Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports

Abstract Background Sugammadex is a modified gamma-cyclodextrin that acts by selectively encapsulating free amino-steroidal neuromuscular relaxants. Several case reports have been published on the use of sugammadex in patients with neuromuscular disorders that include neuromuscular junction diseases, myopathies, neuropathies, and motor neurone disorders. The primary aim of this review is to systematically review the evidence on the use of sugammadex in patients with this heterogeneous group of diseases and provide recommendations for clinical practice. Methods A systematic electronic search of Medline, Embase and CINAHL databases was done until June 2019, to identify case reports describing the use of sugammadex in adult surgical patients with neuromuscular disorders. Results Of the 578 records identified through database searches, 43 articles were finally included for the systematic review. Of these, 17 reports were on patients with myopathy, 15 reports on myasthenia gravis, 9 reports on motor neuron diseases and 2 reports on neuropathies. Conclusions Majority of the articles reviewed report successful use of sugammadex to reverse steroidal muscle relaxants, especially rocuronium, in patients with neuromuscular diseases. However, with sugammadex, unpredictability in response and uncertainty regarding optimum dose still remain issues. Quantitative neuromuscular monitoring to ensure complete reversal and adequate postoperative monitoring is strongly recommended in these patients, despite the use of sugammadex.

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Post COVID-19 Organizing Pneumonia: A Systematic Review and Meta-analysis

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i38b32122 ◽

2021 ◽

pp. 259-270

Author(s):

Talal Khalid Abdullah Alanazi ◽

Nasser Faris Ali Alahmari ◽

Faris Essa Ibrahim Qubays ◽

Solaiman Hosaian ibraheem Alenezi ◽

Meshal Faleh Mofadhe Alenezi

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Web Of Science ◽

Case Reports ◽

Meta Analysis ◽

Organizing Pneumonia ◽

Eligible Study ◽

Data Synthesis ◽

Electronic Search ◽

Review Manager

Introduction: Several observational studies have found parallels between COVID-19 pneumonia and organizing pneumonia (OP). This study aims to investigate the published literature of OP related to COVID-19, estimates the prevalence of OP among COVID-19 patients, and assesses the risk or COVID-19 severity associated with OP. Methodology: This was a systematic review and meta-analysis. A systematic electronic search through PubMed, Web of Science, Science Direct, EBSCO, and Google Scholar was conducted to include relevant and eligible literature. The authors used Review Manager 5.4 to perform quantitative data synthesis for the condition of interest analyses. Results: A total of 9 eligible study articles and 12 case reports were included in this study. The estimated pooled organizing pneumonia prevalence among COVID-19 patients was 45.6% [23.1%-68.2%]. The association between OP and severe COVID-19 infection revealed a pooled OR [95% CI] of 5.22 [-0.96-11.41]. Conclusion: COVID-19 patients had a rather high OP prevalence (43%). Surprisingly, cancer patients with COVID-19 infection had the lowest OP prevalence. OP was identified as a possible risk factor for the severity of COVID-19 infection.

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Viscerotropic leishmaniasis: a systematic review of the case reports to highlight spectrum of the infection in endemic countries

Parasitology Open ◽

10.1017/pao.2018.9 ◽

2018 ◽

Vol 4 ◽

Cited By ~ 2

Author(s):

Amir Abdoli ◽

Nahid Maspi ◽

Fatemeh Ghaffarifar ◽

Vahid Nasiri

Keyword(s):

Systematic Review ◽

New World ◽

Leishmania Donovani ◽

Case Reports ◽

Clinical Manifestations ◽

Parasitic Disease ◽

Leishmania Chagasi ◽

Electronic Search ◽

Co Morbidity ◽

Causative Agents

AbstractVisceral leishmaniasis is an important neglected parasitic disease that is generally caused byLeishmania infantum,Leishmania donovaniandLeishmania chagasi. However, several causative species of cutaneous leishmaniasis (CL) causes an interstitial form of leishmaniasis which known viscerotropic leishmaniasis. The aim of this paper is a systematic review of the cases of viscerotropic leishmaniasis to present the main causative agents, clinical manifestations, treatment and outcomes of the cases. An electronic search (any date to August 2017) without language restrictions was performed using Medline, PubMed, Scopus and Google Scholar. The searches identified 19 articles with total 30 case reports. Of them, old worldLeishmaniaspecies was reported from 23 (76.7%) cases, including 20 cases ofL. tropicaand three cases ofL. major; whereas new worldLeishmaniaspecies were reported in seven (23.4%) cases. The infection was more prevalent in male (24/30, 80%) than female (5/30, 16.7%) patients. Co-morbidity/co-infection was observed in 13 out of 30 cases (43.4%), which the most of them was HIV/AIDS (10 out of 13 cases, 76.9%). The results suggested that viscerotropic leishmaniasis should be more attended in the endemic countries of CL and in immunocompromised patients in order to exact discrimination from other endemic infectious diseases.

