Epileptogenic role of occult temporal encephalomeningocele

Neurology ◽  
2018 ◽  
Vol 90 (14) ◽  
pp. e1200-e1203 ◽  
Author(s):  
Sara Gasparini ◽  
Edoardo Ferlazzo ◽  
Giuseppe Pustorino ◽  
Michele Ascoli ◽  
Vittoria Cianci ◽  
...  
Keyword(s):  
Drug Sensitivity ◽  
Case Control Study ◽  
Brain Mri ◽  
Unknown Origin ◽  
Unknown Etiology ◽  
Drug Resistant ◽  
Temporal Lobes ◽  
Control Study

ObjectiveThe purpose of this case-control study is to evaluate the prevalence of occult temporal encephalomeningocele (OTE) in patients with temporal lobe epilepsy (TLE) of unknown etiology presenting to an epilepsy center, independently from drug sensitivity.MethodsWe studied 95 patients with TLE (51 female, mean age 49.4 ± 17.1 years) and 151 controls (88 female, mean age 54.1 ± 21.0 years) using a 1.5T brain MRI, including balanced steady-state gradient echo sequences, targeted to the temporal lobes.ResultsOTE was found in 5.2% of the TLE population (9.5% of drug-resistant TLE) and in none of the controls (p = 0.008). Two patients with OTE and drug-resistant TLE became seizure-free after lesionectomy (follow-up 18–24 months).ConclusionOTE is not a rare finding in unselected patients with TLE of unknown origin, provided that it is carefully searched. The absence of OTE in a large group of nonepileptic controls adds evidence to its epileptogenic role.

The Significance of the Variants Erythrovirus in Patients with Cytopenias of Unknown Origin

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4837-4837
Author(s):  
Sheila Oliveira Garcia ◽  
Juliana Pereira ◽  
Sabri Sanabani ◽  
Walter Kleine Neto ◽  
Ester Cerdeira Sabino
Keyword(s):  
Bone Marrow ◽  
Case Control Study ◽  
Unknown Origin ◽  
Case Control ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Genotype 2 ◽  
Bone Marrow Plasma ◽  
Control Study

Abstract Erythrovirus are now classified in three groups: genotype 1 (prototype Pvbaua); genotype 2 (Lali prototype) and genotype 3 (V9 prototype). The role of genotypes 2 and 3 in the development of disease remains uncertain. We have recently showed that those genotypes may represent 50% of the infections in Brazil. The objective of this study is to verify if these viruses are associated with cytopenia of unknown origin. We have designed a case control study in which the prevalence of erythrovirus in the bone marrow sample was compared among cases of cytopenia of unknown origin and 2 controls: bone marrow donors (C1) and, individuals with chronic leukemia (C2). For detection of the virus a nested PCR was performed in bone marrow and plasma samples. Table 1 describes the results obtained in 68 C0, 35 C1 and 67 C2 collected during the year of 2007. The prevalence of the virus in bone marrow was the same in the 3 groups. This result suggests that erythrovirus are common in bone marrow and probably not are responsible for most of cytopenias of unknown origin. A detection of this agent only in bone marrow has little clinical relevance. Table 1. Results obtained during the year of 2007 Cases (C0) Cytopenias Control 1 (C1) Bone marrow donors Controle 2 (C2) Chronics Leukemias Bone marrow Plasma Bone marrow Plasma Bone marrow Plasma positive total positive total positive total positive total positive total positive total 6 (9%) 68 1 (1%) 68 3 (8%) 35 0 35 5 (7%) 67 0 67

scholarly journals Neuro-radiology: a new gold standard investigation for management of central nervous system tuberculosis

2016 ◽  
Vol 4 (1) ◽  
pp. 14
Author(s):  
Vinod Gautam
Keyword(s):  
Drug Sensitivity ◽  
Therapeutic Interventions ◽  
Drug Resistant ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Radiological Investigation ◽  
Ct Guided ◽  
Ct Guided Biopsy

