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HIV related Myelopathy

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61. Safety and Preliminary Efficacy of FAB117-HC in Patients With Acute Traumatic Spinal Cord Injury

or significant impairment in the level of consciousness, including unconsciousness due to sedative-analgesic medications, that interferes with the performance or interpretation of assessments specific in the protocol. Preexisting or current significant diseases such as hepatitis C, HIV, epilepsy, neoplastic disease or other diseases that could cause neurological deficits including syphilis, myelopathy, and polyneuropathy. Background or acute episode of Guillain-Barre syndrome. History of meningitis (...) : Recruiting First Posted : September 28, 2016 Last Update Posted : August 21, 2018 See Sponsor: Ferrer Internacional S.A. Collaborator: Histocell S.L. Information provided by (Responsible Party): Ferrer Internacional S.A. Study Details Study Description Go to Brief Summary: The main objective of the study is the evaluation of the safety and tolerability of FAB117-HC (a medicinal product containing human allogeneic adipose derived adult mesenchymal stem cells expanded and pulsed with H2O2, HC016 cells

2016 Clinical Trials

62. Selumetinib in Treating Patients With Neurofibromatosis Type 1 and Plexiform Neurofibromas That Cannot Be Removed by Surgery

or surgery Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active bleeding diatheses or renal transplant, including any patient known to have hepatitis B, hepatitis C or human immunodeficiency virus (HIV), or psychiatric illness/social situations that would limit compliance with study requirements; patients with HIV who have adequate CD4 counts and who have no requirement (...) Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Phase II Trial of the MEK1/2 Inhibitor Selumetinib (AZD6244 Hydrogen Sulfate) in Adults With Neurofibromatosis Type 1 (NF1) and Inoperable Plexiform Neurofibromas Actual Study Start Date : January 11, 2016 Estimated Primary Completion Date : June 30, 2019 Resource links provided by the National Library of Medicine related topics: related topics: resources: Arms and Interventions Go to Arm

2015 Clinical Trials

63. Prospective Comparative Study to Compare Safety and Effectiveness of Two Vertebral Compression Fracture Reduction Techniques

, Comparative Clinical Study to Compare the Safety and Effectiveness of Two Vertebral Compression Fracture (VCF) Reduction Techniques: the SpineJack® and the KyphX Xpander® Inflatable Bone Tamp Study Start Date : April 2015 Actual Primary Completion Date : February 20, 2018 Actual Study Completion Date : February 20, 2018 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: SpineJack® system VCF treatment system (...) and effectiveness): Reduction in VCF fracture-related pain at 12 months from baseline as measured by a 100 mm VAS scale (reduction of pain at 12 months by > 20 mm) AND, Maintenance or improvement in function at 12 months from baseline as measured by the 100 point Oswestry Disability Index (ODI) AND, Absence of device-related serious adverse events, defined as device-related adverse events (device migration, recollapse, protrusion) or symptomatic cement extravasation requiring surgical re-intervention

2015 Clinical Trials

64. Study to Evaluate Safety and Efficacy of Three Different Dosages of NewGam in Patients With Chronic Inflammatory Demyelinating Poly (Radiculo) Neuropathy

minimum clinically important difference (MCID) cut-off of 8 kilopascal (kPa) Inflammatory Rasch-built overall disability scale (I-RODS Score) [ Time Frame: at Week 24 ] Proportion of responders in the 0.5 g/kg and 2.0 g/kg NewGam arms at Week 24 relative to baseline at Week 0 compared to the 1.0 g/kg arm, based on the Inflammatory Rasch-built overall disability scale (I-RODS Score) using the MCID concept related to the varying standard errors (MCID-SE) as recently demonstrated Worsening (...) before any study-related procedures are conducted Exclusion Criteria: Unifocal forms of Chronic inflammatory demyelinating polyneuropathy (CIDP) Pure sensory Chronic inflammatory demyelinating polyneuropathy (CIDP) Multifocal motor neuropathy (MMN) with conduction block [van den Bergh et al., 2010] Patients who previously failed immunoglobulin treatment Treatment with immunomodulatory/suppressive agents (cyclosporin, methotrexate, mitoxantrone, mycophenolate mofetil or azathioprine) during the six

