Long-term outcomes in temporal lobe epilepsy with glutamate decarboxylase antibodies

Journal of Neurology - To assess the long-term outcomes of patients with temporal lobe epilepsy and CSF anti-glutamate decarboxylase antibodies (GAD65-Abs). We retrospectively analyzed the clinical...     

Paraneoplastic neurological syndromes associated with renal or bladder cancer: case series and PRISMA-IPD systematic review

Journal of Neurology - The link between paraneoplastic neurological syndromes (PNS) and renal cell and bladder cancer (RCC/BC) is rare and uncertain. Our aim was to clinically evaluate, in light of...     

Endoscopic management of pancreatic fistula after distal pancreatectomy and enucleation

Background

Preoperative endoscopic pancreatic sphincterotomy (EPS) has been proposed to prevent postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) or enucleation (EN). The use of EPS as a curative treatment for POPF has been scarcely reported. We reported 10 consecutive patients who were successfully treated by EPS for a prolonged POPF.

Study design

Ten patients underwent EPS for prolonged POPF (median duration = 40 days, range 20-114; median daily output = 80 mL, range 50-250) after 6 DPs, 2 ENs, and 2 medial pancreatectomies.

Results

EPS was performed in all patients, with stent insertion in 4. No patient developed a specific complication because of EPS. POPF healed within a median delay of 4 days (range 1-12). One patient underwent a repeated endoscopy to treat stent malposition. The median delay of discharge after EPS was 13 days (range 8-15). With a 20-month median follow up, 1 patient developed early transient POPF recurrence because of spontaneous stent migration.

Conclusions

EPS is indicated for prolonged POPF after DP or EN because it is highly feasible, shortens healing, and is well tolerated.     

Reorientation of Suspended Ceramic Particles in Robocasted Green Filaments during Drying

This work considers the fabrication of ceramic parts with the help of an additive manufacturing process, robocasting, in which a paste with suspended particles is robotically extruded. Within the final part, the material properties depend on the orientation of the particles. A prediction of the particle orientation is challenging as the part usually undergoes multiple processing steps with varying contributions to the orientation. As the main contribution to the final particle orientation arises from the extrusion process, many corresponding prediction models have been suggested. Robocasting involves, however, further processing steps that are less studied as they have a smaller influence on the orientation. One of the processing steps is drying by natural convection, which follows directly after the extrusion process. A quantification of the reorientation that occurs during drying is mostly unknown and usually neglected in the models. Therefore, we studied the amount of reorientation of suspended particles in robocasted green filaments during drying in detail. For our study, we applied the discrete element method, as it meets various requirements: The exact particle geometry can be resolved precisely; particle–particle interactions can be described; the paste composition is reproduced exactly; the initial particle orientation can be set in accordance with the prediction from the analytical models for the extrusion part; macroscopic force laws exist to represent capillary forces due to the remaining fluid phase that remains during drying. From our study, we concluded that the magnitude of particle reorientation during drying is small compared to the orientation occurring during the extrusion process itself. Consequently, reorientation during drying might further be neglected within analytical orientation prediction models.     

Controlled Epstein–Barr virus reactivation after allogeneic transplantation is associated with improved survival

Epstein–Barr virus reactivation (EBV‐R) frequently occurs in patients having allogeneic hematopoietic stem cell transplantation (HSCT). We evaluated the impact of controlled EBV‐R on survival of 190 patients (114M/76F, median age: 51 yr, range 18–69), having HSCT for hematological malignancies (105 acute leukemias and myelodysplasias, 71 lymphoproliferative disorders, 14 others). Overall survival (OS) and progression‐free survival (PFS) were compared between patients with and without EBV‐R. Of 138, patients had reduced‐intensity conditioning regimen. Various stem cell sources (141 PB, 33 umbilical cord blood and 16 bone marrow) were used. Patients with EBV‐R had longer PFS and OS than those without EBV‐R: PFS at 2 yr 69% vs. 51% and at 5 yr 47% vs. 38% (P < 0.04); OS at 2 yr 76% vs. 64% and at 5 yr 63% vs. 47%) (P < 0.001). The use of rituximab had no impact on OS and PFS, but it reduced the intensity of GVHD, despite the fact that TRM was not significantly different between the two groups of patients. So, rituximab may have an additional effect to other factors on PFS and OS. In multivariate analysis, antithymocyte globulin administration was not a significant factor for PFS (P = 0.68) and for OS (P = 0.81). Circulating NK cells were significantly increased by 22% (P = 0.03) in EBV‐R patients with no differences for other parameters. Controlled EBV‐R in the setting of HSCT is associated with better OS and PFS, with a significant increase in circulating NK cells.     

Delayed severe decompensation of leucinosis. Significance of emergency blood exchange transfusion. Apropos of 2 cases

The observations of two gypsy cousins born to consanguineous parents and exhibiting classical leucinemia are reminders that severe, life-threatening ketotic decompensations may occur at any time. Emergency exchange-transfusions in these two children aged 3 and 5 years reversed the course of extremely severe attacks. Medium term evaluations showed very satisfactory neuropsychologic development in both children. Pathogenesis and prevention of such episodes are discussed.