology, Affiliated Dermatology Hospital of Hainan Medical College, Haikou, China
| | - Rong Xiao
- Department of Dermatology, Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, Changsha, China
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23
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Fleury M, Buck S, Binding LP, Caciagli L, Vos SB, Winston GP, Thompson P, Koepp MJ, Duncan JS, Sidhu MK. Episodic memory network connectivity in temporal lobe epilepsy. Epilepsia 2022; 63:2597-2622. [PMID: 35848050 PMCID: PMC9804196 DOI: 10.1111/epi.17370] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) affects brain networks and is associated with impairment of episodic memory. Temporal and extratemporal reorganization of memory functions is described in functional magnetic resonance imaging (fMRI) studies. Functional reorganizations have been shown at the local activation level, but network-level alterations have been underinvestigated. We aim to investigate the functional anatomy of memory networks using memory fMRI and determine how this relates to memory function in TLE. METHODS Ninety patients with unilateral TLE (43 left) and 29 controls performed a memory-encoding fMRI paradigm of faces and words with subsequent out-of-scanner recognition test. Subsequent memory event-related contrasts of words and faces remembered were generated. Psychophysiological interaction analysis investigated task-associated changes in functional connectivity seeding from the mesial temporal lobes (MTLs). Correlations between changes in functional connectivity and clinical memory scores, epilepsy duration, age at epilepsy onset, and seizure frequency were investigated, and between connectivity supportive of better memory and disease burden. Connectivity differences between controls and TLE, and between TLE with and without hippocampal sclerosis, were explored using these confounds as regressors of no interest. RESULTS Compared to controls, TLE patients showed widespread decreased connectivity between bilateral MTLs and frontal lobes, and increased local connectivity between the anterior MTLs bilaterally. Increased intrinsic connectivity within the bilateral MTLs correlated with better out-of-scanner memory performance in both left and right TLE. Longer epilepsy duration and higher seizure frequency were associated with decreased connectivity between bilateral MTLs and left/right orbitofrontal cortex (OFC) and insula, connections supportive of memory functions. TLE due to hippocampal sclerosis was associated with greater connectivity disruption within the MTL and extratemporally. SIGNIFICANCE Connectivity analyses showed that TLE is associated with temporal and extratemporal memory network reorganization. Increased bilateral functional connectivity within the MTL and connectivity to OFC and insula are efficient, and are disrupted by greater disease burden.
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Affiliation(s)
- Marine Fleury
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Sarah Buck
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Lawrence P. Binding
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of Computer Science, Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Sjoerd B. Vos
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Neuroradiological Academic Unit, University College London Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Gavin P. Winston
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
- Division of Neurology, Department of MedicineQueen's UniversityKingstonOntarioCanada
| | - Pamela J. Thompson
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Matthias J. Koepp
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
| | - Meneka K. Sidhu
- Department of Clinical and Experimental EpilepsyUniversity College London Queen Square Institute of NeurologyLondonUK
- MRI UnitEpilepsy SocietyBuckinghamshireUK
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Adin ME, Durand D, Zucconi WB, Huttner AJ, Spencer DD, Bronen RA. The changing landscape in epilepsy imaging: Unmasking subtle and unique entities. Diagn Interv Radiol 2022; 28:503-515. [PMID: 35997478 PMCID: PMC9682800 DOI: 10.5152/dir.2022.21339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dramatic changes have occurred recently in the field of epilepsy, including a fundamental shift in the etiology of epileptogenic substrates found at surgery. Hippocampal sclerosis is no longer the most common etiology found at epilepsy surgery and this decrease has been associated with an increase in the incidence of focal cortical dysplasia and encephaloceles. Significant advances have been made in molecular biology and genetics underlying the basis of malformations of cortical development, and our ability to detect epileptogenic abnormalities with MR imaging has markedly improved. This article begins with a discussion of these trends and reviews imaging techniques essential for detecting of subtle epilepsy findings. Representative examples of subtle imaging findings are presented, which are often overlooked but should not be missed. These include temporal lobe encephaloceles, malformations of cortical development (and especially focal cortical dysplasia), hippocampal sclerosis, hippocampal malformation (also known as HIMAL), ulegyria, autoimmune encephalitis, and Rasmussen's encephalitis. Recent findings on the pathophysiology and genetic underpinnings of several causes of localization-related epilepsy are incorporated. For instance, it has been recently found that focal cortical dysplasia IIb, tuberous sclerosis, hemimegalencephaly, and gangliogliomas are all the result of mutations of the mTOR pathway for cell growth.
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Affiliation(s)
- Mehmet E Adin
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - David Durand
- Department of Radiology Abbott Northwestern Hospital, Minneapolis, Mminnesota, USA
| | - William B Zucconi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Anita J Huttner
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dennis D Spencer
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard A Bronen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
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25
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Lopez SM, Aksman LM, Oxtoby NP, Vos SB, Rao J, Kaestner E, Alhusaini S, Alvim M, Bender B, Bernasconi A, Bernasconi N, Bernhardt B, Bonilha L, Caciagli L, Caldairou B, Caligiuri ME, Calvet A, Cendes F, Concha L, Conde‐Blanco E, Davoodi‐Bojd E, de Bézenac C, Delanty N, Desmond PM, Devinsky O, Domin M, Duncan JS, Focke NK, Foley S, Fortunato F, Galovic M, Gambardella A, Gleichgerrcht E, Guerrini R, Hamandi K, Ives‐Deliperi V, Jackson GD, Jahanshad N, Keller SS, Kochunov P, Kotikalapudi R, Kreilkamp BAK, Labate A, Larivière S, Lenge M, Lui E, Malpas C, Martin P, Mascalchi M, Medland SE, Meletti S, Morita‐Sherman ME, Owen TW, Richardson M, Riva A, Rüber T, Sinclair B, Soltanian‐Zadeh H, Stein DJ, Striano P, Taylor P, Thomopoulos SI, Thompson PM, Tondelli M, Vaudano AE, Vivash L, Wang Y, Weber B, Whelan CD, Wiest R, Winston GP, Yasuda CL, McDonald CR, Alexander D, Sisodiya SM, Altmann A. Event-based modeling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data. Epilepsia 2022; 63:2081-2095. [PMID: 35656586 PMCID: PMC9540015 DOI: 10.1111/epi.17316] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Recent work has shown that people with common epilepsies have characteristic patterns of cortical thinning, and that these changes may be progressive over time. Leveraging a large multicenter cross-sectional cohort, we investigated whether regional morphometric changes occur in a sequential manner, and whether these changes in people with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS) correlate with clinical features. METHODS We extracted regional measures of cortical thickness, surface area, and subcortical brain volumes from T1-weighted (T1W) magnetic resonance imaging (MRI) scans collected by the ENIGMA-Epilepsy consortium, comprising 804 people with MTLE-HS and 1625 healthy controls from 25 centers. Features with a moderate case-control effect size (Cohen d ≥ .5) were used to train an event-based model (EBM), which estimates a sequence of disease-specific biomarker changes from cross-sectional data and assigns a biomarker-based fine-grained disease stage to individual patients. We tested for associations between EBM disease stage and duration of epilepsy, age at onset, and antiseizure medicine (ASM) resistance. RESULTS In MTLE-HS, decrease in ipsilateral hippocampal volume along with increased asymmetry in hippocampal volume was followed by reduced thickness in neocortical regions, reduction in ipsilateral thalamus volume, and finally, increase in ipsilateral lateral ventricle volume. EBM stage was correlated with duration of illness (Spearman ρ = .293, p = 7.03 × 10-16 ), age at onset (ρ = -.18, p = 9.82 × 10-7 ), and ASM resistance (area under the curve = .59, p = .043, Mann-Whitney U test). However, associations were driven by cases assigned to EBM Stage 0, which represents MTLE-HS with mild or nondetectable abnormality on T1W MRI. SIGNIFICANCE From cross-sectional MRI, we reconstructed a disease progression model that highlights a sequence of MRI changes that aligns with previous longitudinal studies. This model could be used to stage MTLE-HS subjects in other cohorts and help establish connections between imaging-based progression staging and clinical features.
