scholarly journals POS0845 SCLERODERMIC HAND SENSOR: SMART TECHNOLOGY APPLIED TO RHEUMATOLOGY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 676.2-677
Author(s):  
S. Parisi ◽  
M. C. Ditto ◽  
C. L. Peroni ◽  
A. Laganà ◽  
E. Fusaro
Keyword(s):  
Hand Function ◽  
Electronic Devices ◽  
Skin Involvement ◽  
Development Environment ◽  
Special Configuration ◽  
Technology Application ◽  
Autoimmune Rheumatic Disease ◽  
Significant Difference ◽  
Hand Disability ◽  
Object Of Study

Background:Systemic Sclerosis (SSc) is an autoimmune rheumatic disease characterized by excessive production and accumulation of collagen in the skin and internal organs and by injuries to small arteries.Impairment of the musculoskeletal system is one of the main causes of disability in SSc, indeed, about 90% of these patients have a loss of hand function. To date, the degree of skin involvement is evaluated through a semi-quantitative method called Rodnan Skin Score (RSS) or Modified-RSS (MRSS). However, MRSS is a method that has limitations related to the operator and his experience and does not provide information on joint mobility.Arduino® is an open source integrated online platform based on easy to use hardware and software. It is a system for creating interactive projects by inserting a special configuration code, using the Arduino® development environment. Through this platform it is possible to create electronic devices with specific purposes to lead the possibility of integrating different kits (eg types of sensors) in relation to the object of study.Objectives:We have therefore created an electronic instrument (Sclerodermic Hand Sensor - SHS) independent operator and easily reproducible in order to measure the degree of mobility (flexion) of the hand in patients with SSc (Fig.1). The aim was to evaluate whether the SHS was able to highlight significant differences between patients with SSc and healthy patients.Methods:We recruited 20 female patients with SSc according to ACR criteria with a mean age of 50.8 ± 15.5 years and 20 healthy (HC) patients with a mean age of 44.3 ± 10.8 years (Tab.1), in order to test the effectiveness and sensitivity of the SHS tool.Results:The results showed a significant difference between the two groups of patients (SSc vs HC) independent of the measurement method used as expected (Goniometer SSc / HC: Δ45.80 ° p: 0.003 SHS SSc / HC: Δ65.17 ° p: 0.002, Fig.1c), however the device created with Arduino® proved to be more sensitive than the goniometric measurement in detecting the degree of joint flexion (p: 0.002). The flexion sensor, indeed, unlike the goniometer, evaluates the simultaneous articular excursion of the entire finger (MCF, IFP and IFD) and not just one segment (Fig.1).Conclusion:This technology application, thanks to the creation of dedicated electronic devices, allows the physicians to be supported in clinical practice with independent operating tools.The tool we propose could be a valid support in accurately assessing the joint and indirectly skin involvement of sclerodactyly in this type of patient, especially in the context of a clinical trial to evaluate the efficacy of a treatment.Further studies are needed to compare with other methods to assess hand disability in SSc such as the use of HAMIS (Hand Mobility in Scleroderma) test.References:[1]Sandqvist G et al. J Rheumatol. 2016 Jul;43(7):1356-62.[2]https://www.arduino.cc.Table 1.SSc Patients CharacteristicsChararcteristicsSScPatients (n°, subset D=Diffuse; L=Limited)20 (9D/11L)Age, mean ± SD years50.8 ± 15.5Duration of Raynaud’s Phenomenon (mean ± SD years)12.8 ± 4.4Duration of SSc (mead ± SD years)8.4 ± 3.6MRSS (mean ± SD years)15.9 ± 5.3Disclosure of Interests:None declared

scholarly journals SAT0398 PERSISTENCE OF USTEKINUMAB (UST) OR TNF INHIBITOR (TNFI) TREATMENT IN PSORIATIC ARTHRITIS (PsA): INSIGHTS FROM THE LARGE, PROSPECTIVE, MULTINATIONAL, REAL-WORLD PsABio COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1149-1150
Author(s):  
L. Gossec ◽  
S. Siebert ◽  
P. Bergmans ◽  
K. De Vlam ◽  
E. Gremese ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Real World ◽  
Treatment Effect ◽  
Cox Model ◽  
Tnf Inhibitor ◽  
Skin Involvement ◽  
Research Support ◽  
Treatment Persistence ◽  
Kaplan Meier ◽  
Significant Difference

