scholarly journals Laterality of Skin Temperature Depending on Sensory Symptoms in Patient with Wallenberg Syndrome

2021 ◽  
Vol 39 (3) ◽  
pp. 150-157
Author(s):  
Ji Eun Han ◽  
Sun Ki Min ◽  
Jinyoung Oh ◽  
Taemin Kim ◽  
Sang Won Han ◽  
...  
Keyword(s):  
Blood Flow ◽  
Clinical Symptoms ◽  
Ventrolateral Medulla ◽  
Sensory Disturbance ◽  
Wallenberg Syndrome ◽  
Sensory Dysfunction ◽  
Body Surface Temperature ◽  
The Relationship ◽  
Lateral Difference

Background: Wallenberg’s syndrome (WS) is caused by dorsal lateral medulla infarction. Clinical symptoms include hoarseness, dysphagia, sensory disturbance, vertigo, ataxia, and Horner’s syndrome. Recently, lateral difference of body surface temperature (BST) has been reported as a symptom of WS, resulting from the disturbances of the sympathetic nerve tract. Although sensory dysfunction is the major symptoms of WS, there is no evidence that BST influences these symptoms. We sought to evaluate the relationship between BST and sensory symptoms in WS using infrared thermography.Methods: Patients with WS within 7 days of symptom onset from June 2018 to December 2020 were enrolled. Infrared thermography was conducted at 7±30 days and 90±30 days after the onset of stroke. Laterality of BST was defined as being positive when macroscopically different and discrepancy >0.5°C in thermography.Results: The final analyses included 12 patients with a mean age of 59.9±11.85 years. Sensory symptoms in nine patients were most often described as numbness (56%), cold (44%), burning (33%), and heaviness (11%). Of these, burning symptoms lasted at 100%, cold 75%, and numbness 50% during 3 months follow-up. All patients with sensory dysfunction showed lateral BST differences. The BST laterality persisted in patients with remaining sensory dysfunction at 3 months follow-up.Conclusions: All patients with sensory dysfunction in WS showed lateral BST differences which was detected with thermography. Laterality of BST and sensory dysfunction in WS might be associated with the disturbance of the connecting pathway of skin blood flow descending from the rostral ventrolateral medulla.

Antinuclear Antibodies and Lupus-like Manifestations in Rheumatoid Arthritis and Ankylosing Spondylitis Patients at 4 Months' Follow-up After Treatment with Infliximab and Etanercept

2020 ◽  
Vol 16 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mir Amir Aghdashi ◽  
Mohsen Khadir ◽  
Roshan Dinparasti-Saleh
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Treatment Regimen ◽  
Antinuclear Antibodies ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Case Group ◽  
Tnf Α ◽  
The Relationship

Background: Up to 44% of patients treated with infliximab and 7% of patients treated with etanercept reported to have anti-drug antibodies within the first 6 months of treatment. Recently, anti-TNF-α therapies have been reported to be employed in the induction of the druginduced lupus erythematous. Objective: The aim of the present study was to investigate the relationship between anti-TNFα antibodies and various manifestations of lupus erythematous. Methods: We enrolled a total of 56 cases divided into 28 known cases of rheumatoid arthritis and 28 cases of ankylosing spondylitis patients and 56 controls. The case group was divided into 4 groups according to the underlying disease (RA or AS) and treatment regimen (infliximab or etanercept). ANA and anti-dsDNA levels and lupus criteria were assessed at the beginning of the study and 4 months after the initiation of anti-TNFα. Results: 36% and 21% of RA patients treated with infliximab, were ANA and anti-dsDNA positive after 4 months (P=0.003, P=0.025). 28% and 7% of RA patients treated with etanercept, were ANA and anti-dsDNA positive after 4 months (P=0.009, P=0.15). 21% and 7% of AS patients treated with infliximab, were ANA and anti-dsDNA positive, respectively (P=0.025, P=0.15). 14% and 7% of AS patients treated with etanercept, were ANA and anti-dsDNA positive, respectively (P=0.63, P=0.15). Three patients who were positive for auto-antibodies developed three criteria for SLE. Conclusions: Infliximab potentially may increase both ANA and anti-dsDNA levels in rheumatoid arthritis, but only ANA in ankylosing spondylitis patients. In general, clinicians should consider different clinical symptoms of ATIL, which may be present as a lupus-like syndrome similar to idiopathic SLE or classical DIL.