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Affiliation(s)
- Seymour M. Lopez
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Leon M. Aksman
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Neil P. Oxtoby
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
| | - Sjoerd B. Vos
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Neuroradiological Academic Unit, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Jun Rao
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Erik Kaestner
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Saud Alhusaini
- Department of NeurologyAlpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Department of Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
| | - Marina Alvim
- Department of Neurology and Neuroimaging LaboratoryUniversity of CampinasCampinasBrazil
| | - Benjamin Bender
- Department of Radiology, Diagnostic and Interventional NeuroradiologyUniversity Hospital TübingenTübingenGermany
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuebecCanada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuebecCanada
| | - Boris Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
| | | | - Lorenzo Caciagli
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Benoit Caldairou
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuebecCanada
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
| | - Angels Calvet
- Magnetic Resonance Image Core FacilityAugust Pi i Sunyer Biomedical Research Institute, University of BarcelonaBarcelonaSpain
| | - Fernando Cendes
- Department of Neurology and Neuroimaging LaboratoryUniversity of CampinasCampinasBrazil
| | - Luis Concha
- Institute of NeurobiologyNational Autonomous University of MexicoQuerétaroMexico
| | - Estefania Conde‐Blanco
- Epilepsy Program, Neurology DepartmentHospital Clinic of BarcelonaBarcelonaSpain
- August Pi i Sunyer Biomedical Research InstituteBarcelonaSpain
| | | | - Christophe de Bézenac
- Department of Pharmacology and TherapeuticsInstitute of Systems, Molecular and Integrative Biology, University of LiverpoolLiverpoolUK
| | - Norman Delanty
- Department of Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
- FutureNeuro SFI Research Centre for Rare and Chronic Neurological DiseasesDublinIreland
| | - Patricia M. Desmond
- Department of Radiology, Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
| | - Orrin Devinsky
- New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and NeuroradiologyGreifswald University MedicineGreifswaldGermany
| | - John S. Duncan
- Department of NeurologyEmory UniversityAtlantaUSA
- Chalfont Centre for EpilepsyChalfont St PeterUK
| | - Niels K. Focke
- Department of NeurologyUniversity Medical CenterGöttingenGermany
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
| | - Marian Galovic
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
- Department of NeurologyUniversity Hospital ZurichZurichSwitzerland
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
- Institute of Neurology, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
| | | | - Renzo Guerrini
- Neuroscience DepartmentUniversity of FlorenceFlorenceItaly
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
- Wales Epilepsy Unit, Department of NeurologyUniversity Hospital of WalesCardiffUK
| | | | - Graeme D. Jackson
- Florey Institute of Neuroscience and Mental Health, Austin CampusHeidelbergVictoriaAustralia
- University of MelbourneParkvilleVictoriaAustralia
- Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
| | - Peter Kochunov
- Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Raviteja Kotikalapudi
- Department of Radiology, Diagnostic and Interventional NeuroradiologyUniversity Hospital TübingenTübingenGermany
- Department of Clinical NeurophysiologyUniversity Hospital GöttingenGöttingenGermany
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain Research, University of TübingenTübingenGermany
| | - Barbara A. K. Kreilkamp
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
- Clinical NeurophysiologyUniversity Medical Center GöttingenGöttingenGermany
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
- Institute of Neurology, Department of Medical and Surgical SciencesMagna Græcia University of CatanzaroCatanzaroItaly
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesA. Meyer Children's Hospital, University of FlorenceFlorenceItaly
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery DepartmentA. Meyer Children's Hospital, University of FlorenceFlorenceItaly
| | - Elaine Lui
- Department of Radiology, Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
| | - Charles Malpas
- Department of NeurologyRoyal Melbourne HospitalMelbourneVictoriaAustralia
- Department of Medicine, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Pascal Martin
- Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Mario Mascalchi
- Mario Serio Department of Clinical and Experimental Medical SciencesUniversity of FlorenceFlorenceItaly
| | - Sarah E. Medland
- Psychiatric GeneticsQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology Unit, OCB HospitalModena University HospitalModenaItaly
| | - Marcia E. Morita‐Sherman
- Department of NeurologyUniversity of CampinasCampinasBrazil
- Cleveland Clinic Neurological InstituteClevelandOhioUSA
| | - Thomas W. Owen
- School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | | | - Antonella Riva
- Giannina Gaslini Institute, Scientific Institute for Research and Health CareGenoaItaly
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenoaGenoaItaly
| | - Theodor Rüber
- Department of EpileptologyUniversity Hospital BonnBonnGermany
| | - Ben Sinclair
- Department of Neuroscience, Central Clinical School, Alfred HospitalMonash UniversityMelbourneVictoriaAustralia
- Departments of Medicine and Radiology, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Hamid Soltanian‐Zadeh
- Radiology and Research AdministrationHenry Ford Health SystemDetroitMichiganUSA
- School of Electrical and Computer EngineeringCollege of Engineering, University of TehranTehranIran
| | - Dan J. Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - Pasquale Striano
- Giannina Gaslini Institute, Scientific Institute for Research and Health CareGenoaItaly
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenoaGenoaItaly
| | - Peter N. Taylor
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
- School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of MedicineUniversity of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Manuela Tondelli
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Primary Care DepartmentLocal Health Authority of ModenaModenaItaly
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology Unit, OCB HospitalModena University HospitalModenaItaly
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred HospitalMonash UniversityMelbourneVictoriaAustralia
- Departments of Medicine and Radiology, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Yujiang Wang
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
- School of ComputingNewcastle UniversityNewcastle Upon TyneUK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition ResearchUniversity of BonnBonnGermany
| | - Christopher D. Whelan
- Department of Molecular and Cellular TherapeuticsRoyal College of Surgeons in IrelandDublinIreland
| | - Roland Wiest
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Gavin P. Winston
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
- Chalfont Centre for EpilepsyChalfont St PeterUK
- Department of Medicine, Division of NeurologyQueen's UniversityKingstonOntarioCanada
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging LaboratoryUniversity of CampinasCampinasBrazil
| | - Carrie R. McDonald
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Daniel C. Alexander
- Centre for Medical Image Computing, Department of Computer ScienceUniversity College LondonLondonUK
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of Neurology, University College LondonLondonUK
- Chalfont Centre for EpilepsyChalfont St PeterUK
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
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Zhu Y, Xu W, Wan C, Chen Y, Zhang C. Prediction model for the risk of ESKD in patients with primary FSGS. Int Urol Nephrol 2022; 54:3211-3219. [PMID: 35776256 DOI: 10.1007/s11255-022-03254-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
The purpose of this study is to build a prediction model for accurate assessment of the risk of end-stage kidney disease (ESKD) in individuals with primary focal segmental glomerulosclerosis (FSGS) by integrating clinical and pathological features at biopsy. The prediction model was created based on a retrospective study of 99 patients with biopsy-proven primary FSGS diagnosed at our hospital between December 2012 and December 2019. We assessed discriminative ability and predictive accuracy of the model by C-index and calibration plot. Internal validation of the prediction model was performed with 1000-bootstrap procedure. Eight patients (8.1%) progressed to ESKD before 31 March 2021. Univariate analysis revealed that disease duration before biopsy, hematuria, hemoglobin, eGFR, and percentages of sclerosis and global sclerosis were associated with renal outcome. In multivariate analysis, three predictors were included in final prediction model: eGFR, hematuria, and percentage of sclerosis. The C-index of the model was 0.811 and 5-year calibration plot showed good agreement between predicted renal survival probability and actual observation. A nomogram and an online risk calculator were built on the basis of the prediction model. In conclusion, we constructed and internally validated the first prediction model for risk of ESKD in primary FSGS, which showed good discriminative ability and calibration performance. The prediction model provides an accurate and simple strategy to predict renal prognosis which may help to identify patients at high risk of ESKD and guide the management for patients with primary FSGS in clinical practice.
