ABSTRACT
A meta-analysis of five published case-control studies that examined the association between previous blood transfusions and Creutzfeld-Jakob disease was performed. The results demonstrated that controls were more likely (p < 0.001, odds ratio = 1.56, 95% confidence interval, 1.22-1.98) to have received previous blood transfusions (18.7%) than Creutzfeld-Jakob disease patients (12.9%), suggesting that selection bias of the control populations had occurred.
Subject(s)
Creutzfeldt-Jakob Syndrome/transmission , Transfusion Reaction , Case-Control Studies , Chi-Square Distribution , Confidence Intervals , Humans , Odds Ratio , Selection BiasABSTRACT
OBJECTIVE: To report a case of fulminant neuropathy with severe quadriparesis associated with vincristine chemotherapy. CASE SUMMARY: A 48-year-old white man with acute lymphoblastic leukemia was started on an induction chemotherapeutic regimen that included intravenous vincristine. He received a total of 6 mg of vincristine over two weeks during induction chemotherapy. Over the next two weeks, he developed a fulminant peripheral neuropathy with severe quadriparesis. DISCUSSION: Although commonly associated with peripheral neuropathy, vincristine neurotoxicity only rarely involves instances of fulminant peripheral neuropathy with severe quadriparesis. Guillain-Barré syndrome is also associated with leukemia and may present as a fulminant peripheral neuropathy with severe quadriparesis. CONCLUSIONS: Fulminant neuropathy with severe quadriparesis occurring in patients with leukemia being treated with vincristine (and who do not have coexistent Charcot-Marie-Tooth disease) is more likely due to Guillain-Barré syndrome than to vincristine neurotoxicity.
Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Peripheral Nervous System Diseases/chemically induced , Quadriplegia/chemically induced , Vincristine/adverse effects , Antineoplastic Agents, Phytogenic/therapeutic use , Fatal Outcome , Guillain-Barre Syndrome/complications , Humans , Male , Middle Aged , Peripheral Nervous System Diseases/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Vincristine/therapeutic useABSTRACT
Background and Purpose-The fornix connects various structures involved in memory. We report a patient with anterograde amnesia after an acute ischemic infarct in the anterior fornix. Case Description-A 71-year-old female with acute-onset amnesia had neuroimaging studies showing ischemic infarction of both columns and the body of the fornix and the genu of the corpus callosum. Neuropsychological evaluation revealed anterograde amnesia without evidence of callosal disconnection. The patient showed marked improvement in her memory function on the follow-up visit. Conclusions-Amnesia in this case is likely due to infarction of the anterior fornix structures.
Subject(s)
Amnesia, Anterograde/etiology , Brain Ischemia/complications , Fornix, Brain/blood supply , Infarction, Anterior Cerebral Artery/complications , Aged , Amnesia, Anterograde/pathology , Corpus Callosum/pathology , Female , Fornix, Brain/pathology , Fornix, Brain/physiopathology , Frontal Lobe/pathology , Humans , Magnetic Resonance Imaging , Neuropsychological TestsABSTRACT
Two young men, aged 34 and 30 years, developed transient recurrent multifocal neurological symptoms with associated severe headache over a 2-week period. Both had a lymphocytic pleocytosis in their cerebrospinal fluid. Cranial imaging studies were normal. All symptoms resolved without recurrence. Although the cause and pathogenesis are undefined, this self-limited benign neurological syndrome may be more common than previously recognized and has a predilection for young adult men.
