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159 results on '"Klein, C J"'

4. LGI1 antibody encephalitis: acute treatment comparisons and outcome

Author

Rodriguez, Andrew, primary, Klein, C J, additional, Sechi, Elia, additional, Alden, Eva, additional, Basso, Michael R, additional, Pudumjee, Shehroo, additional, Pittock, Sean J, additional, McKeon, Andrew, additional, Britton, Jeffrey W, additional, Lopez-Chiriboga, A Sebastian, additional, Zekeridou, Anastasia, additional, Zalewski, Nicholas L, additional, Boeve, B F, additional, Day, Gregory S, additional, Gadoth, Avi, additional, Burkholder, David, additional, Toledano, Michel, additional, Dubey, Divyanshu, additional, and Flanagan, Eoin P, additional

Published
2021
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8. LGI1 antibody encephalitis: acute treatment comparisons and outcome.

Author

Rodriguez, Andrew, Klein, C. J., Sechi, Elia, Alden, Eva, Basso, Michael R., Pudumjee, Shehroo, Pittock, Sean J., McKeon, Andrew, Britton, Jeffrey W., Lopez-Chiriboga, A. Sebastian, Zekeridou, Anastasia, Zalewski, Nicholas L., Boeve, B. F., Day, Gregory S., Gadoth, Avi, Burkholder, David, Toledano, Michel, Dubey, Divyanshu, and Flanagan, Eoin P.

Subjects
ENCEPHALITIS, TREATMENT effectiveness, ELECTRONIC health records, CEREBROSPINAL fluid, SHORT-term memory, IMMUNOGLOBULINS
Abstract

Objective: To compare acute treatment responses and long-term outcome in leucine-rich glioma-inactivated 1 (LGI1) antibody encephalitis.Methods: Retrospective case series of 118 patients with LGI1 antibody encephalitis evaluated at Mayo Clinic across all US sites from 1 May 2008 to 31 March 2019. Patient clinical data were identified and analysed through the neuroimmunology laboratory and electronic medical record. LGI1 antibody detection was by cell-based indirect immunofluorescence assay of serum, cerebrospinal fluid or both. Clinical outcomes were faciobrachial dystonic seizure (FBDS) resolution, modified Rankin Scale (mRS) score, Kokmen Short Test of Mental Status (STMS) score (0-38 point scale) and neuropsychometric testing results.Results: Compared with intravenous immunoglobulin (IVIg) (n=21), patients treated with single-agent acute corticosteroids (intravenous, oral or both) (n=49) were more likely to experience resolution of FBDS (61% vs 7%, p=0.002) and improvements in mRS score (ΔmRS score 2 vs 0, p=0.008) and median Kokmen STMS scores (ΔKokmen STMS score 5 points vs 0 points, p=0.01). In 54 patients with long-term follow-up (≥2 years), the median mRS score was 1 (range 0-6) and the median Kokmen STMS score was 36 (range 24-38) after all combinations of immunotherapy. Neuropsychometric testing in 32 patients with long-term follow-up (≥2 years) demonstrated short-term memory impairments in 37%.Conclusions: Corticosteroids appeared more effective acutely than IVIg in improving LGI1 antibody encephalitis in this retrospective comparison of immunotherapies. While improvement with immunotherapy is typical and long-term outcome is favourable, short-term memory deficits are noted in approximately a third of the patients. [ABSTRACT FROM AUTHOR]

Published
2022
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19. Bias in protected-area location and its effects on long-term aspirations of biodiversity conventions

Author

Venter, O., Magrach, A., Outram, N., Klein, C. J., Possingham, H. P., Di Marco, M., and Watson, J. E. M.

Subjects
Conservation of Natural Resources, Convención por la Diversidad Biológica, Convention on Biological Diversity, planeación sistemática de la conservación, protección residual, protected area, residual protection, systematic conservation planning, área protegida, Endangered Species, Biodiversity, Bias, Vertebrates, Animals
Abstract

To contribute to the aspirations of recent international biodiversity conventions, protected areas (PAs) must be strategically located and not simply established on economically marginal lands as they have in the past. With refined international commitments under the Convention on Biological Diversity to target protected areas in places of "importance to biodiversity," perhaps they may now be. We analyzed location biases in PAs globally over historic (pre-2004) and recent periods. Specifically, we examined whether the location of protected areas are more closely associated with high concentrations of threatened vertebrate species or with areas of low agricultural opportunity costs. We found that both old and new protected areas did not target places with high concentrations of threatened vertebrate species. Instead, they appeared to be established in locations that minimize conflict with agriculturally suitable lands. This entrenchment of past trends has substantial implications for the contributions these protected areas are making to international commitments to conserve biodiversity. If protected-area growth from 2004 to 2014 had strategically targeted unrepresented threatened vertebrates,30 times more species (3086 or 2553 potential vs. 85 actual new species represented) would have been protected for the same area or the same cost as the actual expansion. With the land available for conservation declining, nations must urgently focus new protection on places that provide for the conservation outcomes outlined in international treaties.