Intraluminal Brachytherapy Using a Self-Expandable Stent Loaded With Linear Iodine-125 Seeds in a Patient With Reiterative Recurrence of Cancer-Associated Vein Obstruction: A Case Report With 3 Months of Follow-Up

2018 ◽  
Vol 52 (6) ◽  
pp. 463-468 ◽  
Author(s):  
Maofeng Gong ◽  
Jinhua Song ◽  
Xu He ◽  
Boxiang Zhao ◽  
Jianping Gu
Keyword(s):  
Blood Flow ◽  
Radioactive Iodine ◽  
Clinical Symptoms ◽  
Common Complication ◽  
Intraluminal Brachytherapy ◽  
Oncological Patients ◽  
Effective Option ◽  
Flow Restoration ◽  
Iodine 125

Cancer-associated vein obstruction (CAVO) is a common complication in oncological patients, but the effective therapeutic options are scant. We report a patient with reiterative recurrent CAVO who was successfully treated with intraluminal brachytherapy using a self-expandable stent loaded with linear radioactive iodine-125 seeds (RIS) strand. During follow-up, her clinical symptoms were well improved. Three-month imaging follow-up revealed satisfactory patency of the iliofemoral vein, and the stents combined with RIS strands performed well. No serious complications associated with the implantation of stent and RIS strands were documented in any of the sessions. Intraluminal brachytherapy using a self-expandable stent loaded with linear RIS may be a safe and effective option for CAVO as long as it includes not only blood flow restoration but also brachytherapy administration for cancer.

scholarly journals Relationship between cerebral blood flow and the development of swelling and life-threatening herniation in acute ischemic stroke

1998 ◽  
Vol 4 (6) ◽  
pp. E1 ◽  
Author(s):  
Andrew D. Firlik ◽  
Howard Yonas ◽  
Anthony M. Kaufmann ◽  
Lawrence R. Wechsler ◽  
Charles A. Jungreis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Clinical Evidence ◽  
Subsequent Development ◽  
Brain Herniation ◽  
Life Threatening ◽  
The Mean ◽  
The Relationship ◽  
Neurosurgical Intervention

Object The purpose of this study was to determine whether cerebral blood flow (CBF) measurements in acute stroke could be correlated with the subsequent development of cerebral edema and life-threatening brain herniation. Methods Twenty patients with aggressively managed acute middle cerebral artery (MCA) territory strokes who underwent xenon-enhanced computerized tomography (Xe-CT) CBF scanning within 6 hours of onset of symptoms were retrospectively reviewed. The relationship among CBF and follow-up CT evidence of edema and clinical evidence of brain herniation during the 36 to 96 hours following stroke onset was analyzed. Initial CT scans displayed abnormal findings in 11 patients (55%), whereas the Xe-CT CBF scans showed abnormal findings in all patients (100%). The mean CBF in the symptomatic MCA territory was 10.4 ml/100 g/minute in patients who developed severe edema compared with 19 ml/100 g/minute in patients who developed mild edema (p < 0.05). The mean CBF in the symptomatic MCA territory was 8.6 ml/100 g/minute in patients who developed clinical brain herniation compared with 18 ml/100 g/minute in those who did not (p < 0.01). The mean CBF in the symptomatic MCA territory that was 15 ml/100 g/minute or lower was significantly associated with the development of severe edema and herniation (p < 0.05). Conclusions Within 6 hours of acute MCA territory stroke, Xe-CT CBF measurements can be used to predict the subsequent development of severe edema and progression to clinical life-threatening brain herniation. Early knowledge of the anatomical and clinical sequelae of stroke in the acute phase may aid in the triage of such patients and alert physicians to the potential need for more aggressive medical or neurosurgical intervention.

The impact of cognitive reserve, cognition and clinical symptoms on psychosocial functioning in first-episode psychoses

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Silvia Amoretti ◽  
Adriane R Rosa ◽  
Gisela Mezquida ◽  
Bibiana Cabrera ◽  
María Ribeiro ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Cognitive Reserve ◽  
Clinical Symptoms ◽  
First Episode ◽  
Cognitive Domains ◽  
The Impact ◽  
The Relationship

Abstract Background Functional impairment is a defining feature of psychotic disorders. A range of factors has been shown to influence functioning, including negative symptoms, cognitive performance and cognitive reserve (CR). However, it is not clear how these variables may affect functioning in first-episode psychosis (FEP) patients. This 2-year follow-up study aimed to explore the possible mediating effects of CR on the relationship between cognitive performance or specific clinical symptoms and functional outcome. Methods A prospective study of non-affective FEP patients was performed (211 at baseline and 139 at follow-up). CR was entered in a path analysis model as potential mediators between cognitive domains or clinical symptoms and functioning. Results At baseline, the relationship between clinical variables or cognitive performance and functioning was not mediated by CR. At follow-up, the effect of attention (p = 0.003) and negative symptoms (p = 0.012) assessed at baseline on functioning was partially mediated by CR (p = 0.032 and 0.016), whereas the relationship between verbal memory (p = 0.057) and functioning was mediated by CR (p = 0.014). Verbal memory and positive and total subscales of PANSS assessed at follow-up were partially mediated by CR and the effect of working memory on functioning was totally mediated by CR. Conclusions Our results showed the influence of CR in mediating the relationship between cognitive domains or clinical symptoms and functioning in FEP. In particular, CR partially mediated the relationship between some cognitive domains or clinical symptoms and functioning at follow-up. Therefore, CR could improve our understanding of the long-term functioning of patients with a non-affective FEP.

