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Khilji H, Silver C, Morrar D, Chhabra AM, Mandel S, Langer DJ, Shani D, Ellis JA. Complete Resolution of Skull Base Solitary Plasmacytoma Using Proton-Beam Radiotherapy: A Case Report. Cureus 2022; 14:e23130. [PMID: 35425679 PMCID: PMC9005338 DOI: 10.7759/cureus.23130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/05/2022] Open
Abstract
Cranial solitary plasmacytomas are uncommon lesions, and localization to the skull base is rare. Here we present a case in a 36-year-old woman who complained of dizziness and mild headaches. Radiographic imaging indicated the presence of a solitary skull base lesion in the posterior cranial fossa. Laboratory tests and imaging excluded systemic disease. A biopsy of the lesion confirmed the diagnosis of plasmacytoma. The patient was treated with proton-beam radiation and had a complete clinical and radiographic resolution, demonstrating the previously unreported utility of monotherapy with proton-beam radiation in such cases.
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Kernt K, Martinez M, Bertin D, Stroman D, Cupp G, Martinez C, Tirado M, Guasch J, Kernt K, Lizin F, Cano J, Wesner M, Alemany P, Jungmann P, Partouche P, Sitruk A, Christmann T, Kandarakis A, Royo M, Arias A, Bacquaert J, Dua H, Tomazzoli L, Forsman E, Gerstenberger A, Bertel F, Bouzas E, Trimarchi F, Kaye S, Orsoni G, Klauss V, Mandel S, Mortemousque B. A Clinical Comparison of Two Formulations of Tobramycin 0.3% Eyedrops in the Treatment of Acute Bacterial Conjunctivitis. Eur J Ophthalmol 2018. [DOI: 10.1177/112067210501500504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To compare the safety and efficacy of a new enhanced viscosity ophthalmic formulation of tobramycin, given twice daily (BID), with the existing four times daily (QID) treatment regimen in patients with acute bacterial conjunctivitis. Methods This was a 12-day, multicenter, observer-masked, randomized, parallel group study. Patients received one drop of tobramycin 0.3% (3 mg/mL) enhanced viscosity ophthalmic solution BID or tobramycin 0.3% (3 mg/mL) ophthalmic solution QID in the affected eyes for 7 days. The primary efficacy variable was the percentage of patients with sustained cure/presumed bacterial eradication based on clinical judgment at the test-of-cure visit (Day 12). Pretherapy bacterial isolates were obtained and tested for susceptibility to tobramycin by determination of minimum inhibitory concentrations (MIC). Results A total of 276 patients were enrolled in the study and 203 of these were culture positive and attended all follow-up examinations. In this group, 98% of those treated with tobramycin enhanced viscosity ophthalmic solution and 99% of those treated with tobramycin 0.3% ophthalmic solution were categorized as having sustained cure/presumed eradication at the test-of-cure visit (p=0.6037). Reported adverse events were not serious, mild to moderate in severity, and generally did not prevent continuation in the study. Several pretreatment pathogens demonstrated tobramycin resistance (MIC > 4 mg/mL). However, therapy with both treatments was effective in the majority of the cases. Conclusions Tobramycin enhanced viscosity ophthalmic solution is well tolerated and has equivalent efficacy to the established treatment regimen with a simplified posology. The formulation provides an alternative therapy for acute bacterial conjunctivitis that should improve patient compliance and satisfaction.
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Affiliation(s)
- K. Kernt
- Augenärztpraxis, Muenchen, Germany
| | - M. Martinez
- R&D Clinical Sciences AlconCusí, Barcelona - Spain
| | - D. Bertin
- R&D Clinical Sciences, Milano - Italy
| | - D. Stroman
- R&D Microbiology, Alcon Research, Ltd., Fort Worth, Texas - USA
| | - G. Cupp
- R&D Microbiology, Alcon Research, Ltd., Fort Worth, Texas - USA
| | - C. Martinez
- R&D Clinical Sciences AlconCusí, Barcelona - Spain
| | - M. Tirado
- R&D Clinical Sciences AlconCusí, Barcelona - Spain
| | - J. Guasch
- R&D Clinical Sciences AlconCusí, Barcelona - Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - H. Dua
- Nottingham, United Kingdom
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Carsons SE, Vivino FB, Parke A, Carteron N, Sankar V, Brasington R, Brennan MT, Ehlers W, Fox R, Scofield H, Hammitt KM, Birnbaum J, Kassan S, Mandel S. Treatment Guidelines for Rheumatologic Manifestations of Sjögren's Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain. Arthritis Care Res (Hoboken) 2017; 69:517-527. [PMID: 27390247 DOI: 10.1002/acr.22968] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Sjögren's Syndrome Foundation clinical practice guidelines (CPGs) are designed to improve quality and consistency of care in Sjögren's syndrome by offering recommendations for management. METHODS Management questions for the systemic manifestations of Sjögren's syndrome were posed by the CPG committee with input from patients and rheumatologists. Clinical questions were assigned to a topic review group that performed systematic reviews and data extraction and drafted guidelines. Quality of evidence and strength of recommendation were rated using the American Society of Clinical Oncology's modification of the Grading of Recommendations Assessment, Development, and Evaluation. Guideline recommendations were reviewed by a consensus expert panel (CEP) composed of 30-40 clinicians from academia and community practices, as well as registered nurses and patients, using a modified Delphi process. A CEP agreement level of 75% was set as a minimum for adoption of a guideline recommendation. RESULTS Consensus was achieved for 19 recommendations; for 11 additional modules, available data were insufficient to allow a recommendation to be formulated. Of the 19 recommendations, 15 required 1 Delphi round, 2 required 2 rounds, and 2 required 3 rounds. CONCLUSION Key recommendations include a decision tree for the use of oral disease-modifying antirheumatic drugs for inflammatory musculoskeletal pain, use of self-care measures and advice regarding exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness and for certain extraglandular manifestations, including vasculitis, severe parotid swelling, inflammatory arthritis, pulmonary disease, and mononeuritis multiplex. The CPG committee strongly discouraged the use of tumor necrosis factor inhibitors for sicca symptoms and for the majority of clinical contexts in primary Sjögren's syndrome.