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Affiliation(s)
- Yuting Zhu
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wenchao Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Cheng Wan
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yiyuan Chen
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Matsushita K, Gao Y, Rubin J, Kirtane AJ, Kodali S, Selvin E, Alonso A, Leon MB, Solomon SD, Coresh J, Fox ER, Shah AM. Association of Mild Valvular Lesions With Long-term Cardiovascular Outcomes Among Black Adults. JAMA Netw Open 2022; 5:e2211946. [PMID: 35552723 PMCID: PMC9099428 DOI: 10.1001/jamanetworkopen.2022.11946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
IMPORTANCE Little is known about the long-term outcomes of mild valvular lesions. OBJECTIVE To examine the associations of 3 major types of valvular lesions (aortic stenosis, trace or mild aortic regurgitation, and trace or mild mitral regurgitation) with risk of cardiovascular mortality, coronary heart disease (CHD), stroke, heart failure, and atrial fibrillation. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed data from the ongoing Atherosclerosis Risk in Communities study and focused on Black participants in the Jackson, Mississippi, site who underwent echocardiography at visit 3 from 1993 to 1995. Data analysis was conducted between April 2021 and February 2022. EXPOSURES Three valvular lesions were analyzed: aortic sclerosis, aortic regurgitation (trace or mild), and mitral regurgitation (trace or mild). MAIN OUTCOMES AND MEASURES The outcomes were cardiovascular mortality, coronary heart disease, heart failure, stroke, and atrial fibrillation. Multivariable Cox proportional hazards regression models were used to examine the independent associations between the 3 valvular lesions and these outcomes. RESULTS A total of 2106 Black participants were included, with a mean (SD) age of 59.1 (5.6) years and 1354 women (64.3%). The baseline prevalence was 7.7% for aortic sclerosis, 15.1% for aortic regurgitation (6.1% with trace, and 9.0% with mild), and 43.0% for mitral regurgitation (29.4% with trace, and 13.6% with mild). During a median (interquartile interval) follow-up of 22.5 (15.6-23.5) years, 890 participants developed at least 1 cardiovascular outcome. Each valvular lesion was significantly associated with at least 1 cardiovascular outcome: aortic sclerosis was associated with cardiovascular mortality (adjusted hazard ratio [HR], 1.54; 95% CI, 1.06-2.22), mild mitral regurgitation was associated with atrial fibrillation (HR, 1.47; 95% CI, 1.09-1.99), and trace or mild aortic regurgitation was associated with all outcomes (HRs ranging from 1.45 [95% CI, 1.17-1.81] to 1.75 [95% CI, 1.29-2.37]) except stroke. The total number of valvular lesions had graded associations with all cardiovascular outcomes except stroke: the HR of cardiovascular mortality was 1.77 (95% CI, 1.18-2.65) for those with 2 to 3 lesions and was 1.44 (95% CI, 1.05-1.96) for those with 1 lesion vs no lesions. CONCLUSIONS AND RELEVANCE Results of this study indicate an association between valvular lesions, even at mild stage, and a long-term risk of cardiovascular events, suggesting the importance of recognizing and monitoring these valvular conditions.
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Affiliation(s)
- Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Yumin Gao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jonathan Rubin
- Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | - Ajay J. Kirtane
- Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | - Susheel Kodali
- Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Martin B. Leon
- Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | - Scott D. Solomon
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ervin R. Fox
- Department of Medicine, University of Mississippi, Jackson
| | - Amil M. Shah
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Agrawal S, Leurgans SE, James BD, Barnes LL, Mehta RI, Dams-O’Connor K, Mez J, Bennett DA, Schneider JA. Association of Traumatic Brain Injury With and Without Loss of Consciousness With Neuropathologic Outcomes in Community-Dwelling Older Persons. JAMA Netw Open 2022; 5:e229311. [PMID: 35476062 PMCID: PMC9047640 DOI: 10.1001/jamanetworkopen.2022.9311] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 03/10/2022] [Indexed: 12/02/2022] Open
Abstract
Importance A history of traumatic brain injury (TBI) has been considered a risk factor for Alzheimer dementia. However, the specific association of TBI, even without loss of consciousness (LOC), with pathologic findings that underlie Alzheimer dementia, including Alzheimer disease (AD), non-AD neurodegenerative, and vascular pathologic findings, remains unclear. Objective To examine the association between TBI with and without LOC and neuropathologic findings in community-based cohorts. Design, Setting, and Participants This cross-sectional analysis used neuropathologic data from 1689 participants from the Religious Orders Study, the Rush Memory and Aging Project, and the Minority Aging Research Study. These studies began enrollment in 1994, 1997, and 2004, respectively. The current study's data set was frozen on April 3, 2021, when the mean (SD) length of follow-up for the participants was 8.7 (5.5) years. Exposure Traumatic brain injury exposure was assessed using a standardized, self-reported questionnaire at baseline and annual follow-up visits. Participants were categorized into those (1) without TBI exposure (n = 1024), (2) with TBI with LOC (n = 161), or (3) with TBI without LOC (n = 504). Main Outcomes and Measures Neuropathologic measures of amyloid-β, paired helical filament tangles, neocortical Lewy bodies, transactive response DNA-binding protein 43, hippocampal sclerosis, gross infarcts, and microinfarcts were assessed. Multiple linear regression and logistic regression models were used to determine whether TBI with or without LOC (compared with no TBI exposure as the reference group) was associated with neuropathologic outcomes after adjusting for age at death, sex, and educational level. Whether the apolipoprotein E (APOE) ε4 allele and sex differences modified associations was also examined. Results A total of 1689 participants (1138 [67%] women and 551 [33%] men; mean [SD] age at death, 89.2 [6.7] years; 80 [5%] Black, 46 [3%] Latino, 1639 [97%] non-Latino, and 1601 [95%] White) participated in the study. Compared with participants without TBI, participants with TBI with LOC had a greater amyloid-β load (estimate, 0.25; 95% CI, 0.06-0.43; P = .008) and higher odds of having 1 or more gross infarcts (odds ratio [OR], 1.45; 95% CI, 1.04-2.02; P = .02) and 1 or more microinfarcts (OR, 1.70; 95% CI, 1.21-2.38; P = .002), particularly subcortical microinfarcts (OR, 1.85; 95% CI, 1.23-2.79; P = .002). Those with TBI without LOC had higher odds of neocortical Lewy bodies (OR, 1.37; 95% CI, 1.01-1.87; P = .04) and 1 or more cortical microinfarcts (OR, 1.43; 95% CI, 1.09-1.87; P = .008). The association of TBI with and without LOC with vascular pathologic outcomes persisted after controlling for vascular risk factors and vascular disease burden. Traumatic brain injury with or without LOC was not associated with paired helical filament tangles, transactive response DNA-binding protein 43, or hippocampal sclerosis. No interactions occurred with APOE ε4 or sex. Conclusions and Relevance This cross-sectional analysis suggests that a history of TBI, even without LOC, is associated with age-related neuropathologic outcomes, both neurodegenerative and vascular. The variation in the neuropathologic outcomes in individuals with and without LOC may provide clues to potential mechanisms, diagnoses, and management in persons with TBI.
