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Vaccination studies of aspergillosis in turkeys: subcutaneous inoculation with several vaccine preparations followed by aerosol challenge exposure.

Five vaccines were prepared from an isolate of Aspergillus fumigatus: a culture filtrate vaccine (I), a spore vaccine (II), a mycelial vaccine (III), and 2 germling vaccines (IV and V). The 2 germling vaccines were produced on different media. Two experiments were conducted to test the vaccines for efficacy in groups of 21 turkey poults by giving each bird 2 subcutaneous inoculations of the respective vaccine at 1 and 2 weeks of age. The birds were challenge exposed to an aerosol of spores of A fumigatus at 1 month of age. The 2 experiments differed only in the challenge exposure. In experiment 1, 38% of the poults were protected when vaccinated with an A fumigatus germling vaccine (IV) and challenge exposed with a dose of aerosolized A fumigatus spores that killed 100% of the nonvaccinated controls. Onset of postchallenge-exposure deaths were delayed by 2 days in the turkeys given vaccine IV. In experiment 2, 48% of the poults were protected when given germling vaccine IV, whereas 62% to 86% of the poults in the nonvaccinated and 3 other vaccine groups died. In experiment 2, 50% of the poults given a mycelial vaccine (III) were protected. Torticollis was a frequent sign of the disease in experiment 2.

Aerosols↗

[Treatment of abnormal movements of extrapyramidal origin with tiapride].

The authors report results attained by means of a replaced benzamide, thiapride, in the treatment of 21 subjects showing involuntary movements of extra-pyramidal origin and more exactly: extra-pyramidal syndromes due to drugs (3), idiopathic dyscinesias (8), choreas (6), dystonias (3), essential tremor (1). The drug was administered per os as well as per IM and EV. Results were good or fair in 71% of cases. The clearest improvements were obtained in iatrogenic dyscinesias (torticollis, diaphragm clonisms). The drug was well tolerated in all cases, both from the clinical and hematochemical standpoint, even at the highest dosages, and, in particular, no case of amenorrhea or galactorrhea was pointed out. Finally, the authors explain how the best results with thiapride may probably be obtained in those forms in which an hyperfunction of the dopaminergic system is proved, thanks to the competitive action of the molecule on presynaptic dopaminergic receptors.

Adolescent↗

Atlantoaxial rotary deformities.

Persistent torticollis in younger patients, particularly after trivial trauma or an upper respiratory tract infection, suggests a diagnosis of atlantoaxial rotary fixation. The diagnosis can be confirmed by cineroentgenography. Anterior displacement of the atlas, indicating a deficient transverse ligament, should be ruled out by flexion-extension lateral roentgenograms. If conservative management fails to achieve reduction or is followed by a recurrence of the deformity, arthrodesis is indicated.

Adolescent↗

[MRI of the semicircular canals in cranio-facial asymmetries and craniomandibular syndrome].

The cranio-mandibular syndrome (CMS) is often secondary to an cranio-facial asymmetry (CFA); it associate a painful masticatory dysfunction syndrome with functional and aching clinical signs in relation with a functional torticollis required for oculo-labyrinthal equilibration maintenance. Our anatomical and functional MRI protocol uses tridimensional study of semi-circular canals (SCC) up relation to the medial cerebral axis (MCA), and permit to measure precisely these CFA and propose, with a multispecialist approach, an adapted treatment of the SCM. Application of MRI to SCC asymmetry looks to its future use for spatial intracranial referencial of cerebral structures.

Craniomandibular Disorders↗

Experimental furazolidone toxicosis in broiler chicks: effect of dosage, duration and age upon clinical signs and some blood parameters.

Groups of broiler chicks of one day and three weeks of age were given feeds containing 0, 400, 800 and 1000 mg furazolidone (Fz)/kg for three weeks. The age of the birds and the dose and duration of Fz treatment significantly (P < or = 0.05) influenced the parameters studied. Clinical signs of Fz toxicosis included ascites, leg weakness and nervous derangement like convulsions and torticollis. The body weight also decreased. Ascites and nervous derangement was not observed in birds fed 400 mg Fz from one day of age. Fz-fed birds developed anaemia and had lower plasma total protein and albumin levels than those fed no Fz. The decrease in body weight was related to reduced feed intake. Decreases found in the haematological parameters and plasma proteins showed no correlation with the chicks' age but were related to the dose and duration of Fz treatment.

Anemia↗

[Dose-response relationship in the treatment of cervical dystonia with botulinum toxin type A (AGN 191622)--a phase II study].

