Academic literature on the topic 'Tabes Dorsalis, complications'

AbstractNeurosyphilis is caused by the bacterium Treponema pallidum subspecies pallidum (T. pallidum). The organism gains entry into the central nervous system (CNS) early (primary syphilis or chancre phase) in the course of infection. While most patients are able to mount an immune response that effectively clears CNS invasion without long-term complications, a minority go on to develop asymptomatic or symptomatic neurosyphilis. Neurosyphilis has been divided into early and late stages. The early stages include asymptomatic meningitis, symptomatic meningitis, gumma, and meningovascular syphilis, while the late stages include dementia paralytica and tabes dorsalis. Ocular and otologic syphilis can occur at any time but often accompany the acute meningitis of early neurosyphilis. The diagnosis of symptomatic neurosyphilis requires meeting clinical, serologic, and cerebrospinal fluid (CSF) criteria, while the diagnosis of asymptomatic neurosyphilis relies on serologic and CSF criteria alone. In the last several decades, a persistent rise in syphilitic meningitis and other forms of early neurosyphilis have been seen in the human immunodeficiency virus-positive population, principally in men who have sex with men. This article reviews the clinical presentation, diagnosis, and treatment of neurosyphilis, and it addresses the controversy regarding the role of lumbar puncture early in the course of infection.

Neurosyphilis accounts for 56%-70% of all visceral syphilis and is a complication in 5%-10% of cases of untreated syphilis. The aim of this study was to evaluate the epidemiological aspects and clinical presentations of neurosyphilis in Morocco through a series of 201 patients attending the Centre for Neurological Services at the university hospital in Rabat between 1986 and 1997. The mean age of the patients was 41.26 [SD 9.23] years [range:17-70 years] ; the majority [91%] were male. The incidence of neurosyphilis in Morocco is high. From 31 cases per year in 1985, it has fallen since 1990 to reach 10 cases in 1997. Among the different clinical presentations recorded, chronic meningoencepahalitis was the commonest, followed by meningovasculitis, tabes dorsalis and optic atrophy

Avaliar na literatura vigente a produção científica acerca das complicações da neurossífilis. Trata-se de uma revisão integrativa da literatura realizada através de materiais científicos indexados na Biblioteca Virtual em Saúde (BVS). Foram utilizadas para a busca dos artigos as seguintes bases de dados: PubMed, SCIELO e Science os descritores de saúde: Sífilis, Neurossífilis, Demência. Na busca foram encontrados 5.648 artigos, dos quais apenas 09 atenderam aos critérios. Considerando os critérios de inclusão: texto completo disponível, artigo original, publicação entre 2010 e 2020, disponíveis na língua materna e inglesa e dentro da temática sugerida na pesquisa. Foram lidos e categorizados de acordo com ano de publicação, tipo de estudo e temática. Evidenciou-se que a neurosssífilis pode acarretar várias complicações nos pacientes acometidos por esta enfermidade dentre as quais podemos destacar: Demência, psicose, tabes dorsales, sífilis meningovascular, alterações cognitivas, déficits motores, cefaleia, ataxia, distúrbios áudios visuais dentre outros. Portanto quanto mais tarde for diagnosticada e tratada maior será as sequelas cognitivas e comportamentais nesses pacientes então se faz necessário um diagnóstico diferencial e um tratamento rápido e eficaz a fim de evitar a deterioração completado do organismo do paciente. Nesta perspectiva cabe ao enfermeiro promover a prevenção e a educação em saúde a fim de oferta uma assistência de qualidade buscando diminuir significativamente os números de casos.

The traditional lateral rhinotomy incision described originally by Moure in 1902 has proved a versatile approach to the mid-facial skeleton. It is not, however, without its complications, particularly poor cosmesis due to depression of the nasofacial groove. In one series 10 per cent of patients developed wound complications. We present our modification of the lateral rhinotomy incision, that takes account of the nasal aesthetic subunits by placing the incision between the dorsal and side wall nasal subunits with extension inferiorly along the alar groove.From November 1994 to February 2001, a retrospective review of case notes showed that 20 patients underwent modified lateral rhinotomy incision for a variety of pathology. Ten cases were for transitional papilloma, nine for malignant disease and one for chronic osteitis of the maxilla and ethmoids post-trauma. Follow up ranged from two weeks to five years. In five cases we were able to preserve the bony piriform aperture without compromising the excision or exposure. We believe that preservation of the bony piriform aperture will further enhance the overall cosmesis and nasal function. No complaints related to the incision were recorded.Our experience with the modified lateral rhinotomy incision has been very satisfactory. It provides good exposure, a low complication rate and excellent cosmetic outcome without undue technical difficulty. It is our preferred incision for all surgery on the mid-facial skeleton and anterior skull base.