<p>Treatment of CNS TB is challenging due to lack of specific biochemical tests and inability to get the pathological sample from deeply located eloquent areas of CNS without causing any neurological deficit. Moreover, it is unnecessary to operate for biopsy in a patient who has presented with a very small granulomatious lesion in brain or spinal cord. In such as situations neuro-radiology helps in managing CNS TB and it may be the only source of establishing diagnosis and evaluating treatment response.</p><p>Role of radiological investigation has expanded from the initial diagnosis to the therapeutic interventions. In some Muli-drug- resistant (MDR) CNS TB cases, Stereotaxy or USG or CT guided biopsy helps in obtaining pathological sample and drug sensitivity testing. A regular clinical and neuro-radiological follow-up is mandatory during the entire course of anti tuberculous therapy to take prompt decisions to change ATT and to reduce morbidity and mortality associated with CNS TB.</p>

scholarly journals First Case-Control Study of Intestinal Parasites in Follow-up Schizophrenia Patients: Are We Overlooking the Role of These Agents?

2021 ◽  
Vol 22 (3) ◽  
pp. 213-217
Author(s):  
Zeynep Yalnız ◽  
Ersel Bulu ◽  
Yasin Kavla ◽  
Burcu Sapmaz ◽  
Reyhan Çalışkan ◽  
...  
Keyword(s):  
Case Control Study ◽  
Intestinal Parasites ◽  
Case Control ◽  
First Case ◽  
Control Study

Arterite de Takayasu em Gestante: Relato de Caso / Takayasu Arteritis in Pregnancy: Case Report

1970 ◽  
Vol 5 (4) ◽  
pp. 61-66
Author(s):  
Patrícia Resende Penido ◽  
Rhanna Junqueira Westin de Carvalho ◽  
Roger Willian Moraes Mendes
Keyword(s):  
Case Report ◽  
Takayasu Arteritis ◽  
Imaging Techniques ◽  
Unknown Origin ◽  
Pregnant Patient ◽  
Immunosuppressive Drugs ◽  
Clinical Treatment ◽  
Satisfactory Outcome

RESUMOIntrodução: A Arterite de Takayasu (AT) consiste em uma vasculopatia de origem indefinida, sendo de caráter crônico, que afeta a aorta e seus ramos principais. Em gestantes é uma condição complexa, em que o tratamento clínico é realizado com restrições. A utilização de corticoides tem sido favorável no controle inflamatório, principalmente naqueles casos em que antes da gravidez se fazia uso de imunossupressores. Casuística: Foi relatado um caso de uma gestante portadora de AT, através da análise de prontuário e de exames complementares, sendo realizado o pré-natal pelas equipes de Obstetrícia e Reumatologia, onde foi realizado tratamento clínico com corticoides, mostrando uma evolução satisfatória, ocorrendo apenas uma hospitalização que foi seguida de uma cesárea na trigésima sexta semana de gravidez, com recém nato saudável de 3.810g. Discussão: A AT pode estar associada a várias etiologias, sendo a gênese pouco conhecida. O diagnóstico na maioria das vezes é demorado, pela dificuldade da suspeita clínica, além de demandar o uso de técnicas de imagem mais sofisticadas. A gestação associada é fenômeno raro, já que as portadoras são orientadas a evitarem a gravidez. O controle clínico permitiu uma gestação sem grandes complicações e serviu como meio para levar a gestação até praticamente o fim do terceiro trimestre. Conclusão: Deve-se ressaltar o papel do acompanhamento clínico, especialmente com esta pan-arterite, mostrando os medicamentos que podem ser utilizados nesse grupo, especialmente quando se usava imunossupressores antes da gravidez. Palavras chave: Arterite de Takayasu, Gravidez, Vasculite. ABSTRACT:Introduction: Takayasu's arteritis (TA) consists of a vascular disease of unknown origin and chronic nature, which affects the aorta and its main branches. In pregnant women it is a complex condition, in which the clinical treatment is performed with restrictions. The use of corticosteroids has been favorable to control inflammation, especially in those cases when immunosuppressant had been used before pregnancy. Case Report: A case of a pregnant patient with TA has been reported through the analysis of medical records and laboratory tests. The Obstetrics and Rheumatology staff performed the prenatal care, and clinical treatment with corticosteroids was done showing a satisfactory outcome. There was only one hospitalization of the patient, which was followed by a cesarean in the thirty sixth week of pregnancy.  The newborn was a healthy one, weighing 3.810g. Discussion: TA may be associated with several etiologies, and the genesis is little known. The diagnosis most often takes time due to the difficulty of clinical suspicion, and requires the use of more sophisticated imaging techniques. The pregnancy is rare phenomenon, since the carriers are advised to avoid pregnancy. The clinical management allowed a pregnancy without major complications and served as a means to carry the pregnancy to almost the end of the third quarter. Conclusion: The role of the clinical follow-up should be noticed especially with this pan-arteritis, showing the drugs that can be used in this group, especially when there is use of immunosuppressive drugs before pregnancy. Keywords: Takayasu Arteritis, Pregnancy, Vasculitis.