2015 Clinical Trials

65. Nivolumab in Treating Patients With HTLV-Associated T-Cell Leukemia/Lymphoma

Patients who have hepatitis C (both reactive anti-hepatitis C virus [HCV] antibody and detectable HCV RNA) and hepatitis B (hepatitis B surface antigen [HBsAg] positive and anti-hepatitis B core [HBc]-total positive), may be enrolled, provided their total bilirubin: =< 1.5 x institutional upper limit of normal (ULN) AST (SGOT)/ALT (SGPT): =< 2.5 x institutional upper limit of normal Patients with concurrent human immunodeficiency virus (HIV) infection may be enrolled if compliant with 3 or more drug (...) Cancer Institute (NCI) Information provided by (Responsible Party): National Cancer Institute (NCI) Study Details Study Description Go to Brief Summary: This phase II trial studies how well nivolumab works in treating patients with human T-cell leukemia virus (HTLV)-associated T-cell leukemia/lymphoma. Nivolumab is an antibody, which is a type of blood protein that tags infected cells and other harmful agents. Nivolumab works against a protein called programmed cell death (PD)-1 and may help the body

2015 Clinical Trials

66. Effect of Raltegravir in Patients With Acute Tropical Spastic Paraparesis

Purpose: Treatment Official Title: Effect of Raltegravir in Patients With Myelopathy/Tropical Spastic Paraparesis Associated With Infection by Human T-Lymphotropic Virus 1 (HTLV-1). Pilot Study Actual Study Start Date : July 1, 2017 Estimated Primary Completion Date : June 2018 Estimated Study Completion Date : June 2019 Resource links provided by the National Library of Medicine related topics: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Experimental: HTLV-1 plus (...) insufficiency, unstable ischemic heart disease, abnormal liver function tests (>2.5 times upper limit normal (ULN)) and abnormal complete blood count (in particular leukopenia, as defined by a lymphocyte count <500, neutrophil <1.5 or platelet count < 100, or thrombocytopenia < 1.5 low limit normal (LLN), or any medical condition which, in the opinion of the chief investigator, would pose additional risk to the patient. Presence of human immunodeficiency virus antibodies. Patients with active hepatitis B

2015 Clinical Trials

67. Thoracic Aortic Disease: Guidelines For the Diagnosis and Management of Patients With

the evidence related to drugs, devices, and procedures for the detection, management, or prevention of disease. Properly applied, rigorous, expert analysis of the available data documenting absolute and relative bene?ts and risks of these therapies and procedures can improve outcomes and reduce costs of care by focusing resources on the most effective strategies. One important use of such data is the production of clinical practice guidelines that, in turn, can provide a foundation for a variety of other (...) readers’ comprehension of the guidelines and will allow queries at the individual recommendation level. e33 JACC Vol. 55, No. 14, 2010 Hiratzka et al. April 6, 2010:e27–129 2010 Guidelines on Thoracic Aortic Diseasecomes for performance improvement. The UHC provided the writing committee with a summary of recent information based on ICD-9 codes for thoracic aortic disease–related hospitalizations from the Clinical DataBase/Resource Man- ager (Tables 2A and 2B). This data table demonstrates a high

2010 American College of Cardiology

68. Vitamin B-12 Associated Neurological Diseases (Follow-up)

in infantile cobalamin deficiency appearing after treatment. Pediatr Neurol . 2001 Jul. 25(1):81-3. . Paltiel O, Falutz J, Veilleux M. Clinical correlates of subnormal vitamin B12 levels in patients infected with the human immunodeficiency virus. Am J Hematol . 1995 Aug. 49(4):318-22. . Pant SS, Asbury AK, Richardson EP Jr. The myelopathy of pernicious anemia. A neuropathological reappraisal. Acta Neurol Scand . 1968. 44:Suppl 5:1-36. . Penix LP. Ischemic strokes secondary to vitamin B12 deficiency-induced (...) and brain lesions in subacute combined degeneration. Neuroradiology . 1998 Nov. 40(11):716-9. . Kieburtz KD, Giang DW, Schiffer RB, Vakil N. Abnormal vitamin B12 metabolism in human immunodeficiency virus infection. Association with neurological dysfunction. Arch Neurol . 1991 Mar. 48(3):312-4. . Kirke PN, Molloy AM, Daly LE. Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects. Q J Med . 1993 Nov. 86(11):703-8. . Krumholz A, Weiss HD, Goldstein PJ, Harris KC