Background:Several biologic DMARDs (bDMARDs) exist for PsA, TNFi and UST being the earliest on European markets. When bDMARDs are insufficiently effective, later-line bDMARDs typically have shorter persistence. Treatment persistence reflects a mix of effectiveness and adverse events (AEs), and persistence data are limited in PsA.Objectives:Comparative analysis of 1-year persistence of UST and TNFi within the prospective PsABio cohort.Methods:PsABio is an observational, multinational study of PsA patients (pts) treated with 1st to 3rd line UST or TNFi at their rheumatologist’s discretion.1Treatment persistence (up to 15 months of follow-up) was defined as time between start of first bDMARD treatment in PsABio, and either stop or switch to another bDMARD, or withdrawal.Persistence of UST and TNFi is shown by Kaplan-Meier curves and compared using Cox regression analysis, with propensity score (PS) to adjust for baseline imbalanced demographic and disease-related covariates (age, sex, bDMARD line, BMI, Clinical Disease Activity index for PSoriatic Arthritis [cDAPSA], 12-item PsA Impact of Disease [PsAID-12], Fibromyalgia Rapid Screening Tool [FiRST] score, co-treatments with MTX, NSAIDs, glucocorticoids, cardiovascular/metabolic comorbidities, dactylitis, enthesitis and body surface area [BSA]). Factors including concomitant MTX use and skin involvement: <3%, 3–10% and >10%, were added to the Cox model to investigate their impact on the PS-adjusted treatment effect.Results:Of 438 and 455 pts who started UST and TNF, respectively, 121 (28%) and 134 (29%) stopped or switched treatment before Month 15, with differences (as expected) according to treatment line (Fig. 1a, b). Reasons for stop/switch were related to safety/AEs in 12% (UST) and 28% (TNFi), and effectiveness (joints, nails or skin) in 77% (UST) and 69% (TNFi) of pts.The observed mean time on drug was 397 days for UST and 385 days for TNFi pts (1st line 410/397 days, 2nd 390/382 days, 3rd 381/338 days). Fig. 1b shows similar persistence for all drugs and treatment lines, except for lower persistence in TNFi 3rd line vs 1st/2nd. In PS-adjusted Cox analysis, no statistically significant difference between UST and TNFi persistence was seen; hazard ratio (HR; 95% CI) for stop/switch bDMARD (UST vs TNFi) was 0.82 (0.60, 1.13). In the model, bDMARD monotherapy (without MTX) and extensive skin involvement (BSA >10%), showed significantly better persistence for UST (HR 0.61 [0.42, 0.90] and 0.41 [0.19, 0.89] respectively; unadjusted Kaplan-Meier graphs shown in Fig. 1c, d). MTX co-therapy and low BSA did not affect the PS-adjusted treatment effect. Other factors added to the PS-adjusted Cox model did not show significant effects.Conclusion:In this real-world PsA cohort undergoing bDMARD treatment, persistence was generally comparable for UST and TNFi, but some clinical situations led to better drug persistence with UST compared to TNFi – particularly monotherapy, more extensive skin involvement, and in 3rd-line treatment. Our data emphasise the importance of skin involvement for pts with PsA.References:[1]Gossec L, et al.Ann Rheum Dis. 2018;77(suppl 2):Abstract AB0928Acknowledgments:This study was funded by Janssen.Disclosure of Interests:Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB, Stefan Siebert Grant/research support from: BMS, Boehringer Ingelheim, Celgene, GlaxoSmithKline, Janssen, Novartis, Pfizer, UCB, Consultant of: AbbVie, Boehringer Ingelheim, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, Celgene, Janssen, Novartis, Paul Bergmans Shareholder of: Johnson & Johnson, Employee of: Janssen, Kurt de Vlam Consultant of: Celgene Corporation, Eli Lilly, Novartis, Pfizer, UCB – consultant, Speakers bureau: Celgene Corporation, Eli Lilly, Novartis, Pfizer, UCB – speakers bureau and honoraria, Elisa Gremese Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Speakers bureau: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Sanofi, UCB, Roche, Pfizer, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Tatiana Korotaeva Grant/research support from: Pfizer, Consultant of: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Speakers bureau: Abbvie, BIOCAD, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, Novartis-Sandoz, Pfizer, UCB, Wim Noel Employee of: Janssen Pharmaceuticals NV, Michael T Nurmohamed Grant/research support from: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Consultant of: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Speakers bureau: Abbvie, Bristol-Myers Squibb, Celltrion, GlaxoSmithKline, Jansen, Eli Lilly, Menarini, Merck Sharp & Dohme, Mundipharma, Pfizer, Roche, Sanofi, USB, Petros Sfikakis Grant/research support from: Grant/research support from Abvie, Novartis, MSD, Actelion, Amgen, Pfizer, Janssen Pharmaceutical, UCB, Elke Theander Employee of: Janssen-Cilag Sweden AB, Josef S. Smolen Grant/research support from: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi, Consultant of: AbbVie, AstraZeneca, Celgene, Celltrion, Chugai, Eli Lilly, Gilead, ILTOO, Janssen, Novartis-Sandoz, Pfizer Inc, Samsung, Sanofi

scholarly journals Anti-phosphatidylserine/prothrombin Complex Antibodies in Patients With Cutaneous Vasculitis: Possible Involvement in the Pathogenesis

2020 ◽  
Author(s):  
Yuto Tamura ◽  
Tamihiro Kawakami ◽  
Yupeng Dong ◽  
Miku Yoshinari ◽  
Yuka Nishibata ◽  
...  
Keyword(s):  
Vascular Endothelium ◽  
Systemic Vasculitis ◽  
Serum Levels ◽  
Cutaneous Vasculitis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Iga Vasculitis ◽  
Skin Involvement ◽  
Wild Type ◽  
Significant Difference