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Affiliation(s)
- Steven E Carsons
- Winthrop-University Hospital Campus, State University of New York, Stony Brook, Mineola
| | | | - Ann Parke
- University of Connecticut Health Center, Farmington
| | | | - Vidya Sankar
- University of Texas San Antonio Dental School, San Antonio
| | | | | | | | - Robert Fox
- Scripps Memorial Hospital Xi-Med, La Jolla, California
| | - Hal Scofield
- University of Oklahoma Health Sciences Center, Oklahoma Medical Research Foundation, and Oklahoma City Department of Veterans Affairs Medical Center, Oklahoma City
| | | | | | | | - Steven Mandel
- Lenox Hill Hospital, New York, and Hofstra Northwell School of Medicine, Hempstead, New York
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Abstract
This paper reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performed a systematic review of the medical literature from 1944 through 2001 on the clinical application of EMG to laryngeal disorders. The review yielded 584 articles of which 33 met the predefined inclusion criteria. The evidence demonstrated that in a double-blind treatment trial of botulinum toxin versus saline, laryngeal EMG used to guide injections into the thyroarytenoid muscle in persons with adductor spasmodic dysphonia was beneficial. A cross-over comparison between laryngeal EMG-guided injection and endoscopic injection of botulinum toxin into the posterior cricoarytenoid muscle in abductor spasmodic dysphonia found no significant difference between the 2 techniques and no significant treatment benefit. Based on the evidence, laryngeal EMG is possibly useful for the injection of botulinum toxin into the thyroarytenoid muscle in the treatment of adductor spasmodic dysphonia. There were no evidence-based data sufficient to support or refute the value of laryngeal EMG for the other uses investigated, although there is extensive anecdotal literature suggesting that it is useful for each of them. There is an urgent need for evidence-based research addressing other applications in the use of laryngeal EMG for other applications. (Otolaryngol Head Neck Surg 2004;130: 770-9.)
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Affiliation(s)
- Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA
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Munin MC, Heman-Ackah YD, Rosen CA, Sulica L, Maronian N, Mandel S, Carey BT, Craig E, Gronseth G. Consensus statement: Using laryngeal electromyography for the diagnosis and treatment of vocal cord paralysis. Muscle Nerve 2016; 53:850-5. [PMID: 26930512 DOI: 10.1002/mus.25090] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2016] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The purpose of this study was to develop an evidence-based consensus statement regarding use of laryngeal electromyography (LEMG) for diagnosis and treatment of vocal fold paralysis after recurrent laryngeal neuropathy (RLN). METHODS Two questions regarding LEMG were analyzed: (1) Does LEMG predict recovery in patients with acute unilateral or bilateral vocal fold paralysis? (2) Do LEMG findings change clinical management in these individuals? A systematic review was performed using American Academy of Neurology criteria for rating of diagnostic accuracy. RESULTS Active voluntary motor unit potential recruitment and presence of polyphasic motor unit potentials within the first 6 months after lesion onset predicted recovery. Positive sharp waves and/or fibrillation potentials did not predict outcome. The presence of electrical synkinesis may decrease the likelihood of recovery, based on 1 published study. LEMG altered clinical management by changing the initial diagnosis from RLN in 48% of cases. Cricoarytenoid fixation and superior laryngeal neuropathy were the most common other diagnoses observed. CONCLUSIONS If prognostic information is required in a patient with vocal fold paralysis that is more than 4 weeks and less than 6 months in duration, then LEMG should be performed. LEMG may be performed to clarify treatment decisions for vocal fold immobility that is presumed to be caused by RLN. Muscle Nerve 53: 850-855, 2016.
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Affiliation(s)
- Michael C Munin
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yolanda D Heman-Ackah
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.,Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Clark A Rosen
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lucian Sulica
- Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Nicole Maronian
- Ear, Nose and Throat Institute, Case Western Reserve University, Cleveland, Ohio, USA
| | - Steven Mandel
- Department of Neurology, Hofstra North Shore LIJ School of Medicine, Hempstead, New York, USA
| | - Bridget T Carey
- Department of Neurology, Weill Cornell Medical College, New York, New York, USA
| | - Earl Craig
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gary Gronseth
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Morse CL, Douglas-Newman K, Mandel S, Swirsky-Sacchetti T. Utility of the Rey-15 Recognition Trial to Detect Invalid Performance in a Forensic Neuropsychological Sample. Clin Neuropsychol 2013; 27:1395-407. [DOI: 10.1080/13854046.2013.832385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Park JH, Hozack B, Kim P, Norton R, Mandel S, Restrepo C, Parvizi J. Common peroneal nerve palsy following total hip arthroplasty: prognostic factors for recovery. J Bone Joint Surg Am 2013; 95:e55. [PMID: 23636194 DOI: 10.2106/jbjs.l.00160] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Common peroneal nerve palsy, although rare, is a serious complication of total hip arthroplasty. Although several publications have dealt with the risk factors for peroneal nerve palsy, there is little literature regarding the time it takes for the nerve to recover and the factors that influence its recovery. The purpose of this study was to elucidate the clinical course of this injury and identify prognostic factors for recovery. METHODS From January 2000 to December 2007, 7969 primary and 1601 revision total hip arthroplasties were performed at our institution. Common peroneal nerve palsy developed following thirty-one (0.32%) of these procedures. Thirty of these patients were evaluated by a neurologist at the time of diagnosis and at regular intervals thereafter. Univariate and multivariate regression analyses were performed to identify risk factors and prognostic factors for recovery. RESULTS On average, patients who developed common peroneal nerve palsy were significantly younger (fifty-six years) than those who did not develop palsy (sixty-three years, p < 0.05). Higher body mass index (BMI) was a negative prognostic factor for recovery from palsy (p < 0.05). The palsy was incomplete in twenty-five of the thirty patients, and fourteen of these recovered fully at a mean of 10.3 months (range, 1.0 to 50.0 months). Three of the five patients with complete nerve palsy recovered fully at a mean of 14.5 months (range, 8.0 to 21.0 months). CONCLUSIONS Only one-half of the patients in the study who developed common peroneal nerve palsy following total hip arthroplasty recovered fully. The mean time to recovery was approximately one year for partial peroneal palsy and one and one-half years for complete palsy. Obesity adversely influenced the nerve recovery.
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Affiliation(s)
- Jai Hyung Park
- Rothman Institute Orthopaedics, Thomas Jefferson University Hospital, 925 Chestnut Street, 2nd Floor, Philadelphia, PA 19107, USA
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Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TSD, Gioia GA, Gronseth GS, Guskiewicz K, Mandel S, Manley G, McKeag DB, Thurman DJ, Zafonte R. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013; 80:2250-7. [PMID: 23508730 DOI: 10.1212/wnl.0b013e31828d57dd] [Citation(s) in RCA: 615] [Impact Index Per Article: 55.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To update the 1997 American Academy of Neurology (AAN) practice parameter regarding sports concussion, focusing on 4 questions: 1) What factors increase/decrease concussion risk? 2) What diagnostic tools identify those with concussion and those at increased risk for severe/prolonged early impairments, neurologic catastrophe, or chronic neurobehavioral impairment? 3) What clinical factors identify those at increased risk for severe/prolonged early postconcussion impairments, neurologic catastrophe, recurrent concussions, or chronic neurobehavioral impairment? 4) What interventions enhance recovery, reduce recurrent concussion risk, or diminish long-term sequelae? The complete guideline on which this summary is based is available as an online data supplement to this article. METHODS We systematically reviewed the literature from 1955 to June 2012 for pertinent evidence. We assessed evidence for quality and synthesized into conclusions using a modified Grading of Recommendations Assessment, Development and Evaluation process. We used a modified Delphi process to develop recommendations. RESULTS Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for postconcussion impairments. Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion. Risk factors for chronic neurobehavioral impairment include concussion exposure and APOE ε4 genotype. Data are insufficient to show that any intervention enhances recovery or diminishes long-term sequelae postconcussion. Practice recommendations are presented for preparticipation counseling, management of suspected concussion, and management of diagnosed concussion.
