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Systemic Spread (systemic + spread)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Systemic adverse events following botulinum toxin A therapy in children with cerebral palsy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2010
KRISHANT NAIDU
Aim, We studied the incidence of incontinence and respiratory events in children with cerebral palsy who received injections of botulinum toxin A (BoNT-A). Method, We used multivariable logistic regression to investigate relationships between (BoNT-A) dose, Gross Motor Function Classification System (GMFCS) level, and the incidence of bladder or bowel incontinence, unplanned hospital admission, emergency department consultation or prescription of antibiotics for respiratory symptoms, and diagnosis of upper respiratory tract infection. Results, Of 1980 injection episodes in 1147 children (mean age 4y 7mo, SD 1y 10mo, range 9mo,23y), 488 (25%) were in children with unilateral involvement and 1492 (75%) in children with bilateral involvement. At the time of injection 440 (22.2%) of children were at GMFCS level I, 611 (30.9%) were at level II, 330 (16.7%) were at level III, 349 (17.6%) were at level IV, and 250 (12.6%) were at level V. The incidence of serious adverse events was low, with 19 episodes of incontinence (1% of injection episodes) and 25 unplanned hospital admissions due to respiratory symptoms (1.3%). Incontinence typically resolved spontaneously 1 to 6 weeks after injection. The incidence of adverse events was associated with GMFCS level and dose of BoNT-A. Interpretation, The incidence of serious adverse events was low but suggests systemic spread as well as a procedural effect. We recommend reviewing upper dose limits for children at all GMFCS levels, particularly those at levels IV and V with a history of aspiration and respiratory disease. In these children, alternatives to mask anaesthesia may be particularly important. [source]

Signet ring-like light chain myeloma with systemic spread

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2003
Joud H. Haidar
Abstract: The morphological presentation of malignant plasma cells in multiple myeloma (MM) varies from mature to anaplastic plasma cells with only one reported case of signet ring variant. We describe here another case of signet ring-like lambda light chain MM associated with extra-skeletal spread to lymph nodes, spleen and liver. The clinical and pathological presentations were atypical with no evidence of bone-lytic lesions or monoclonal component on protein electrophoresis, leading to a delay of several years in the diagnosis. Recognition of this morphological entity of MM may help in an early diagnosis of this rare variant. [source]

Sciatic inflammatory neuritis (SIN): Behavioral allodynia is paralleled by peri-sciatic proinflammatory cytokine and superoxide production

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2001
Lawrence S. Gazda
Abstract We have recently developed a model of sciatic inflammatory neuritis (SIN) to assess how immune activation near peripheral nerves influences somatosensory processing. Administration of zymosan (yeast cell walls) around a single sciatic nerve produces dose-dependent low-threshold mechanical allodynia without thermal hyperalgesia. Low (4 ,g) doses produce both territorial and extraterritorial allodynia restricted to the injected hindleg. In contrast, higher (40 ,g) doses produce territorial and extraterritorial allodynias of both hindlegs, an effect not accounted for by systemic spread of the zymosan. The aim of these experiments was to determine whether these behavioral allodynias were correlated with immunological and/or anatomical changes in or around the sciatic nerve. These experiments reveal that zymosan-induced bilateral allodynia was associated with the following: (a) increased release of both interleukin-1, and tumor necrosis factor-, from peri-sciatic immune cells; (b) increased release of reactive oxygen species from peri-sciatic immune cells; (c) no change in circulating levels of proinflammatory cytokine; (d) no apparent zymosan-induced influx of immune cells into the sciatic nerve from the endoneurial blood vessels; (e) mild edema of the sciatic, which was predominantly restricted to superficial regions closest to the peri-sciatic immune cells; and (f) no anatomic evidence of changes in either the ipsilateral saphenous nerve or contralateral sciatic nerve that could account for the appearance of extraterritorial or contralateral ("mirror") allodynia, respectively. No reliable differences were found when the low-dose zymosan was compared with vehicle controls. Taken together, these data suggest that substances released by peri-sciatic immune cells may induce changes in the sciatic nerve, leading to the appearance of bilateral allodynia. [source]

Could proximal white subungual onychomycosis be a complication of systemic spread?

BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2005
The lessons to be learned from Maladie Dermatophytique, other deep infections
Summary There are several published cases where dermatophyte infections have spread systemically, resulting in widespread internal dissemination as well as spread to local lymphatics and lymph nodes. The best example is provided by the condition known as Maladie Dermatophytique. In this commentary the arguments are discussed for a potential role of lymphatic dissemination in the development of proximal white subungual onychomycosis, where invasion of the nail plate by fungi proceeds from the proximal nail fold. [source]

Trichophyton rubrum showing deep dermal invasion directly from the epidermis in immunosuppressed patients

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2001
K.J. Smith
Trichophyton rubrum is the most widely encountered dermatophyte infection, and is usually regarded as exclusively keratinophilic often leading to chronic cutaneous and nail infections, even in healthy individuals. We present three patients with acute leukaemias, with ill-defined pre-existent cutaneous eruptions that were treated with a potent topical corticosteroid. All three patients received aggressive marrow toxic chemotherapy. These patients had progression of their cutaneous disease, which showed deep dermal invasion of T. rubrum, invading directly from the epidermis with no evidence of systemic spread. We conclude that systemic pancytopenia, in association with prolonged local immunosuppression, may increase the risk of direct dermal invasion of dermatophyte infections. However, even in these patients, the risk of systemic spread still appears very low. Amphotericin B did not appear effective in treating these dermatophyte infections. [source]