Objectives: Anti-IL6R tocilizumab (TCZ) therapy has proved to be useful in the treatment of refractory ocular and/or neurological involvement of Behçet's disease (BD). However, TCZ efficacy in other BD manifestations remains unclear. In this study we aimed to assess the efficacy of TCZ in the different clinical phenotypes of BD.
Methods: This is a multicentre study of BD patients treated with TCZ, due to refractivity to standard systemic treatment.
Results: We studied 16 patients (10 men/6 women); mean age 36.5±18.2 years. The main clinical manifestations at TCZ onset were ocular, oral and/or genital ulcers, arthritis, folliculitis and/or neurological involvement. Before TCZ, they had received several conventional and/or biological immunosuppressants, such as methotrexate, cyclosporine, adalimumab or infliximab. TCZ was used in monotherapy or combined with conventional immunosuppressive drugs. The main indications for TCZ prescription were refractory uveitis (n=14) and refractory neurobehçet (n=2). After a median [IQR] follow-up of 20 [9-45] months using TCZ, neurological and ocular domains improved in most cases with complete remission in most patients with uveitis. Articular and peripheral venous manifestations also experienced a favourable evolution. However, oral/genital ulcers, skin lesions and intestinal manifestations followed a torpid course.
Conclusions: TCZ is effective in BD with major clinical involvement. However, it does not seem to be effective in oral/genital ulcers or skin lesions.
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http://dx.doi.org/10.55563/clinexprheumatol/9ipkcs | DOI Listing |
J Neurosurg Spine
January 2025
6Presbyterian St. Lukes Medical Center, Denver, Colorado.
Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.
View Article and Find Full Text PDFJ Neurosurg
January 2025
1Department of Neurological Surgery and.
Objective: Traumatic hemorrhagic cerebral contusions are a well-established cause of morbidity and mortality in neurosurgery. This study aimed to determine prognostic factors for long-term functional outcomes and longitudinal contusion volume changes in traumatic brain injury (TBI) patients.
Methods: Data from 285 patients with traumatic cerebral contusions were retrospectively reviewed to identify variables predictive of initial contusion volume, contusion expansion on short-term follow-up imaging, and functional outcomes according to the modified Rankin Scale (mRS).
J Neurosurg Spine
January 2025
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and.
Objective: Mixed-reality (MR) applications provide opportunities for technical rehearsal, education, and estimation of surgical performance without the risk of patient harm. In this study, the authors provide a structured literature review on the current state of MR applications and their effects on neurosurgery training. They also introduce an MR prototype for neurosurgical spine training.
View Article and Find Full Text PDFJ Neurosurg
January 2025
1Department of Neurosurgery, ASST Cremona, Italy.
Objective: Brainstem cavernous malformations (BSCMs) were once considered inoperable. Microsurgical resection now represents a valuable option for treating patients with hemorrhagic or symptomatic lesions. The aim of this study was to provide a practical guide for surgical planning by analyzing postoperative neurological and functional outcomes.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Centre for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona 08018, Spain.
A fundamental topological principle is that the container always shapes the content. In neuroscience, this translates into how the brain anatomy shapes brain dynamics. From neuroanatomy, the topology of the mammalian brain can be approximated by local connectivity, accurately described by an exponential distance rule (EDR).
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