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Affiliation(s)
- Christopher C Giza
- Division of Pediatric Neurology, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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9
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Martinez N, Mandel S, Peterson JR. Neurologic causes of hip pain in dancers. J Dance Med Sci 2011; 15:157-159. [PMID: 22687655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hip pain in dancers is typically attributed to musculoskeletal etiologies due to local "wear-and-tear"; however, one must be aware of neurologic etiologies that may present with additional clinical findings and require specialized treatment. This article explores the presentation, potential causes, suggested work-up, and treatment options for femoral neuropathy, lateral femoral cutaneous syndrome, and piriformis syndrome.
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Affiliation(s)
- Nina Martinez
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
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Sataloff RT, Praneetvatakul P, Heuer RJ, Hawkshaw MJ, Heman-Ackah YD, Schneider SM, Mandel S. Laryngeal Electromyography: Clinical Application. J Voice 2010; 24:228-34. [DOI: 10.1016/j.jvoice.2008.08.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 08/18/2008] [Indexed: 11/16/2022]
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Yadla S, Gehret J, Campbell P, Mandel S, Ratliff J. A Pain in the Neck: Review of Cervicogenic Headache and Associated Disorders. ACTA ACUST UNITED AC 2010. [DOI: 10.29046/jhnj.005.1.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mandel S, Fishman T, Reznichenko L, Youdim M. O.090 Modeling sporadic Parkinson's disease by selective gene manipulation. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70105-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Fishman-Jacob T, Youdim M, Mandel S. P3.118 Silencing/over-expressing selected genes as a novel model of sporadic Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70682-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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White PF, Tang J, Wender RH, Yumul R, Stokes OJ, Sloninsky A, Naruse R, Kariger R, Norel E, Mandel S, Webb T, Zaentz A. Desflurane Versus Sevoflurane for Maintenance of Outpatient Anesthesia: The Effect on Early Versus Late Recovery and Perioperative Coughing. Anesth Analg 2009; 109:387-93. [DOI: 10.1213/ane.0b013e3181adc21a] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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16
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Youdim MBH, Levites Y, Weinreb O, Mandel S. c-DNA Microarray to determine molecular events in neurodegeneration and neuroprotection. J Neurochem 2008. [DOI: 10.1046/j.1471-4159.2002.00014.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ruocco AC, Swirsky-Sacchetti T, Chute DL, Mandel S, Platek SM, Zillmer EA. Distinguishing between Neuropsychological Malingering and Exaggerated Psychiatric Symptoms in a Neuropsychological Setting. Clin Neuropsychol 2008; 22:547-64. [PMID: 17853126 DOI: 10.1080/13854040701336444] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
It is unclear whether symptom validity test (SVT) failure in neuropsychological and psychiatric domains overlaps. Records of 105 patients referred for neuropsychological evaluation, who completed the Test of Memory Malingering (TOMM), Reliable Digit Span (RDS), and Millon Clinical Multiaxial Inventory-III (MCMI-III), were examined. TOMM and RDS scores were uncorrelated with MCMI-III symptom validity indices and factor analysis revealed two distinct factors for neuropsychological and psychiatric SVTs. Only 3.5% of the sample failed SVTs in both domains, 22.6% solely failed the neuropsychological SVT, and 6.1% solely failed the psychiatric SVT. The results support a dissociation between neuropsychological malingering and exaggeration of psychiatric symptoms in a neuropsychological setting.
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Affiliation(s)
- Anthony C Ruocco
- Department of Psychology, Neuropsychology Program, Drexel University, Philadelphia, PA 19102-1192, USA.
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18
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Abstract
Laryngeal electromyography (LEMG) evaluates the integrity of the neuromuscular system in the larynx by recording action potentials generated in the laryngeal muscles during voluntary and involuntary contraction. LEMG is particularly useful for helping to differentiate between disorders involving upper motor neurons, lower motor neurons, peripheral nerves, the neuromuscular junction, muscle fibers, and the laryngeal cartilages and joints. LEMG should be considered to be an extension of the physical examination, not an isolated laboratory procedure. A careful history and laryngeal evaluation determine the indication for LEMG and which muscles or muscle groups, in particular, are to be studied. Abnormalities detected by LEMG are always interpreted within the context of the clinical picture.
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Affiliation(s)
- Yolanda D Heman-Ackah
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 1721 Pine Street, Philadelphia, PA 19103, USA.
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Abstract
An interdisciplinary task force of physicians and neuropsychologists with advanced training in impairment and disability assessment provided a review of the literature on malingering in chronic pain, medical disorders, and mental/cognitive disorders. Our review suggests that treating health care providers often do not consider malingering, even in cases of delayed recovery involving work injuries or other personal injuries, where there may be a significant incentive to feign or embellish symptoms or delay recovery. This report discusses the implications of this issue and offers recommendations to evaluating physicians and other health care professionals.
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Affiliation(s)
- Gerald M Aronoff
- Duke University Medical Center, Department of Psychiatry, Pain Evaluation and Treatment Service, Charlotte, North Carolina, USA.
