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Delayed neurological deterioration following head trauma

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Neural Regeneration Research 2010年第23期5卷 1829-1831页

作者： Sung Ho Jang department of Physical Medicine and Rehabilitation College of MedicineYeungnam University

We report a patient who presented with neurological deterioration 26 days after a motor vehicle accident. A 25-year-old man crashed a car onto farmland from a height of approximately 3 meters. Neurological deterioration including ataxia and visual disturbance became apparent 26 days after the accident. Brain magnetic resonance imaging did not reveal any abnormality, but brain single photon emission computed tomography showed mild hypoperfusion in the left frontotemporal lobe. An ophthalmic examination revealed no specific abnormality, but visual-evoked potentials revealed prolonged latencies in both eyes. We propose that this neurological deterioration might have resulted from traumatic axonal injury. As such, future studies should examine preventive strategies against delayed deterioration in patients with head trauma.

关键词： brain injury ataxia axonal injury head trauma

Can the change of vasomotor activity in irritable bowel syndrome patients be detected via color Doppler ultrasound?

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World Journal of Radiology 2023年第7期15卷 226-233页

作者： Omer Kazci Fahrettin Ege Huseyin Aydemir Saliha Kazci Sonay Aydin department of Radiology Ankara Training and Research HospitalAnkara 06600Turkey department of Neurology VM Medicalpark HospitalAnkara 06600Turkey department of Radiology Erzincan Binali Yildirim University Mengucek Gazi Training and Research HospitalErzincan 24400Turkey department of Epidemiology Ankara University Faculty of MedicineAnkara 06600Turkey

BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequently referred conditions to the gastrointestinal outpatient *** pathophysiology of IBS has not been determined with *** hypersensitivity is indicated as one of the *** sympathetic nervous system is primarily in charge of controlling the arteries,and its effect is vasospasm in the medium and large arteries,resulting in decreased blood *** To demonstrate,using Doppler evaluation of the brachial artery,that sympathetic activity impairs vasomotor performance due to autonomic neuropathy,which we believe is associated with *** There were 58 participants in the *** control group consisted of 29 healthy patients,while the remaining 29 patients had been diagnosed with *** who met the Rome IV criteria and had IBS were included in the *** with known polyneuropathy or non-IBS chronic conditions that can progress were excluded from the trial,as were those with essential hypertension,diabetes mellitus,cardiovascular disease,or peripheral arterial disease,and patients diagnosed with anxiety or *** with moderate to severe carpal tunnel syndrome or a median nerve lesion due to trauma were also excluded from the trial.A Doppler probe was used to measure the baseline diameter and flow rates of the brachial artery from 2 cm superior to the antecubital *** Doppler probe remained stationary throughout the experiment,allowing for continuous ***,to activate the sympathetic fibers,an electrical stimulus for 5 s with an intensity of 10 mA and a frequency of 1 Hz was applied to the median nerve at the wrist level via the bipolar stimulus *** artery diameter and flow rates were measured again immediately following the fifth *** In healthy persons with no history of chronic illness,there was a statistically significant decrease in flow rate after stimulation(P<0.001).In addition,stimulation resulted

关键词： Irritable bowel syndrome Doppler ultrasonography Brachial artery Median nerve Peripheral neuropathy Autonomic neuropathy

Surgical Treatment of Recent traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and traumatological surgery department of the CHU Bocar Sidy Sall de Kati: About 20 Cases

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Surgical Science 2023年第5期14卷 338-346页

作者： Souleymane Diallo Sory Ibrahim Tambassi Kaly Tounkara Terna Traore Kalifa Coulibaly Aboubacar Diallo Soumana Traore Aboubacar Sidiki Sangaré Salif Kone Drissa Kaloga Bagayoko Cheick Oumar Sanogo department of Orthopedics and traumatology CHU Pr Bocar Sidy Sall of Kati Kati Mali department of Orthopedics and traumatology Etablissement Public Hospitalier Sikasso Sikasso Mali department of Anesthesia and Intensive Care University Hospital of Luxembourg Bamako Mali

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

关键词： Fractures Epiphyseal Detachments Distal End of Femur Pinning

The innate immune response to allotransplants: mechanisms and therapeutic potentials

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Cellular & Molecular Immunology 2019年第4期16卷 350-356页

作者： Jordi Ochando Farideh Ordikhani Peter Boros Stefan Jordan department of Oncological Sciences Icahn School of Medicine at Mount SinaiNew YorkNYUSA Immunología de Trasplantes Centro Nacional de MicrobiologíaInstituto de Salud Carlos IIIMadridSpain

