Infection

High activity of human cytomegalovirus in patients with Sjögren’s disease

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In a cross-sectional observational study using immunohistochemistry and serology to assess human cytomegalovirus (HCMV) activity in salivary gland tissue and serum samples, Pantalone et al. (Karolinska Institutet, Stockholm; Turku University, Finland) — published in Clinical Immunology — investigated the presence and potential role of HCMV in patients with Sjögren’s disease (SD).

Their findings showed:

  • SD patients had significantly higher expression of HCMV proteins in salivary gland tissue:
    1. HCMV-IE: 88.9%
    2. HCMV-LA: 69.2%
    3. HCMV-pp65: 45.8%
  • HCMV-specific IgM was more frequent in SD patients than in controls (32.1% vs. 13.4%, p = 0.04)
  • HCMV-IgG titers were significantly elevated in the SD group (p < 0.0001)

These results suggest a possible role of active or latent HCMV infection in the pathogenesis of Sjögren’s disease, although a causal relationship has not been established.

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🧠 Takeaway Message for Neurosurgeons

While Sjögren’s disease is primarily a rheumatologic condition, this study provides important implications for neurosurgeons:

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Challenges in Pulmonary Management after Traumatic Brain and Spinal Cord Injury

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In a review Zhou et al. published in Neurosurgery clinics of North America the most common pulmonary complications following traumatic brain injury (TBI) and spinal cord injury (SCI) — such as neurogenic pulmonary edema, Acute Respiratory Distress Syndrome, Ventilator-Associated Pneumonia, and thromboembolic events — and summarize current understanding of their pathophysiology and treatment, with the goal of guiding early recognition and management to improve outcomes in neurotrauma patients 3)

🧨 Verdict: ❝A clinically themed PowerPoint stretched into ten pages. No risk. No depth. No new thought.❞

⚠️ Fundamental Flaws No Original Contribution → This is not a review — it’s a recitation. The article contributes zero new data, no expert algorithm, and no provocative insight into managing a leading cause of secondary injury in neurotrauma.

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Fever in the Neurocritically Ill Patient

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In a review Kitagawa et al. from McGovern Medical School at the University of Texas Health Science Center at Houston published in Neurosurgical Clinics of North America to review fever etiology in neurocritically ill patients, assessed current pharmacologic and mechanical strategies for temperature control, and evaluated the existing evidence on whether these interventions improve clinical outcomes. The goal was to inform clinical decision-making in the neuro ICU setting. They concuded that fever is common in neuro ICU patients and is associated with worse outcomes. While several interventions effectively reduce body temperature, the literature remains inconclusive regarding their impact on prognosis. Management should be individualized, weighing the potential benefits against adverse effects. Further research is needed to clarify the clinical value of temperature control in this population 4)

Another polished yet pointless review, safely orbiting the surface of a real clinical problem without offering a single actionable insight. If you’ve spent time in a Neuro-ICU, you already know everything this article says. And if you haven’t — reading it won’t help you survive your next febrile crisis.

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