Relationship between cerebral blood flow and the development of swelling and life-threatening herniation in acute ischemic stroke

1998 ◽  
Vol 89 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Andrew D. Firlik ◽  
Howard Yonas ◽  
Anthony M. Kaufmann ◽  
Lawrence R. Wechsler ◽  
Charles A. Jungreis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subsequent Development ◽  
Brain Herniation ◽  
Content Type ◽  
Life Threatening ◽  
The Mean ◽  
The Relationship ◽  
Fine Print

Object. The purpose of this study was to determine whether cerebral blood flow (CBF) measurements in acute stroke could be correlated with the subsequent development of cerebral edema and life-threatening brain herniation. Methods. Twenty patients with aggressively managed acute middle cerebral artery (MCA) territory strokes who underwent xenon-enhanced computerized tomography (Xe-CT) CBF scanning within 6 hours of onset of symptoms were retrospectively reviewed. The relationship among CBF and follow-up CT evidence of edema and clinical evidence of brain herniation during the 36 to 96 hours following stroke onset was analyzed. Initial CT scans displayed abnormal findings in 11 patients (55%), whereas the Xe-CT CBF scans showed abnormal findings in all patients (100%). The mean CBF in the symptomatic MCA territory was 10.4 ml/100 g/minute in patients who developed severe edema compared with 19 ml/100 g/minute in patients who developed mild edema (p < 0.05). The mean CBF in the symptomatic MCA territory was 8.6 ml/100 g/minute in patients who developed clinical brain herniation compared with 18 ml/100 g/minute in those who did not (p < 0.01). The mean CBF in the symptomatic MCA territory that was 15 ml/100 g/minute or lower was significantly associated with the development of severe edema and herniation (p < 0.05). Conclusions. Within 6 hours of acute MCA territory stroke, Xe-CT CBF measurements can be used to predict the subsequent development of severe edema and progression to clinical life-threatening brain herniation. Early knowledge of the anatomical and clinical sequelae of stroke in the acute phase may aid in the triage of such patients and alert physicians to the potential need for more aggressive medical or neurosurgical intervention.

scholarly journals Syringomyelia in children with closed spinal dysraphism: long-term outcomes after surgical intervention

2020 ◽  
Vol 25 (3) ◽  
pp. 319-325 ◽  
Author(s):  
Amy K. Bruzek ◽  
Jordan Starr ◽  
Hugh J. L. Garton ◽  
Karin M. Muraszko ◽  
Cormac O. Maher ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Symptoms ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Presenting Symptoms ◽  
Age At Surgery ◽  
Intradural Lipoma ◽  
The Relationship

OBJECTIVEThe nature of the relationship between spinal cord syrinx and tethered cord is not well known. It is unclear if surgical cord untethering results in resolution or improvement of an associated syrinx. The objective of this study was to report the response of spinal cord syrinx to surgical cord untethering.METHODSThe authors retrospectively reviewed all patients with a syrinx and tethered cord who presented to a single institution over an 11-year interval. Patients with open neural tube defects were excluded. Thirty-one patients were identified, 25 of whom had both clinical and imaging follow-up after surgery. Patients were grouped according to etiology of the tethered cord. Clinical outcomes and syrinx characteristics were recorded.RESULTSOf the 25 patients with tethered cord, 68% (n = 17) were male. The average age at presentation was 2.5 years (0–10.1 years) and age at surgery was 3.7 years (range 1 day to 17 years). Etiologies of tethered cord were lipomyelomeningocele (n = 8), thickened/fatty filum (n = 7), intradural lipoma (n = 5), myelocystocele (n = 2), meningocele (n = 2), and diastematomyelia (n = 1). Twenty-three of the patients underwent primary untethering, whereas 2 patients had received untethering previously at another institution. The average syrinx length and width prior to surgery were 4.81 vertebral levels (SD 4.35) and 5.19 mm (SD 2.55 mm), respectively. Conus level ranged from L1 to S3. Patients were followed for an average of 8.4 years (1.35–15.85 years). Overall there was no significant change in syrinx length or width postoperatively; the average syrinx length increased by 0.86 vertebral levels (SD 4.36) and width decreased by 0.72 mm (SD 2.94 mm). Seven of 25 patients had improvement in at least one presenting symptom, including scoliosis, weakness, bowel/bladder dysfunction, and pain. Eight patients had stable presenting symptoms. Six patients were asymptomatic and 5 patients had new or worsening symptoms, which included scoliosis, pain, or sensory changes.CONCLUSIONSAlthough some syrinxes improved after surgery for tethered cord, radiological improvement was not consistent and did not appear to be associated with change in clinical symptoms. The decision to surgically untether a cord should be focused on the clinical symptoms and not the presence of a syrinx alone. Further studies are needed to confirm this finding.