Surgical trauma and ischemia reperfusion injury(IRI)are unavoidable aspects of any solid organ transplant *** trigger a multifactorial antigen-independent inflammatory process that profoundly affects both the early and long-term outcomes of the transplanted *** injury associated with donor organ procurement,storage,and engraftment triggers innate immune activation that inevitably results in cell death,which may occur in many different *** cells in donor grafts release damage-associated molecular patterns(DAMPs),which alert recipient innate cells,including macrophages and dendritic cells(DCs),through the activation of the complement cascade and toll-like receptors(TLRs).The long-term effect of inflammation on innate immune cells is associated with changes in cellular metabolism that skew the cells towards aerobic glycolysis,resulting in innate immune cell activation and inflammatory cytokine *** different roles of proinflammatory cytokines in innate immune activation have been described,and these cytokines also stimulate optimal T-cell expansion during allograft ***,early innate immune events after organ transplantation determine the fate of the adaptive immune *** this review,we summarize the contributions of innate immunity to allograft rejection and discuss recent studies and emerging concepts in the targeted delivery of therapeutics to modulate the innate immune system to enhance allograft survival.

关键词： metabolism immunity inflammation

Occult Adrenal Insufficiency in Patients with Chronic Renal Disease

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International Journal of Clinical Medicine 2024年第8期15卷 375-381页

作者： Kamel El-Reshaid Abdulmohsen Al-Bader Hossameldin Tawfik Sallam department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait department of Otolaryngology Farwania Hospital Ministry of Health Kuwait City Kuwait department of Medicine Al-Amiri Renal Center Ministry of Health Kuwait City Kuwait

Background: Addison’s disease is a rare disorder of the adrenal cortex that leads to inadequate production of cortisol initially followed by aldosterone and androgens. Its manifestations are usually slow and non-specific with potential for life-threatening adrenal crisis following hypermetabolic demands (infection, trauma, surgery). Patients: Over the past 10 years, 19 CRD-patients were diagnosed with occult PAI in our center. Results: Unprovoked hypotension was the most common manifestations of occult PAI and was the unmasking event in 11 (58%). It was without significant cardiac and/or severe systemic sepsis and was refractory to isotonic saline infusions. Equal number of the remaining patients (n = 2) presented with persistent and inexplicable electrolytes abnormalities viz. 1) hyponatremia despite restricted oral fluid intake, lack of dehydration and massive fluid overload, as well as 2) hyperkalemia despite potassium-restricted diet, hyperkalemic drugs and adequate therapy with Furosemide and low-potassium dialysis-baths. On the other hand, similar proportions presented with unprovoked 3) progressive weight loss, decrease appetite and cachexia as well as 4) frequent hypoglycemic attacks. All patients were treated and were medically stable after 29 (2 - 60) months of follow up. Autoantibodies to 21-hydroxylase enzyme were positive in 16 (90%). At diagnosis, and subsequent follow up, only 7 patients (37%) had multi-endocrine dysfunction of whom 2 with type 1 and 5 with type 2. Conclusion: High index of suspicion should be exerted in diagnosis of PAI in patients with CRD, since its clinical picture is similar to CRD manifestations and complications. In those patients, confirmatory tests and specific management can save their lives. .

关键词： Addison’s Disease Autoimmune Adrenalitis Chronic Renal Disease Multiple Endocrine Dysfunctions Primary Adrenal Insufficiency

1990至2002年全膝关节置换术关节置换登记系统的回顾研究

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骨科动态 2006年第4期2卷 193-197页

作者： Pu-YI SHENG LIISA KONTTINEN MATTI LEHTO DAISUKE OGINO ESA JAMSEN JuHA NEVALAINEN JORMA PAJAMAKI PEKKA HALONEN YRJO T KONTTINEN 徐卫东（译）费起礼（校） Investigation performed at COXA Hospital for Joint Replacement Tampere ORTON orthopaedic Hospital Invalid Foundation Helsinki National Agency for Medicines Helsinki and department of Medicine Helsinki University Central Hospital Helsinki Finland 上海第二军医大学附属长海医院骨科 200433 天津医院 300211

背景：采用国家和地区的关节置换登记系统资料研究初次全膝关节置换术的结果。该研究的目的是提供全膝关节翻修术的治疗结果，并以再次翻修为终点评估假体生存的预测指标。方法：从1990至2002年芬兰国家关节置换登记系统资料共包括全膝... 详细信息

背景：采用国家和地区的关节置换登记系统资料研究初次全膝关节置换术的结果。该研究的目的是提供全膝关节翻修术的治疗结果，并以再次翻修为终点评估假体生存的预测指标。方法：从1990至2002年芬兰国家关节置换登记系统资料共包括全膝关节翻修术2637例，以再次翻修为终点对术后全膝关节翻修的假体生存状态进行分析。生存状态分析包括单变量和多变量统计及适合的诊断模型，以评价相对危险假设。结果：全膝关节翻修术后假体2年生存率为95％（1874膝）（95％可信区间，94％-96％），5年为89％（944膝）（95％可信区间，88％-90％），10年为79％（141膝）（95％可信区间，78％-81％）。多变量回归分析表明，假体生存最显著的预测指标是患者的年龄和初次全膝关节置换术后的使用时间（即初次与翻修手术间隔的时间）。第一次翻修的年份和翻修原因也是预测生存率的重要指标。结论．70岁以上的患者、初次关节置换术后5年或以上施行翻修以及无髌骨半脱位的患者，预示全膝关节翻修术后假体生存率较好。随着年龄的增长、疾病的加重（骨关节炎和类风湿关节炎）以及降低治疗（初次全膝关节置换），均可以减少活动量，加上医生可能不愿对老年患者施行手术，使老年患者的再翻修率降低。可信水平：预测性研究，Ⅱ级。进一步可信度参见作者介绍。

