Operative planning for a functional precision medicine assay of recurrent high-grade glioma: illustrative case.

Background: Functional precision medicine (FPM) represents a personalized and efficacious modality for treating malignant neoplasms. However, acquiring sufficient live tissue to perform FPM analyses is complicated by both difficult identification on imaging and radiation necrosis, particularly in cases of recurrence. The authors describe a case of planning biopsy trajectories for an FPM assay in a patient with recurrent high-grade glioma.

Secondary mitral regurgitation: Maintaining coherence with the American Society of Echocardiography grading guidelines, which proportionality concept best predicts prognosis in the real world?

Introduction: Proportionality of secondary mitral regurgitation (sMR) may be a key factor in deciding whether a patient may benefit from mitral intervention. The aim of this study was to evaluate the prognostic value of two different concepts of proportionality and assess their ability to improve MR stratification proposed by the American Society of Echocardiography (ASE) guidelines.

Methods: We conducted a retrospective analysis in patients with reduced left ventricular ejection fraction (LVEF) (<50%) and at least mild sMR.

Prevalence of cerebrovascular accidents in patients with ulcerative colitis in a single academic health system.

In general, IBD increases arteriovenous thromboembolic events, though the association between UC and cerebrovascular complications remains inconclusive. Some studies suggest young women with UC have an increased risk of cerebrovascular accidents (CVA). The focus of this study was to characterize the rates, anatomic distribution, and risk factors for CVA in patients with UC.

The many paths to diagnose diaphragmatic paralysis: Cardiopulmonary ultrasound on stage.

Abnormal diaphragmatic motion (ADM) due to phrenic nerve injury is a recognized complication of cardiac surgery and several diagnostic techniques can be used to determine the diagnosis. Due to its relationship with the diaphragm, cardiac kinetics is affected by the abnormal movement of the diaphragm in cases of left hemidiaphragm paralysis. The authors present a case of diaphragmatic paralysis in which the initial diagnosis is made through echocardiography.

Assessing proportionate and disproportionate functional mitral regurgitation with individualized thresholds.

Aims: The concept of proportionate/disproportionate functional mitral regurgitation (FMR) has been limited by the lack of a simple way to assess it and by the paucity of data showing its prognostic superiority. The aim of this study was to evaluate the prognostic value of an individualized method of assessing FMR proportionality.

Methods And Results: We retrospectively identified 572 patients with at least mild FMR and reduced left ventricular ejection fraction (<50%) under medical therapy.

Neurotoxicity of antibodies in cancer therapy: A review.

The objective of this manuscript is to identify the neurological side effect profile associated with different classes of antibodies used in cancer pharmacotherapy and to estimate the frequency in which these neurotoxicity occurs. A systematic review of the literature was conducted using OVID MEDLINE and EMBASE databases for articles written between January of 2010 till August of 2018. The spectrum of neurotoxicity was searched using expanded terminology, medical subject headings, truncation, spelling variations and database specific controlled vocabulary.

Long-term assessment of the Ross procedure in adults: Clinical and echocardiographic follow-up at 20 years.

Introduction: The Ross procedure is an alternative to standard aortic valve (AV) replacement in young and middle-aged patients. However, durability and incidence of reoperation remain a concern for most cardiac surgeons. Our aim was to assess very long-term clinical and echocardiographic outcomes of the Ross procedure.

Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up.

Background: Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).

Tobacco and end stage renal disease: a multicenter, cross-sectional study in Argentinian Northern Patagonia.

Background: Smoking and chronic kidney disease are major public health problems with common features -high prevalence and mortality, high cardiovascular risk, gender differences and high prevalence in low income people-, but the link between them is poorly recognized. Our objectives were to investigate the exposure of dialysis patients to tobacco and to know their smoking behavior.

Methods: We performed a multicenter, cross-sectional study in nine dialysis units in the Argentinian Northern Patagonia.

Short myelitis lesions in aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders.

Importance: Short transverse myelitis (STM; <3 vertebral segments) is considered noncharacteristic of neuromyelitis optica (NMO) spectrum disorders (NMOSDs). Nonappreciation of the potential for STM to occur in NMOSD may lead to increased disability from delay in diagnosis and appropriate treatment.

Objectives: To determine the frequency of short lesions at the initial myelitis manifestation of NMOSD and to compare the demographic, clinical, and radiological characteristics of aquaporin-4-IgG (AQP4-IgG) seropositive and seronegative STM.

AQP4 autoantibody assay performance in clinical laboratory service.

Objective: To compare performance of contemporary aquaporin-4-immunoglobulin (Ig) G assays in clinical service.