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Affiliation(s)
- Sonal Agrawal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Bryan D. James
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Rupal I. Mehta
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Mt Sinai School of Medicine, New York, New York
- Department of Neurology, Mt Sinai School of Medicine, New York, New York
| | - Jesse Mez
- Boston University Alzheimer’s Disease Center, Boston University School of Medicine, Boston, Massachusetts
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Al-Mousily M, Nicoara O, Selewski DT, Twombley K. Liposorber® LA-15 system for LDL apheresis in resistant nephrotic syndrome patients. Pediatr Nephrol 2022; 37:585-592. [PMID: 34453196 DOI: 10.1007/s00467-021-05211-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Steroid-resistant nephrotic syndrome (SRNS) is a major cause of stage 5 chronic kidney disease (CKD 5) in children. LDL apheresis (LDL-A) is now FDA approved for the treatment of pediatric focal segmental glomerulosclerosis (FSGS). Effective management of hyperlipidemia with LDL-A in SRNS patients may prevent progression of kidney disease and lead to remission. We report a case series of patients who received LDL-A for treatment of SRNS METHODS: We describe five children with SRNS who were treated with 12 sessions of LDL-A. Partial remission (PR) is defined as urine protein to creatinine ratio (UPC) of 0.2-2 (g/g) or decrease in UPC ≥ 50%, and complete remission (CR) is defined as UPC < 0.2 (g/g). RESULTS One patient achieved CR and three achieved PR. One patient did not respond to therapy. The earliest that a patient achieved PR was at treatment #10 and some did not respond until after LDL-A was completed. Those who responded stayed in either CR or PR for extended periods of time. LDL-A was successful at significantly reducing LDL (p < 0.001), total cholesterol (p < 0.001), and triglyceride (p < 0.001). CONCLUSIONS LDL-A was able to significantly decrease the lipid levels in these patients and induce CR and PR in the majority. The current study confirms previous studies showing those with a higher glomerular sclerosis burden were less likely to respond. LDL-A should be considered in patients with treatment-resistant SRNS and should be considered before there is a high burden of glomerular sclerosis to provide the best chance of success.
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Affiliation(s)
- Mohammad Al-Mousily
- Medical University of South Carolina, 10 McClennan Banks Dr. MSC91529425, Charleston, SC, 29425, USA.
| | - Oana Nicoara
- Department of Pediatrics, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - David T Selewski
- Department of Pediatrics, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Katherine Twombley
- Department of Pediatrics, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
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Wu H, Liu Y, Liu L, Meng Q, Du C, Li K, Dong S, Zhang Y, Li H, Zhang H. Decreased expression of the clock gene Bmal1 is involved in the pathogenesis of temporal lobe epilepsy. Mol Brain 2021; 14:113. [PMID: 34261484 PMCID: PMC8281660 DOI: 10.1186/s13041-021-00824-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
Clock genes not only regulate the circadian rhythm of physiological activities but also participate in the pathogenesis of many diseases. Previous studies have documented the abnormal expression of clock genes in epilepsy. However, the molecular mechanism of brain and muscle Arnt-like protein 1 (Bmal1), one of the core clock genes, in the epileptogenesis and seizures of temporal lobe epilepsy (TLE) remain unclear. We first investigated the levels of Bmal1 and other clock proteins in the hippocampus of subjects with epilepsy to define the function of Bmal1. The levels of Bmal1 were decreased during the latent and chronic phases in the experimental group compared with those in the control group. Knockout of Bmal1 in hippocampal dentate gyrus (DG) neurons of Bmal1flox/flox mice by Synapsin 1 (Syn1) promoter AAV (adeno-associated virus) lowered the threshold of seizures induced by pilocarpine administration. High-throughput sequencing analysis showed that PCDH19 (protocadherin 19), a gene associated with epilepsy, was regulated by Bmal1. PCDH19 expression was also decreased in the hippocampus of epileptic mice. Furthermore, the higher levels of Bmal1 and PCDH19 were detected in patients with no hippocampal sclerosis (no HS) than in patients with HS International League Against Epilepsy (ILAE) type I and III. Altogether, these data suggest that decreased expression of clock gene Bmal1 may participate in epileptogenesis and seizures via PCDH19 in TLE.
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Affiliation(s)
- Hao Wu
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
- Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Yong Liu
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Lishuo Liu
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Qiang Meng
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Changwang Du
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Kuo Li
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Shan Dong
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Yong Zhang
- School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Huanfa Li
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Hua Zhang
- Department of Neurosurgery, Clinical Research Center for Refractory Epilepsy of Shannxi Province, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
- Center of Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
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Marcus C, Baum Y, Abiodun-Ojo OA, Jani AB, Schuster DM. Ring Sclerosis in Prostate Cancer: Circle of Malignancy or Benignity? Clin Nucl Med 2021; 46:e286-e289. [PMID: 33315669 PMCID: PMC8026482 DOI: 10.1097/rlu.0000000000003434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Prostate cancer osteoblastic metastases may have different morphologies, and some of these may overlap with certain benign bone lesions. In this series of 5 prostate cancer patients, we describe bone lesions with central lucency and surrounding peripheral sclerosis and their varying appearances on different imaging modalities. Although prostate cancer metastases are commonly associated with sclerotic lesions, they can also present as osteolytic or lucent lesions, and these lesions should be carefully evaluated. The findings emphasize the importance of correlation with prior imaging, comparing findings on different imaging techniques and follow-up to differentiate benign disease from metastatic disease in these situations.
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Affiliation(s)
- Charles Marcus
- Division of Nuclear Medicine and Molecular Imaging. Department of Radiology and Imaging Sciences. Emory University School of Medicine. Atlanta, GA, USA
| | - Yoram Baum
- Division of Nuclear Medicine and Molecular Imaging. Department of Radiology and Imaging Sciences. Emory University School of Medicine. Atlanta, GA, USA
| | - Olayinka A. Abiodun-Ojo
- Division of Nuclear Medicine and Molecular Imaging. Department of Radiology and Imaging Sciences. Emory University School of Medicine. Atlanta, GA, USA
| | - Ashesh B. Jani
- Winship Cancer Institute. Department of Radiation Oncology. Emory University School of Medicine. Atlanta, GA, USA
| | - David M. Schuster
- Division of Nuclear Medicine and Molecular Imaging. Department of Radiology and Imaging Sciences. Emory University School of Medicine. Atlanta, GA, USA
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Gorospe L, Rigual-Bobillo JA, Cabañero-Sánchez A, Muñoz-Molina GM, Gambí-Pisonero E, Ayala-Carbonero AM. Massive Dilatation of the Hemiazygos Vein Secondary to Fibrosing Mediastinitis. Ann Thorac Surg 2020; 110:e249. [PMID: 32497639 DOI: 10.1016/j.athoracsur.2020.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Luis Gorospe
- Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain.
