Paediatric Empyema Thoracis: Roles and Outcomes of Surgical Intervention in Advanced Disease
YL Ho, M Fauzi, Sothee K, A Salleh, AY Khamis and Basheer A Kareem
Article Type: Research Article | First Published: January 03, 2020
Empyema thoracis has become increasingly common in paediatric population. Antibiotics and thoracostomy have been the cornerstones in managing stage 1 empyema, where as management of stage 2-3 empyema remains controversial. Surgical intervention is perceived to be associated with high morbidity and protracted recovery. This paper reviews the roles and outcomes of surgical decortication, and to provide data for comparison with other treatment modalities. Thirty children (median age 5.2 years, range 2 months to 12 years) with stage 2-3 empyema who underwent surgical decortications in our unit fro...
Case Series Synopsis: Gaucher Disease Type 1 Patients Treated with Eliglustat over 6 Years
Cristina Fraga, Sonia Medeiros, Sara Serpa and David Silva
Article Type: Case Series | First Published: January 08, 2020
Gaucher disease (GD) type 1 is a lysosomal storage disorder associated with bone disease, hepatosplenomegaly, anemia and thrombocytopenia. Here we present a case series from 5 (3 females and 2 males) Portuguese individuals from a single institution with GD type 1 who were treated with substrate-reduction therapy (eliglustat, 84 mg once or twice daily) for 6-years. Four cases were switched from IV imiglucerase (28 U/kg q2 week [n = 1]) or 45 U/kg q2 week [n = 3]) and one was enzyme-replacement therapy naive prior to eliglustat dosing. Two patients had 1304A > C (homozygous)/ N435T mutations and...
Prognostic Factors for Disability and Pain Outcomes in Patients with Axial Low Back Pain Undergoing a Multidisciplinary Spine Treatment Program
Nicholas K Donohue, Emily J Graf, Alexis M Visotcky, Sergey S Tarima and Andrew C Hsu
Article Type: Research Article | First Published: January 11, 2020
Several studies in the past have examined factors impacting improvement in low back pain in the primary care context. However, there is limited evidence regarding prognostic factors for pain and disability scores in patients with axial low back pain entering a multidisciplinary spine program. The goal of this study was to assess which baseline demographic, disability, and pain-related characteristics may be prognostic for improvement in pain and disability scores entering a multidisciplinary spine program. This was a retrospective review of patients with axial low back pain who participated in...
Amnion-Chorion Strips in the Treatment of Peri-Implantitis, Report of a Case
Mohamed A Maksoud, DMD
Article Type: Case Report | First Published: January 04, 2020
Dental implant disease described as Peri-implantitis is bacterial inflammation of the implant surrounded soft and hard tissue that can lead to bone loss and eventual failure of the implant fixture. Several protocols have been introduced to treat implantitis including the use of systemic and local antibiotics in addition to bone grafting in advanced cases. Although the treatment outcome is effective in the early to moderate cases its unpredictable in cases with severe bone loss. Human placental tissue has been introduced in medicine for the treatment of burns and ophthalmic disease around the t...
Towards a Biological Definition of Alzheimer Disease
Kurt A Jellinger, MD
Article Type: Commentary | First Published: January 08, 2020
Alzheimer disease (AD), the most common form of dementia, is a heterogenous syndrome with various pathobiologically defined subtypes. The clinical diagnosis of probable AD is enabled by the recent ATN biomarker system, but the definite diagnosis is only possible at post-mortem according to the updated NIA-AA criteria. The recent developments in the clinical and neuropathological diagnosis of AD including its specific subtypes improving the evaluation of AD and its impact on public health are briefly discussed. Alzheimer disease (AD), the most common form of dementia that currently affects arou...
Polymyositis in Adamantiades-Behcet's Disease
Carlos Arteaga Rodriguez, MD, MSc, Otto J Hernandez Fustes, MD, MSc, Renato Puppi Munhoz, MD, PhD and Olga Judith Hernandez Fustes, MD, MSc
Article Type: Case Report | First Published: January 04, 2020
Although Adamantiades-Behçet’s disease (ABD) has a worldwide distribution, it is considered rare in the Americas, with a prevalence of 0.12-0.33:100.000 in the United States. The characteristic triad of recurrent oral aphthous lesions, genital ulcers and iridociclitis occurring more often in young adults during their third or fourth decade of life was initially described by Hippocrates but gained it's classic eponym to acknowledge the Greek ophthalmologist from Asia Minor (nowadays part of Asian Turkey) Benediktos Adamantiades and Turkish dermatologist Hulusi Behçet, who in first identifi...
Predictors of Health-Related Quality of Life and Communicative Participation in Individuals with Dysarthria from Parkinson’s Disease
Kristie A Spencer, Clare Friedlander and Katherine A Brown
Article Type: Researc h Article | First Published: January 03, 2020
The motor and non-motor deficits of Parkinson’s disease (PD) can cause daily challenges and have been associated with reduced health-related quality of life (HrQoL). A number of variables have been consistently, though not unequivocally, identified as important in influencing overall HrQoL in individuals with PD, such as demographic factors, cognitive decline, and level of motor impairment. However, the presence and severity of dysarthria is often overlooked, despite the potentially adverse influence on HrQoL. The primary purpose of this study was to understand the predictors of HrQoL, as we...
Candidate Genetic Polymorphisms and Haplotypes Associated with Endometrial Cancer Risk (United States)
Jane A McElroy, Robin L Kruse, J David Robertson, Helen Yampara-Iquise, Elizabeth C Bryda and Jeremy F Taylor
Article Type: Original Article | First Published: December 30, 2019
Exploration of single nucleotide polymorphisms (SNPs) that alter the expression or function of a gene may enable the development of diagnostics for endometrial cancer susceptibility. We evaluated eleven candidate SNPs that have previously been reported in the literature or that are associated with cadmium sequestering (i.e., metallothionein) for their effects on endometrial cancer risk. We also predicted haplotypes for SNPs within genes on chromosomes 6, 14 and X and tested haplotype effects for cancer risk. Our population-based study comprised 480 cases and 513 controls with 96% non-Hispanic ...
General Anesthesia Affecting on Developing Brain: Evidence from Animal to Clinical Research
Xinyue Liu, MD, Jing Ji, MD and Guo-Qing Zhao, MD, PhD
Article Type: Review Article | First Published: January 04, 2020
As the recent update of General Anaesthesia compared to Spinal anaesthesia (GAS) studies has been published in 2019, together with other clinical evidence, the human studies provided an overwhelming mixed evidence of an association between anaesthesia exposure in early childhood and later neurodevelopment changes in children. Pre-clinical studies in animals provided strong evidence on how anaesthetic and sedative agents (ASAs) causing neurotoxicity in developing brain and deficits in long-term cognitive functions. However pre-clinical results cannot translate to clinical practice directly. Thr...
How Long Do We Need to Restrict Weight Bearing after Fixation of Pediatric Femur Fractures?
Amy N Ford, MD, Elizabeth A Harkin, MD, Joseph Romano, MD, William D Lack, MD, Hobie D Summers, MD and Joseph B Cohen, MD
Article Type: Original Article | First Published: January 06, 2020
Surgical management of pediatric femur fractures is accomplished with intramedullary nailing or plate fixation. These fractures heal quickly with a low incidence of complications, although there is a paucity of evidence on how long postoperative weight bearing restrictions need to be in place or whether they are even necessary at all. The objectives of this study are to compare methods of fixation of pediatric femur fractures and postoperative weight bearing protocols and to correlate these with healing time and complication rates....