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Gupta V, Puttaswamy K, Lassoued W, Redlinger M, Ransone K, Gold K, Lee W, LiVolsi V, Fraker D, Mandel S, Brose MS. Sorafenib targets BRAF and VEGFR in metastatic thyroid carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.6019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6019 Background. There is no effective therapy for patients with metastatic thyroid cancer not cured by surgery or treatment with I131. Sorafenib is a promising multi-tyrosine kinase inhibitor for patients with metastatic PTC (mPTC). Although the primary targets of sorafenib are thought to include BRAF and VEGFR, this has been the subject of debate. Whether sorafenib primarily acts on the tumor cells (TC) or endothelial cells (EC) and how BRAF mutation status (45% of PTC harbor V600E) relates to response is also unknown. Methods. Responses of patients with metastatic, iodine-refractory PTC, enrolled into our phase II study of sorafenib were monitored by PET at 4 wks and CTs every 2 mos. Sorafenib activity was studied using immunohistochemistry (IHC) for pERK, pAKT, and pVEGFR-2, while Ki-67 showed proliferating cells in tumor tissue pre- and on treatment. BRAF mutation status was determined by DNA sequencing. Results. Of 15 patients, five patients achieved a PR, three are stable (SD), two progressed, and three patients with SD withdrew due to toxicity. Target lesions decreased on average 31%. Eight of 10 PET scans showed decreased activity at 4 weeks. IHC on tissue from 2 patients (at 1 and 2 wks, both BRAFwt) showed 50% decrease in pERK (downstream of VEGFR2 and BRAF) and 30% decrease in pAKT (downstream of VEGFR2). p-ERK and p-AKT were altered in both the TC and EC. Ki-67 decreased from 10% to <1%. No change in VEGFR-2 was seen; but, pVEGFR-2 completely disappeared in one sample while the other showed a small decrease. Quantitative analysis using a multispectral imaging system confirmed the changes observed by IHC. In tissue from a patient at 17 months on sorafenib, the decrease in pERK and pAKT appeared to be the same or reversed, suggesting compensatory changes in these pathways in resistant but stable disease. Conclusions. Our study shows the early clinical and biologic activity of sorafenib in patients with mPTC and the targets of early suppression. Importantly, it also reveals compensatory changes in target molecules in cells resistant to therapy. These cells are the likely source of tumor resistance that has been seen to develop to other similar targeted agents. Sorafenib is the first viable treatment option for patients with mPTC, and these results provide key insights into the mechanisms of action and resistance of this drug. No significant financial relationships to disclose.
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Affiliation(s)
- V. Gupta
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | | | - W. Lassoued
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - M. Redlinger
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - K. Ransone
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - K. Gold
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - W. Lee
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - V. LiVolsi
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - D. Fraker
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - S. Mandel
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
| | - M. S. Brose
- Hosp of the Univ of Pennsylvania, Philadelphia, PA
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Bales CW, McCrory M, Zheng J, Champagne C, Gilhooly C, Hannah J, Racette S, Martin C, Obert K, Das S, Delany J, Mandel S, Rochon J, Roberts S, Schechtman K. Quality of self‐selected diets of non‐obese participants in a randomized controlled trial of caloric restriction (CR): the CALERIE study. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a155-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - M McCrory
- Tufts UnivWashington StBostonMA02111
| | - J Zheng
- Washington UnivForest Park AveSt. LouisMO63108
| | - C Champagne
- Pennington Biomed Res CtrPerkins RdBaton RougeLA70808
| | | | | | - S Racette
- Washington UnivForest Park AveSt. LouisMO63108
| | - C Martin
- Pennington Biomed Res CtrPerkins RdBaton RougeLA70808
| | - K Obert
- Washington UnivForest Park AveSt. LouisMO63108
| | - S Das
- Tufts UnivWashington StBostonMA02111
| | - J Delany
- Pennington Biomed Res CtrPerkins RdBaton RougeLA70808
| | - S Mandel
- Washington UnivForest Park AveSt. LouisMO63108
| | - J Rochon
- Duke Clin Res InstBox 17969DurhamNC27715
| | - S Roberts
- Tufts UnivWashington StBostonMA02111
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Grünblatt E, Mandel S, Müller T, Jost W, Youdim M, Riederer P. 1.100 Early diagnosis for Parkinson's disease according to whole blood gene profile. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Grünblatt E, Mandel S, Müller T, Jost W, Youdim M, Riederer P. 1.011 Early diagnosis for Parkinson's disease according to whole blood gene profile. Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Mandel S, Weinreb O, Reznichenko L, Kalfon L, Amit T. Green tea catechins as brain-permeable, non toxic iron chelators to "iron out iron" from the brain. J Neural Transm Suppl 2006:249-57. [PMID: 17447435 DOI: 10.1007/978-3-211-33328-0_26] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Evidence to link abnormal metal (iron, copper and zinc) metabolism and handling with Parkinson's and Alzheimer's diseases pathology has frequently been reported. The capacity of free iron to enhance and promote the generation of toxic reactive oxygen radicals has been discussed numerous times. Metal chelation has the potential to prevent iron-induced oxidative stress and aggregation of alpha-synuclein and beta-amyloid peptides. The efficacy of iron chelators depends on their ability to penetrate the subcellular compartments and cellular membranes where iron dependent free radicals are generated. Thus, natural, non-toxic, brain permeable neuroprotective drugs, are preferentially advocated for "ironing out iron" from those brain areas where it preferentially accumulates in neurodegenerative diseases. This review will discuss the most recent findings from in vivo and in vitro studies concerning the transitional metal (iron and copper) chelating property of green tea, and its major polyphenol, (-)-epigallocatechin-3-gallate with respect to their potential for the treatment of neurodegenerative diseases.
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Affiliation(s)
- S Mandel
- Eve Topf and US NPF Centers for Neurodegenerative Diseases and Department of Pharmacology, Faculty of Medicine, Technion, Haifa, Israel.
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25
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Rubin AD, Praneetvatakul V, Heman-Ackah Y, Moyer CA, Mandel S, Sataloff RT. Repetitive phonatory tasks for identifying vocal fold paresis. J Voice 2006; 19:679-86. [PMID: 16301110 DOI: 10.1016/j.jvoice.2004.11.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2004] [Indexed: 02/01/2023]
Abstract
Vocal fold paresis may be present in patients with voice complaints. Identification of paresis is important so that appropriate neurolaryngologic evaluation can be ordered and the appropriate treatment can be offered. Repetitive phonatory tasks (RPTs) fatigue patients vocally and may elicit signs of subtle paresis. In this study, four laryngologists independently reviewed the RPT portions of routine fiberoptic voice examinations of 100 patients in a blinded fashion. All patients had presented with voice complaints, were suspected of having a movement disorder of the larynx, and had been referred for laryngeal electromyography (LEMG). Predictions were compared with LEMG results and with predictions made at the time of each initial evaluation. Although RPTs are useful to laryngologists, predictions based on the entire examination are more accurate. LEMG can confirm clinical suspicions or identify paresis missed on fiberoptic laryngeal examination.
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Affiliation(s)
- Adam D Rubin
- Lakeshore Professional Voice Center, Lakeshore Ear, Nose, & Throat Center, St. Clair Shores, MI, USA
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26
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Youdim MBH, Grünblatt E, Mandel S. The copper chelator, D-penicillamine, does not attenuate MPTP induced dopamine depletion in mice. J Neural Transm (Vienna) 2006; 114:205-9. [PMID: 16736232 DOI: 10.1007/s00702-006-0499-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 03/14/2006] [Indexed: 11/24/2022]
Abstract
In MPTP (N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) and 6-hydroxydopamine induced dopaminergic neurotoxicity and Parkinson's disease iron accumulates in substantia nigra pars compacta which has been suggested to participate in oxidative stress induced neurodegeneration. Pretreatment with iron chelators desferal, clioquinol, VK-28 and M30 are neuroprotective in both models. To determine the specificity of chelation neuroprotective activity we have examined the effect of D-penicillamine, a relatively specific copper chelator, in the mice model of MPTP-induced dopamine depletion. Our studies show that D-penicillamine, employed for removal of copper in Wilson disease is relatively weak in preventing dopaminergic neurotoxicity induced by MPTP, as compared to iron chelators previously studied. The results indicate that for prevention of MPTP-induced dopamine depletion and dopamine neurodegeneration, iron rather than copper chelation may be more effective and specific.