scholarly journals Persistent symptoms and association with inflammatory cytokine signatures in recovered COVID-19 patients

2021 ◽  
Author(s):  
Sean Wei Xiang Ong ◽  
Siew-Wai Fong ◽  
Barnaby Edward Young ◽  
Yi-Hao Chan ◽  
Bernett Lee ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Acute Infection ◽  
Public Hospitals ◽  
Multivariable Model ◽  
Persistent Symptoms ◽  
Immune Mediators ◽  
Prospective Longitudinal ◽  
The Relationship

Abstract Background The complications and sequelae of coronavirus disease 2019 (COVID-19) and their effect on long-term health are unclear, and the trajectory of associated immune dysregulation poorly understood. Methods We conducted a prospective longitudinal multi-center cohort study at four public hospitals in Singapore. COVID-19 patients were monitored for a median of six months after recovery from acute infection. Clinical symptoms and radiologic data were collected, along with plasma samples for quantification of immune mediators. The relationship between clinical symptoms and immune cytokine profiles was investigated. Results 288 participants were recruited, and follow-up data were available for 183, 175, and 120 participants at days 30, 90 and 180 post-symptom onset respectively. Symptoms related to COVID-19 were present in 31 (16.9%), 13 (7.4%), and 14 (11.7%) at days 30, 90 and 180. In a multivariable model, age &gt;65 years, non-Chinese ethnicity, and the severity of acute infection were associated with increased likelihood of persistent symptoms. Recovered COVID-19 patients had elevated levels of pro-inflammatory IL-17A, SCF, IL-12p70, IL-1βand pro-angiogenic MIP-1β, BDNF, VEGF at day 180 compared to healthy controls. Higher levels of MCP-1 and PDGF-BB were detected in patients with persistent symptoms, versus symptom-free patients. Conclusions About 10% of recovered patients had persistent symptoms six months after initial infection. Immune cytokine signatures of the recovered patients reflected ongoing chronic inflammation and angiogenesis. COVID-19 patients should be monitored closely for emerging long-term health consequences.

scholarly journals The Relationship Between Regional Cerebral Blood Flow Estimates and Alcohol Problems at 5‐Year Follow‐Up: The Role of Level of Response

2019 ◽  
Vol 43 (5) ◽  
pp. 812-821 ◽  
Author(s):  
Kelly E. Courtney ◽  
Maria Alejandra Infante ◽  
Gregory G. Brown ◽  
Susan F. Tapert ◽  
Alan N. Simmons ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Alcohol Problems ◽  
Regional Cerebral Blood ◽  
The Relationship

Ventilatory threshold is related to walking tolerance in patients with intermittent claudication

VASA ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 275-281 ◽  
Author(s):  
da Rocha Chehuen ◽  
G. Cucato ◽  
P. dos Anjos Souza Barbosa ◽  
A. R. Costa ◽  
M. Ritti-Dias ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oxygen Uptake ◽  
Intermittent Claudication ◽  
Lower Limb ◽  
Ventilatory Threshold ◽  
Reactive Hyperemia ◽  
Ankle Brachial Index ◽  
Metabolic Parameters ◽  
Walking Distance ◽  
The Relationship

Background: This study assessed the relationship between lower limb hemodynamics and metabolic parameters with walking tolerance in patients with intermittent claudication (IC). Patients and methods: Resting ankle-brachial index (ABI), baseline blood flow (BF), BF response to reactive hyperemia (BFRH), oxygen uptake (VO2), initial claudication distance (ICD) and total walking distance (TWD) were measured in 28 IC patients. Pearson and Spearman correlations were calculated. Results: ABI, baseline BF and BF response to RH did not correlate with ICD or TWD. VO2 at first ventilatory threshold and VO2peak were significantly and positively correlated with ICD (r = 0.41 and 0.54, respectively) and TWD (r = 0.65 and 0.71, respectively). Conclusions: VO2peak and VO2 at first ventilatory threshold, but not ABI, baseline BF and BFHR were associated with walking tolerance in IC patients. These results suggest that VO2 at first ventilatory threshold may be useful to evaluate walking tolerance and improvements in IC patients.

Sign in / Sign up

Export Citation Format

Share Document