Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Wanglang Road, Siriraj, Bangkok Noi, Bangkok, 10700, Thailand.
Published: August 2024
AI Article Synopsis
Article Abstract
This study aimed to elucidate the incidence and characteristics of neurotoxicity in patients receiving methotrexate (MTX) treatment. A retrospective analysis was performed using data from the electronic cohort database spanning from January 1990 to December 2021. This review focused on patients who manifested neurotoxic symptoms post-MTX therapy, excluding patients with peripheral neuropathy. Of the 498 individuals who received MTX, 26 (5.22%) exhibited neurotoxicity. Pediatric patients (< 18 years) accounted for 18 cases (7.44%), whereas adults (> 18 years) comprised eight cases (3.13%). The median onset age was 11 years (range 4-15) in the pediatric cohort and 39.5 years (range 19-67) in the adult cohort. A predominant male predisposition was noted (21 patients, 80.77%). The majority of patients (21, 80.77%) experienced neurotoxic effects following multiple MTX administrations. Modes of MTX delivery included intrathecal (37.0%), intravenous (22.2%), and combined routes (40.7%). Clinical presentations were predominantly encephalopathy (69.2%), followed by encephalomyelopathy (15.4%), myelopathy (11.5%), and polyradiculopathy (3.8%). Fourteen patients recovered (53.85%). Risk factors were male sex, pediatric age (particularly above 10 years), and administration route (intrathecal in adults and intravenous in pediatrics). Although infrequent, MTX-related neurotoxicity has a substantial impact on patient prognosis, with potential development following even a single dose. Its radiological resemblance to diverse neuropathologies, such as cerebral infarction and subacute combined degeneration, necessitates vigilant diagnostic scrutiny.
Background: Dimethyl fumarate (DMF) is increasingly used in treating multiple sclerosis (MS) with controversial results of the safety and efficacy of different DMF doses. We aimed to systematically review the literature to examine the safety and efficacy of DMF for MS patients.
Methods: We searched PubMed Medline, Cochrane, Web of Science, Scopus databases and clinicaltrials.
Gastric teratomas are an extremely rare variety of teratomas in children. The aim of our series is to present the natural history and progression of the disease. Retrospective analysis of prospectively maintained data of all the gastric teratoma patients treated at our center was done from their electronic medical records.
Objectives: This study aims to evaluate the effect of osteoporosis education on osteoporosis knowledge level (OKL) and behavioral changes in daily life in patients with Parkinson's disease (PD).
Patients And Methods: Between May 2019 and December 2019, a total of 54 patients (34 males, 20 females; median age: 68.5 years; range, 50 to 87 years) were included in the study.
To determine the incidence of periprosthetic femoral fractures during the operation in primary hip arthroplasties and correlate them with the inherent risk factors associated with patients, implants, and the diagnosis of coxarthrosis and/or femoral neck fractures. Cross-sectional study, with retrospective analysis of medical records and image exams of patients operated between 2014 and 2019. The variables analyzed followed those proposed by the world literature, namely: age, sex, Dorr index, surgical indication, Vancouver classification, location, type of fixation (cemented or non-cemented), implant model used, intraoperative diagnosis, and corresponding treatment approach.
