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Search Results: 1 - 10 of 233707 matches for " Edward C. Mader Jr. "
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Human Rabies with Initial Manifestations that Mimic Acute Brachial Neuritis and Guillain-Barré Syndrome
Edward C. Mader Jr,Joaquin S. Maury,Lenay Santana-Gould,Randall D. Craver
Clinical Medicine Insights: Case Reports , 2012,
Typical Spike-and-Wave Activity in Hypoxic-Ischemic Brain Injury and its Implications for Classifying Nonconvulsive Status Epilepticus
Edward C. Mader Jr,Nicole R. Villemarette-Pittman,Sergei V. Kashirny,Lenay Santana-Gould
Clinical Medicine Insights: Case Reports , 2012,
Botulinum Toxin Injections for Simple Partial Motor Seizures Associated with Pain
Edward C. Mader Jr.,Bruce J. Fisch,Nicole R. Villemarette-Pittman,Piotr W. Olejniczak,Michael E. Carey
Case Reports in Medicine , 2012, DOI: 10.1155/2012/295251
Abstract: Intractable epilepsy with painful partial motor seizures is a relatively rare and difficult disorder to treat. We evaluated the usefulness of botulinum toxin to reduce ictal pain. Two patients received two or four botulinum toxin (BTX) injections at one-to-two-month intervals. Patient 1 had painful seizures of the right arm and hand. Patient 2 had painful seizures involving the left foot and leg. Injections were discontinued after improved seizure control following resective surgery. Both patients received significant pain relief from the injections with analgesia lasting at least two months. Seizure severity was reduced, but seizure frequency and duration were unaffected. For these patients, BTX was effective in temporarily relieving pain associated with muscle contraction in simple partial motor seizures. Our findings do not support the hypothesis that modulation of motor end-organ feedback affects focal seizure generation. BTX is a safe and reversible treatment that should be considered as part of adjunctive therapy after failure to achieve control of painful partial motor seizures.
Typical Spike-and-Wave Activity in Hypoxic-Ischemic Brain Injury and its Implications for Classifying Nonconvulsive Status Epilepticus
Edward C. Mader Jr, Nicole R. Villemarette-Pittman, Sergei V. Kashirny, Lenay Santana-Gould and Piotr W. Olejniczak
Clinical Medicine Insights: Case Reports , 2012, DOI: 10.4137/CCRep.S9861
Abstract: Introduction: Typical spike-and-wave activity (TSWA) in the electroencephalogram (EEG) indicates idiopathic generalized epilepsy (IGE). IGE-related nonconvulsive status epilepticus (NCSE) is typically an absence status epilepticus (ASE). ASE and TSWA respond dramatically to benzodiazepines. Patients with no history of seizure/epilepsy may develop ASE “de novo” in the context of an acute brain disorder. However, we are aware of only one previous case of de novo ASE with TSWA in hypoxic-ischemic brain injury. Case presentation: A 65-year-old man, with congestive heart failure and history of substance abuse, survived cardiorespiratory arrest after 18 minutes of cardiopulmonary resuscitation. Post-resuscitation, the patient was in coma with intact brainstem function. Toxicology was positive for cocaine and marijuana. Eyelid myoclonus suggested NCSE, which was initially treated with lorazepam and fosphenytoin. EEG monitoring showed sustained TSWA confirming NCSE and demonstrating de novo ASE (the patient and his family never had seizure/epilepsy). The TSWA was resistant to lorazepam, levetiracetam, and low-dose midazolam; it was eliminated only with midazolam at a dose that resulted in burst-suppression (≥1.2 mg/kg/hour). Conclusion: This is an unusual case of TSWA and hypoxic-ischemic brain injury in a patient with no history of seizure/epilepsy. The TSWA was relatively resistant to benzodiazepines suggesting that cerebral hypoxia-ischemia spared the thalamocortical apparatus generating TSWA but impaired the cortical/thalamic inhibitory circuits where benzodiazepines act to suppress TSWA. Albeit rare, ‘post-hypoxic’ TSWA offers us some valuable insights for classifying and managing nonconvulsive status epilepticus.
Human Rabies with Initial Manifestations that Mimic Acute Brachial Neuritis and Guillain-Barré Syndrome
Edward C. Mader Jr, Joaquin S. Maury, Lenay Santana-Gould, Randall D. Craver, Rima El-Abassi, Enrique Segura-Palacios and Austin J. Sumner
Clinical Medicine Insights: Case Reports , 2012, DOI: 10.4137/CCRep.S9318
Abstract: Introduction: Human rabies can be overlooked in places where this disease is now rare. Its diagnosis is further confused by a negative history of exposure (cryptogenic rabies), by a Guillain-Barré syndrome (GBS) type of presentation, or by symptoms indicating another diagnosis, eg, acute brachial neuritis (ABN). Case presentation: A 19-year-old Mexican, with no past health problems, presented with a two-day history of left shoulder, arm, and chest pain. He arrived in Louisiana from Mexico five days prior to admission. Of particular importance is the absence of a history of rabies exposure and immunization. On admission, the patient had quadriparesis, areflexia, and elevated protein in the cerebrospinal fluid, prompting a diagnosis of GBS. However, emerging neurological deficits pointed towards acute encephalitis. Rabies was suspected on hospital day 11 after common causes of encephalitis (eg, arboviruses) have been excluded. The patient tested positive for rabies IgM and IgG. He died 17 days after admission. Negri bodies were detected in the patient's brain and rabies virus antigen typing identified the vampire bat as the source of infection. Conclusion: Rabies should be suspected in every patient with a rapidly evolving GBS-like illness—even if there is no history of exposure and no evidence of encephalitis on presentation. The patient's ABN-like symptoms may be equivalent to the pain experienced by rabies victims near the inoculation site.
