4 research outputs found
Antecedent infections and vaccinations in chronic inflammatory demyelinating polyneuropathy: a European collaborative study.
No full textINTRODUCTION/AIMS
Chronic inflammatory demyelinating polyneuropathy (CIDP) may be rarely preceded by infection. A causative link remains unproven, in contrast to Guillain-Barré syndrome (GBS), which is commonly post-infectious with well-demonstrated pathophysiologic mechanisms of molecular mimicry following Campylobacter jejuni enteritis. Uncommonly, infections are reported before the onset of CIDP. We aimed to determine the frequency and characteristics of CIDP occurring after antecedent infections or vaccinations in two large European cohorts.
METHODS
We reviewed the records of 268 subjects with "definite" or "probable" CIDP from the Inflammatory Neuropathy clinic, Birmingham, U.K. (129 subjects), and from the Serbian national CIDP database (139 subjects).
RESULTS
Twenty-five of 268 (9.3%) subjects had a respiratory or gastrointestinal infection in the 6 weeks preceding CIDP onset and 3/268 (1.1%) had received an influenza vaccination. CIDP disease onset occurred at a younger age (44.25 years S.D. 17.36 vs. 54.05 years S.D. 15.19; p < 0.005) and acute-onset CIDP was more common (42.9% vs. 12.1%; OR: 5.46; 95% CI: 2.35-12.68; p < 0.001), in subjects with preceding infections or vaccinations. No differences in CIDP subtype, rates of cerebrospinal fluid protein level elevation, disability or likelihood of treatment response, were observed.
DISCUSSION
Antecedent infections or vaccinations may precede about 10% of cases of CIDP and are more common in younger subjects. Acute-onset CIDP is more frequent after antecedent events. These findings may suggest specific pathophysiological mechanisms in such cases. This article is protected by copyright. All rights reserved
Recommended from our members
Early Buddhist architecture of Bengal: morphological study on the vihāra of c. 3rd to 8th centuries
No full textThis dissertation examines the evolution of early Buddhist architectural forms of Bengal, specifically its vihāra and shrine structures. In general, this research explores Gupta and post-Gupta (c. third to eighth centuries AD) vihāra architecture of Bengal, where the primary focus is on the Buddhist shrine architecture constructed during this period. There is a preconception amongst historians that the period between the Gupta and the Pāla periods was characterized by disorder and chaos, commonly known as the period of Matsyanyayam. This is the reason why discussions on the architectural history of Bengal have generally commenced from the Pāla period (c. 750 AD onwards). Analyzing extant and new evidences this study argues that the Buddhist architecture of Bengal thrived during the intervening period, albeit under the patronage of local kings and rulers. In the field of art and sculpture it is accepted that Buddhist Pāla art was a continuation of previous Gupta art forms, where post-Gupta period acted as the transition or a bridge. Following this general pattern, as this thesis argues, the rectangular Gupta shrine plan takes a mature cruciform shape during the Pāla period through a complex morphological development. The nature of Buddhist shrine architecture in Bengal during the early Gupta, later Gupta, and post-Gupta periods is described in the light of analyzed archaeological findings and architectural trends
Prevalence and orthopedic management of foot and ankle deformities in Charcot Marie Tooth disease
No full textINTRODUCTION: Foot deformities are frequent complications in Charcot-Marie-Tooth disease (CMT) patients, often requiring orthopedic surgery. However, there are no prospective, randomized studies on surgical management, and there is variation in the approaches among centers both within and between countries. METHODS: In this study we assessed the frequency of foot deformities and surgery among patients recruited into the Inherited Neuropathies Consortium (INC). We also designed a survey addressed to orthopedic surgeons at INC centers to determine whether surgical approaches to orthopedic complications in CMT are variable. RESULTS: Foot deformities were reported in 71% of CMT patients; 30% of the patients had surgery. Survey questions were answered by 16 surgeons working in different specialized centers. Most of the respondents were foot and ankle surgeons. There was marked variation in surgical management. CONCLUSIONS: Our findings confirm that the approaches to orthopedic management of CMT are varied. We identify areas that require further research. Muscle Nerve, 2017
Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study
No full textIntroduction: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARSCoV-2 in neurological syndromes, which risks under- or over-reporting. Methods: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (kappa <= 0.4), "moderate" or "good" (kappa > 0.6). Results: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barre ' syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed
