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[PMID]: 29237996
[Au] Autor:Uesaka K; Koyama K; Horiuchi N; Kobayashi Y; Nishikawa Y; Inokuma H
[Ad] Address:Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido 080-8555, Japan.
[Ti] Title:A clinical case of neosporosis in a 4-week-old holstein friesian calf which developed hindlimb paresis postnatally.
[So] Source:J Vet Med Sci;80(2):280-283, 2018 Feb 20.
[Is] ISSN:1347-7439
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:A 4-week-old female Holstein Friesian calf presented with hindlimb paresis. Neurologic examination of spinal reflexes revealed depressed or absent reflexes of the hindlimbs. Menace responses on both sides disappeared on examination of cranial nerves. The calf was finally diagnosed with Neospora caninum infection by pathological findings including nonsuppurative inflammation associated with cysts in the cerebrum and spinal cord. High levels of antibody against recombinant surface antigen 1 of N. caninum (NcSAG1) were detected by ELISA from both serum and cerebrospinal fluid (CSF) samples. This result suggests that detection of antibodies against N. caninum by NcSAG1-ELISA in serum and CSF could be useful for the clinical diagnosis of neosporosis in calves with acquired neurological signs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1292/jvms.17-0205

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[PMID]: 29522149
[Au] Autor:Krekeler BN; Wendt E; Macdonald C; Orne J; Francis DO; Sippel R; Connor NP
[Ad] Address:Department of Communication Sciences and Disorders, University of Wisconsin, Madison.
[Ti] Title:Patient-Reported Dysphagia After Thyroidectomy: A Qualitative Study.
[So] Source:JAMA Otolaryngol Head Neck Surg;, 2018 Mar 08.
[Is] ISSN:2168-619X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: It is important that clinicians understand consequences of thyoridectomy on swallowing from the patient perspective to better care for this population. Objective: Using rigorous qualitative methodology, this study set out to characterize the effect of swallowing-related symptoms after thyroidectomy on patient quality of life and swallowing-related outcomes. Design, Setting, and Participants: Prospective, grounded theory analysis of interviews with 26 patients at 3 time points after thyroidectomy (2 weeks, 6 weeks, and 6 months) Data were collected from an ongoing clinical trial (NCT02138214), and outpatient interviews were conducted at the University of Wisconsin Hospital and Clinics. All participants were age 21 to 73 years with a diagnosis of papillary thyroid cancer without cervical or distant metastases and had undergone total thyroidectomy. Exclusion criteria were preexisting vocal fold abnormalities (eg, polyps, nodules), neurological conditions affecting the voice or swallowing ability, and/or development of new-onset vocal fold paresis or paralysis (lasting longer than 6 months) after total thyroidectomy. Interventions: Total thyroidectomy. Main Outcomes and Measures: Symptoms of dysphagia and related effects on quality of life elicited through grounded theory analysis of semistructured interviews with patients after thyroidectomy designed to foster an open-ended, patient-driven discussion. Results: Of the 26 patients included, 69% were women (n = 18); mean (SD) age, 46.4 (14.1) years; mean (SD) tumor diameter 2.2 (1.4) cm. Two weeks after thyroidectomy, 80% of participants (n = 20) reported at least 1 swallowing-related symptom when prompted by the interview cards; during the open interview, 53% of participants (n = 14) volunteered discussion of swallowing-related symptoms unprompted. However, only 8% of participants in this study (n = 2) qualified for a follow-up dysphagia evaluation, indicating that the majority of reported symptoms were subjective in nature. Six weeks and 6 months after thyroidectomy, 42% (n = 11) and 17% (n = 4) of participants, respectively, reported continued swallowing symptoms using the prompts; 12% (n = 3) discussed symptoms without prompting cards at both time points. Conclusions and Relevance: Swallowing symptoms after thyroidectomy are underreported in the literature. This study revealed that as many as 80% of patients who have thyroidectomy may experience swallowing-related symptoms after surgery, and many develop compensatory strategies to manage or reduce the burden of these symptoms. Considering the large number of individuals who may experience subjective dysphagia, preoperative counseling should include education and management of such symptoms.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1001/jamaoto.2017.3378