2014 eMedicine.com

69. Transfusion-Transmitted Diseases (Diagnosis)

transmitted through blood transfusion include the following: Human immunodeficiency virus (HIV) West Nile virus (WNV) Cytomegalovirus (CMV) Human T-cell lymphotrophic viruses (HTLVs) Parvovirus B19 Protozoal organisms that can be passed on through transfusion include species of the genus Plasmodium , which cause malaria. Prions, which cause Creutzfeldt-Jakob disease, are also transmissible through transfusion; they cannot be destroyed using current techniques for inactivating pathogens in the blood supply (...) of contamination. A negative culture for 24-48 hours before the product is released for transfusion is highly recommended. Previous Next: Viral Infections Human immunodeficiency virus The human immunodeficiency virus (HIV), a member of the Lentivirus family of retroviruses, is the causative agent of acquired immunodeficiency syndrome (AIDS). In the United States, more than 1.2 million people are living with HIV, and 1 in 8 of them don't know it. Individuals who engage in male-male sexual behavior accounted

2014 eMedicine.com

70. Syringomyelia (Diagnosis)

include (1) spinal trauma, (2) radiation necrosis, (3) hemorrhage from aneurysm rupture or arteriovenous malformation or in a tumor bed, (4) infection (spinal abscess, human immunodeficiency virus, transverse myelitis), and (5) cavitation following ischemic injury or degenerative disease. Syringomyelia and spinal dysraphism Spinal dysraphism may cause syringomyelia through a variety of mechanisms, including those mentioned under the previous three categories. Identification and treatment of associated (...) malformation Membranous abnormalities include the following: Arachnoid cysts [ ] , rhombic roof, or vascularized membranes Posthemorrhagic or postinflammatory membranes Other etiologies not associated with craniovertebral abnormalities may include the following: Arachnoid scarring related to spinal trauma Arachnoid scarring related to meningeal inflammation Arachnoid scarring related to surgical trauma Subarachnoid space stenosis due to spinal neoplasm or vascular malformation Subarachnoid space stenosis

2014 eMedicine.com

71. Human T-Cell Lymphotrophic Viruses (Diagnosis)

Haematol . 1996 Sep. 94(4):713-5. . Castilla J, Pachon I, Gonzalez MP, et al. Seroprevalence of HIV and HTLV in a representative sample of the Spanish population. Epidemiol Infect . 2000 Aug. 125(1):159-62. . Cavrois M, Gessain A, Gout O, Wain-Hobson S, Wattel E. Common human T cell leukemia virus type 1 (HTLV-1) integration sites in cerebrospinal fluid and blood lymphocytes of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis indicate that HTLV-1 crosses the blood-brain barrier (...) , proviral load, and molecular analysis from HTLV-1 in saliva. J Med Virol . 2012 Sep. 84(9):1428-36. . Murata M, Mizusawa H, Kanazawa I, Yazawa T, Uchida Y. [An autopsy case of HTLV-I associated myelopathy (HAM) with adult T-cell leukemia (ATL)]. Rinsho Shinkeigaku . 1990 Jul. 30(7):754-9. . Furukawa Y, Okadome T, Tara M, Niina K, Izumo S, Osame M. Human T-cell lymphotropic virus type-I (HTLV-I)-associated myelopathy/tropical spastic paraparesis with acute type of adult T-cell leukemia. Intern Med

2014 eMedicine.com

72. Retinitis, CMV (Diagnosis)

eye involvement and retinal detachment. Ophthalmology . 2004 Dec. 111(12):2232-9. . Banker AS. Posterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome. Indian J Ophthalmol . 2008 Sep-Oct. 56 (5):377-83. . Wong JX, Wong EP, Teoh SC. Outcomes of cytomegalovirus retinitis-related retinal detachment surgery in acquired immunodeficiency syndrome patients in an Asian population. BMC Ophthalmol . 2014 Nov 27. 14:150. . Stewart MW. Optimal management (...) in patients with human immunodeficiency virus infection. Rev Gastroenterol Disord . 2002 Fall. 2 (4):176-88. . Baumal CR, Levin AV, Read SE. Cytomegalovirus retinitis in immunosuppressed children. Am J Ophthalmol . 1999 May. 127(5):550-8. . Sugar EA, Jabs DA, Ahuja A, Thorne JE, Danis RP, Meinert CL. Incidence of cytomegalovirus retinitis in the era of highly active antiretroviral therapy. Am J Ophthalmol . 2012 Jun. 153(6):1016-1024.e5. . . Kempen JH, Sugar EA, Lyon AT, Lewis RA, Jabs DA, Heinemann MH