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Affiliation(s)
- M B H Youdim
- Eve Topf and US National Parkinson Foundation, Centers of Excellence For Neurodegenerative Diseases Research, Technion-Rappaport Family Faculty of Medicine, Haifa, Israel.
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27
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Reznichenko L, Amit T, Zheng H, Avramovich-Tirosh Y, Youdim MBH, Weinreb O, Mandel S. Reduction of iron-regulated amyloid precursor protein and beta-amyloid peptide by (-)-epigallocatechin-3-gallate in cell cultures: implications for iron chelation in Alzheimer's disease. J Neurochem 2006; 97:527-36. [PMID: 16539659 DOI: 10.1111/j.1471-4159.2006.03770.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Brain iron dysregulation and its association with amyloid precursor protein (APP) plaque formation are implicated in Alzheimer's disease (AD) pathology and so iron chelation could be considered a rational therapeutic strategy for AD. Here we analyzed the effect of the main polyphenol constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), which possesses metal-chelating and radical-scavenging properties, on the regulation of the iron metabolism-related proteins APP and transferrin receptor (TfR). EGCG exhibited potent iron-chelating activity comparable to that of the prototype iron chelator desferrioxamine, and dose dependently (1-10 microm) increased TfR protein and mRNA levels in human SH-SY5Y neuroblastoma cells. Both the immature and full-length cellular holo-APP were significantly reduced by EGCG, as shown by two-dimensional gel electrophoresis, without altering APP mRNA levels, suggesting a post-transcriptional action. Indeed, EGCG suppressed the translation of a luciferase reporter gene fused to the APP mRNA 5'-untranslated region, encompassing the APP iron-responsive element. The finding that Fe(2)SO(4) reversed the action of EGCG on APP and TfR proteins reinforces the likelihood that these effects are mediated through modulation of the intracellular iron pool. Furthermore, EGCG reduced toxic beta-amyloid peptide generation in Chinese hamster ovary cells overexpressing the APP 'Swedish' mutation. Thus, the natural non-toxic brain-permeable EGCG may provide a potential therapeutic approach for AD and other iron-associated disorders.
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Affiliation(s)
- L Reznichenko
- Eve Topf and US National Parkinson Foundation Centers for Neurodegenerative diseases and Department of Pharmacology, Faculty of Medicine, Technion, Haifa, Israel
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Weinreb O, Amit T, Bar-Am O, Sagi Y, Mandel S, Youdim MBH. Involvement of multiple survival signal transduction pathways in the neuroprotective, neurorescue and APP processing activity of rasagiline and its propargyl moiety. J Neural Transm Suppl 2006:457-65. [PMID: 17017568 DOI: 10.1007/978-3-211-45295-0_69] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Our recent studies aimed to elucidate the molecular and biochemical mechanism of actions of the novel anti-Parkinson's drug, rasagiline, an irreversible and selective monoamine oxidase (MAO)-B inhibitor and its propargyl moiety, propargylamine. In cell death models induced by serum withdrawal in rat PC12 cells and human SH-SY5Y neuroblastoma cells, both rasagiline and propargylamine exerted neuroprotective and neurorescue activities via multiple survival pathways, including: stimulation of protein kinase C (PKC) phosphorylation; up-regulation of protein and gene levels of PKCalpha, PKCepsilon and the anti-apoptotic Bcl-2, Bcl-xL, and Bcl-w; and up-regulation of the neurotrophic factors, BDNF and GDNF mRNAs. Rasagiline and propargylamine inhibited the cleavage and subsequent activation of pro-caspase-3 and poly ADP-ribose polymerase. Additionally, these compounds significantly down-regulated PKCgamma mRNA and decreased the level of the pro-apoptotic proteins, Bax, Bad, Bim and H2A.X. Rasagiline and propargylamine both regulated amyloid precursor protein (APP) processing towards the non-amyloidogenic pathway. These structure-activity studies have provided evidence that propargylamine promoted neuronal survival via neuroprotective/neurorescue pathways similar to that of rasagiline. In addition, recent study demonstrated that chronic low doses of rasagiline administered to mice subsequently to 1 methyl-4 phenyl 1,2,3,6 tetrahydropyridine (MPTP), rescued dopaminergic neurons in the substantia nigra pars compacta via activation of the Ras-PI3K-Akt survival pathway, suggesting that rasagiline may possess a disease modifying activity.
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Affiliation(s)
- O Weinreb
- Eve Topf and USA National Parkinson Foundation Centers of Excellence for Neurodegenerative Diseases Research, Department of Pharmacology, Rappaport Family Research Institute, Technion-Faculty of Medicine, Haifa, Israel.
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29
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Abstract
The risk of depression is increased in chronic neurologic illness and can adversely affect the course of disease. Recent literature is reviewed for depression in stroke, epilepsy, and multiple sclerosis. Depression can share pathophysiologic aspects of the comorbid illness, such as neurotransmitter pathway disturbances, hypothalamus-pituitary-adrenal pathway disturbances, and changes in immunologic function. Depression also can be a psychologic reaction to the burden of the neurologic condition. Risk factors for development of depression are reviewed. Depression and other medical conditions can have shared symptoms (eg, fatigue, psychomotor retardation) that can complicate the diagnosis of depression in neurologic illness. Proper selection of antidepressant treatment is necessary to avoid worsening the neurologic disorder.
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Affiliation(s)
- Richard M Sobel
- Department of Psychiatry, Jefferson Medical College, 1518 Walnut Street, Suite 1110, Philadelphia, PA 19102, USA.
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Robinson JL, Mandel S, Sataloff RT. Objective voice measures in nonsinging patients with unilateral superior laryngeal nerve paresis. J Voice 2005; 19:665-7. [PMID: 16129578 DOI: 10.1016/j.jvoice.2005.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Accepted: 11/17/2004] [Indexed: 11/20/2022]
Abstract
The clinical value of objective voice measures in nonsinging patients with superior laryngeal nerve dysfunction is unknown. In this study, patients with symptomatic unilateral superior nerve paresis were evaluated for maximum phonation time, frequency range of phonation, and mean flow rate. Patients with coexisting pathology, bilateral superior nerve paresis, and those with recurrent laryngeal nerve paresis were excluded from this analysis. A total of 35 nonsinging patients, 14 men and 21 women, with unilateral superior laryngeal nerve paresis were examined between 1999 and 2002. The severity of superior laryngeal nerve paresis ranged from 25% to 85% of normal recruitment with a mean of 70% superior laryngeal nerve recruitment in men and 65% in women by electromyography. In both men and women with superior laryngeal nerve paresis, the maximum phonation time and frequency range of phonation were decreased and the mean air flow rate was increased when compared with normal population values. The jitter percent, shimmer percent, and noise-to-harmonic ratio were also increased in patients when compared with normative data. Selected objective voice measures are abnormal in voice patients with superior laryngeal nerve paresis, which suggests that the measures may be useful as outcomes measures after therapy. More research is encouraged.