Injection of botulinum toxin type A has been the treatment of choice for spasmodic torticollis for several years. Although previous reports demonstrate its effectiveness and safety, the treatment strategy has been empirical. The present study, using the freeze-dried crystalline botulinum toxin type A (AGN 191622; Allergan Inc., Irvine, CA), aimed to compare the efficacy among three treatment groups divided into low, medium and high dosage levels. Fifty-one patients who entered the study were grouped into low-dose (60 units/session), medium-dose (120 units/session) and high-dose (240 units/session) groups. Two patients (one in low-dose group and the other in high-dose group) were excluded from the assessment of efficacy because they dropped out in the early phase of the study. One experienced worsening of an existing psychosis and the other developed an acute respiratory infection. Injection sites were decided individually by palpation. If the clinical response was not satisfactory four weeks after an injection, the patient was re-injected with the same dose of toxin. The follow-up period was 14 weeks from the initial injection. The results showed that the high-dose group improved more than the other groups in the parameters of severity of symptoms and subjective benefit (p = 0.000). Also, fewer injections were required in the high-dose group to achieve substantial clinical benefit. Although the mean reduction in Tsui's score was not statistically significant among the groups, the "marked improvement" was seen more frequently in the high-dose group (p = 0.033). Unfavorable adverse effects including excessive weakness and dysphasia were always mild and transient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Dystonia as the cause of pharyngolaryngeal motility disorders].

Dystonia as cause of pharyngo-laryngeal motility disorders has not been adequately considered in most clinical ENT practices. This case study of a patient with spasmodic torticollis, Meige's syndrome and pharyngo-laryngeal motility disorder was found to be due to dystonia as the underlying cause. The possibility of local symptomatic therapy with botulinum toxin injections has currently provided the physician with an effective means for alleviating the disorder.

Botulinum Toxins↗

[Tardive dystonia. A rare neuroleptic-induced disease picture].

This paper reports on a case of spasmodic torticollis after longterm treatment with neuroleptics. This form of dystonia is called tardive dystonia to distinguish it from tardive dyskinesia. Its pathophysiology is unknown. Pathological changes are described in the basal ganglia. Increased signal was found on magnetic resonance imaging on both sides of the basal ganglia reflecting structural lesions. These structural changes, together with neuroleptic medication, represent predisposing factors for the manifestation of tardive dystonia.

Basal Ganglia↗

[Lateral sinus thrombophlebitis].

Lateral sinus thrombophlebitis (LST) is an intracranial complication of otitis media. Its incidence has markedly decreased in the era of antibiotic therapy but mortality is still high. A 13-year-old girl presented with fever, ear discharge and torticollis. On the day of admission LST was diagnosed from the clinical presentation and CT-scan. She was operated immediately and intravenous antibiotics were administered. Despite the rapid intervention, the course was protracted, with recurrent events of septic pulmonary embolism. Despite internal jugular vein ligation, fever continued and anticoagulant therapy was begun. The possibility of LST should be considered in patients with ear discharge and fever. CT-scan enables early diagnosis of LST and MRI has a role in detecting additional intracranial septal foci. Surgical intervention should be early and aggressive. The efficacy of jugular vein ligation is unclear; anticoagulant therapy should be considered.

Adolescent↗

Occipital condylar dysplasia in two Jacob sheep.

Two young Jacob sheep which presented with severe ataxia and torticollis had abnormally formed atlanto-occipital joints. Postmortem examination revealed marked dissimilarity in size between the left and right occipital condyles, with reduction in size of the foramen magnum. The atlantoaxial joint and dens were normally formed, and were not abnormally positioned in radiographs taken of one lamb. Histological evaluation of the cervicomedullary junction demonstrated extensive loss of axons and myelin, gliosis, and mild hydromyelia in one lamb.

Animals↗

Atlanto-axial rotatory fixation. (Fixed rotatory subluxation of the atlanto-axial joint).

In seventeen cases of irreducible atlanto-axial rotatory subluxation (here called fixation), the striking features were the delay in diagnosis and the persistent clinical and roentgenographic deformities. All patients had torticollis and restricted, often painful neck motion, and seven young patients with long-standing deformity had flattening on one side of the face. The diagnosis was suggested by the plain roentgenograms and tomograms and confirmed by persistence of the deformity as demonstrated by cineroentgenography. Treatment included skull traction, followed by atlanto-axial arthrodesis if necessary. Of the thirteen patients treated by atlanto-axial arthrodesis, eleven had good results, one had a fair result, and one had not been followed for long enough to determine the result. Of the remaining four patients, one treated conservatively had not been followed for long enough to evaluate the result, two declined surgery, and one died while in traction as the result of cord transection produced by further rotation of the atlas on the axis despite the traction.

Adolescent↗

[Botulinum toxin in blepharospasm, in hemifacial spasm, and in cervical dystonia: results in 33 patients].