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[PMID]: 29388842
[Au] Autor:Huang SL; Chen BB; Hsueh IP; Jeng JS; Koh CL; Hsieh CL
[Ad] Address:a School of Occupational Therapy, College of Medicine , National Taiwan University , Taipei , Taiwan.
[Ti] Title:Prediction of lower extremity motor recovery in persons with severe lower extremity paresis after stroke.
[So] Source:Brain Inj;32(5):627-633, 2018.
[Is] ISSN:1362-301X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To investigate the extent of motor recovery and predict the prognosis of lower extremity (LE) recovery in patients with severe LE paresis after stroke Methods: 137 patients with severe LE paresis after stroke were recruited from a local medical centre. Voluntary LE movement was assessed with the LE subscale of the Stroke Rehabilitation Assessment of Movement (STREAM-LE). Univariate and stepwise regression analyses were used to investigate 25 clinical variables (including demographic, neuroimaging, and behavioural variables) for finding the predictors of LE recovery. RESULTS: The STREAM-LE at discharge (DC ) of the participants covered a very wide range (0-19). Specifically, 5.1% of the participants were nearly completely recovered, 11.7% were moderately recovered, 36.5% were slightly recovered, and 46.7% remained severely paralysed. 'Score of STREAM-LE at admission (AD )' and 'volume of lesion and oedema') were significant predictors of LE movement at discharge, explaining 25.1% of the variance of the DC (p < 0.001). CONCLUSIONS: LE motor recovery varied widely in our participants, indicating that patients' recovery might not follow simple rules. The low predictive power (about a quarter) indicates that LE motor recovery in patients with severe LE paresis after stroke was hardly predictive.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1080/02699052.2018.1432897

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[PMID]: 29511323
[Au] Autor:Low KJ; Stals K; Caswell R; Wakeling M; Clayton-Smith J; Donaldson A; Foulds N; Norman A; Splitt M; Urankar K; Vijayakumar K; Majumdar A; Study D; Ellard S; Smithson SF
[Ad] Address:Department of Clinical Genetics, St Michaels Hospital, Bristol, UK.
[Ti] Title:Phenotype of CNTNAP1: a study of patients demonstrating a specific severe congenital hypomyelinating neuropathy with survival beyond infancy.
[So] Source:Eur J Hum Genet;, 2018 Mar 06.
[Is] ISSN:1476-5438
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:CHN is genetically heterogeneous and its genetic basis is difficult to determine on features alone. CNTNAP1 encodes CASPR, integral in the paranodal junction high molecular mass complex. Nineteen individuals with biallelic variants have been described in association with severe congenital hypomyelinating neuropathy, respiratory compromise, profound intellectual disability and death within the first year. We report 7 additional patients ascertained through exome sequencing. We identified 9 novel CNTNAP1 variants in 6 families: three missense variants, four nonsense variants, one frameshift variant and one splice site variant. Significant polyhydramnios occurred in 6/7 pregnancies. Severe respiratory compromise was seen in 6/7 (tracheostomy in 5). A complex neurological phenotype was seen in all patients who had marked brain hypomyelination/demyelination and profound developmental delay. Additional neurological findings included cranial nerve compromise: orobulbar dysfunction in 5/7, facial nerve weakness in 4/7 and vocal cord paresis in 5/7. Dystonia occurred in 2/7 patients and limb contractures in 5/7. All had severe gastroesophageal reflux, and a gastrostomy was required in 5/7. In contrast to most previous reports, only one patient died in the first year of life. Protein modelling was performed for all detected CNTNAP1 variants. We propose a genotype-phenotype correlation, whereby hypomorphic missense variants partially ameliorate the phenotype, prolonging survival. This study suggests that biallelic variants in CNTNAP1 cause a distinct recognisable syndrome, which is not caused by other genes associated with CHN. Neonates presenting with this phenotype will benefit from early genetic definition to inform clinical management and enable essential genetic counselling for their families.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1038/s41431-018-0110-x