Sporadic Creutzfeldt-Jakob disease with focal findings: caveats to current diagnostic criteria
Edward C. Mader,Rima El-Abassi,Nicole R. Villemarette-Pittman,Lenay Santana-Gould
Neurology International , 2013, DOI: 10.4081/ni.2013.e1
Abstract: The clinical diagnosis of Creutzfeldt-Jakob disease (CJD) is largely based on the 1998 World Health Organization diagnostic criteria. Unfortunately, rigid compliance with these criteria may result in failure to recognize sporadic CJD (sCJD), especially early in its course when focal findings predominate and traditional red flags are not yet present. A 61-year-old man presented with a 3-week history of epilepsia partialis continua (jerking of the left upper extremity) and a 2-week history of forgetfulness and left hemiparesis; left hemisensory neglect was also detected on admission. Repeated brain magnetic resonance imaging (MRI) showed areas of restricted diffusion in the cerebral cortex, initially on the right but later spreading to the left. Electroencephalography (EEG) on hospital days 7, 10, and 14 showed right-sided periodic lateralized epileptiform discharges. On day 20, the EEG showed periodic sharp wave complexes leading to a diagnosis of probable sCJD and subsequently to definite sCJD with brain biopsy. Neurological decline was relatively fast with generalized myoclonus and akinetic mutism developing within 7 weeks from the onset of illness. CJD was not immediately recognized because of the patient’s focal/lateralized manifestations. Focal/lateralized clinical, EEG, and MRI findings are not uncommon in sCJD and EEG/MRI results may not be diagnostic in the early stages of sCJD. Familiarity with these caveats and with the most current criteria for diagnosing probable sCJD (University of California San Francisco 2007, MRI-CJD Consortium 2009) will enhance the ability to recognize sCJD and implement early safety measures.
Book Reviews
Jerome C. Arnett. Jr., M.D.,Edward Stevenson
Journal of American Physicians and Surgeons , 2009,
Abstract: Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (Gary Taubes) Reviewed by Jerome C. Arnett. Jr., M.D. Indoctrination U.: The Left’s War Against Academic Freedom (David Horowitz) Reviewed by Jerome C. Arnett. Jr., M.D. Patient Heal Thyself—How the New Medicine Puts the Patient in Charge (Robert M. Veatch) Reviewed by Edward Stevenson
A Novel Flow-Perfusion Bioreactor Supports 3D Dynamic Cell Culture
Alexander M. Sailon,Alexander C. Allori,Edward H. Davidson,Derek D. Reformat,Robert J. Allen Jr.,Stephen M. Warren
Journal of Biomedicine and Biotechnology , 2009, DOI: 10.1155/2009/873816
Abstract: Background. Bone engineering requires thicker three-dimensional constructs than the maximum thickness supported by standard cell-culture techniques (2 mm). A flow-perfusion bioreactor was developed to provide chemotransportation to thick (6 mm) scaffolds. Methods. Polyurethane scaffolds, seeded with murine preosteoblasts, were loaded into a novel bioreactor. Control scaffolds remained in static culture. Samples were harvested at days 2, 4, 6, and 8 and analyzed for cellular distribution, viability, metabolic activity, and density at the periphery and core. Results. By day 8, static scaffolds had a periphery cell density of 67%±5.0%, while in the core it was 0.3%±0.3%. Flow-perfused scaffolds demonstrated peripheral cell density of 94%±8.3% and core density of 76%±3.1% at day 8. Conclusions. Flow perfusion provides chemotransportation to thick scaffolds. This system may permit high throughput study of 3D tissues in vitro and enable prefabrication of biological constructs large enough to solve clinical problems.
Aplica??es da cirurgia videolaparoscópica em crian?as
Esteves, Edward;O. Neto, Miguel;C. Neto, Eriberto;Terêncio Jr., Osmar;Carvalho, Bernardina B.;Pereira, Ruy E.;
Jornal de Pediatria , 2001, DOI: 10.1590/S0021-75572001000500012
Abstract: objectives: to present the videolaparoscopies performed by the children's surgery service, and study the main indications for pediatric laparoscopic surgeries, considering advantages and disadvantages over conventional open procedures. methods: retrospective analysis of 612 videolaparoscopies in children aged between 8 days and 17 years treated from november/95 to 2000. basic principles of videolaparoscopy and the postoperative management of several pediatric diseases are described. the results, advantages, and complications were analyzed after a 5-year follow-up period. results:laparoscopic surgery allowed for a wide series of abdominal procedures conventionally carried out through open surgery, mainly for the treatment of gastroesophageal reflux disease, inflammatory acute abdomen, adhesive intestinal obstruction, biliary lithiasis, tumors, cryptorchidism, ovarian diseases, splenectomies, aganglionosis, trauma and others. morbidity was low (1%), and mortality due to laparoscopy was nonexistent. conversion to laparotomy occurred in only 14 cases (2.3%), mainly because of trauma. the principal advantages included minimal surgical trauma, pain and reflex ileum, short hospital stay, almost no incisional hernias and better cosmetic scars. conclusions: videolaparoscopy seems to be a great advance in modern pediatric surgery, allowing safer and less invasive treatment of a wide series of abdominal diseases at all pediatric ages.
The changing dimensions of rheumatoid arthritis and its treatment
Harris Jr.,Edward D.
Bulletin of the World Health Organization , 2003,
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