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Obstetric-Gynecological Complications in Neuromuscular Disorders

RRNMF Neuromuscular Journal ◽

10.17161/rrnmf.v1i3.13580 ◽

2020 ◽

Vol 1 (3) ◽

pp. 5-8

Author(s):

Lakshmi Digala ◽

Zahra Haider ◽

Raghav Govindarajan

Keyword(s):

Neuromuscular Disease ◽

Muscular Atrophy ◽

Case Reports ◽

Neuromuscular Disorders ◽

Neuromuscular Diseases ◽

Retrospective Chart Review ◽

Obstetric Complications ◽

University Of Missouri ◽

Charcot Marie Tooth Disease ◽

One Year

Background and Objective: The data on the obstetric and gynecological complications in patients diagnosed with neuromuscular diseases is very limited and is primarily obtained from various case reports, series, and small studies. The objective of our study was to analyze the prevalence of these complications in a large cohort of patients with various neuromuscular diseases. Methods: This study is a retrospective chart review of patients diagnosed with various neuromuscular diseases at the University of Missouri, Columbia, from 2012 to 2017. We included patients who have at least one year follow up with us. We collected data on patient demographics, neuromuscular disease diagnosed, obstetric complications, and gynecologic complications. Data are reported as means ± SEM, and the results reported using prevalence rates. Results: Ninety-five female patients were identified. Among them, 97% were Caucasian, and 3% were African-American with a mean age of 47.96 years. Neuromuscular diseases identified among them are Myasthenia Gravis (44%), Muscular Dystrophy (23%), Amyotrophic Lateral Sclerosis-ALS (16%), Charcot-Marie-Tooth disease-CMT (10%), and Spinal Muscular atrophy- SMA (7%). The majority of the patients reviewed have had no obstetric complications- (89.40%). The most common obstetric complication recorded was C-section (8.40%). 41% of women did not have any gynecological complaints. Urine incontinence (24.20%) is the most common complication. Conclusion: C-sections and urinary incontinence are common obstetric and gynecological events seen in women with neuromuscular disease.

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Neuromuscular Disorders in the Cat: Clinical Approach to Weakness

Journal of Feline Medicine and Surgery ◽

10.1016/j.jfms.2011.09.005 ◽

2011 ◽

Vol 13 (11) ◽

pp. 837-849 ◽

Cited By ~ 11

Author(s):

Holger A Volk ◽

Nadia Shihab ◽

Kaspar Matiasek

Keyword(s):

Case Reports ◽

Neuromuscular Disorders ◽

Neuromuscular Diseases ◽

Evidence Base ◽

Clinical Approach ◽

Neuromuscular System ◽

Diagnostic Challenge ◽

Retrospective Case ◽

Fluid Analysis ◽

Successful Work

Practical relevance Weakness is a relatively common clinical presentation in feline medicine and can be caused by primary neuromuscular disease or by diseases of other body systems affecting the neuromuscular system secondarily. Successful work-up relies on a thorough clinical and neurological examination, and logical problem solving, based on an understanding of the underlying neuroanatomical and pathophysiological mechanisms. Clinical challenges Feline neuromuscular diseases can be a diagnostic challenge. On initial inspection, the presenting signs can mimic disorders of other body systems, particularly cardiovascular, pulmonary and orthopaedic disease, or may be confused with systemic illnesses. Additionally, because many different pathologies of the feline neuromuscular system converge to a similar clinical phenotype, further diagnostic steps such as electrodiagnostics, cerebrospinal fluid analysis, and muscle and nerve biopsies must be considered even after neuromuscular dysfunction has been identified. Audience This review provides a framework for the clinical approach to the weak cat and gives a practical summary of neuromuscular diseases for the general practitioner and specialist alike. Evidence base Many diseases affecting the feline neuromuscular system have been well described in the veterinary literature, mostly based on retrospective case reports and series. The evidence base for the treatment of feline neuromuscular diseases remains very limited.

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Cognitive impairment in neuromuscular diseases: A systematic review

Neurology International ◽

10.4081/ni.2018.7473 ◽

2018 ◽

Vol 10 (2) ◽

Cited By ~ 5

Author(s):

Marco Orsini ◽

Ana Carolina Andorinho de F. Ferreira ◽

Anna Carolina Damm de Assis ◽

Thais Magalhães ◽

Silmar Teixeira ◽

...