Published
2016

20. Polyneuropathy improvement following autologous stem cell transplantation for POEMS syndrome

Author

D'Souza, A., Mandrekar, J., Dyck, P. J. B., Karam, C., Mauermann, M. L., Klein, C. J., and Dispenzieri, A.

Abstract

OBJECTIVE: To study the evolution of the neuropathy and long-term disability in a large cohort of patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome following autologous stem cell transplantation (ASCT). METHODS: Retrospective chart review documenting the clinical, electrophysiologic, and laboratory characteristics of patients with POEMS syndrome undergoing ASCT at Mayo Clinic, Rochester. RESULTS: Sixty patients with a median follow-up time of 61 months were studied. All patients had peripheral polyneuropathy and demonstrated neurologic improvement after ASCT (apart from one patient who died early). Before ASCT, 27 patients (45%) required a wheelchair and 17 (29%) required a walker or foot brace. At the end of the follow-up period, no patient was using a wheelchair and 23 patients (38%) were using a foot brace. The median Neuropathy Impairment Score improved from 66 to 48 points at 12 months and to 30 points at most recent follow-up (p < 0.0001). Median Rankin Scale score improved from 3 to 1.5 (p < 0.0001). Vascular endothelial growth factor levels decreased from a median of 452 to 63.5 pg/mL (p < 0.0001). The ulnar compound motor action potential amplitude (median) improved from 4.3 to 7.6 mV (p < 0.0001) and ulnar compound motor action potential conduction velocity (median) improved from 34 to 51 m/s (p < 0.0001). Predicted forced vital capacity improved from 81% to 88% (p < 0.0001). Periengraftment syndrome occurred in 24 patients. Fourteen patients required additional chemotherapy and/or radiation following ASCT, but there was no clinical deterioration in the neuropathy in any of these patients. Six patients died: 1 due to POEMS, 1 due to failed engraftment, and 4 due to other malignancies (2 myelodysplastic syndrome, 1 lymphoma, 1 metastatic lung cancer). CONCLUSION: Patients with POEMS syndrome who undergo ASCT have a significant and meaningful improvement of their neuropathy by multiple measurements during both short and long-term follow-up, which corresponds to reduction in morbidity and disability (none are in wheelchair long-term). Periengraftment syndrome was common but manageable. Fatal complications, although rare, did occur, usually in association with other malignancies. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with POEMS syndrome, ASCT improves neuropathy-related function.

Published
2015
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22. IgM-gammopathy strongly favours immune treatable MMN and MADSAM over ALS.

Author

Shelly, Shahar, Mills, John R., Martinez-Thompson, Jennifer M., Rofforth, Matt M., Pittock, Sean J., Mandrekar, Jay, Triplett, James Douglas, Mauermann, Michelle, Dubey, Divyanshu, and Klein, C. J.

Subjects
MONOCLONAL gammopathies, SPINAL muscular atrophy, MOTOR neuron diseases, AMYOTROPHIC lateral sclerosis, BLOOD protein electrophoresis, PATHOLOGY
Published
2020
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25. Utility of an immunotherapy trial in evaluating patients with presumed autoimmune epilepsy

Author

Toledano, M., primary, Britton, J. W., additional, McKeon, A., additional, Shin, C., additional, Lennon, V. A., additional, Quek, A. M. L., additional, So, E., additional, Worrell, G. A., additional, Cascino, G. D., additional, Klein, C. J., additional, Lagerlund, T. D., additional, Wirrell, E. C., additional, Nickels, K. C., additional, and Pittock, S. J., additional

Published
2014
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41. Post-surgical inflammatory neuropathy

Author

Staff, N. P., primary, Engelstad, J., additional, Klein, C. J., additional, Amrami, K. K., additional, Spinner, R. J., additional, Dyck, P. J., additional, Warner, M. A., additional, Warner, M. E., additional, and Dyck, P. J. B., additional

Published
2010
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46. Modeling Chronic Glycemic Exposure Variables as Correlates and Predictors of Microvascular Complications of Diabetes: Response to Orchard et al.

Author

Dyck, P. J., primary, Davies, J. L., additional, Clark, V. M., additional, Litchy, W. J., additional, Dyck, P. J. B., additional, Klein, C. J., additional, Rizza, R. A., additional, Pach, J. M., additional, Klein, R., additional, Larson, T. S., additional, Melton, L. J., additional, and O'Brien, P. C., additional

Published
2007
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