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Maatouk I, Battistella M, Hélou G, Fouéré S. Penile Lymphangioma Secondary to Sclerosing Lymphangitis/Mondor's Disease in an HIV-Positive Patient. Skinmed 2019; 17:128-129. [PMID: 31145067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 34-year-old man presented with a painless lesion of the glans present for more than 4 years. The patient became HIV-positive in 2011, and he has been treated with tenofovir, emtricitabine, and efavirenz. A CD4 count performed 4 months prior was 570 cells/mL3; syphilis, hepatitis B, and hepatitis C serologies performed on the same date were non-reactive.
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Affiliation(s)
- Ismaël Maatouk
- STD Clinic, Department of Dermatology, Saint-Louis Hospital, Paris, France;
| | | | | | - Sebastien Fouéré
- STD Clinic, Department of Dermatology, Saint-Louis Hospital, Paris, France
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Omura T, Mori H, Matsuoka M, Hori Y. Surgical Management of Descending Necrotizing Mediastinitis Complicated by Purulent Pericarditis and Lemierre's Syndrome. Am Surg 2019; 85:e47-e49. [PMID: 30760372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Sahraian MA, Ghiasian M, Moghadasi AN, Shafaei M, Ghaffari M. Progressive solitary sclerosis presented with diplopia: A case report. Mult Scler Relat Disord 2018; 28:129-131. [PMID: 30594812 DOI: 10.1016/j.msard.2018.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/26/2018] [Accepted: 12/16/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To report a patient presented with diplopia followed by progressive quadriparesis in the setting of a solitary pontomedullary lesion. CASE PRESENTATION We report a 24-year-old woman presented with an attack of diplopia with full recovery, followed by progressive quadriparesis. The patient had a single pontomedullary lesion. Extensive diagnostic work up was negative. After follow up for 6 years, despite of clinical deterioration, the patient had the same pontomedullary lesion consistent with progressive solitary sclerosis. Corticosteroid pulse therapy and rituximab, didn't yield significant improvement, and the course was progressive, but after adding cyclophosphamide, partial improvement was seen. CONCLUSION Progressive solitary sclerosis can cause progressive quadriparesis after an attack of diplopia without evidence of dissemination in time and space even after a prolonged period. This rare entity should be included in differential diagnosis of demyelinating lesions.
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Affiliation(s)
- Mohammad Ali Sahraian
- MS Research Center, Neuroscience institute, Tehran University of Medical sciences, Tehran, Iran
| | | | | | - Maryam Shafaei
- MS Research Center, Neuroscience institute, Tehran University of Medical sciences, Tehran, Iran
| | - Mehran Ghaffari
- MS Research Center, Neuroscience institute, Tehran University of Medical sciences, Tehran, Iran.
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Sanchis-Borja M, Pastré J, Mercier S, Juvin K, Benattia A, Israël-Biet D. [Pulmonary fibrosis associated with hereditary fibrosing poikiloderma caused by FAM111B mutation: A case report]. Rev Mal Respir 2018; 35:968-973. [PMID: 30341002 DOI: 10.1016/j.rmr.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/17/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Hereditary fibrosing poikiloderma with tendon contractures, myopathy and pulmonary fibrosis (POIKTMP) is a recently described, extremely rare, entity belonging to the spectrum of inherited poikilodermas. It is provoked by a mutation of the FAM111B gene. Respiratory involvement has never been fully described but usually involves a restrictive respiratory pattern. We present here a case of pulmonary fibrosis associated with POIKTMP and describe the clinical, functional, radiological and evolutionary characteristics. OBSERVATION A 38 year-old patient with poikiloderma diagnosed in childhood was referred on account of dyspnoea. Initial evaluation showed a diffuse, fibrosing, interstitial pneumonitis with upper lobe predominance, associated with severe muscular involvement on imaging that remained sub-clinical during the evolution of the disease. Lung function impairment was severe and a rapid worsening of the pulmonary fibrosis and an acute exacerbation led to death after a follow-up of 21 months. CONCLUSION This case illustrates the fibrosing pulmonary involvement associated with POIKTMP and confirms its extreme severity. It is found only in adults and is universally fatal after a variable time. It highlights the necessity for a systematic screening as soon as the diagnosis of POIKTMP is confirmed in order to establish specialised respiratory management.
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Affiliation(s)
- M Sanchis-Borja
- Service de pneumologie et soins intensifs, centre de compétence maladies pulmonaires rares, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - J Pastré
- Service de pneumologie et soins intensifs, centre de compétence maladies pulmonaires rares, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75270 Paris, France.
| | - S Mercier
- Service de génétique médicale, CHU et université de Nantes, 44000 Nantes, France; Inserm UMR 1089, Nantes, France
| | - K Juvin
- Service de pneumologie et soins intensifs, centre de compétence maladies pulmonaires rares, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - A Benattia
- Service de pneumologie et soins intensifs, centre de compétence maladies pulmonaires rares, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75270 Paris, France
| | - D Israël-Biet
- Service de pneumologie et soins intensifs, centre de compétence maladies pulmonaires rares, hôpital Européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75270 Paris, France
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Vaughn RL, Stern TA. Challenges Faced When Caring for Foreign Nationals With Comorbid Medical and Psychiatric Problems in the General Hospital. Psychosomatics 2018; 59:95-100. [PMID: 29150211 DOI: 10.1016/j.psym.2017.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Rubiahna L Vaughn
- Department of Psychiatry, NYU Langone Medical Center, New York City, NY.
| | - Theodore A Stern
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
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Adry RARDC, Meguins LC, da Silva Júnior SC, Pereira CU, de Araújo Filho GM, Marques LHN. Factors predicting the outcome following surgical treatment of mesial temporal epilepsy due to mesial temporal sclerosis. Acta Neurochir (Wien) 2016; 158:2355-2363. [PMID: 27770263 DOI: 10.1007/s00701-016-2992-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mesial temporal sclerosis (MTS) is the most common disease found in an epilepsy surgery series. Early age of onset, a history of febrile convulsions, epileptiform discharges on EEG, duration of epilepsy, number of generalized seizures and severity of psychiatric disorders are possible prognostic factors in patients with MTS. OBJECTIVE The aim of this study is to review the clinical, semiotic, psychological, electrophysiological and neuroradiological researches and relate their findings to the prognosis of patients with MTS who underwent anteromedial temporal lobectomy (ATL). METHODS Of 1,214 patients evaluated for surgery in the epilepsy Center of Faculdade de Medicina de São Jose do Rio Preto (FAMERP), a tertiary Brazilian epilepsy center, 400 underwent ATL for MTS. Examinations and clinical data were analyzed and compared with the Engel Outcome Classification. RESULTS Of all the items analyzed, the MRI showed the greatest influence on patient outcome. As for the clinical evaluation and pathological antecedents, age at surgery, epilepsy duration, perinatal insults, family history of epilepsy, febrile seizures, neuropsychological abnormalities and presence of generalized tonic-clonic seizure all had statistical significance. CONCLUSION In order to identify the most appropriate candidates for ATL, it is very important to consider the prognostic factors associated with a favorable outcome for counseling patients in daily practice.