The effects of botulinum toxin type A were studied in 33 patients with dystonia (12 blepharospasms, 10 hemifacial spasms and 11 spasmodic torticollis). A rate scale was used to evaluate the severity of the dystonic movements, before and two weeks after each injection. Among blepharospasm patients, eight were female and four were male; the mean age was 57.7 years; the mean time of the disease duration was four years. Three had familial history for similar disease; nine were essential and three had used neuroleptic drugs (tardive dystonia). The mean dose used was 51.3 U, with a mean time of beneficial effects of 2.8 months. For 22 injections and reinjections, 14 (63.7%) showed an excellent result, five (22.7%) good and three (13.6%) null. In the hemifacial spasm group, eight were female and two male; the mean age was 52.6 years; the mean time of the disease duration was 7.4 years; eight were essential and two post-paralytic. The mean dose used was 32 U. From the total of 15 injections and reinjections, all of them (100%) had an excellent result, with a mean time of beneficial effect of 3.4 months. Among the cervical dystonic patients, eight were male and three female; the mean age was 44.2 years; the mean time of the disease duration was 12.2 years; six had essential dystonia, three had used neuroleptic drugs and two had familial history for similar disease. The mean dose used was 238.6 U, with the mean duration of effect of 3.5 months. From the total of 20 injections and reinjections, 18 (90%) had good result, one (5%) mild and one (5%) null.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Own experience with botulinum treatment of dystonia].

Fifty-five patients were treated with botulin injections into the muscles showing dystonia, contracture or tremor. Twenty two of them had torticollis, 21 had blepharospasm, 10 had hemifacial spasm, and 2 had tremor. In all, 112 injections were done with good result in 64%, slight effect in 27% and without effect in 9% of the cases. Similar results have been reported from other centers in the world. Adverse effects were not significant and disappeared after several days or weeks. They included ptosis, speech and deglutition disturbances, general weakness and neurotic reactions. These adverse effects developed in 12 cases. In cases of tremor the dose as well as the technique of injections must be individualized. The method is an important therapeutic advance and can be applied in outpatient clinics.

Adult↗

Atlanto-axial rotatory fixation.

OBJECTIVES: To analyse the causes of atlanto-axial rotatory fixation (AARF) and discuss the diagnosis and treatment. DESIGN: Retrospective case studies. SETTING: Medical University of Southern Africa-Ga-Rankuwa referral hospital. PATIENTS: A total of 10 patients admitted to and treated in the Department of Orthopaedics, Ga-Rankuwa Hospital, between July 1989 and June 1993. OUTCOME MEASURE: Dynamic computed tomography (CT) scan. RESULTS: Upper respiratory tract infection and trauma were the commonest causes of AARF. There was a delay in diagnosis ranging between 4 weeks and 2 years 6 months. Clinical and radiological reduction was obtained by gradual skeletal traction in 6 patients. Two patients had improvement of the torticollis but still had subluxation on the CT scan. In 1 patient no reduction was obtained on occipitocervical fusion and transoral decompression was necessary. In 1 case the parents refused any form of treatment. There was no recurrence in the 7 patients followed up (minimum 6 months). CONCLUSION: This study shows that AARF is often diagnosed late. The patients diagnosed early responded well to skeletal traction followed by external support. In patients diagnosed late the AARF could not be reduced completely and needed surgical fusion. If untreated, condition can be complicated by tetraparesis.

Adolescent↗

Human toxicosis caused by the tick Ixodes redikorzevi in Israel.

The clinical symptoms of a tick toxicosis caused by Ixodes redikorzevi in northern Israel are described. The patient was a nine-year-old Arab boy from an agricultural village who was admitted to a local hospital and had been suffering for 4 days from fever and torticollis. A partially engorged female tick was removed from the nuchal area of the scalp, and the symptoms disappeared within 2 hours. Morphometrical measurements indicated that the tick was attached to the skin for 3-4 days.

Animals↗

[Traumatic palsies of the inferior oblique muscle (author's transl)].

The author discussed the increase in the frequency of traumatic paralyses of the ocular muscles, and reported 6 cases of inferior oblique muscle paresis caused by local blunt or sharp traumas (haematoma, contusion, rupture, incarceration) and one case of traumatic Brownian pseudo-paralysis. The localisation of the injuries in 3 cases was on the inferior temporal part and in the other 3 cases on the superior part of the bulbar conjunctiva. Atypical horizontal deviation and characteristic vertical deviation, torsion and torticollis were observed in the majority of cases. One patient recovered spontaneously. 3 patients became asymptomatic after correction by prisms and one after recession of contralateral superior rectus muscle. The symptoms remained unchanged in the case of a "blow out" fracture (in spite of operation) and a Brown's syndrome (without treatment).

Adult↗

Acupuncture in a university hospital: implications for an inpatient consulting service.

This case series reviews my experience in providing acupuncture treatment to inpatients at a midwestern, tertiary care, university teaching hospital. I review 4 cases, including patients with torticollis, ileus, brain injury, and intractable migraine. The lessons learned from each of these cases are summarized, and the implications for the development of an inpatient acupuncture service are discussed.

Acupuncture Analgesia↗