PurposeTo compare the effectiveness of anti-tumour necrosis factor (TNF) agents in biologically naive and 'switched' rheumatoid arthritis (RA) patients.METHODS: RA patients enrolled in the CORRONA registry newly prescribed adalimumab (n=874), etanercept (n=640), or infliximab (n=728) were stratified based on previous anti-TNF use. Clinical effectiveness at 6, 12 and 24 months ...

OBJECTIVE: We implemented a retrospective study to explore discontinuation of therapy with adalimumab (ADA) without exacerbation in rheumatoid arthritis (RA) patients who had achieved low disease activity (LDA) with the biological agent. METHODS: We enrolled 46 RA patients who had completed open extension of a double-blind, placebo-controlled trial of ADA ...

Objective. To explore the incidence of disability pension (DP) due to RA as an estimation of permanent work disability before and after introduction of biological drugs.Methods. The annual incidence of DP was derived from the Swedish National Social Insurance Register and rates of DP due to RA were compared with ...

Introduction:  Human leukocyte antigen (HLA) -Cw*06 has a strong influence on the clinical features and the susceptibility of psoriasis in different ethnicity. It is also used as a biomarker to predict the therapeutic efficacy of biologics with inconsistent results. Additionally, most Asian patients with psoriasis do not carry HLA-Cw*06. Aim:  ...

OBJECTIVE: The study aims to examine the threshold in disease activity associated with switching biologic treatment regimens in RA patients in real-world clinical practice. METHODS: Using data from a prospective observational North American cohort of RA patients through 12/30/2009, patients who initiated a new anti-TNF agent with ≥ 6 months ...

Rationale Exacerbations of chronic obstructive pulmonary disease (COPD) are heterogeneous with respect to inflammation and etiology. Objectives Investigate biomarker expression in COPD exacerbations to identify biological clusters and determine biomarkers that recognise clinical COPD exacerbation phenotypes namely those associated with bacteria, viruses or eosinophilic airway inflammation. Methods Patients with COPD ...

PURPOSE: The value of intraoperative neurophysiological monitoring (IONM) with surgical detethering in dysraphic patients has been questioned. A retrospective analysis of our series of 65 patients is presented with special focus on technical set-up and outcome. METHODS: All patients were diagnosed with a tethered cord (TC) due to spinal dysraphism. ...

The pathogenesis of widespread pain and increased tenderness in Fibromyalgia (FM) are still unknown. Recently, the role of central nervous system hyperexcitability is emphasized in pathogenesis of FM. The central sensitization was demonstrated with decrease in nociceptive flexion reflex (NFR) threshold in patients with FM. The NFR and cutaneous silent ...

We retrospectively reviewed plain radiographs from patients with four different diseases that can cause vertebral collapse: osteoporotic vertebral collapse, spinal infection, spinal metastasis, and multiple myeloma. The objective of the study was to find the percentages of intravertebral vacuum phenomena and vertebral collapse rates in the four groups. The vacuum ...

Object The current standard of care for symptomatic chronic spondylolysis (SP) is a one-level posterior spinal fusion for defects at L-5 or direct pars repair (motion segment sparing) for more rostral SP in younger patients and if no disc degeneration or listhesis is present. Since many patients with SP undergoing ...

BACKGROUND AND PURPOSE: Previous studies have quantified CSF flow in patients with Chiari I at the foramen magnum with single-axial or single-sagittal PCMR. The goal of this study was to measure CSF velocities at multiple cervical spinal levels in patients with Chiari I malformation. MATERIALS AND METHODS: In a patient ...

Aim  Rett syndrome is a neurodevelopmental disorder starting in early childhood with devastating consequences both on the brain and on systemic neurons. Scoliosis is a common complication in most of these patients. The aim of the study was to describe the prevalence of scoliosis, classify spinal deformity, and evaluate the ...

OBJECTIVE: To assess diffusion tensor imaging (DTI) parameters in cervical compressive myelopathy (CCM) patients compared to normal volunteers, to relate them with myelopathy severity, and to relate tractography patterns with postoperative neurologic improvement. SUBJECTS AND METHODS: Twenty patients suffering from CCM were prospectively enrolled (M:F = 13:7, mean age, 49.6 years; range 22-67 years) ...

Purpose: To evaluate the accuracy of trabecular analysis of the lumbar spine by using multidetector computed tomography (CT) in differentiating multiple myeloma patients without spinal fractures from control subjects. Materials and Methods: This retrospective single-institution study was approved by the institutional review board, with a waiver of informed consent. Spinal ...

Amino acids related to neurotransmitters and the GABAergic/glutamatergic system were measured using a 3 T-MRI instrument in 12 patients with autism and 10 normal controls. All measurements were performed in the frontal lobe (FL) and lenticular nuclei (LN) using a conventional sequence for n-acetyl aspartate (NAA) and glutamate (Glu), and the ...

In neuroschistosomiasis, the spinal cord is the most common place of the disease. In high prevalent areas for schistosomiasis mansoni, the clinical alertness is important for an early diagnostic, in order to decrease the final neurological damage. This study provides some useful neurologic information about a series of patients with ...