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Affiliation(s)
- Rodrigo Antonio Rocha da Cruz Adry
- Neurosurgery. Department of Neurological Sciences, Hospital de Base de São José do Rio Preto-Faculty of Medicine at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
- Hospital Aliança, Salvador, Bahia, Brazil.
| | - Lucas Crociati Meguins
- Neurosurgery. Department of Neurological Sciences, Hospital de Base de São José do Rio Preto-Faculty of Medicine at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | - Sebastião Carlos da Silva Júnior
- Neurosurgery. Department of Neurological Sciences, Hospital de Base de São José do Rio Preto-Faculty of Medicine at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | | | - Gerardo Maria de Araújo Filho
- Psychiatry. Department of Neurological Sciences, Hospital de Base de São José do Rio Preto-Faculty of Medicine at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | - Lúcia Helena Neves Marques
- Neurology. Department of Neurological Sciences, Hospital de Base de São José do Rio Preto-Faculty of Medicine at São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
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Zhou J, Yang D, Zhou SH, Wang JP, Lu Y, Wang HJ, Zhang JH, Lei SW. [Efficacy Observation of Chinese Herbal Fumigation Combined Western Drugs for Treating Sys- temic Sclerosis Complicated Pulmonary Arterial Hypertension]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2016; 36:933-937. [PMID: 30640987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective To observe the therapeutic efficacy and safety of Chinese herbal fumigation combined with leflunomide (LEF) and prednisone (Pred) in treatment of systemic sclerosis (SSc) complicated pulmonary arterial hypertension (PAH). Methods Totally 99 SSc patients complicated early PAH were randomly assigned to the Western drugs group (WD, 49 cases) and the integrative medicine group (IM, 50 cases). Patients in the WD group took LEF (20 mg) and Pred (15 mg) , once per day. In addition to routine WD program, those in the IM group additionally received Chinese herbal fumigation. All treatment lasted for 6 months. Raynaud's phenomenon (RP) was observed in each group before and after treatment. RP score, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), pulmonary arterial systolic pressure (PASP) , and pulmonary function were compared between the two groups before and after treatment. The clinical efficacy and adverse reactions were evaluated. Results Thirteen cases were lost due to various reasons. A total of 86 patients completed this study, 41 in the WD group and 45 in the IM group. Compared with the same group before treatment, RP score, levels of ESR and CRP all decreased in the two groups after treatment (P <0. 05). Compared with the WM group after treatment, RP score, levels of ESR and CRP were obviously lowered in the IM group after treatment (P < 0. 05). Besides, lowered differences between post-pre-values of ESR, CRP, and PASP were more obviously higher, while elevated differences between post-pre-values of total lung capacity (TLC) and carbon monoxide diffusing capacity (DLCO) were more obviously higher in the IM group (P <0. 05). The total effective rate was 93. 33% (42/45) in the IM group, obviously higher than that in the WD group [70. 73% (29/41) , P <0. 05 ]. There was no statistical difference in total adverse reaction rate between the two groups (x² =0. 019, P =0. 891). Conclusion Chinese herbal fumigation combined with WD had obvious efficacy with less adverse reactions, so it was worth clinical spread.
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Tugcu B, Gungor A, Akpinar A, Kinay D, Kuscu DY, Gül G, Kayrak N, Keskinkilic C, Akdemir H, Emel E. Outcome of surgical treatment of hippocampal sclerosis from relatively new epilepsy surgery center. J Neurosurg Sci 2016; 60:159-168. [PMID: 27150541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Surgery is apparently superior to prolonged medical therapy in therapy of efficacy and safety for mesial temporal lobe epilepsies. We ‑ as a new center ‑ presented outcome results and possible outcome predictors of 50 consecutive patients with hippocampal sclerosis underwent resective epilepsy surgery. METHODS Between 2006 and 2011, fifty patients with intractable mesial temporal lobe epilepsy due to hippocampal sclerosis underwent anterior temporal lobectomy and they were followed-up at least 1 year postoperatively. Detailed neuropsychological tests, video-electroencephalography monitoring and magnetic resonance imaging with epilepsy protocol were obtained for all patients. Standard anteromedial temporal lobectomy was performed. Modified Engel and ILAE classifications were used for seizure outcome. All morbidities were recorded. Demographic variables, diagnostic tests and early postoperative outcome were analyzed for possible predictors of the ultimate seizure outcome. RESULTS Fifty patients were evaluated. The mean follow-up duration was 47,1 month (range, 12-75 months). The favorable outcome at 1 year was 90% and 82% according to Engel and ILAE classifications respectively. These rates were almost same at the end of follow-up period (92% and 82% respectively). The completely seizure free rate at one year was 80% and decreased to 68% at the end of the follow-up. There was no mortality. Morbidity rate was 10% and none of them was permanent. Triple concordance of the noninvasive tests (neuropsychological tests, video- electroencephalography monitoring and magnetic resonance imaging) and favorable seizure outcome at the first year were predictors of the ultimate seizure outcome (P=0.01 and P=0.04 respectively). CONCLUSIONS Our findings demonstrated that anteromedial temporal lobectomy is a safe and effective treatment method in well-chosen patients with hippocampal sclerosis. This surgical procedure can be performed with a low rate of morbidity even in relatively new epilepsy surgery center.
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Affiliation(s)
- Bekir Tugcu
- Department of Neurosurgery, Bakirköy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Bakirköy, Istanbul, Turkey -
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Valentin LI, Kuban JD, Ramanathan R, Whigham CJ. Endovascular Treatment of Bilateral Pulmonary Artery Stenoses and Superior Vena Cava Syndrome in a Patient with Advanced Mediastinal Fibrosis. Tex Heart Inst J 2016; 43:249-51. [PMID: 27303243 DOI: 10.14503/thij-15-5091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Vascular stenosis is a relatively uncommon and often fatal sequela of mediastinal fibrosis. There are very few reports in the medical literature of endovascular treatment for concomitant bilateral pulmonary artery stenoses and superior vena cava syndrome. We report the endovascular treatment of these conditions in a 54-year-old man, and the long-term outcome.
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Velmurugan J, Sinha S, Nagappa M, Mariyappa N, Bindu PS, Ravi GS, Hazra N, Thennarasu K, Ravi V, Taly AB, Satishchandra P. Combined MEG-EEG source localisation in patients with sub-acute sclerosing pan-encephalitis. Neurol Sci 2016; 37:1221-31. [PMID: 27056375 DOI: 10.1007/s10072-016-2571-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
Abstract
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. Ten isomorphic classical PCs with significant field topography per patient were analysed at the 'onset' and at 'earliest significant peak' of the burst using discrete and distributed source imaging methods. MEG background was asymmetrical in 2 and slow in 3 patients. Complexes were periodic (3) or quasi-periodic (2), occurring every 4-16 s and varied in morphology among patients. Mean source localization at onset of bursts using discrete and distributed source imaging in magnetic source imaging (MSI) was in thalami and or insula (50 and 50 %, respectively) and in electric source imaging (ESI) was also in thalami and or insula (38 and 46 %, respectively). Mean source localization at the earliest rising phase of peak in MSI was in peri-central gyrus (49 and 42 %) and in ESI it was in frontal cortex (52 and 56 %). Further analysis revealed that PCs were generated in thalami and or insula and thereafter propagated to anterolateral surface of the cortices (viz. sensori-motor cortex and frontal cortex) to same side as that of the onset. This novel MEG-EEG based case series of PCs provides newer insights for understanding the plausible generators of myoclonus in SSPE and patterns of their propagation.
