Chiari Malformation Presenting in Adults: A Surgical Experience in 127 Cases

Neurosurgery ◽  
1983 ◽  
Vol 12 (4) ◽  
pp. 377-390 ◽  
Author(s):  
Walter Joseph Levy ◽  
Laura Mason ◽  
Joseph F. Hahn

Abstract We reviewed 127 patients who were operated upon for adult presentation Chiari malformation and made six conclusions: (a) The clinical examination remains crucial in the diagnosis. (b) The surgical anatomy is highly varied. (c) Syrinxes can be missed on preoperative contrast studies. (d By a conservative grading system, we determined that 46%; of the patients improved during long term follow-up. One-quarter deteriorated over the long run in spite of any treatment. (e) The overall results did not differ whether the treatment was plugging of the central canal plus decompression or decompression alone. (f) In patients with progression, plugging of the central canal obtained superior results. A review of the literature shows that the natural history of this complex disease process has not been established. This history is needed to identify the course of what may be several important factors that lead to the pathological condition in this disease.

PEDIATRICS ◽  
1961 ◽  
Vol 28 (1) ◽  
pp. 42-42
Author(s):  
JOHN M. CRAIG

This small but easily read book is a carefully documented summary of the clinical, laboratory and necropsy experience at the Presbyterian Hospital in New York City in 200 cases of systemic lupus erythematosus during a 20-year period. The disease process is presented according to manifestations in individual organs and laboratory examinations. This approach emphasizes the role of the disease as one of the "great imitators" of medicine, along with syphilis, tuberculosis and malaria. Of great value are the careful observations and long-term follow-up of these patients, which gives a genuine picture of the natural history of the disease, one of the stated aims of the author.


2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  

2020 ◽  
Vol 26 (43) ◽  
pp. 5609-5616
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Djuro Macut

Early activation of the adrenal zona reticularis, leading to adrenal androgen secretion, mainly dehydroepiandrosterone sulfate (DHEAS), is called premature adrenarche (PA). The fact that adrenal hyperandrogenism in females has been linked to a cluster of cardiovascular (CV) risk factors, even in prepubertal children, warrants investigation. Controversial results have been obtained in this field, probably due to genetic, constitutional, and environmental factors or differences in the characteristics of participants. In an attempt to understand, in depth, the impact of PA as a potential activator of CV risk, we critically present available data stratified according to pubertal status. It seems that prepubertally, CV risk is increased in these girls, but is somewhat attenuated during their second decade of life. Furthermore, different entities associated with PA, such as polycystic ovary syndrome, non-classical congenital adrenal hyperplasia, heterozygosity of CYP21A2 mutations, and the impact of DHEAS on CV risk, are reviewed. At present, firm and definitive conclusions cannot be drawn. However, it may be speculated that girls with a history of PA display a hyperandrogenic hormonal milieu that may lead to increased CV risk. Accordingly, appropriate long-term follow-up and early intervention employing a patient-oriented approach are recommended.


2021 ◽  
Vol 93 (6) ◽  
pp. AB350
Author(s):  
Achintya D. Singh ◽  
Amit Bhatt ◽  
Abel Joseph ◽  
Neal Mehta ◽  
Gautam N. Mankaney ◽  
...  

Author(s):  
Paweł Bukowski ◽  
Filip Novokmet

AbstractWe construct the first consistent series on the long-term distribution of income in Poland by combining tax, household survey and national accounts data. We document a U-shaped evolution of inequalities from the end of the nineteenth century until today: (1) inequality was high before WWII; (2) abruptly fell after the introduction of communism in 1947 and stagnated at low levels during the whole communist period; (3) experienced a sharp rise with the return to capitalism in 1989. We find that official survey-based measures strongly under-estimate the rise in inequality since 1989. Our results highlight the prominent role of capital income in driving the U-shaped evolution of top income shares. The unique inequality history of Poland speaks to the central role of institutions and policies in shaping inequality in the long run.


FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.


Author(s):  
Thafar S. A. Safar ◽  
Karmen B. Katay ◽  
Reem H. Khamis

At the end of 2019, coronavirus disease (COVID-19) outbreak is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Worldwide researchers and physician try to explore the mechanisms of damage induced by virus, they focus on the short-term and long-term immune-mediated consequences induced by the virus infection. Every day discover a new pathological condition induced by virus and new symptoms and disease may occur after recovery from disease. Our case report is 41 years old, Indian lady who presented to our primary health care centre complaining of multiple small hand joints pain, both elbows and knees pain with swelling of them and prolonged morning stiffness, diagnosed seropositive rheumatoid arthritis (RA) (arthritis, positive rheumatoid factor (RF), and X-ray changes) after 1 month recovery from COVID-19 infection. She did not have any joint pain and she had negative RF before COVID-19 infection with no family history of RA.


2022 ◽  
Vol 12 (6) ◽  
pp. 56-60
Author(s):  
Anu P Baby ◽  
Jigeesh PP

Diagnosis in Ayurveda is not always in terms of the name of the disease but in terms of the nature or phenomenon. This phenomenon is described in terms of Samprapti of the disease in each patient, comprising Dosha, Dushya and Adhishtana components. The prime factors in the pathogenesis of the disease are Dosha and Dushya. Shat kriyakala refers to the stage of development of a pathological process in which a physician can intervene by the most accurate treatment modality and medicine, thereby halting the progression of the disease process. By intricate understanding of the process of Shat kriyakala, the disease process could be arrested, and further complications can be avoided. In the current scenario, the concept of prevention has become broad-based. The natural history of disease is one of the significant elements of epidemiology. The course of a disease takes in individual people from its pathological onset until its eventual resolution. Natural history of disease is possible to correlate pre-pathogenesis with Sanchaya, Prakopa, Prasara and pathogenesis with Sthanasamsraya, Vyakti and Bhedavastha of Shat kriyakala. Recent studies have shown that it is possible to identify certain pre-clinical stages for many diseases like Parkinson’s disease, which can help in the early successful treatment. Shat kriyakala helps to arrest the disease process at the very early stage itself. Along with current technology, the need for research for validating the Shat kriyakala will benefit humankind in the long run.


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