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Affiliation(s)
- Jamie L Robinson
- Department of Otolaryngology-Head and Neck Surgery, Eugene, Oregon
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31
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Reznichenko L, Amit T, Youdim MBH, Mandel S. Green tea polyphenol (-)-epigallocatechin-3-gallate induces neurorescue of long-term serum-deprived PC12 cells and promotes neurite outgrowth. J Neurochem 2005; 93:1157-67. [PMID: 15934936 DOI: 10.1111/j.1471-4159.2005.03085.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Our previous studies have shown that the green tea polyphenol (-)-epigallocatechin-3-gallate (EGCG) prevents neuronal cell death caused by several neurotoxins. The present study sought to determine the neuroprotective effect of EGCG when it is administered after the induction of cell damage ('neurorescue'). In an attempt to imitate a progressive mode of death, PC12 cells were initially subjected to serum-starvation conditions for a period of 1 or 3 days before administration of EGCG (0.1-10 microM) for up to 3 days. In spite of the high percentage of cell death, single or repetitive administration of EGCG (1 microM) significantly attenuated cell death. The neurorescue effect of EGCG was abolished by pre-treatment with the protein kinase C inhibitor GF109203X (2.5 microM), suggesting the involvement of the protein kinase C pathway in neurorescue by the drug. This is consistent with the rapid (15 min) translocation of the protein kinase C alpha isoform to the cell membrane in response to EGCG. The correlative neurite outgrowth activity of EGCG on PC12 cells may also contribute to its neurorescue effect. The present findings suggest that EGCG may have a positive impact on aging and neurodegenerative diseases to retard or perhaps even reverse the accelerated rate of neuronal degeneration.
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Affiliation(s)
- L Reznichenko
- Eve Topf and NPF Centers of Excellence for Neurodegenerative Diseases Research and Department of Pharmacology, Technion-Rappaport Family Faculty of Medicine, Haifa, Israel
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32
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An P, Teran-Garcia M, Rice T, Rankinen T, Weisnagel SJ, Bergman RN, Boston RC, Mandel S, Stefanovski D, Leon AS, Skinner JS, Rao DC, Bouchard C. Genome-wide linkage scans for prediabetes phenotypes in response to 20 weeks of endurance exercise training in non-diabetic whites and blacks: the HERITAGE Family Study. Diabetologia 2005; 48:1142-9. [PMID: 15868134 DOI: 10.1007/s00125-005-1769-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2004] [Accepted: 01/27/2005] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS Impaired insulin secretion, insulin action, insulin-independent glucose effectiveness, glucose tolerance and the associated abnormalities in insulin and glucose metabolism phenotypes are precursors of type 2 diabetes. Genome-wide multipoint variance component linkage scans were carried out using 654 markers to identify quantitative trait loci for insulin sensitivity, acute insulin response to glucose, disposition index and glucose effectiveness training responses in whites and blacks in the HERITAGE Family Study. METHODS These phenotypes were obtained from an IVGTT with the minimal model. The distributions of insulin sensitivity, acute insulin response to glucose and disposition index training responses (post-training minus baseline) were approximately normalised using a square-root transformation. All phenotypes were adjusted for the effects of age, BMI and their respective baseline values within sex and generation by race prior to linkage scans. RESULTS In blacks, a promising linkage with a maximum lod score of 3.1 on 19q (54-62 Mb) for glucose effectiveness training response was found. Six interesting linkages with lod scores of at least 1.0 were found for disposition index training response in whites. They included 1p (30 Mb), 3q (152 Mb), 6p (23-42 Mb), 7q (95-96 Mb), 10p (15 Mb) and 12q (119-126 Mb). CONCLUSIONS/INTERPRETATION Quantitative trait loci for 20 weeks of endurance exercise training responses in insulin action and glucose metabolism phenotypes were found on chromosome 19q as well as 6p and 7q, with nominal (6p, 7q) but consistent (6p) linkages across the races.
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Affiliation(s)
- P An
- Division of Biostatistics, Washington University School of Medicine, Campus Box 8067, 660 South Euclid Avenue, St Louis, MO, 63110, USA.
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33
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Aronoff GM, Harden N, Stanton-Hicks M, Dorto AJ, Ensalada LH, Klimek EH, Mandel S, Williams JM. American Academy of Disability Evaluating Physicians (AADEP) position paper: complex regional pain syndrome I (RSD): impairment and disability issues. Pain Med 2005; 3:274-88. [PMID: 15099263 DOI: 10.1046/j.1526-4637.2002.02044.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To provide an overview and methodology for the evaluation of impairment and functional residual capacity in complex regional pain syndrome I (CRPS I, RSD). This paper is intended to provide assistance to physicians asked to evaluate impairment- and disability-related issues and is not primarily geared to guide treatment of the CRPS I patient. METHOD Conference and literature review by neurology, anesthesiology, pain medicine, physiatry, and disability evaluating physicians followed by description of issues, options, and recommendations based upon the committee's deliberations and the widely used AMA Guides to the Evaluation of Permanent Impairment, fourth and fifth editions. The authors present functional criteria for assessing the severity of CRPS. These criteria were developed by committee consensus opinion based on multidisciplinary clinical experience considering daily functional issues. They can be used in conjunction with CRPS-ADL Classes of Impairment in order to categorize an individual into a specific class for purposes of permanent impairment rating. Future reliability and validity studies of this rating scale are pending future use, acceptance and, hopefully, additional studies. RESULTS Evaluators should perform a comprehensive assessment of patients with CRPS I to make an accurate diagnosis and exclude other conditions that could explain the symptoms and signs of the condition. While radiological, laboratory, and other diagnostic studies may be of assistance in making the diagnosis, in the final analysis, this is a clinical diagnosis. Impairment is based on objectively validated limitation in activities of daily living (ADL).
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Sataloff RT, Hawkshaw MJ, Mandel H, Zwislewski AB, Armour J, Mandel S. Abnormal Computerized Dynamic Posturography Findings in Dizzy Patients with Normal ENG Results. Ear Nose Throat J 2005. [DOI: 10.1177/014556130508400412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CDP also appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.