关键词：全膝关节置换术全膝关节翻修术系统预测指标可信区间类风湿关节炎翻修手术老年患者

The Content of Silver, Cobalt, Chromium, Iron, Mercury, Rubidium, Antimony, Selenium, and Zinc in Osteogenic Sarcoma

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Journal of Cancer Therapy 2015年第6期6卷 493-503页

作者： Sofia Zaichick Vladimir Zaichick department of Medicine University of Illinois College of Medicine at Chicago Chicago USA Radionuclide Diagnostics department Medical Radiological Research Centre Obninsk Russia

Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides was performed. Methods: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn) mass fraction, Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fraction multiplications were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 27 patients with osteosarcoma (9 females and 18 males, 6 to 71 years old). The reliability of difference in the results between intact bone and osteosarcoma tissues was evaluated by Student’s t-test. Results: In the osteosarcoma tissue the mass fractions of Co, Cr, Fe, Sb, Se, and Zn are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, we found significantly lower values of Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as significant higher mean values of Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fractions multiplications in the osteosarcoma tissue compared to intact bone. In the osteosarcoma tissue many correlations between trace elements found in the control group were no longer evident. Conclusion: In osteosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.

关键词： Trace Elements Human Bone Osteogenic Sarcoma Neutron Activation Analysis

Caring Behaviour of Nurses in orthopaedic Wards of Selected Health Institutions as Perceived by Patients

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Open Journal of Nursing 2016年第5期6卷 396-403页

作者： Florence O. Adeyemo Oladeji Oloyede Michael Layi Okunlade Pat. U. Okpala department of Nursing College of Health Sciences Ladoke Akintola University of Technology Osogbo Nigeria department of Nursing University of Nigeria Enugu Campus Nigeria

Nurses are trained to provide hands-on care to patients in a variety of settings, which include physical care which can range from total care to helping a patient prevent illness. The health of a patient can significantly improve when they (patients) perceive caring nursing behaviours and are satisfied with the quality of care been received from their care giver. The aim of this study was to determine the caring behaviour of nurses as perceived by patients admitted to orthopaedic ward in some selected hospitals in Osogbo, Osun state, Nigeria. A descriptive comparative design was used. Convenient sample technique was used to select 616 respondents consisting of male and female patients admitted to orthopaedic wards of selected hospitals. The questionnaire on Caring Behaviour Assessment scale was adapted from CBI. The most highly ranked perceived nurses’ behaviour by patients rated “satisfactory” was the general perception of the patients and rendering of basic needs. The findings also revealed that patients rated nurses behaviour (care-giving) with respect to human needs assistance, the provision of safe environment, assisting in psychological care and giving physical comfort as average. Lastly, findings also revealed that patients rated perceived nurses behaviour (care-giving) as “not satisfactory” with regards to meeting their communication needs, nutritional needs and individualized care. In conclusion, care giving is an important branch of nursing and it depicts the quality of care received by a patient which in turn is capable of aiding speedy recovery.

关键词： Caring Behaviours Perception Patients orthopaedic Wards

Common Movement Disorders in Children: Diagnosis, Pathogenesis and Management

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Neuroscience & Medicine 2012年第1期3卷 90-100页

作者： Isabelle Korn-Lubetzki Israel Steiner department of Neurology Rabin Medical Center Beilinson Campus Petah Tiqva Israel department of Neurology Shaare Zedek Medical Center Jerusalem Israel

Movement disorders in childhood are a heterogeneous group of diseases with presentations that vary according to etiopathogenesis and age of onset. While sharing certain characteristics with the conditions that affect adults, they also have unique features that are determined by the metabolic, physiological and environmental distinctiveness of the developing brain. This context makes the nervous system of children vulnerable to various insults such as birth trauma, infections and toxicity. Some inborn errors of metabolism and genetic conditions selectively affect the young brain and psychological adaptation may also contribute to the occurrence and severity of certain conditions at this age group. The present review outlines the pathophysiology, clinical presentation and course, diagnosis and therapy of movement disorders in children. We also emphasize, when available, preventive and prophylactic measures and conclude by suggesting several avenues for future research in aspects that are currently not well understood.

关键词： Movement Disorder Children