scholarly journals Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Negeso Gebeyehu Gejo ◽  
Melaku Tesfaye W/mariam ◽  
Biruk Assefa Kebede ◽  
Ritbano Ahmed Abdo ◽  
Abebe Alemu Anshebo ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Antenatal Care ◽  
Medical Records ◽  
Case Control Study ◽  
Southern Ethiopia ◽  
Preterm Neonates ◽  
Factors Associated ◽  
Induced Hypertension ◽  
Control Study

Abstract Background Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. Methods An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. Result The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. Conclusions The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

scholarly journals Determinants of short birth interval among women in South Gondar, Ethiopia: community-based unmatched case-control study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Gedefaye Nibret Mihretie ◽  
Fentahun Yenealem Beyene ◽  
Bekalu Getnet Kassa ◽  
Alemu Degu Ayele ◽  
Tewachew Muche Liyeh ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Birth Interval ◽  
Case Control Study ◽  
Birth Spacing ◽  
Case Control ◽  
Community Based ◽  
Short Birth Interval ◽  
South Gondar ◽  
Control Study

Abstract Background The effect of short birth interval on socio-economic, negative maternal and child health outcomes remains common in developing countries. This study aimed to assess determinants of short birth interval among reproductive age women, who gave birth in health institution for last six-month in South Gondar, Ethiopia 2019. Methods Community-based unmatched case control study design was conducted from February 1 to March 30, 2019. Sample size of 150 was included by simple random sampling technique. The data was collected by semi-structured and pre-tested face to face interviewer-administered questionnaire from selected respondent. The collected data was entered with Epi-Data version 3.1 and analyzed by using SPSS version 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% CI and P-value < 0.05 were used to determine the statistical association. Result The mean age of the respondents was 32.42 (SD ± 5.14) and 35.12 (SD ± 5.86) for cases and controls, respectively. Mothers not used contraceptives (AOR = 6.29, 95% CI (1.95, 20.24)), participants who had ≤2 alive children (AOR = 5.57, 95% CI (1.47, 21.13)), mothers who breast fed less than 24 months (AOR = 3.42, 95% CI (1.38, 8.46)), husband decision on contraceptives utilization (AOR = 2.69,95% CI (1.05,6.88)) and mothers who did not have history of antenatal care follow up (AOR = 3.52, 95% CI (1.27, 9.75)) were associated with short birth interval. Conclusion The optimum birth spacing plays a vital role in decreasing fertility and the morbidity and mortality of mothers and children. Thus, providing health information on the benefit of breast feeding, follow-up of antenatal care during pregnancy, use of contraceptives after delivery and encouraging mothers to make decisions about their own health and use of contraceptives to optimize birth spacing for rural communities.

scholarly journals Diagnostic utility of a Ferritin-to-Procalcitonin Ratio to differentiate patients with COVID-19 from those with Bacterial Pneumonia: A multicenter study

2021 ◽  
Author(s):  
Amal A Gharamti ◽  
Fei Mei ◽  
Katherine C Jankousky ◽  
Jin Huang ◽  
Peter Hyson ◽  
...  
Keyword(s):  
Bacterial Pneumonia ◽  
Operating Characteristic ◽  
Case Control Study ◽  
Receiver Operating Characteristic Analysis ◽  
Similar Proportion ◽  
Characteristic Analysis ◽  
Multivariable Analyses ◽  
Prevalence Of Diabetes Mellitus ◽  
Control Study