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Affiliation(s)
- Robert T. Sataloff
- Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia
- Department of Otolaryngology–Head and Neck Surgery, Graduate Hospital, Philadelphia
| | | | - Heidi Mandel
- Philadelphia College of Podiatric Medicine, Philadelphia
| | | | | | - Steven Mandel
- Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia
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35
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Sataloff RT, Hawkshaw MJ, Mandel H, Zwislewski AB, Armour J, Mandel S. Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results. Ear Nose Throat J 2005; 84:212-4. [PMID: 15929319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CD Palso appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.
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Affiliation(s)
- Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, USA.
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36
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Grünblatt E, Mandel S, Jacob-Hirsch J, Zeligson S, Amariglo N, Rechavi G, Ravid R, Arzberger T, Roggendorf W, Youdim MBH, Riederer P. Genexpressionanalysen von Substantia-nigra-Gewebe Parkinson-Kranker. Akt Neurol 2005. [DOI: 10.1055/s-2005-866647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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37
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Burger O, Pick E, Zwickel J, Klayman M, Meiri H, Slotky R, Mandel S, Rabinovitch L, Paltieli Y, Admon A, Gonen R. Placental protein 13 (PP-13): effects on cultured trophoblasts, and its detection in human body fluids in normal and pathological pregnancies. Placenta 2004; 25:608-22. [PMID: 15193867 DOI: 10.1016/j.placenta.2003.12.009] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/31/2003] [Indexed: 11/19/2022]
Abstract
Placental tissue protein 13 (PP-13), one of the 56 known placental proteins identified till today, was purified from placentas obtained from women at delivery, and used to evoke antibodies against it. The purified PP-13 was lysed to peptides, which were sequenced, leading to the full-length cDNA sequencing and its expression in Escherichia coli. Sequence analysis in databases showed homology to the galectin family. Of the various antibody preparations developed, a pair of monoclonal antibodies (MAbs) coupled to the recombinant PP-13 (PP-13-R) was used for the immunodetection of PP-13 in pregnant women's serum with the solid-phase ELISA format. With a dynamic range of 25-500 pg/mL with no background in non-pregnant women's serum and men's serum, the ELISA test was suitable for the detection of PP-13 in the 1st, 2nd, and 3rd trimesters. PP-13 levels slowly increase during pregnancy. In the 1st trimester, lower than normal PP-13 levels were found in fetal growth restriction (IUGR), preeclampsia (PE), and particularly in early PE (<34 weeks of gestation). In the 2nd and 3rd trimesters, higher than normal concentrations were found in PE, IUGR and in preterm delivery (PTD). Application of PP-13 to cultured trophoblasts elicited depolarization carried by calcium ions, followed by liberation of linoleic and arachidonic acids from the trophoblast membrane, and a subsequent elevation of prostacyclin and thromboxane. These effects were negligible when PP-13 derived from the placentas of patients with IUGR, PE or PTD was used. The results are discussed in view of the potential utilization of PP-13 for early serum screening to assess the risk to develop placental insufficiency, coupled to a differential analysis of the various pathologies by analyzing cultured trophoblasts.
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Affiliation(s)
- O Burger
- Diagnostic Technology, 49 Ha'Histadrut St., PO Box 25266, Haifa 31250, Israel
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38
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Grünblatt E, Mandel S, Jacob-Hirsch J, Zeligson S, Amariglo N, Rechavi G, Li J, Ravid R, Roggendorf W, Riederer P, Youdim MBH. Gene expression profiling of parkinsonian substantia nigra pars compacta; alterations in ubiquitin-proteasome, heat shock protein, iron and oxidative stress regulated proteins, cell adhesion/cellular matrix and vesicle trafficking genes. J Neural Transm (Vienna) 2004; 111:1543-73. [PMID: 15455214 DOI: 10.1007/s00702-004-0212-1] [Citation(s) in RCA: 262] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Accepted: 08/02/2004] [Indexed: 10/26/2022]
Abstract
Gene expression profiling of human substantia nigra pars compacta (SNpc) from Parkinson's disease (PD) patients, was examined employing high density microarrays. We identified alterations in the expression of 137 genes, with 68 down regulated and 69 up regulated. The down regulated genes belong to signal transduction, protein degradation (e.g. ubiquitin-proteasome subunits), dopaminergic transmission/metabolism, ion transport, protein modification/phosphorylation and energy pathways/glycolysis functional classes. Up-regulated genes, clustered mainly in biological processes involving cell adhesion/cytoskeleton, extracellular matrix components, cell cycle, protein modification/phosphorylation, protein metabolism, transcription and inflammation/stress (e.g. key iron and oxygen sensor EGLN1). One major finding in the present study is the particular decreased expression of SKP1A, a member of the SCF (E3) ligase complex specifically in the substantia nigra (SN) of sporadic parkinsonian patients, which may lead to a wide impairment in the function of an entire repertoire of proteins subjected to regulatory ubiquitination. These findings reveal novel players in the neurodegenerative scenario and provide potential targets for the development of novel drug compounds.
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Affiliation(s)
- E Grünblatt
- Institute of Clinical Neurochemistry and National Parkinson Foundation Centre of Excellence Laboratories, Clinic and Policlinic for Psychiatry and Psychotherapy, University of Würzburg, Germany
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Abstract
This paper reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders, including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performed a systematic review of the medical literature from 1944 through 2001 on the clinical application of EMG to laryngeal disorders. Thirty-three of the 584 articles met the predefined inclusion criteria. The evidence demonstrated that in a double-blind treatment trial of botulinum toxin versus saline, laryngeal EMG used to guide injections into the thyroarytenoid muscle in persons with adductor spasmodic dysphonia was beneficial. A cross-over comparison between laryngeal EMG-guided injection and endoscopic injection of botulinum toxin into the posterior cricoarytenoid muscle in abductor spasmodic dysphonia found no significant difference between the two techniques and no significant treatment benefit. Based on the evidence, laryngeal EMG is possibly useful for the injection of botulinum toxin into the thyroarytenoid muscle in the treatment of adductor spasmodic dysphonia. There were no evidence-based data sufficient to support or refute the value of laryngeal EMG for the other uses investigated, although there is extensive anecdotal literature suggesting that it is useful for each of them. There is an urgent need for evidence-based research addressing other applications in the use of laryngeal EMG for other applications.
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Derk CT, Vivino FB, Kenyon L, Mandel S. Inclusion body myositis in connective tissue disorders: case report and review of the literature. Clin Rheumatol 2004; 22:324-8. [PMID: 14576992 DOI: 10.1007/s10067-003-0715-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2002] [Accepted: 02/28/2003] [Indexed: 10/26/2022]
Abstract
We report a patient with systemic lupus erythematosus (SLE) and secondary Sjögren's syndrome (SS) who developed inclusion body myositis (IBM) which, contrary to the typical presentation of this disorder, was symmetrical in nature although the diagnosis was only made after electron microscopy was performed. Therapy with increased doses of methotrexate proved to be beneficial, with the patient having full recovery after 8 months of therapy. It appears that a subset of IBM may be related to autoimmune disorders, an issue that was disputed in the past, and these patients may have a better prognosis than typical IBM patients. This is the first case report of IBM in a patient who had the dual diagnosis of SLE and SS.