The presence of a supernumerary posterior atlantoaxial facet joint has not been reported in the literature. To describe a patient who presented with a unilateral anomalous posterior facet joint and discuss its possible embryological origin. Case report. A 35-year-old woman presented with severe neck pain, headaches, and tingling radiating down ...

Introduction: Ischemia in the distribution of the posterior spinal artery is rare. Methods: Between 2004 and 2008 we observed 4 patients with posterior spinal artery ischemia (PSAI). Results: All patients had the expected loss of posterior column function but also suffered from motor deficits which were severe, and the leading ...

The Rho pathway has been shown to be important in the neuronal response to growth inhibitory proteins after CNS injury. BA-210 (trademarked as Cethrin®) blocks activation of Rho and has shown promise in preclinical animal studies of spinal cord injury. This is a report of a Phase I/IIa clinical study ...

Axial psoriatic arthritis (PsA) represents a more severe form of disease than peripheral PsA. We evaluate the usefulness of various spinal mobility measurements in predicting a radiographically defined axial PsA. A cross-sectional study on PsA patients with spinal mobility measurement performed. PsA were classified to axial or peripheral PsA by ...

Friedreich's ataxia (FRDA) affects very young persons. In a large series, the mean ages of onset and death were 11 and 38 years, respectively. The clinical spectrum of FRDA has expanded after genetic confirmation of the mutation became a routine laboratory test. The main cause of death in juvenile-onset FRDA is ...

Object A subset of patients with Chiari malformation Type I (CM-I) presented with acute onset of a neurological deficit. In this study the authors summarize their experience with these patients' clinical presentation, imaging results, timing of surgery, and outcome following decompression. Methods The authors reviewed clinical records, imaging studies, and ...

ABSTRACT:: Study Design. Prospective radiological analysis of patients with achondroplasia.Objective. To analyze sagittal spinal alignment and pelvic orientation in achondroplasia patients.Summary of Background Data. Knowledge of sagittal spinopelvic parameters is important for the treatment of achondroplasia, because they differ from those of the normal population and can induce pain.Methods: The ...

Objective: Cervical spinal dysraphism is a rare congenital spinal pathology. The results obtained from our series are compared with the results obtained from other series of studies in the literature. Methods: Seven patients with cervical myelomeningocele and meningocele who underwent surgery between January 1996 and March 2009 at the YYU ...

Background. Long-term immunosuppression with oral corticosteroids is frequently used to treat inflammatory diseases of the lung and is advocated in the management of some patients with asthma. Methods. The authors describe the case of a 35-year-old man with severe refractory asthma who developed a slowly progressive thoracic spinal cord syndrome. ...

Complex regional pain syndrome (CRPS) generally remains restricted to one limb but occasionally may spread to other limbs. Knowledge of the spreading pattern of CRPS may lead to hypotheses about underlying mechanisms but to date little is known about this process. The objective is to study patterns of spread of ...

STRUCTURED ABSTRACT:: STUDY DESIGN: Retrospective consecutive case series.OBJECTIVES: To assess the symptoms, neurological signs, and radiological findings in a large series of patients with myelopathy due to SDAVF.SUMMARY OF BACKGROUND: The clinical diagnosis of spinal dural arteriovenous fistula SDAVF is difficult because presenting symptoms and signs can be similar to ...

STUDY DESIGN: The focus of this study was on the frequency of negative initial/subsequent ultrasound (US) of the lower extremities but positive spinal computed tomography contrast angiography (CTA) diagnostic of pulmonary embolism (PE) among 75 patients undergoing cervical laminectomy/fusion and 165 patients having lumbar laminectomy/noninstrumented fusion. OBJECTIVE: To determine the ...

Object The aim of this paper was to define the clinical characteristics of spinal ependymomas associated with neurofibromatosis Type 2 (NF2). Methods The authors retrospectively reviewed the clinical records of patients with NF2 who had imaging findings consistent with ependymomas and were seen at Massachusetts General Hospital between 1994 and ...

Background and Objective: It was the aim of this study to determine the prevalence of anti-aquaporin 4 antibody (anti-AQP4 Ab) and long spinal cord lesions in neuromyelitis optica (NMO) and multiple sclerosis (MS) patients in Taiwan. Asia has a relatively high rate of NMO compared with MS patients. Anti-AQP4 Ab ...

PURPOSE: Degenerative cervical spondylolisthesis has received insufficient attention, in contrast to degenerative lumbar spondylolisthesis. In fact, degenerative cervical spondylolisthesis may be more common than previously thought. METHODS: In order to provide appropriate guidelines for the treatment of degenerative cervical spondylolisthesis, a systematic review of degenerative cervical spondylolisthesis was performed. An ...

BACKGROUND: Alteration in ventricular repolarization has been reported in patients with spinal cord injuries (SCIs). However, its clinical impact remains unclear. OBJECTIVES: The study investigated the correlation between SCIs and ventricular repolarization, and the associated clinical impact. METHODS: One hundred and forty-four patients with an SCI were retrospectively reviewed, and ...