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Affiliation(s)
- J Velmurugan
- Magnetoencephalography Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sanjib Sinha
- Magnetoencephalography Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India.
| | - Madhu Nagappa
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India
| | - N Mariyappa
- Magnetoencephalography Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - P S Bindu
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India
| | - G S Ravi
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Nandita Hazra
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - K Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - V Ravi
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - A B Taly
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India
| | - P Satishchandra
- Magnetoencephalography Research Centre, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
- Department of Neurology, 1st Floor, Faculty Block, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore, 560 029, India
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Wei W, Zhang Z, Xu Q, Yang F, Sun K, Lu G. More Severe Extratemporal Damages in Mesial Temporal Lobe Epilepsy With Hippocampal Sclerosis Than That With Other Lesions: A Multimodality MRI Study. Medicine (Baltimore) 2016; 95:e3020. [PMID: 26962820 PMCID: PMC4998901 DOI: 10.1097/md.0000000000003020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS) presents different clinical presentations from that with other lesions (OL). It is significant to investigate the neural mechanism underlying the different clinical presentations using neuroimaging study.Thirty mTLE patients with mTLE-HS, 30 mTLE patients with other lesions (mTLE-OL), and 30 age- and sex-matched healthy controls were involved. Amplitude of low-frequency fluctuation (ALFF) analysis-based resting-state functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM) based morphometric MRI were employed to describing functional and structural imaging alterations in mTLE. Imaging parameters of ALFF and gray matter volume (GMV) were compared among groups and correlated with clinical variables and cognitive scores.For parameter of ALFF, both patient groups of mTLE-HS and mTLE-OL showed decrease in the frontal cortices relative to the healthy controls; mTLE-HS showed more decrease in the prefrontal and brain default regions relative to mTLE-OL. For GMV, both patient groups showed decrease in the frontal cortex, thalamus, and cerebellum; mTLE-HS showed more GMV decrease relative to the mTLE-OL, also mainly in the prefrontal and brain default regions. In both patient groups, the prefrontal regions showed negative correlation between GMV and epilepsy duration.This work revealed distinct alteration patterns of functional and structural brain organizations in mTLEs with different forms. MTLE-HS, despite with smaller lesion size of the pathological focus, presented more severe functional and structural damages in the extratemporal regions than mTLE-OL. The findings provided imaging evidence to support the proposal that mTLE-HS is a special epilepsy syndrome.
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Affiliation(s)
- Wei Wei
- From the Department of Medical Imaging (WW, ZZ, QX, GL), Department of Neurology (QX), Department of Neurosurgery (FY), Jinling Hospital, Nanjing University School of Medicine, and State Key Laboratory of Analytical Chemistry for Life Science (ZZ, GL), Nanjing University, Nanjing, China
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DeMaria D, Mejia-Lopez E, Kelting SM, Soukoulis V. A case of familial calcific aortic and mitral stenosis in association with hereditary sclerosing poikiloderma. Cardiovasc Pathol 2016; 25:195-199. [PMID: 26874040 DOI: 10.1016/j.carpath.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/19/2015] [Accepted: 01/06/2016] [Indexed: 11/18/2022] Open
Abstract
Hereditary sclerosing poikiloderma is a rare, familial disease with the primary clinical features being dermatologic. Widespread poikiloderma, as well as linear hyperkeratotic and sclerotic bands, tends to be the most common sign of this disease. It has been suggested that cardiac involvement may represent an important element of this disorder; however, this has not been well studied. We confirm here a case of hereditary sclerosing poikiloderma in a patient and his family with significant cardiac involvement characterized by heavily calcified stenotic aortic and mitral valves on echocardiography. Due to the patient's symptomatic severe valvular disease, he underwent simultaneous aortic and mitral valve replacement. Histopathologic analysis of the valves confirmed severe calcification of the aortic and mitral valve leaflets, suggesting a potential common mechanism between the cardiac and skin pathology of this disease. Multiple other family members had presented with similar cardiac and skin manifestations. Further research is needed to better understand the cardiac pathophysiology of this disease.
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Affiliation(s)
- David DeMaria
- University of Virginia Health System, Charlottesville, VA, USA
| | | | - Sarah M Kelting
- University of Virginia Health System, Charlottesville, VA, USA
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Abstract
Neurocysticercosis (NCC) is the most common helminthic infection of the nervous system and a frequent cause of reactive seizures and epilepsy worldwide. In many cases, multiple episodes of focal seizures related to an identifiable parenchymal brain cyst (and likely attributable to local damage) continue for years after the cyst resolves. However, cases where seizure semiology, interictal EEG abnormalities, and parasites location do not correlate raise concerns about the causal relationship between NCC and either reactive seizures or epilepsy, as well as the epileptogenic potential of parasites. Neurosurgical series of patients with intractable epilepsy and cross-sectional population-based studies have shown a robust association between NCC and hippocampal sclerosis (HS), which might contribute to the above-referred inconsistencies. Current information does not allow to define whether in patients with NCC, HS could result from recurrent seizure activity from a local or distant focus or from chronic recurrent inflammation. In either case, HS may become the pathological substrate of subsequent mesial temporal lobe epilepsy (MTLE). Longitudinal clinical- and population-based cohort studies are needed to evaluate the causal relationship between NCC and HS and to characterize this association with the occurrence of MTLE. If a cause-and-effect relationship between NCC and HS is demonstrated, NCC patients could be assessed to examine neuronal mechanisms of hippocampal epileptogenesis in comparison with animal models, to identify biomarkers of hippocampal epileptogenesis, and to develop novel interventions to prevent epilepsy in NCC and perhaps in other forms of acquired epilepsy.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador.
- , Air Center 3542, PO Box 522970, Miami, FL, 33152-2970, USA.