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Affiliation(s)
- C T Derk
- Thomas Jefferson University Hospital, Pennsylvania, Philadelphia, USA.
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Abstract
This article reports on an evidence-based review of laryngeal electromyography (EMG) as a technique for use in the diagnosis, prognosis, and treatment of laryngeal movement disorders including the laryngeal dystonias, vocal fold paralysis, and other neurolaryngological disorders. The authors performed a systematic review of the medical literature from 1944 through 2001 on the clinical application of EMG to laryngeal disorders. Thirty-three of the 584 articles met the predefined inclusion criteria. The evidence demonstrated that in a double-blind treatment trial of botulinum toxin versus saline, laryngeal EMG used to guide injections into the thyroarytenoid muscle in persons with adductor spasmodic dysphonia was beneficial. A cross-over comparison between laryngeal EMG-guided injection and endoscopic injection of botulinum toxin into the posterior cricoarytenoid muscle in abductor spasmodic dysphonia found no significant difference between the two techniques and no significant treatment benefit. Based on the evidence, laryngeal EMG is possibly useful for the injection of botulinum toxin into the thyroarytenoid muscle in the treatment of adductor spasmodic dysphonia. There were no evidence-based data sufficient to support or refute the value of laryngeal EMG for the other uses investigated, although there is extensive anecdotal literature suggesting that it is useful for each of them. There is an urgent need for evidence-based research addressing the use of laryngeal EMG for other applications.
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Affiliation(s)
- Robert T Sataloff
- Laryngeal Task Force, American Association of Electrodiagnostic Medicine
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Mandel S, Maitz EA, Tracy JI, Gordon JE. Severity of sports-related concussion and neuropsychological test performance. Neurology 2003; 61:144. [PMID: 12847183 DOI: 10.1212/wnl.61.1.144-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Weinreb O, Mandel S, Youdim MBH. cDNA microarray to determine early and late gene expression in dopaminergic neurodegeneration. J Neurochem 2003. [DOI: 10.1046/j.1471-4159.85.s2.8_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kirshtein B, Roy-Shapira A, Lantsberg L, Mandel S, Avinoach E, Mizrahi S. The use of laparoscopy in abdominal emergencies. Surg Endosc 2003; 17:1118-24. [PMID: 12728376 PMCID: PMC7101823 DOI: 10.1007/s00464-002-9114-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2002] [Accepted: 12/12/2002] [Indexed: 12/04/2022]
Abstract
BACKGROUND The purpose of this article is to describe our experience using laparoscopy in the management of emergent and acute abdominal conditions. METHODS Between March 1997 and November 2001, 277 consecutive minimally invasive procedures were performed for various nontrauma surgical emergencies. The indications for operation were nonspecific abdominal pain in 129 cases (46%), peritonitis in 64 cases (23%), small bowel obstruction in 52 cases (19%), complications after previous surgery or invasive procedures in 24 cases (9%), and sepsis of unknown origin in 8 cases (3%). RESULTS Laparoscopy obtained a correct diagnosis in 98.6% of the cases. In 207 patients (75%), the procedure was completed laparoscopically. An additional 35 patients (12.5%) required a target incision. The remaining 35 patients (12.5%) underwent formal laparotomy. The morbidity rate was 5.8%. No laparoscopy-related mortality was observed. CONCLUSIONS For patients with abdominal emergencies, the laparoscopic approach provides diagnostic accuracy and therapeutic options, avoids extensive preoperative studies, averts delays in operative intervention, and appears to reduce morbidity.
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Affiliation(s)
- B Kirshtein
- Department Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, POB 151 Beer Sheva, Israel 84101.
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Sataloff RT, Heman-Ackah YD, Simpson LL, Park JB, Zwislewski A, Sokolow C, Mandel S. Botulinum toxin type B for treatment of spasmodic dysphonia: a case report. J Voice 2002; 16:422-4. [PMID: 12395995 DOI: 10.1016/s0892-1997(02)00114-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Although treatment with botulinum toxin type A (BTXA) has become the standard of care for most patients with laryngeal dystonia, its use is limited by the development of resistance to the toxin in some patients. Botulinum toxin type B (BTXB) has been found to be safe and effective in the treatment of cervical dystonia, but it has not been used previously to treat spasmodic dysphonia. Our experience with BTXB in a patient who developed resistance to BTXA suggests that BTXB may be safe and effective for the treatment of laryngeal dystonia, as well.
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Affiliation(s)
- Robert Thayer Sataloff
- Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Phillyent.com
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Youdim MB, Grünblatt E, Levites-Royak Y, Mandel S. Drugs to prevent cell death in Parkinson's disease. Neuroprotection against oxidative stress and inflammatory gene expression. Adv Neurol 2002; 86:115-24. [PMID: 11553968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- M B Youdim
- EveTopf and NPF Centers, Technion Faculty of Medicine, Haifa 31086, Israel
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Weintraub MI, Mandel S, Esposito J, Gordon J, Maitz E, Massari D, Mandel H, Kasch H, Bach FW, Jensen TS. Handicap after acute whiplash injury. Neurology 2002. [DOI: 10.1212/wnl.58.1.157-a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mandel S, Esposito J, Gordon JE, Maitz EA, Massari DJ, Mandel H. Handicap after acute whiplash injury. Neurology 2002; 58:158; author reply 158-9. [PMID: 11781438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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Abstract
Substantial evidence suggests that fruit and vegetable intake reduces the risk of some cancers and other chronic diseases. While a varied diet containing fruits and vegetables may confer benefits greater than those of any single nutrient, it would be useful to have data on the plasma nutrients most influenced by fruit and vegetable intake. The authors examined the correlation between fruit and vegetable intake as measured by the abbreviated CLUE II food frequency questionnaire and several plasma antioxidants. This study includes 116 male subjects aged 35-72 years who were nonsmokers and nonusers of vitamin supplements and who provided blood samples in the CLUE II Study in Washington County, Maryland. Plasma was assayed for ascorbic acid, beta-carotene, beta-cryptoxanthin, and alpha- and gamma-tocopherol. Lipid- and energy-adjusted partial correlation for the relation with fruit and vegetable intake was r = 0.64 for ascorbic acid, r = 0.44 for beta-carotene, and r = 0.50 for beta-cryptoxanthin. While this study does not address efficacy, the stronger association of ascorbic acid with fruit and vegetable intake seen here may imply that ascorbic acid is an important component of the protective effect seen for fruits and vegetables in numerous epidemiologic studies.
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Affiliation(s)
- G Block
- University of California, Berkeley, Berkeley, CA 94720, USA.
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