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[PMID]: 29510943
[Au] Autor:Lee MGY; Millar J; Rose E; Jones A; Wood D; Luitingh TL; Zannino D; Brink J; Konstantinov IE; Brizard CP; d'Udekem Y
[Ad] Address:Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia; Heart Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
[Ti] Title:Laryngeal ultrasound detects a high incidence of vocal cord paresis after aortic arch repair in neonates and young children.
[So] Source:J Thorac Cardiovasc Surg;, 2018 Feb 09.
[Is] ISSN:1097-685X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To determine the incidence of vocal cord paresis (VCP) after neonatal aortic arch repair/Norwood-type procedure, and the effectiveness of noninvasive laryngeal ultrasound in detecting VCP compared with gold standard invasive nasoendoscopy. METHODS: Fifty-two patients who underwent an arch repair (39 of 52; 75%) or Norwood-type procedure (13 of 52; 25%) via sternotomy between April 1, 2015, and April 30, 2017 underwent laryngeal ultrasound (50 of 52; 96%) and/or flexible fiber optic nasoendoscopy (39 of 52; 75%) at 48 to 72 hours after endotracheal extubation. Primary arch diagnoses were coarctation in 56% (29 of 52), hypoplastic left heart syndrome in 17% (9 of 52), isolated hypoplastic arch in 17% (9 of 52), and interrupted aortic arch in 10% (5 of 52). The median patient age at surgery was 5.5 days (interquartile range, 4.0-12.5 days). Fifteen patients (15 of 52; 29%) required preoperative intubation. RESULTS: Left VCP was present in 59% (23 of 39) of patients on nasoendoscopy and in 59% (27 of 46) of patients on laryngeal ultrasound, and 4 additional patients had inconclusive ultrasound results. There was agreement between the results of nasoendoscopy and conclusive ultrasound in all cases. The overall sensitivity, specificity, positive and negative predictive values, and Cohen's kappa coefficient of laryngeal ultrasound compared with nasoendoscopy for the detection of left VCP were 95%, 88%, 91%, 93%, and 0.83, respectively. On multivariable analysis, preoperative intubation and arch repair techniques other than the Norwood procedure were associated with left VCP (odds ratio, 12.7; P = .03; and 14.1; P = .03, respectively). CONCLUSIONS: There is a high incidence of VCP after arch repair via sternotomy. Laryngeal ultrasound seems to be an effective and noninvasive method for detecting VCP in neonates and young children.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