Category: Lesser Toes Introduction/Purpose: The plantar plate is a fibrocartilaginous structure that plays a fundamental role in the sagittal stability of the metatarsophalangeal joint (MTPJ). Traumatic and degenerative lesions affecting the plantar plate have the potential to cause instability, swelling, pain and deformity. Extensive plantar plate tears (grade IV) still challenge surgeons as primary repair is impossible, demanding a reconstructive procedure which, unfortunately, can be associated with high morbidity such as stiffness, persistence of discomfort, vascular compromise to the digit and amputation. The purpose of this work is to describe a new technique that uses a synthetic tape and one absorbable screw to achieve the MTPJ stabilization in plantar plate grade IV tears. We believe that this procedure can achieve better results than other techniques described in the literature. Methods: Two bone tunnels are made at the base of the proximal phalanx. Both medial and lateral tunnels are directed in a light oblique fashion from a distal-dorsal entry point to a proximal, justarticular plantar exit. Two new oblique dorsal-plantar bone tunnels - medial and lateral - are made at the distal metaphyseal metatarsal area. A #2 FiberTape is passed through the bone tunnels guided by a Nitinol wire, creating a mesh for the plantar stabilization of the MTPJ. Then both Fiber Tapes limbs are driven, with the help of a nitinol loop, through the plantar orifices of corresponding sides of the metatarsal bone tunnels, exiting in its dorsal aspect. One of the limbs of the tape is passed from dorsal to plantar trough the other metatarsal orifice. Both limbs are tensioned, and the toe should be kept at neutral sagittal position (flexion-extension). Fixation is made with a Biotenodesis screw. Results: Only a few patients were submitted to this technique. At one year follow up, none of them presented with complaints or complications. Conclusion: The surgical technique described in this article can change the way physicians treat plantar complex plantar plate tears when there is no viable biologic tissue to repair. A lesser complication rate it's also expected. Nonetheless comparative, and biomechanical studies are still needed to confirm our hypothesis.

AbstractComplete body fossils of salamanders are relatively rare, but provide critical information on the evolutionary roots of extant urodele clades. We describe new specimens of the fossil salamandridsTaricha oligocenicaVan Frank, 1955, andTaricha lindoeiNaylor, 1979, from the Oligocene Mehama and John Day formations of Oregon that illustrate aspects of skeletal morphology previously unseen in these taxa, and contribute to our understanding of population-level variation. Morphological analysis of these specimens supports the classification ofT.oligocenicaandT.lindoeias two different species, distinct from extantTaricha. Parsimony-based, heuristic analysis of phylogeny using 108 morphological characters for 40 taxa yields different results from a phylogenetic analysis that excludes four taxa known only via vertebrae. Our smaller analysis generally agrees with molecular phylogenies of the family Salamandridae, but with poorer resolution for molgin newts, especially betweenTarichaandNotophthalmus. The analysis including all taxa produced polytomies mostly related to complications from several fossil taxa. The presence or absence of dorsally expanded, sculptured neural spine tables on trunk vertebrae, an important character in past descriptions of fossil salamandrids, appears to be either homoplastic within the Salamandridae, or requires an expansion of characters or character states.Taricha oligocenicaandT. lindoeiare separate species of an at least 33 million-year-old clade, but their relationships with each other and extant North American salamandrids remain unclear with current levels of morphological data. Salamandrid research requires additional morphological data, particularly for the vertebrae and ribs, to better resolve salamandrid evolutionary history through morphological characters.

Invasion of the central nervous system occurs early in the course of syphilis infection. Neurosyphilis causes a meningitis, a myeloradiculopathy due to pachymeningitis, gummatous (granulomatous) cord and brain lesions; endarteritis may cause infarction and a low-grade meningoencephalitis affecting the brain results in dementia (general paralysis of the insane) and in the spinal cord, a sensory ataxic syndrome (tabes dorsalis). The introduction of highly active antiretroviral therapies has greatly reduced the frequency of these complications in patients with access to these treatments. However, newer complications are now increasingly recognized such as neurological immune reconstitution inflammatory syndrome, a compartmentalization syndrome (cerebrospinal fluid escape). This chapter looks at these and other important issues regarding the background, diagnosis, treatment, and outlook for neurosyphilis and neuro-AIDS.

Background: Syphilis is an infectious disease that can present systemic symptoms during its progression, reaching the central nervous system, causing neurosyphilis, combined include involvement of the meninges and spinal cord. Objectives: to review information on meningomyelitis in patients with positive syphilis serology, assessing the need for serological screening for syphilis knowledge and the importance of the clinician for an accurate diagnosis, preventing major sequelae or fatalities Methods: We analyzed 14 clinical cases of syphilitic myelitis from January 2000 to January 2021. Documents were resolved to determine clinical issues, apparent symptoms, radiological findings, penal treatment and complications. Results: 85.7% suffered from chronic myelopathy and 14.3% revealed subacute transverse myelitis. The most common clinical condition of chronic myelopathy was tabes dorsalis, present in 50%, afterwards it was syphilitic meningomyelite, present in 33.3%. Conclusion: Syphilitic myelitis is a rare condition, but there are studies that prove an increase in cases of myelopathy in patients with positive syphilis serology. The condition manifests itself with weakness of the lower limbs, sensory disturbance and urinary and fecal incontinence, in addition to long spinal cord injuries and abnormal enhancement, predominantly in the superficial parts of the spinal cord, in imaging exams. There is a differential diagnosis with multiple pathologies, such as intramedullary tumors, herniated intervertebral disc, myelopathy caused by HIV, among others. Therefore, it is important to know the signs and symptoms and an approach to serological screening for syphilis in patients with neurological disorders and non-compressive medical injuries.