The Trömner sign is commonly used as a clinical neurological examination for upper motor neuron lesions above the fifth or sixth cervical segments of the spinal cord. This study aims to assess and quantify the Trömner signs utilizing electrophysiological test, and correlate to the severity of cord compression in cervical ...

Study Design. Prospective, multicenter study.Objective. To conduct peripheral arterial disease (PAD) screening on Intermittent claudication (IC) patients with lumbar spinal canal stenosis (LSCS) to examine the relationships among combined LSCS and PAD, symptoms, and physical findings.Summary of Background Data. IC occurs due to two underlying diseases, LSCS and PAD, and ...

Spontaneous pyogenic spinal epidural abscess (SEA) is a rare condition but might be devastating and fatal. Traditional treatment is surgical decompression and antibiotics. A retrospective study was designed to assess the eff ect of clinical findings and treatment methods on the outcome. MATERIAL and 14 patients were reviewed (10 male, ...

Retrospective. With approximately 10,000 new spinal cord injury (SCI) patients in the United States each year, predicting public health outcomes is an important public health concern. Combining all regions of the spine in SCI trials may be misleading if the lumbar and sacral regions (conus) have a neurologic improvement at ...

To study the demographic data of optico-spinal inflammatory demyelinating disease (OS-IDD) patients at Siriraj Hospital between January 1997 and October 2006. Retrospective study of OS-IDD patients. There were 84 OS-IDD patients. Cerebrospinal fluid analysis revealed higher white blood cell count and neutrophilia in neuromyelitis optica (NMO) patients than those of ...

Optic neuritis and myelitis are manifestations in both multiple sclerosis (MS) and neuromyelitis optica (NMO). But unlike MS, NMO is characterized by severe optic neuritis, longitudinally extensive and transverse myelitis, and the presence of aquaporin-4 antibody. Since patients with optic neuritis and myelitis have often been diagnosed with "optic-spinal MS ...

The consequence of a deficiency in trace elements has been associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) disease progression and mortality. This study examined the association between high scalp hair and blood arsenic, cadmium, lead, and nickel concentrations and opportunistic infections in hospitalized patients with ...

BACKGROUND: Rectoanal inhibitory reflex (RAIR) is a physiological reflex implicated in anorectal continence. A lack of RAIR modulation is only described in spinal cord-injured patients with a lesion under L2. No quantitative data has been published concerning the normal modulation in amplitude and in duration in functional disorders. METHODS: A ...

OBJECTIVE: Spasticity is common after spinal cord injury (SCI). Exaggerated tendon jerks, clonus, and spasms are key features of spasticity that result from hyperexcitability of the stretch reflex circuit. Here we studied the effects of vibration on the rectus femoris muscle (RF) on clinical and electrophysiological measures of spasticity in ...

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the CNS caused by the interplay of genetic and environmental factors. In the last years, it has been suggested that an abnormal venous drainage due to stenosis or malformation of the internal jugular and/or azygous veins may play a major pathogenetic ...

A relationship between the depth of sedation as measured by the bispectral index (BIS) and spinal sensory block height in patients with light to no additional sedation has been described previously. The present study was designed to investigate the hypothesis that BIS values closely correlate with the spread of spinal ...

. The current diagnostic criteria of urinary tract infection (UTI) in male patients with spinal cord injury (SCI) are not clear. . The authors studied 381 episodes of "symptomatic" UTI (209 participants) and 277 episodes of "asymptomatic" UTI (205 participants) in male SCI patients using intermittent catheterization. UTI was defined ...

Abstract TAR DNA binding protein of 43 kDa (TDP-43) is likely to be the major pathogenetic protein in amyotrophic lateral sclerosis (ALS). A previous study has shown that levels of TDP-43 in CSF measured by an ELISA are significantly higher for ALS patients than for controls. The aim of this ...

Background: Although the typical clinical manifestations of multiple myeloma (MM) are summarized by the CRAB symptoms (hypercalcemia, renal insufficiency, anemia, and bone lesions), a significant proportion of patients with MM present with a variety of other clinical manifestations. We conducted a study evaluating the presenting symptoms that led to the ...

A 53-year-old man had chronic low back and leg pain for four years without any history of trauma or neurological manifestations. There was a reduction in symptoms after a lumbar epidural block. Two hours later after the procedure, the patient complained of perineal numbness and lower extremity weakness. The neurological ...

Aim: To determine the frequency of epilepsies in the family members of epileptic patients. Methods: The records of 4,851 patients with epilepsy were reviewed. The frequency and patterns of different epilepsies and epileptic syndromes in the patients, number of affected relatives and consanguinity were studied. Results: A total of 1,753 ...

The aim of the present study was to prospectively evaluate long-term changes in interictal heart rate variability (HRV) in patients with temporal lobe epilepsy (TLE). A 24-h ECG was recorded at baseline and after a mean follow-up of 6.1 years in 18 patients with refractory TLE and 18 patients with ...

A variety of ictal automatisms with strong emotional elements have been described. Ictal kissing has not been well characterized and may provide useful clinical information and insight into the mechanisms of stereotyped ictal behaviour. Three of 220 patients (1.4%) admitted for video EEG monitoring between 7/2006 and 6/2009 with ictal ...