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[PMID]: 29510290
[Au] Autor:Coluccia D; Roth T; Marbacher S; Fandino J
[Ad] Address:Department of Neurosurgery and Brain Tumor Center, Kantonsspital Aarau, Switzerland. Electronic address: daniel.coluccia@gmail.com.
[Ti] Title:Impact Of Laterality On Surgical Outcome Of Glioblastoma Patients: A Retrospective Single Center Study.
[So] Source:World Neurosurg;, 2018 Mar 03.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Resection of left hemispheric tumors (LH) is often complicated by the risks of causing language dysfunction. Although neurosurgeons' concerns when operating on the presumed dominant hemisphere are well known, literature evaluating laterality as a predictive surgical parameter in glioblastoma (GB) patients is sparse. We evaluated whether tumor laterality correlated with surgical performance, functional outcome, and survival. METHODS: All GB patients treated at our institution between 2006 and 2016 were reviewed. Analysis comprised clinical characteristics, extent-of-resection (EOR), neurological outcome, and survival in relation to tumor lateralization. RESULTS: A total of 235 patients were included. Right hemisphere tumors (RH) were larger and more frequently extended into the frontal lobe. Preoperatively, limb paresis was more frequent in RH, while language deficits were more frequent in LH (p=0.0009 and p<0.0001, respectively). At 6 months after resection, LH patients presented lower Karnofsky-Performance-Status (KPS) (p=0.036). More LH patients suffered from dysphasia (p<0.0001), while no difference was seen for paresis. Average EOR was comparable, but complete resection was achieved less often in LH (37.7 vs. 64.8%, p=0.0028). While overall-survival (OS) did not differ between groups, progression-free-survival (PFS) was shorter in LH (7.4 vs. 10.1 months, p=0.0225). CONCLUSION: LH patients had a pronounced KPS decline and shorter PFS without impact on OS. This observation might partially be attributed to a more conservative surgical resection. Further investigations are needed to assess whether systematic use of awake surgery and intraoperative mapping results in increased EOR as well as in improved quality survival of GB patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  7 / 30435 MEDLINE  
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[PMID]: 29451668
[Au] Autor:Irugu DVK; Singh A; Ch S; Panuganti A; Acharya A; Varma H; Thota R; Falcioni M; Reddy S
[Ad] Address:Department of Otorhinolaryngology and Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Title:Comparison between early and delayed facial nerve decompression in traumatic facial nerve paralysis - A retrospective study.
[So] Source:Codas;30(1):e20170063, 2018.
[Is] ISSN:2317-1782
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Purpose To study the intraoperative findings in case of early and delayed decompression of facial nerve paralysis and compare their results. Methods Retrospective data analysis of 23 cases of longitudinal temporal bone fracture with House-Brackmann grade V and VI facial nerve paralysis. All cases were thoroughly evaluated and underwent facial nerve decompression through the transmastoid approach. All cases were under regular follow-up till the date of manuscript submission. Results Clinical improvement of the facial nerve function was observed for early vs. delayed facial nerve decompression. In the early decompression group, facial nerve function improved to grade II in eight cases (80%) and grade III in two cases (20%), whereas in the delayed decompression group it improved to grade II in one case (7.70%), grade III in four cases (30.76%), grade IV in seven cases (53.84%), and grade V in one case (7.70%). Conclusions Early decompression of facial nerve provides better results than delayed decompression because it enables early expansion of the nerve.
[Mh] MeSH terms primary: Facial Nerve Injuries/surgery
Facial Paralysis/surgery
[Mh] MeSH terms secundary: Adult
Decompression, Surgical/methods
Facial Nerve Injuries/diagnostic imaging
Facial Paralysis/diagnostic imaging
Female
Humans
Male
Middle Aged
Retrospective Studies
Skull Fractures/physiopathology
Skull Fractures/surgery
Temporal Bone/injuries
Temporal Bone/surgery
Time-to-Treatment
Young Adult
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Js] Journal subset:IM
[Da] Date of entry for processing:180217
[St] Status:MEDLINE

  8 / 30435 MEDLINE  
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[PMID]: 29429357
[Au] Autor:Bach Á; Sztanó B; Kiss JG; Volk GF; Müller A; Pototschnig C; Rovó L
[Ad] Address:Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 111., 6725.
[Ti] Title:A laryngealis electromyographia szerepe a hangszalag-mozgászavarok diagnosztikájában és az alkalmazott kezelés kiválasztásában. [The role of laryngeal electromyography in the diagnosis of vocal cord movement disorders].
[So] Source:Orv Hetil;159(8):303-311, 2018 Feb.
[Is] ISSN:0030-6002
[Cp] Country of publication:Hungary
[La] Language:hun
[Ab] Abstract:The development of the therapeutic possibilities of vocal cord immobility necessitated the parallel renewal of diagnostic methods. In the last years, laryngeal electromyography, which was first introduced more than 70 years ago, has been re-discovered. After reviewing the international literature and their own experience, the authors present the indications, technical requirements, method and, particularly, the evaluation of the results of this procedure. Laryngeal electromyography makes the differentiation between mechanical fixation and immobility with neurological origin of the vocal folds possible. In case of laryngeal paralysis/paresis it also evaluates objectively the severity of neural injury, the prognosis of the disease and the necessity of any glottis-widening procedure. The widespread application of dynamic rehabilitation interventions is not conceivable without the routine application of laryngeal electromyography, so this sensitive diagnostic tool has to be introduced in all laryngological centers. Orv Hetil. 2018; 159(8): 303-311.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1556/650.2018.30975