| | - Jerome Engel
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Dawn S Eliashiv
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Hector H García
- Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
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Seferian A, Steriade A, Jaïs X, Planché O, Savale L, Parent F, Amar D, Jovan R, Fadel E, Sitbon O, Simonneau G, Humbert M, Montani D. Pulmonary Hypertension Complicating Fibrosing Mediastinitis. Medicine (Baltimore) 2015; 94:e1800. [PMID: 26554778 PMCID: PMC4915879 DOI: 10.1097/md.0000000000001800] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Fibrosing mediastinitis is caused by a proliferation of fibrous tissue in the mediastinum with encasement of mediastinal viscera and compression of mediastinal bronchovascular structures. Pulmonary hypertension (PH) is a severe complication of fibrosing mediastinitis caused by extrinsic compression of the pulmonary arteries and/or veins.We have conducted a retrospective observational study reviewing clinical, functional, hemodynamic, radiological characteristics, and outcome of 27 consecutive cases of PH associated with fibrosing mediastinitis diagnosed between 2003 and 2014 at the French Referral Centre for PH.Fourteen men and 13 women with a median age of 60 years (range 18-84) had PH confirmed on right heart catheterization. The causes of fibrosing mediastinitis were sarcoidosis (n = 13), tuberculosis-infection confirmed or suspected (n = 9), mediastinal irradiation (n = 2), and idiopathic (n = 3). Sixteen patients (59%) were in NYHA functional class III and IV. Right heart catheterization confirmed moderate to severe PH with a median mean pulmonary artery pressure of 42 mm Hg (range 27-90) and a median cardiac index of 2.8 L/min/m (range 1.6-4.3). Precapillary PH was found in 22 patients, postcapillary PH in 2, and combined postcapillary and precapillary PH in 3. Severe extrinsic compression of pulmonary arteries (>60% reduction in diameter) was evidenced in 2, 8, and 12 patients at the main, lobar, or segmental levels, respectively. Fourteen patients had at least one severe pulmonary venous compression with associated pleural effusion in 6 of them. PAH therapy was initiated in 7 patients and corticosteroid therapy (0.5-1 mg/kg/day) was initiated in 3 patients with sarcoidosis, with 9 other being already on low-dose corticosteroids. At 1-year follow-up, 3 patients had died and among the 21 patients evaluated, 3 deteriorated, 14 were stable, and only 4 patients with sarcoidosis improved (4 receiving corticosteroids and 1 receiving corticosteroids and PAH therapy). Survival was 88%, 73%, and 56% at 1, 3, and 5 years, respectively.We found no clear clinical improvement with the use of specific PAH therapy. Corticosteroid therapy may be associated with clinical improvement, in some patients with fibrosing mediastinitis due to sarcoidosis. Although never performed for this indication, lung transplantation may be proposed in eligible patients with severe PH and fibrosing mediastinitis.
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Affiliation(s)
- Andrei Seferian
- From the University Paris-Sud, Faculté de Médecine (AS, AS, XJ, OP, LS, FP, DA, RJ, EF, OS, GS, MH, DM); AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre (AS, AS, XJ, LS, FP, DA, RJ, OS, GS, MH, DM); UMR_S 999, University Paris-Sud; INSERM; Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson (AS, AS, XJ, LS, FP, DA, RJ, EF, OS, GS, MH, DM); AP-HP, Service de Radiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre (OP); and Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Le Plessis Robinson, France (EF)
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Doucet KM, Labinaz M, Chandy G, Mielniczuk L, Stewart D, Contreras-Dominguez V, Pugliese C, Dennie C, Burwash IG, Davies RA. Pulmonary hypertension due to fibrosing mediastinitis treated successfully with stenting of pulmonary vein stenoses. Can J Cardiol 2014; 31:548.e5-7. [PMID: 25840104 DOI: 10.1016/j.cjca.2014.12.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 12/08/2014] [Accepted: 12/23/2014] [Indexed: 11/20/2022] Open
Abstract
We describe a patient with fibrosing mediastinitis after childhood histoplasmosis who presented with severe pulmonary hypertension secondary to pulmonary vein stenoses. Stenting of 2 stenosed pulmonary veins via a transseptal approach resulted in an immediate decrease in systolic pulmonary artery pressure from 90 to 68 mm Hg and improvement in dyspnea and cardiac index, which was sustained at 6 months. This case highlights the importance of routinely assessing the pulmonary veins during workup for pulmonary hypertension.
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Affiliation(s)
- Katie M Doucet
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Marino Labinaz
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - George Chandy
- Divisions of Respirology and Internal Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Mielniczuk
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Duncan Stewart
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Carolyn Pugliese
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Carole Dennie
- Division of Diagnostic Imaging, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian G Burwash
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Ross A Davies
- Divisions of Cardiology and Nursing, University of Ottawa, Ottawa, Ontario, Canada.
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Takeyari S, Yamamoto T, Kinoshita Y, Fukumoto S, Glorieux FH, Michigami T, Hasegawa K, Kitaoka T, Kubota T, Imanishi Y, Shimotsuji T, Ozono K. Hypophosphatemic osteomalacia and bone sclerosis caused by a novel homozygous mutation of the FAM20C gene in an elderly man with a mild variant of Raine syndrome. Bone 2014; 67:56-62. [PMID: 24982027 DOI: 10.1016/j.bone.2014.06.026] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 06/19/2014] [Accepted: 06/20/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Hypophosphatemia and increased serum fibroblast growth factor 23 (FGF23) levels have been reported in young brothers with compound heterozygous mutations for the FAM20C gene; however, rickets was not observed in these cases. We report an adult case of Raine syndrome accompanying hypophosphatemic osteomalacia with a homozygous FAM20C mutation (R408W) associated with increased periosteal bone formation in the long bones and an increase in bone mineral density in the femoral neck. CASE The patient, a 61-year-old man, was born from a cousin-to-cousin marriage. A short stature and severe dental demineralization were reported at an elementary school age. Hypophosphatemia was noted inadvertently at 27years old, at which time he started to take an active vitamin D metabolite (alphacalcidol) and phosphate. He also manifested ossification of the posterior longitudinal ligament. On bone biopsy performed at the age of 41years, we found severe osteomalacia surrounding osteocytes, which appeared to be an advanced form of periosteocytic hypomineralized lesions compared to those reported in patients with X-linked hypophosphatemic rickets. Laboratory data at 61years of age revealed markedly increased serum intact-FGF23 levels, which were likely to be the cause of hypophosphatemia and the decreased level of 1,25(OH)2D. We recently identified a homozygous FAM20C mutation, which was R408W, in this patient. When expressed in HEK293 cells, the R408W mutant protein exhibited impaired kinase activity and secretion. DISCUSSION Our findings suggest that certain homozygous FAM20C mutations can cause FGF23-related hypophosphatemic osteomalacia and indicate the multiple roles of FAM20C in bone.
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Affiliation(s)
- Shinji Takeyari
- Department of Pediatrics, Minoh City Hospital, Osaka 562-8562, Japan
| | - Takehisa Yamamoto
- Department of Pediatrics, Minoh City Hospital, Osaka 562-8562, Japan.
| | - Yuka Kinoshita
- Division of Nephrology and Endocrinology, Department of Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Seiji Fukumoto
- Division of Nephrology and Endocrinology, Department of Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Francis H Glorieux
- Genetics Unit, Shriners Hospitals for Children, Montreal H3G 1A6, Canada
| | - Toshimi Michigami
- Department of Bone and Mineral Research, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka 594-1011, Japan
| | - Kosei Hasegawa
- Department of Pediatrics, Okayama University Hospital, Okayama 700-8558, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Yasuo Imanishi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan
| | | | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
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Teopompi E, Tchana B, Chetta A, Aiello M, Sgrignoli M, Carano N, Agnetti A. Pulmonary arterial hypertension in childhood: an unsual presentation with fibrosing mediastinitis. Acta Biomed 2014; 85:68-72. [PMID: 24897974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/28/2013] [Accepted: 09/11/2013] [Indexed: 06/03/2023]
Abstract
Acquired stenosis of normally connected pulmonary veins is a rare condition in children, usually associated with mediastinal processes. It may present later with a less specific clinical picture, symptoms and signs mimicking chronic lung disease. Fibrosing mediastinitis is a rarer disorder of unknown etiology, although several suspected causes such as granulomatous diseases, characterized by fibrous tissue proliferation within the mediastinum, leading to respiratory and cardiac failure by bronchial obstruction or pulmonary hypertension.
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