2014 eMedicine.com

73. Neurosyphilis (Diagnosis)

> Neurosyphilis Overview of Syphilis of the CNS Updated: Jul 17, 2018 Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Share Email Print Feedback Close Sections Sections Neurosyphilis Overview of Syphilis of the CNS Overview of Syphilis of the CNS Syphilis is a sexually transmitted disease caused by Treponema pallidum, with human beings as the only host. Syphilitic infection of the nervous system results in the most chronic, insidious meningeal inflammatory (...) process known. Invasion of the CNS occurs early in the course of untreated syphilis. Of late, there has been a drastic increase, worldwide, in the incidence of syphilis, especially in urban areas. [ ] This fact leads clinicians to heighten their degree of suspicion, being profoundly alert to the possibility of this infection within the HIV populations. [ ] Neurosyphilis, quite directly, is defined as a CSF WBC count of 20 cells/µL or greater or a reactive CSF Venereal Disease Research Laboratory (VDRL

2014 eMedicine.com

74. Primary CNS Lymphoma (Diagnosis)

30 cells/µL. Virtually all PCNSLs in patients with AIDS express an Epstein-Barr virus (EBV)-related genome. PCNSL is less frequently associated with EBV in patients without AIDS. The overwhelmingly common risk factor for PCNSL related to human immunodeficiency virus (HIV) infection is intravenous (IV) drug abuse. Corboy et al reported that 56% of a group of immunocompetent and immunocompromised patients had human herpes virus 8 (HHV-8) in their tumors. This is the same herpes virus (...) , Little RF, et al. Paradoxical central nervous system immune reconstitution syndrome in acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Haematologica . 2014 Oct 10. . Corboy JR, Garl PJ, Kleinschmidt-DeMasters BK. Human herpesvirus 8 DNA in CNS lymphomas from patients with and without AIDS. Neurology . 1998 Feb. 50(2):335-40. . Gomez-Brouchet A, Delisle MB, Vital A, Brousset P. Immunohistochemical assessment of human herpesvirus 8 infection in primary central

2014 eMedicine.com

75. Pathophysiology of Chronic Back Pain (Diagnosis)

. In humans, painful disks have a lower pH than nonpainful disks. Also, experimental lowering of the pH in animal models induced pain-related behaviors and hyperalgesia. Diskography of canine disks that were normally or experimentally deformed seemed to show increased concentrations of neuropeptides, such as substance P (SP), calcitonin gene-related peptide (CGRP), and vasoactive intestinal peptide (VIP) in the dorsal root ganglion (DRG), implicating their possible role in the transmission or modulation (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0NDEzMC1vdmVydmlldw== processing > Low Back Pain and Sciatica Updated: Aug 22, 2018 Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA Share Email Print Feedback Close Sections Sections Low Back Pain and Sciatica Overview Overview Like a modern skyscraper, the human spine defies gravity, and defines us as vertical bipeds. It forms the infrastructure of a biological machine that anchors the kinetic chain and transfers biomechanical forces into coordinated functional activities

2014 eMedicine.com

76. Intravenous Immunoglobulin (Diagnosis)

, corticosteroid-resistant extensive, GCSF-induced Sweet syndrome. [ ] Miscellaneous Adrenoleukodystrophy Acute cardiomyopathy Congenital heart block Autoimmune blistering dermatosis Acute idiopathic dysautonomia Endotoxemia Hemophagocytic syndrome Lower motor neuron syndrome Human T-cell lymphotrophic virus-1–associated myelopathy Nephritic syndrome Membranous nephropathy Euthyroid ophthalmopathy Opsoclonus-myoclonus Recurrent Paraneoplastic cerebellar degeneration Paraproteinemic neuropathy (general (...) remains unproven. IVIG does not prevent further losses among women with primary, recurrent, spontaneous pregnancy loss. IVIG is a useful treatment for immunodeficiencies with a greater role than simple replacement therapy. [ ] One study suggests that IVIGs are effective in the treatment of pretibial myxedema and may have immunomodulatory action in patients with Graves disease and related disorders. Patients with ataxic sensory neuronopathy with Sjögren syndrome and stiff man syndrome have benefited