Subject(s)
Cerebrospinal Fluid/cytology , Headache/complications , Hypesthesia/complications , Leukocytosis/complications , Military Personnel/statistics & numerical data , Muscle Weakness/complications , Paresthesia/complications , Adult , Age Distribution , Headache/cerebrospinal fluid , Headache/diagnostic imaging , Humans , Hypesthesia/cerebrospinal fluid , Hypesthesia/diagnostic imaging , Leukocytosis/cerebrospinal fluid , Leukocytosis/diagnostic imaging , Male , Muscle Weakness/cerebrospinal fluid , Muscle Weakness/diagnostic imaging , Paresthesia/cerebrospinal fluid , Paresthesia/diagnostic imaging , Radiography , Recurrence , Remission, Spontaneous , Risk Factors , Sex Distribution , Syndrome , United StatesABSTRACT
Tear film flow and stability studies were carried out in 25 serologically positive patients with rheumatoid arthritis, who were without ocular symptoms, by performing Schirmer test I and break-up time (BUT) measurements. The values of BUT and Schirmer in 25 cases were decreased significantly when compared with 25 matched controls. Further, an inverse relation was observed between the values of these tear function tests and the serum immunoglobulin levels, thereby depicting that higher values of serum immunoglobulins in rheumatoid arthritis may be helpful in segregating the cases who may eventually develop dry eyes.
Subject(s)
Arthritis, Rheumatoid/immunology , Tears/immunology , Adult , Arthritis, Rheumatoid/physiopathology , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Middle Aged , Rheumatoid Factor/analysis , Tears/analysisABSTRACT
Methyl cellulose instillation enhanced the values of BUT in healthy individuals, as well as in patients with trachoma stage III and chronic conjunctivitis, while no effect was observed in patients with squamous blepharitis.
Subject(s)
Blepharitis/physiopathology , Conjunctivitis/physiopathology , Eyelid Diseases/physiopathology , Methylcellulose/pharmacology , Tears/drug effects , Trachoma/physiopathology , Chronic Disease , Humans , Tears/physiology , Time FactorsABSTRACT
Tear film flow and stability studies were carried out in patients suffering from chronic dacryocystitis by performing Schirmer test-I and tear film break-up-time (BUT) measurements. The results of Schirmer's test corroborated the theory that a reduced out flow of tears causes a compensatory reduced tear secretion. The results of break-up-time confirm the fact that BUT is independent of outflow of tears in patients with epiphora.
Subject(s)
Dacryocystitis/metabolism , Tears/metabolism , Adult , Chronic Disease , HumansABSTRACT
Tear film flow and stability studies were carried out in patients suffering from acute and chronic conjunctivitis by performing Schirmer test-I and break-up-time (BUT) measurements. In this clinical study, patients with chronic conjunctival inflammation demonstrated a premature break-up of tear film despite normal amounts of aqueous tears. In acute catarrhal conjunctivitis the values of BUT were within normal limits, whereas the values of Schirmer test-I were significantly higher (t-test, P less than 0.001) and are considered to be due to reflex hypersecretion of tears.
Subject(s)
Conjunctivitis/metabolism , Tears/metabolism , Adult , HumansABSTRACT
Tear film flow and stability studies were carried out in patients suffering from herpes simplex keratitis and chronic blepharitis by performing Schirmer test I and tear film break-up-time (BUT) measurements. In herpes simplex keratitis the values of BUT were within normal limits. Values of Schirmer test I were significantly higher (t-test, P less than 0.001) in these patients and are considered to be due to reflex hypersecretion of tears. Schirmer test I was found to be unaffected, whereas the values of BUT seen were significantly lower (t-test, P less than 0.001) in patients suffering from chronic blepharitis. These lower values of BUT can perhaps be attributed to the altered resurfacing of precorneal tear film as a result of changes in the lid margins.
Subject(s)
Blepharitis/physiopathology , Eyelid Diseases/physiopathology , Keratitis, Dendritic/physiopathology , Tears/metabolism , Chronic Disease , Humans , MethodsABSTRACT
Tear film flow and stability studies were carried out in patients suffering from cicatrizing trachoma by Schirmer test I and tear film break-up-time (BUT) measurements, respectively. Both Schirmer test I and BUT values were decreased significantly (t-test, P less than 0.001) depicting aqueous as well as mucin deficiency and hence, an unstable tear film in this condition.