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[PMID]: 29509290
[Au] Autor:Monsa R; Peer M; Arzy S
[Ad] Address:Department of Medical Neurobiology, Hadassah Hebrew University Medical School, Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
[Ti] Title:Self-reference, emotion inhibition and somatosensory disturbance: preliminary investigation of network perturbations in conversion disorder.
[So] Source:Eur J Neurol;, 2018 Mar 06.
[Is] ISSN:1468-1331
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Conversion disorder (CD), or functional neurological disorder, is manifested as a neurological disturbance that is not macroscopically visible in clinical structural neuroimaging, and is instead ascribed to underlying psychological stress. Known for many years in neuropsychiatry, a comprehensive explanation to the way by which psychological stress leads to a neurological deficit of a structural-like origin is still a mystery. METHODS: We applied whole-brain network-based data-driven analyses on resting-state functional MRI, recorded in seven CD patients with unilateral paresis and hypoesthesia as compared to 15 age-matched healthy controls. We used a clustering analysis to measure functional connectivity strength (FC) within ten different brain networks, as well as between these networks. Finally, we tested FC of specific brain regions that are known to be involved in CD. RESULTS: We found a significant increase in FC strength only within the default-mode network (DMN), which manages self-referential processing. Examination of inter-connectivity between networks showed a structure of disturbed connectivity, which included a decreased connectivity between the DMN and the salience network, increased connectivity between the salience network and the temporo-parieto-occipital junction (TPOJ) network, decreased connectivity between the TPOJ and the medial temporal lobe (MTL), and between the MTL and the sensorimotor network. Region-specific FC analysis showed increased connectivity between the hippocampus and the DMN. DISCUSSION: These preliminary results of disturbances in brain networks related to memory, emotions and self-referential processing, and networks involved in motor planning and execution, suggest a role of these cognitive functions in the psychopathology of CD. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher
[do] DOI:10.1111/ene.13613

  10 / 30435 MEDLINE  
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Braga, Angélica de Fátima de Assunçäo
Braga, Franklin Sarmento da Silva
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[PMID]: 29506860
[Au] Autor:Teixeira CEFA; Braga AFA; Braga FSDS; Carvalho VH; Costa RMD; Brighenti GIT
[Ad] Address:Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Anestesiologia, Campinas, SP, Brasil.
[Ti] Title:Anestesia para parto cesáreo em paciente portadora de síndrome de Klippel­Trenaunay. [Anesthesia for cesarean delivery in a patient with Klippel-Trenaunay syndrome].
[So] Source:Rev Bras Anestesiol;, 2018 Mar 02.
[Is] ISSN:1806-907X
[Cp] Country of publication:Brazil
[La] Language:por
[Ab] Abstract:INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome. She was admitted to attempt inhibition of preterm labor. As manifestations of Klippel-Trenaunay syndrome, the patient presented with cerebral and cutaneous hemangioma, mainly in the trunk and lumbar region, paresis in the left upper and lower limbs, and limb asymmetry, requiring the use of a walking stick. Physical examination revealed absence of airway vascular malformations and Mallampati class 3. Laboratory tests were normal and abdominal angiotomography showed irregular uterus, with multiple varices and vessels of arterial origin and bilateral periadnexal varices. She evolved with failure in preterm labor inhibition, and cesarean section under total intravenous anesthesia was indicated. Monitoring, central and peripheral venous access, radial artery catheterization, and diuresis were performed. Cesarean section was performed with median incision and longitudinal uterine body section for fetal extraction. Two episodes of arterial hypotension were seen intraoperatively. The postoperative evolution was uneventful. The choice of anesthesia was dependent on the clinical manifestations and the lack of imaging tests proving the absence of neuraxial hemangiomas.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher


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