Keyword(s):

Cognitive Impairment ◽

Genetic Analysis ◽

Motor Neuron ◽

Case Reports ◽

Experimental Studies ◽

Neuromuscular Diseases ◽

Mitochondrial Disorders ◽

Motor Neuron Diseases ◽

Fiber Damage ◽

Molecular Alterations

Neuromuscular diseases are multifactorial pathologies characterized by extensive muscle fiber damage that leads to the activation of satellite cells and to the exhaustion of their pool, with consequent impairment of neurobiological aspects, such as cognition and motor control. To review the knowledge and obtain a broad view of the cognitive impairment on Neuromuscular Diseases. Cognitive impairment in neuromuscular disease was explored; a literature search up to October 2017 was conducted, including experimental studies, case reports and reviews written in English. Keywords included Cognitive Impairment, Neuromuscular Diseases, Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. Several cognitive evaluation scales, neuroimaging scans, genetic analysis and laboratory applications in neuromuscular diseases, especially when it comes to the Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. In addition, organisms model using rats in the genetic analysis and laboratory applications to verify the cognitive and neuromuscular impacts. Several studies indicate that congenital molecular alterations in neuromuscular diseases promote cognitive dysfunctions. Understanding these mechanisms may in the future guide the proper management of the patient, evaluation, establishment of prognosis, choice of treatment and development of innovative interventions such as gene therapy.

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Current Genetic Survey and Potential Gene-Targeting Therapeutics for Neuromuscular Diseases

International Journal of Molecular Sciences ◽

10.3390/ijms21249589 ◽

2020 ◽

Vol 21 (24) ◽

pp. 9589

Author(s):

Wei Chiu ◽

Ya-Hsin Hsun ◽

Kao-Jung Chang ◽

Aliaksandr A. Yarmishyn ◽

Yu-Jer Hsiao ◽

...

Keyword(s):

Gene Expression ◽

Muscular Dystrophy ◽

Motor Neuron ◽

Muscular Atrophy ◽

Neuromuscular Disorders ◽

Neuromuscular Diseases ◽

Premature Termination Codon ◽

Becker Muscular Dystrophy ◽

Functional Impairments ◽

Motor Neuron Diseases

Neuromuscular diseases (NMDs) belong to a class of functional impairments that cause dysfunctions of the motor neuron-muscle functional axis components. Inherited monogenic neuromuscular disorders encompass both muscular dystrophies and motor neuron diseases. Understanding of their causative genetic defects and pathological genetic mechanisms has led to the unprecedented clinical translation of genetic therapies. Challenged by a broad range of gene defect types, researchers have developed different approaches to tackle mutations by hijacking the cellular gene expression machinery to minimize the mutational damage and produce the functional target proteins. Such manipulations may be directed to any point of the gene expression axis, such as classical gene augmentation, modulating premature termination codon ribosomal bypass, splicing modification of pre-mRNA, etc. With the soar of the CRISPR-based gene editing systems, researchers now gravitate toward genome surgery in tackling NMDs by directly correcting the mutational defects at the genome level and expanding the scope of targetable NMDs. In this article, we will review the current development of gene therapy and focus on NMDs that are available in published reports, including Duchenne Muscular Dystrophy (DMD), Becker muscular dystrophy (BMD), X-linked myotubular myopathy (XLMTM), Spinal Muscular Atrophy (SMA), and Limb-girdle muscular dystrophy Type 2C (LGMD2C).

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Cannabis-associated arteritis

VASA ◽

10.1024/0301-1526/a000004 ◽

2010 ◽

Vol 39 (1) ◽

pp. 43-53 ◽

Cited By ~ 17

Author(s):

Grotenhermen

Keyword(s):

Systematic Review ◽

Case Reports ◽

Case Series ◽

Cardiovascular Effects ◽

Causative Factor ◽

Cannabis Use ◽

Thromboangiitis Obliterans ◽

Pathological Features ◽

Scientific Support ◽

Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term cannabis arteritis should be avoided until or unless more convincing scientific support is forthcoming.

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Capecitabine Induced Hand-Foot Syndrome: A Systematic Review of Case Reports

Clinical and Experimental Health Sciences ◽

10.33808/clinexphealthsci.469538 ◽

2019 ◽

Author(s):

Elif ARAS ◽

Kamer Tecen YÜCEL ◽

Aygin Bayraktar EKİNCİOĞLU ◽

İbrahim GÜLLÜ

Keyword(s):

Systematic Review ◽

Case Reports ◽

Hand Foot Syndrome

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Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.5.peds19126 ◽

2019 ◽

Vol 24 (5) ◽

pp. 558-571 ◽

Cited By ~ 3

Author(s):

Kartik Bhatia ◽

Hans Kortman ◽

Christopher Blair ◽

Geoffrey Parker ◽

David Brunacci ◽

...

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Mechanical Thrombectomy ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

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Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽

10.1177/0961203320965702 ◽

2020 ◽

pp. 096120332096570

Author(s):

Juliana P Ocanha-Xavier ◽

Camila O Cola-Senra ◽

Jose Candido C Xavier-Junior

Keyword(s):

Systematic Review ◽

Case Report ◽

Literature Review ◽

English Language ◽

Case Reports ◽

Histopathological Diagnosis ◽

Skin Disorders ◽

Histopathological Findings ◽

Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

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