Abstract Background There is an urgent need for accurate, rapid, inexpensive biomarkers that can differentiate COVID-19 from bacterial pneumonia. We assess the role of the ferritin-to-procalcitonin (F/P) ratio to classify pneumonia cases into those due to COVID-19 or due to bacterial pathogens. Methods This multicenter case-control study compared patients with either COVID-19 and bacterial pneumonia, admitted between March 1 and May 31, 2020. Patients with COVID-19 and bacterial pneumonia co-infection were excluded. The F/P in patients with COVID-19 or with bacterial pneumonia were compared. Receiver operating characteristic analysis determined the sensitivity and specificity of various cut-off F/P values for COVID-19 versus bacterial pneumonia. Results A total of 242 COVID-19 pneumonia cases and 34 bacterial pneumonia controls were included. Patients with COVID-19 pneumonia had a lower mean age (57.11 vs 64.4 years, p=0.02) and a higher BMI (30.74 vs 27.15 kg/m 2, p=0.02) compared to patients with bacterial pneumonia. Cases and controls had a similar proportion of women (47% vs 53%, p=0.5) and COVID-19 patients had a higher prevalence of diabetes mellitus (32.6% vs 12%, p=0.01). The median F/P was significantly higher in patients with COVID-19 (4037.5) compared to the F/P in bacterial pneumonia (802, p&lt;0.001). An F/P ≥ 877 used to diagnose COVID-19 resulted in a sensitivity of 85% and a specificity of 56%, with a positive predictive value of 93.2%, and a likelihood ratio of 1.92. In multivariable analyses, an F/P ≥ 877 was associated with greater odds of identifying a COVID-19 case (OR: 11.27, CI: 4-31.2, p&lt;0.001). Conclusion An F/P ≥ 877 increases the likelihood of COVID-19 pneumonia compared to bacterial pneumonia.

scholarly journals Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: a case‐control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lin Du ◽  
Yanzheng Gao ◽  
Changqing Zhao ◽  
Tangjun Zhou ◽  
Haijun Tian ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Cervical Myelopathy ◽  
Case Control Study ◽  
Case Control ◽  
Axial Symptom ◽  
Segmental Instability ◽  
Neurologic Status ◽  
Multilevel Cervical Myelopathy ◽  
Control Study

Abstract Background Segmental cervical instability is a risk factor for the progression of osteophytic bone spurs and development of myelopathy, and is treated as a relative contraindication of cervical laminoplasty. The aim of this study was to compare laminoplasty with selective fixation (LPSF) versus laminectomy with fusion (LCF) in patients with multilevel cervical myelopathy accompanied by segmental instability. Methods A case-control study was conducted by reviewing data from 63 patients who underwent LPSF (n = 30) or LCF (n = 33). Cervical alignment, range of motion (ROM), neurologic status and axial symptom severity pre-operation, 3-days after operation, and at the final follow-up (minimum 24 months) were measured and compared between groups. Results Postoperation, patients in the LPSF group lost 31.1 ± 17.3 % of cervical lordosis and 43.2 ± 10.9 % cervical ROM while patients in the LCF group lost 5.7 ± 8.2 % and 67.9 ± 15.5 %, respectively. Both LPSF and LCF groups significantly improved neurologic status and axial symptom severity at the final follow-up with similar between-group results(P > 0.05). Blood loss, operation time, hospital stay, and medical cost in the LPSF group were significantly less than in the LCF group(P < 0.05). Conclusions In 2 years of clinical observation, LPSF was effective in maintaining the stability of the cervical spine with less sacrifice of mobility and surgical trauma for multilevel myelopathy with segmental instability compared to LCF.

Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
L.A. Vaira ◽  
C. Hopkins ◽  
M. Petrocelli ◽  
J.R. Lechien ◽  
S. Cutrupi ◽  
...  
Keyword(s):  
Treatment Group ◽  
Case Control Study ◽  
Spontaneous Recovery ◽  
Olfactory Function ◽  
Control Group ◽  
Initial Control ◽  
Group A ◽  
Control Study

BACKGROUND: The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify effective treatments that enhance the spontaneous recovery of olfactory function. METHODS: Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS: In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS: Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.

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