Myasthenia Gravis
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  • ||||||||||  Review, Journal:  Sustainable Effects of Distigmine Bromide on Urinary Bladder Contractile Function. (Pubmed Central) -  Oct 30, 2020   
    In this review, we present our findings for the long-lasting feature of distigmine on isolated urinary bladder contraction and in vivo urinary function of guinea pig. We also present our results on the mechanism of its long-lasting sustainability using recombinant human AChE.
  • ||||||||||  Journal, Video:  The Outcomes of Subxiphoid Thoracoscopic Versus Video-Assisted Thoracic Surgery for Thymic Diseases. (Pubmed Central) -  Oct 30, 2020   
    We also present our results on the mechanism of its long-lasting sustainability using recombinant human AChE. S-VATT is a safe approach for patients with thymic diseases and has potential advantages of a shorter operative time, less intraoperative bleeding, and less postoperative pain compared with the lateral transthoracic approach, especially for patients with MG.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Journal:  Rituximab in Late-Onset Myasthenia Gravis is Safe and Effective. (Pubmed Central) -  Oct 30, 2020   
    The presence of multiple comorbidities and the risks of other immunotherapy in older patients makes rituximab an attractive option. More experience is needed to clarify the use of rituximab for patients in this age group.
  • ||||||||||  Journal:  A study of comorbidities in myasthenia gravis. (Pubmed Central) -  Oct 28, 2020   
    The patients with poor outcome had ≥ 2 comorbidities, myasthenic crisis, leukocytosis, elevated serum bilirubin and creatinine, and increased number of hospital admissions (P < 0.05). Myasthenia gravis is associated with comorbidities in majority of patients especially in late onset group, and more than two comorbidities are related to poor outcome.
  • ||||||||||  prednisone / Generic mfg., azathioprine orodispersible / Generic mfg.
    Clinical, Journal:  Late-onset generalized myasthenia gravis: clinical features, treatment, and outcome. (Pubmed Central) -  Oct 28, 2020   
    In conclusion, the presence of neither anti-titin nor anti-MuSK antibodies points to unfavorable outcome. Prednisone and azathioprine combination has beneficial effects in non-thymomatous generalized LOMG.
  • ||||||||||  Journal:  Treatment of Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorder and Myasthenia Gravis during the COVID-19 Pandemic (Pubmed Central) -  Oct 28, 2020   
    To prevent relapse or aggravation of the underlying diseases due to COVID-19, all patients should perform general preventive measures, such as social distancing, frequent hand washing, and respiratory hygiene. In patients undergoing immunotherapy, current treatment should be continued to prevent exacerbation of symptoms; however, exceptions to this include high-risk patients for COVID-19, such as the elderly, those with comorbidities including cardiac and respiratory diseases, those taking therapy with immunosuppressive agents, and those with deteriorating symptoms of COVID-19.
  • ||||||||||  Review, Journal:  Roles of GM-CSF in the Pathogenesis of Autoimmune Diseases: An Update. (Pubmed Central) -  Oct 27, 2020   
    Conversely, a protective role has also been described in other autoimmune diseases where humoral responses are detrimental such as myasthenia gravis (MG), Hashimoto's thyroiditis (HT), inflammatory bowel disease (IBD), and systemic lupus erythematosus (SLE). In this review, we aimed for a comprehensive analysis of literature data on the multiple roles of GM-CSF in autoimmue diseases and possible therapeutic strategies that target GM-CSF production.
  • ||||||||||  Clinical, Review, Journal:  Neuromuscular presentations in patients with COVID-19. (Pubmed Central) -  Oct 26, 2020   
    A handful of patients with myasthenia gravis showed exacerbation of their disease after acquiring COVID-19 disease. Most of these patients recovered with either intravenous immunoglobulins or steroids.
  • ||||||||||  azathioprine orodispersible / Generic mfg.
    Clinical, Journal:  Robotic extended re-thymectomy for refractory myasthenia gravis: a case series. (Pubmed Central) -  Oct 24, 2020   
    AChR antibody positive MG patients with a treatment refractory long-term course after thymectomy might have remaining thymic tissue with the two commonly associated thymus pathologies, thymoma and follicular hyperplasia. Robotic extended re-thymectomy might be considered as a safe and beneficial treatment option in these patients.
  • ||||||||||  donepezil / Generic mfg., memantine / Generic mfg., rivastigmine / Generic mfg.
    Review, Journal:  Natural and synthetic drugs used for the treatment of the dementia. (Pubmed Central) -  Oct 21, 2020   
    Recently discovered by French scientists from Marseille triterpenoid hydroperoxides demonstrate high activity as potential therapeutic agents for the treatment of dementia. The information presented in this review is of great interest to pharmacologists, medical chemists, physiologists, neurologists and doctors, as well as for the pharmaceutical industry.
  • ||||||||||  Clinical, Journal:  Prevalence and genetic subtypes of congenital myasthenic syndromes in the pediatric population of Slovenia. (Pubmed Central) -  Oct 21, 2020   
    The prevalence of genetically confirmed CMS in Slovenian children at the end of 2018 exceeds previously reported prevalence by more than two-fold, which suggests that prevalence in the literature is likely to be underestimated. Two extremely rarely detected mutations in MUSK and CHRND gene were detected and patient's clinical descriptions add important information on genotype-phenotype correlation.
