A deficiency of this essential vitamin results in demyelination, a deterioration of the axons layer of insulation causing interrupted signal transmission, with a currently unknown specificity to the posterior region.PCS may develop with the failure to treat syphilis. Symptoms typically appear during the tertiary phase of the disease, between twenty and thirty years after the initial syphilis infection. Failure to treat syphilis leads to progressive degeneration of the nerve roots and posterior columns. The bacteria Treponema pallidum that causes syphilis results in locomotor ataxia and tabes dorsalis. Further complications from tabes dorsalis include optic nerve damage, blindness, shooting pains, urinary incontinence, and degeneration of the joints.In most cases, lesions present bilaterally. However, in rare cases, lesions have been seen unilaterally. Moreover, general symptoms of posterior spinal artery infarcts include ipsilateral loss of proprioceptive sensation, fine touch, pressure, and vibration below the lesion; deep tendon areflexia; and in severe circumstances, complete paralysis below the portion of the spinal cord affected. Diagnosis
Complete spinal imaging, X-rays, computed tomography (CT), or magnetic resonance imaging (MRI) can be used to identify infarctions on the dorsal columns. Imaging alone is often inconclusive and does not present a full analysis of the affected columns. Clinical history, blood and cerebral spinal fluid (CSF) tests can also be used to make a full diagnosis. Treatment
Treatment for patients with posterior cord syndrome depends on the causes and symptoms of the patient, as well as the source of the infraction. The main goal of treatment is to stabilize the spine.
Rifabutin is well-tolerated in people with HIV-related TB, but new findings suggest that those with low CD4+ cell counts have a higher risk of treatment failure or relapse due to acquired rifamycin resistance. Since patients co-infected with TB and HIV are likely to be treated for TB first, when the CD4+ cell population is depressed at the time TB treatment begins, doctors and patients should be aware of the possibility for rifamycin resistance to develop.Rifamycins, including rifabutin, are useful in the treatment of Chlamydophila pneumoniae (Cpn) infection. Rifabutin is being tested in clinical trials for treating Crohns disease as part of the anti-MAP therapy. In a Phase III study administering sub-therapeutic doses of rifabutin in combination therapy to patients not identified with MAP infections, it was associated with significant short term benefits.Rifabutin is also being investigated for the treatment of infections caused by the Gram-negative bacillus Acinetobacter baumannii, which has shown promise in animal studies. History
Scientists at the Italian drug company Achifar discovered rifabutin in 1975. (Eventually Archifar became part of Farmitalia Carlo Erba, a unit of the conglomerate Montedison which was subsequently bought by Pharmacia) This companys Adria Laboratories subsidiary filed for Food and Drug Administration (FDA) approval of rifabutin under the brand name Mycobutin in the early 1990s and the drug gained FDA approval in December 1992.Rifabutin is primarily bactericidal antibiotic drug used to treat tuberculosis. Its effect on bacteria is based on the DNA-dependent RNA polymerase blocking drug rifamycin S, a semi-synthetic derivative.