2014 eMedicine.com

77. Human T-Cell Lymphotrophic Viruses (Overview)

Haematol . 1996 Sep. 94(4):713-5. . Castilla J, Pachon I, Gonzalez MP, et al. Seroprevalence of HIV and HTLV in a representative sample of the Spanish population. Epidemiol Infect . 2000 Aug. 125(1):159-62. . Cavrois M, Gessain A, Gout O, Wain-Hobson S, Wattel E. Common human T cell leukemia virus type 1 (HTLV-1) integration sites in cerebrospinal fluid and blood lymphocytes of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis indicate that HTLV-1 crosses the blood-brain barrier (...) , proviral load, and molecular analysis from HTLV-1 in saliva. J Med Virol . 2012 Sep. 84(9):1428-36. . Murata M, Mizusawa H, Kanazawa I, Yazawa T, Uchida Y. [An autopsy case of HTLV-I associated myelopathy (HAM) with adult T-cell leukemia (ATL)]. Rinsho Shinkeigaku . 1990 Jul. 30(7):754-9. . Furukawa Y, Okadome T, Tara M, Niina K, Izumo S, Osame M. Human T-cell lymphotropic virus type-I (HTLV-I)-associated myelopathy/tropical spastic paraparesis with acute type of adult T-cell leukemia. Intern Med

2014 eMedicine.com

78. Vitamin B-12 Associated Neurological Diseases (Overview)

in infantile cobalamin deficiency appearing after treatment. Pediatr Neurol . 2001 Jul. 25(1):81-3. . Paltiel O, Falutz J, Veilleux M. Clinical correlates of subnormal vitamin B12 levels in patients infected with the human immunodeficiency virus. Am J Hematol . 1995 Aug. 49(4):318-22. . Pant SS, Asbury AK, Richardson EP Jr. The myelopathy of pernicious anemia. A neuropathological reappraisal. Acta Neurol Scand . 1968. 44:Suppl 5:1-36. . Penix LP. Ischemic strokes secondary to vitamin B12 deficiency-induced (...) and brain lesions in subacute combined degeneration. Neuroradiology . 1998 Nov. 40(11):716-9. . Kieburtz KD, Giang DW, Schiffer RB, Vakil N. Abnormal vitamin B12 metabolism in human immunodeficiency virus infection. Association with neurological dysfunction. Arch Neurol . 1991 Mar. 48(3):312-4. . Kirke PN, Molloy AM, Daly LE. Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects. Q J Med . 1993 Nov. 86(11):703-8. . Krumholz A, Weiss HD, Goldstein PJ, Harris KC

2014 eMedicine.com

79. Syringomyelia (Overview)

include (1) spinal trauma, (2) radiation necrosis, (3) hemorrhage from aneurysm rupture or arteriovenous malformation or in a tumor bed, (4) infection (spinal abscess, human immunodeficiency virus, transverse myelitis), and (5) cavitation following ischemic injury or degenerative disease. Syringomyelia and spinal dysraphism Spinal dysraphism may cause syringomyelia through a variety of mechanisms, including those mentioned under the previous three categories. Identification and treatment of associated (...) malformation Membranous abnormalities include the following: Arachnoid cysts [ ] , rhombic roof, or vascularized membranes Posthemorrhagic or postinflammatory membranes Other etiologies not associated with craniovertebral abnormalities may include the following: Arachnoid scarring related to spinal trauma Arachnoid scarring related to meningeal inflammation Arachnoid scarring related to surgical trauma Subarachnoid space stenosis due to spinal neoplasm or vascular malformation Subarachnoid space stenosis

2014 eMedicine.com

80. Somatosensory Evoked Potentials: Clinical Applications (Overview)

for detecting abnormalities Vascular lesions Tumors Myelomeningocele Tethered cord syndrome Infectious disorders (eg, human T-lymphocytic virus 1 and HIV) Previous Next: Brain Stem and Brain Brain stem lesions and stroke SEPs are normal in Wallenberg's syndrome but are generally abnormal when medial lemniscus is involved. SEPs are also unaffected and normal in some of the hemispheric (eg, pure motor lacunar infarctions, occipital lobe infarctions). In larger brainstem or hemispheric lesions, N20 and later (...) in the course of the disease, when distal conduction and F-wave studies may be normal Chronic acquired demyelinating neuropathies Infectious causes (eg, HIV) Toxic neuropathies Focal neuropathy The test of choice in focal neuropathy is standard NCSs. Entrapment neuropathies, such as carpal tunnel syndrome, may be found incidentally when SEPs are recorded. The use of SEP for detection of saphenous neuropathy, intercostal neuropathy, and trigeminal neuropathy has been reported. However, standard NCSs

2014 eMedicine.com

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