  • ||||||||||  Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Journal:  Rituximab for Late Onset MG: Evidence Mounting but Deliberations Continue. (Pubmed Central) -  Oct 21, 2020   
    Two extremely rarely detected mutations in MUSK and CHRND gene were detected and patient's clinical descriptions add important information on genotype-phenotype correlation. No abstract available
  • ||||||||||  Clinical, Journal, HEOR:  Determinants of Quality of Life in Myasthenia Gravis Patients. (Pubmed Central) -  Oct 20, 2020   
    Moderate physical activity (twice a week) improved PCS (p = 0.045). Our study confirmed that greater severity of symptoms, age, age of onset but also BMI, type of work, education status and physical activity affect QoL in MG.
  • ||||||||||  Rebif (human IFN-β-1a) / EMD Serono, Bridion (sugammadex) / Merck (MSD), Vecuron (vecuronium) / Sun Pharma
    [VIRTUAL] Neuromuscular Blockade Reversal Trends In The United States Outpatient Setting () -  Oct 17, 2020 - Abstract #ASA2020ASA_2101;    
    In a large generalizable population of US adult outpatients administered NMBs, we observed an increase in age, number of comorbidities, and an increase in pharmacologic reversal compared to spontaneous reversal between 2014 and 2019. How and whether these trends relate to the observed variability of these characteristics by NMB reversal agent, the changes in outpatient practice in general with regard to procedures performed, patients treated, or reversal agent options available will be further assessed to help inform clinical approaches and outcomes studies.
  • ||||||||||  [VIRTUAL] Code Strokes, Smoke And Mirrors: The Cost Of A Missed Diagnosis () -  Oct 17, 2020 - Abstract #ASA2020ASA_1532;    
    An otherwise uneventful anesthetic ended with multiple failed extubation attempts, activation of a "Code Stroke", CT and MRI imaging, and ICU admission. This case demonstrates the potential cost and patient morbidity that results when a multidisciplinary team fails to properly diagnose myasthenia gravis in the perioperative period.
  • ||||||||||  [VIRTUAL] Anesthetic Management Of A Parturient With Type 2 Von Willebrand Disease, Myasthenia Gravis And Lupus () -  Oct 17, 2020 - Abstract #ASA2020ASA_1214;    
    We developed a thorough perioperative plan. A multidisciplinary approach involved anesthesia, obstetrics, neurology, hematology and rheumatology in order to evaluate neuromuscular involvement from myasthenia gravis and need for treatment, to rule out severe systemic manifestations from lupus, and to optimize coagulation status in order to minimize bleeding and to make neuraxial anesthesia a feasible option.
  • ||||||||||  [VIRTUAL] Anesthetic Management And Critical Care Of Stiff Person Syndrome () -  Oct 17, 2020 - Abstract #ASA2020ASA_738;    
    While anesthetic care for anterior mediastinal mass and MG are well understood, principle management of SPS patients is less clear. We focus on perioperative management of SPS in a patient with anterior mediastinal mass and two concurrent autoimmune neurologic diseases.
  • ||||||||||  Rebif (human IFN-β-1a) / EMD Serono, Bridion (sugammadex) / Merck (MSD), Vecuron (vecuronium) / Sun Pharma
    [VIRTUAL] Neuromuscular Blockade (nmb) Utilization Patterns And Time Trends In Us Outpatient Surgical Encounters () -  Oct 17, 2020 - Abstract #ASA2020ASA_112;    
    Results from this study suggest a trend of increased utilization of rocuronium and/or vecuronium from 2014 to 2019, and a general trend towards decreased use of both short acting succinylcholine alone as well as in combination of other long acting agents during the same time period. How and whether these trends relate to the introduction of sugammadex in the US in 2016, or other changes in general outpatient practice or availability of agents, should be further analyzed to help understand changes in treatment practices in outpatient settings.
  • ||||||||||  Journal:  Reply to Finsterer. (Pubmed Central) -  Oct 16, 2020   
    How and whether these trends relate to the introduction of sugammadex in the US in 2016, or other changes in general outpatient practice or availability of agents, should be further analyzed to help understand changes in treatment practices in outpatient settings. No abstract available
  • ||||||||||  Soliris (eculizumab) / Alexion Pharma, Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
    Review, Journal:  Myasthenia Gravis and its Association With Thyroid Diseases. (Pubmed Central) -  Oct 15, 2020   
    Eculizumab and plasmapheresis are the two new treatment options for MG, with supporting evidence of marked improvement in recent studies...In this comprehensive review article, we tried to establish an association between myasthenia gravis and Graves' disease (GD) by exploring currently available literature from PubMed. However, more studies need to be done to establish an association between pathologies.
  • ||||||||||  doxorubicin hydrochloride / Generic mfg., cyclophosphamide intravenous / Generic mfg.
    [VIRTUAL] THYMIC CANCER WITH ADRENAL METASTASIS: A RARE PRESENTATION () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_2796;    
    1) Though thymic cancers are uncommon, it must always be included in the differentials for a patient presenting with a mediastinal mass. 2) The prognosis of thymic carcinoma is generally poor and tumor stage is the most important prognostic indicator.
  • ||||||||||  prednisone / Generic mfg.
    [VIRTUAL] CAN'T SWALLOW, CAN'T SPEAK. MYASTHENIA MADE ME WEAK () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_2787;    
    Although bulbar symptoms such as dysphagia and dysphonia are manifestations of MG, they may anchor the physician towards motor neuron disease. In conclusion, this case highlights the importance of appropriate recognition of MG in elderly patients presenting with bulbar symptoms.