{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T12:17:17Z","timestamp":1789906637322,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The etiology of acute exacerbations of myasthenia gravis (MG) is not well understood and further characterization can lead to improved preventative measures. This study aims to characterize factors contributing to MG exacerbations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 127 MG patient charts were reviewed retrospectively (2011\u20102016) to obtain demographics, immunizations, pharmaceutical records, contributing factors of each MG exacerbation, emergency department (ED) visits, hospitalizations, and duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 212 exacerbations requiring 106 ED visits and 141 hospitalizations (average admission 6.5\u2009days). Highest contributors were infections (30%) and medications that may worsen MG (19%), with 24% unattributed. Infection related exacerbations were associated with 44.3% of ED visits and 39.7% of hospitalizations. Patients prescribed beta\u2010blockers were associated with more exacerbations (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Patients prescribed medications that may worsen MG had a higher exacerbation frequency shortly after administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Infections and cautioned medications are frequently factors in acute MG exacerbations needing urgent medical attention and warrant caution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.26689","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T12:07:49Z","timestamp":1567166869000},"page":"693-699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":122,"title":["Factors associated with acute exacerbations of myasthenia gravis"],"prefix":"10.1002","volume":"60","author":[{"given":"Rohit Reddy","family":"Gummi","sequence":"first","affiliation":[{"name":"University of Missouri School of Medicine  Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie Anna","family":"Kukulka","sequence":"additional","affiliation":[{"name":"University of Missouri School of Medicine  Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea B.","family":"Deroche","sequence":"additional","affiliation":[{"name":"Health Management and Informatics University of Missouri School of Medicine  Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Govindarajan","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Missouri Hospital  Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70063-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00145-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.053"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.5.752"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/IBPC.S9486"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21440"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2017.13.4.325"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SMJ.0b013e31815d4398"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2007.04.045"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6703a1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-3439"},{"key":"e_1_2_9_13_1","unstructured":"Myasthenia Gravis Foundation of America. Cautionary drugs. 2019.https:\/\/myasthenia.org\/What-is-MG\/MG-Management\/Cautionary-Drugs. Accessed September 1 2019."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.1997.tb03085.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-197005000-00033"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440250045006"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.11.1689"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2018.01.011"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20950"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.144438"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X20130108"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2015.03.018"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2000.04.1003"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn152"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-004-0034-3"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:3:3:189"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.5.1253"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941875210382918"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22077"},{"key":"e_1_2_9_31_1","unstructured":"MehriziM FontemRF GearhartTR PascuzziRM. Medications and Myasthenia Gravis (A Reference for Health Care Professionals). 2012.https:\/\/www.myasthenia.org\/portals\/0\/draft_medications_and_myasthenia_gravis_for_MGFA_website_8%2010%2012.pdf. Accessed September 1 2019."}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.26689","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.26689","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.26689","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T20:05:22Z","timestamp":1694203522000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.26689"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1002\/mus.26689"],"URL":"https:\/\/doi.org\/10.1002\/mus.26689","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,10]]},"assertion":[{"value":"2018-03-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}