Blog #9-Close Reading

20 Feb

I. A Treatable Muscle Weakness Disorder

A. Your imagination? One eyelid is drooping lower then the other one

B. The doctor wants to look into possible diseases and one is Myasthenia Gravis a neuromuscular disorder that affects weakness in muscles.

II. Lost Connections

A. When a persons moves, the brain transmits nerve impulses to muscles, the nerve impulses signal nerve endings which release a chemical to the junction to the muscle which contract the muscle

B. Myasthenia Gravis occurs when there is a lost connection between brain and muscles, with myasthenia gravis the anti-bodies that are produced interfere with the chemical receptors.

C. Myasthenia Gravis can occur at any age, the disease affects muscles people move on there own which includes the facial muscles, eye muscles, movement of the head, arms and legs.

D. There are bunch of signs and symptoms of the disease.

III. Diagnosing Myasthenia Gravis

A. Muscle weakness is common in many disorders which is why when only a few muscles are affected it is hard to diagnose.

B. If myasthenia gravis is suspected many tests will be done, some of the tests are an emg, blood, and neurological.

IV. Renewed Strength

A. Treatment options include medication, surgery to remove thymus, Plasmapheresis and IVIG.

V. Prognosis Generally Good

A. Remission can occur but most stay on medications indefinitely.

“Myasthenia gravis.” Mayo Clinic Health Letter 25.3 (2007): 6. Health Source – Consumer Edition. EBSCO. Web. 20 Feb. 2010. <;

Question answers

There is no lit review. The introduction starts with a question. Then talks about the person notices there eyelids are different from another and it also is noticeable in photos of the recent anniversary celebration. The purpose/objective is make readers aware of what myasthenia gravis is and what the signs/symptoms are, how it is diagnosed and what the treatment options are.  The importance of the article is make people aware of the disease. I don’t think there is a main research question. No methods and no results but the final conclusion is that the prognosis is good and that most stay on medications for life unless remission occurs.  The introduction is I. in my outline,  purpose is II and III, and final conclusion is IV and V.

I. Introduction

A. Authors searched for trials that included the placebo.

B. A second search looked at the three different types of symptoms.

C. Only a small percentage of papers and studies were used because they were ineligible or just wanted to not include them.

D. Results were not strong enough for evidence of treatment.

E. In conclusion, the results can’t prove treatment helps relieve pain.

II. Spondyloarthritis

A.Evaluation of the diagnostic utility of spinal magnetic resonance imaging in axial spondylarthritis. Bennett AN, Rehman A, Hensor EM et al.
Leeds Institute of Molecular Medicine, Leeds, UK. Arthritis Rheum 2009;60:1331–41.

1. Editors note

a. MRI’s can help detect spondyloarthritis and help detect inflammatory changes, it can also help the doctor tell the person when to start treatments.

b. Scans were done on subjects with different kinds and stages of the disease, the study came up with an average age.

c. All of the patients had an MR of the whole back and some of them had an MR done on there joints, the images were scored and the authors gave detail about the how they came up with the scoring system.

d. Only some had an agreement with both tests.

e. The spinal and sacroiliac combination’s were improved.

f. The presence of a single RL was not a good discriminator between spondyloarthritis and  arthritis, this improved where there were multiple and/or severe RLs.

g. In conclusion, MRI’s can help improve the disease and pin point the problems especially if the persons age and other details like that are taken into consideration.

B.Circulating concentration of infliximab and response to treatment in ankylosing spondylitis: results from a randomized control study. Krzysiek R, Breban M, Ravaud P et al.; the French Ankylosing Spondylitis Infliximab Network. Universite Paris–Sud, Paris, France. Arthritis Rheum 2009;61:569–76.

1. Editors note

a. Infliximab is used to treat different inflammatory diseases with a small amount that doesn’t respond to the treatment.

b. Subjects were all involved with a study and were injected with infliximab at intervals of weeks.

c. Infliximab was monitored by the serum and some didn’t respond to the drug.

d. Of 247 only 169 were included due to different reasons.

e. The subjects included were separated into two different groups and the mean age is 40.

f. In the continuous-treatment group, the serum was measured at certain weeks and only some responded to the treatment.

g. In the on-demand group, some of the subjects relapsed before 16 weeks and others that didn’t, did not respond to the treatment.

h. In summary, levels of infliximab were not associated with the clinical repsonse while others were.

C. Adalimumab effectiveness for the treatment of ankylosing spondylitis is maintained for up to 2 years: long-term results from the ATLAS trial.
van der Heijde D, Schiff MH, Sieper J et al.; the ATLAS Study Group.
Leiden University, Leiden, The Netherlands. Ann Rheum Dis 2009;68:922–9.

3. Editors note

a. Several trials have come up with different effects of drugs.

b. The ATLAS trial had subjects 18 and older, they had different effects of drugs.

c. The mean time of the trial for adalimumab treatment was two years.

d. Safety data was encouraging because most people only got infections and headaches, no one died.

e. In conclusion, the study adds that anti-tnf agents are well tolerated.

Spondyloarthritis.” Current Medical Literature: Rheumatology 28.4 (2009): 93-97. Academic Search Complete. EBSCO. Web. 22 Feb. 2010. <;

There is no lit review. The authors did not attempt to hook the readers. The article is very dry. The purpose is to review different studies. Importance is that it talks about different things that happened in trials that need to be said for people that have the diseases. There is no main research question. Methods was that the authors took different studies and put them into there own words. Results are generally good.

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Posted by on February 20, 2010 in Uncategorized


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