Methods: Sera from neurologic patients (4 groups) and controls were tested initially by service ELISA (recombinant human aquaporin-4, M1 isoform) and then by cell-based fluorescence assays: fixed (CBA, M1-aquaporin-4, observer-scored) and live (fluorescence-activated cell sorting [FACS], M1 and M23 aquaporin-4 isoforms). Group 1: all Mayo Clinic patients tested from January to May 2012; group 2: consecutive aquaporin-4-IgG-positive patients from September 2011 (Mayo and non-Mayo); group 3: suspected ELISA false-negatives from 2011 to 2013 (physician-reported, high likelihood of neuromyelitis optica spectrum disorders [NMOSDs] clinically); group 4: suspected ELISA false-positives (physician-reported, not NMOSD clinically).

Neural autoantibody clusters aid diagnosis of cancer.

Purpose: Clustering of neural autoantibodies in patients with paraneoplastic neurologic disorders may predict tumor type. A mathematical analysis of neural autoantibody clusters was performed in 78,889 patients undergoing evaluation for a suspected paraneoplastic autoimmune neurologic disorder. Tumor predictive autoantibody profiles were confirmed in sera from patients with histologically proven tonsillar cancer, thymoma, and lung cancer.

Inhibition of ovine in vitro fertilization by anti-Prt antibody: hypothetical model for Prt/ZP interaction.

Background: The impact of prion proteins in the rules that dictate biological reproduction is still poorly understood. Likewise, the role of prnt gene, encoding the prion-like protein testis specific (Prt), in ram reproductive physiology remains largely unknown. In this study, we assessed the effect of Prt in ovine fertilization by using an anti-Prt antibody (APPA) in fertilization medium incubated with spermatozoa and oocytes.

Diagnostic utility of NMO/AQP4-IgG in evaluating CNS inflammatory disease in Thai patients.

Epidemiological studies in Thailand have reported that inflammatory demyelinating diseases (IDDs) commonly affect the optic nerve and spinal cord. We investigated the diagnostic utility of aquaporin (AQP)-4-IgG testing in 31 consecutive patients evaluated for CNS IDDs in 3 academic Thai hospital neurology clinics between February 2008 and January 2009. Patients were classified into 3 clinical diagnostic groups: Neuromyelitis optica (NMO, n=10) multiple sclerosis (MS, n=5) and unclassified IDD (n=16).

[Successful cardiac resynchronization therapy in a patient with heart failure and ischemic mitral regurgitation: importance of septal flash].

We describe the case of a 76-year-old man with a history of ischemic heart disease and functional mitral regurgitation who over the previous six months had experienced worsening of functional class (NYHA III/IV) under optimal medical therapy, without ischemic symptoms and with negative ischemic tests. Mitral valve annuloplasty was considered. As the patient presented left bundle branch block on the surface ECG, cardiac resynchronization therapy (CRT) was also considered.

Load-independent parameters of diastolic and systolic function by speckle tracking and tissue doppler in hemodialysis patients.

Background: Assessment of diastolic function using conventional Doppler techniques is limited by their significant dependence on volume load status. Whether new echocardiographic methods are load-independent in evaluating left ventricular systolic and diastolic function remains controversial.

Objective: The aim of this study was to identify load-independent echocardiographic parameters for systolic and diastolic function in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) and to evaluate agreement between the new methods.

Prediction of the outcome of preoperative chemotherapy in breast cancer using DNA probes that provide information on both complete and incomplete responses.

Background: DNA microarray technology has emerged as a major tool for exploring cancer biology and solving clinical issues. Predicting a patient's response to chemotherapy is one such issue; successful prediction would make it possible to give patients the most appropriate chemotherapy regimen. Patient response can be classified as either a pathologic complete response (PCR) or residual disease (NoPCR), and these strongly correlate with patient outcome.

Organic personality disorder after traumatic brain injury: cognitive, anatomic and psychosocial factors. A 6 month follow-up.

Objective: The purpose of the study is to describe psychosocial adjustment in patients who present Organic Personality Disorder (OPD) after TBI in relation to patients with TBI without OPD.

Method: The group included patients who were admitted as inpatients in the Neurology Service. Exclusion criteria were: previous personality disorders; previous alcohol and drugs addiction, history of head injury and other neurological diseases.

[Aicardi syndrome and choroid plexus papilloma: a rare association. Case report].

The authors report a case of a 5 months old female child with clinical features of Aicardi syndrome: agenesis of the corpus callosum, occular abnormalities ("chorioretinal lacunae" and microphthalmus), infantile spasms, mental retardation, vertebral malformations and thoracic deformity. The pacient was submitted to complementary examinations that confirmed the diagnosis. The neuroradiologic images (MRI) showed besides corpus callosum agenesis a tumor located at the left ventricular atrium (choroid plexus papilloma).