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Background: Immune checkpoint inhibitors (ICI)-induced myasthenia gravis (MG) is an uncommon but potentially fatal neurotoxicity. We aim to help physicians familiarize themselves with the clinical characteristics of ICI-induced MG, facilitating early diagnosis and prompt intervention. Methods: We searched the Chinese People's Liberation Army General Hospital medical record system from January 2017 to August 2023 for patients diagnosed with ICI-induced MG. We systematically reviewed the literature until August 2023 to identify all similar patients. We collected clinical information on these patients. Results: 110 patients were identified, 9 from our institution and 101 from case reports. In our institution, Median age was 66 years (range: 49-79 years). 6 were males. The most common was lung cancer (n = 4). All patients had no previous history of MG and received PD-1 or PD-L1 inhibitors. The median time from ICI initiation to first MG symptoms was 4 weeks (range: 2-15 weeks). ICIs were discontinued in all patients. Most patients initially received high-dose corticosteroids, and their symptoms improved. Some patients are discharged with corticosteroids maintenance therapy. In addition, 55 patients (50%) with concomitant myositis and/or myocarditis and MG-induced mortality were more common in the myositis and/or myocarditis group (10.9% vs. 34.5%, p = 0.016). Overlap of myositis with MG (OR = 3.148, p = 0.009) and anti-AChR antibody positivity (OR = 3.364, p = 0.005) were both significantly associated with poor outcomes. Conclusion: Our study reveals the prognosis of ICI-induced MG and suggests that myositis and/or myocarditis are severe comorbidities of ICI-induced MG, emphasizing the importance of early diagnosis and clinical intervention.
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ABSTRACT Introduction: The topic of preventing tissue damage during sports is a heavily debated one. Uncovering factors related to sports injuries is essential to deal with this issue. Objective: To analyze the causes of athletes' sports injuries, providing a theoretical basis for reducing the occurrence of sports injuries and increasing the success rate of athletes. Methods: This article uses statistical methods to investigate and analyze the causes of athletes' sports injuries. Results: Four important factors lead to athletes' sports injuries: poor physical fitness, inadequate warm-up activities, incorrect techniques, and excessive loads. Conclusion: Coaches should systematically prepare multi-year training plans, step by step, and pay attention to long-term effects. This is the only way athletes can achieve their best performance at the appropriate age. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução: A prevenção de danos teciduais durante a prática esportiva é um tópico acaloradamente debatido. Descobrir os fatores relacionados a ferimentos esportivos é essencial para lidar com esse agravo. Objetivo: Analisar as causas dos ferimentos esportivos em atletas, fornecendo uma base teórica para reduzir o número de ferimentos esportivos e aumentar a taxa de sucesso de atletas. Métodos: Esse artigo usa métodos estatísticos para investigar e analisar a causa das lesões esportivas em atletas. Resultados: Quatro fatores importantes levam às lesões esportivas dos atletas: preparo físico ruim, aquecimento inadequado, técnica incorreta e cargas excessivas. Conclusão: Técnicos deveriam preparar, passo-a-passo, treinamentos sistemáticos com duração de vários anos, levando em consideração seus efeitos de longo prazo. Só assim atletas podem atingir sua melhor performance na idade adequada Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.
RESUMEN Introducción: La prevención de daños tisulares durante la práctica deportiva es un tópico muy debatido. Descubrir los factores relacionados con las lesiones deportivas es esencial para lidiar con este problema. Objetivo: Analizar las causas de las lesiones deportivas en atletas, suministrando una base teórica para reducir el número de lesiones deportivas y aumentar la tasa de éxito de atletas. Métodos: Este artículo usa métodos estadísticos para investigar y analizar la causa de las lesiones deportivas en atletas. Resultados: Cuatro factores importantes ocasionan las lesiones deportivas de los atletas: preparación física insuficiente, calentamiento inadecuado, técnica incorrecta y cargas excesivas. Conclusión: Técnicos deberían preparar, paso a paso, entrenamientos sistemáticos con duración de varios años, teniendo en cuenta sus efectos a largo plazo. Solo así los atletas podrían alcanzar su mejor desempeño en la edad adecuada. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.