Abstract Objective. It was previously demonstrated that cutaneous vasculitis, including IgA vasculitis and cutaneous arteritis (CA), is associated with the presence of IgM antibodies (Abs) against the phosphatidylserine/prothrombin complex (PS/PT). Recently, novel enzyme-linked immunosorbent assay kits for the detection of IgG and IgM anti-PS/PT (aPS/PT) Abs have become commercially available.Methods. The prevalence of serum IgG and IgM aPS/PT Abs in both cutaneous and systemic vasculitis was determined using these kits. In addition, to examine whether aPS/PT Abs were involved in the pathogenesis of cutaneous vasculitis, inbred wild-type rats were intravenously administered with a rat IgM class aPS/PT monoclonal Ab established previously or with rat immunoglobulins as controls. To express PS on the surface of vascular endothelium, these rats were given a subcutaneous injection of cell-free histones (250 µg/ml, 300 µl/site) 2 hours in advance. Results. Serum IgM aPS/PT Ab levels were elevated in patients with systemic vasculitis with skin involvement and CA compared to those in patients with systemic vasculitis without skin involvement and healthy controls. There was no significant difference in the serum levels of IgG aPS/PT Abs between the patients and healthy controls. Correspondingly, inbred wild-type rats intravenously administered with the aPS/PT monoclonal IgM Ab after appropriate priming—subcutaneous histone injection—developed cutaneous vasculitis. Some rats given rat IgM instead of the aPS/PT monoclonal Ab also developed cutaneous vasculitis, whereas vasculitis did not occur in rats given IgG or only priming by histones. Conclusion. IgM aPS/PT Abs could be involved in the pathogenesis of cutaneous vasculitis.

scholarly journals Tempo Digital: Quando a escola invade o smartphone

2020 ◽  
pp. 62-67
Author(s):  
Maria Luísa Luís Duarte
Keyword(s):  
Young People ◽  
Creative Process ◽  
Electronic Devices ◽  
School Context ◽  
Digital Natives ◽  
Work Of Art ◽  
History Of ◽  
Current Context ◽  
History Of Culture ◽  
Object Of Study

This article derives from the master’s research in which it seeks to understand what uses the teenagers of this generation, known as millennials (or digital natives), are giving to their smartphones in a given Portuguese school context. Bearing in mind that our young people (as well as adults) spend a large part of their time “clinging” to small electronic devices, the present investigation looks at this problem as an opportunity to produce artistic content through a didactic use. At the same time, it helps young “producer / consumer” students to recognize themselves in the production of subjectivity inherent in certain work proposals carried out within the scope of the History of Culture and Arts. Starting from the concepts inherent to the disciplines of Artistic Education and the selection and study of a work of art, and having self-representation as the object of study, the student (re) creates (the work selected by himself) through the use of the smartphone, mobilizing skills transversal (technical, aesthetic and methodological) in a process that wants to be creative. In the creative process several aspects are contemplated that can, and should, be deepened, namely the question of time. The time we live in is an unexpected time! Time of seclusion, distance, confinement! We seek to ask whether the current context of confinement can provide an opportunity to reflect on the didactic use of the smartphone to produce artistic content while maintaining the principles of equality and equity.

scholarly journals Roles of Environmental System Knowledge in Promoting University Students’ Environmental Attitudes and Pro-Environmental Behaviors

2019 ◽  
Vol 11 (16) ◽  
pp. 4270 ◽  
Author(s):  
Piyapong Janmaimool ◽  
Samattaphong Khajohnmanee
Keyword(s):  
Political Ecology ◽  
Formal Education ◽  
Environmental Attitudes ◽  
Environmental Knowledge ◽  
Direct Impact ◽  
Development Environment ◽  
Environmental Behaviors ◽  
Environmental System ◽  
Significant Difference ◽  
System Knowledge

This study aims to investigate the role of environmental system knowledge in promoting pro-environmental behaviors. Relationships between environmental knowledge and environmental attitudes as well as environmental knowledge and pro-environmental behaviors were analyzed. Environmental system knowledge includes knowledge of political ecology, sustainable development, environment and ecology, and environmental situations. This study included 128 students enrolling in the elective course entitled “Environment and Development” provided by the King Mongkut’s University of Technology Thonburi in Bangkok city of Thailand and 150 students who were not participating in this course. The results revealed that environmental attitudes of students participating in the course was significantly higher than that of students not attending the course. Only knowledge of the environment and ecology highly correlated with environmental attitudes; on the other hand, diverse environmental knowledge significantly correlated with pro-environmental behaviors. The result also demonstrated that indirect impact environmental behaviors reported by both groups were statistically different, but there was no significant difference in direct impact environmental behaviors. This study suggested that environmental knowledge provided through a formal education could promote environmental attitudes, but it may not contribute to students’ engagement in direct impact environmental behaviors.

scholarly journals Accuracy of two hand-held electronic devices for determination of blood β-hydroxybutyrate in dairy cows

2017 ◽  
Vol 18 (3) ◽  
pp. 439-445 ◽  
Author(s):  
Eliana FIORENTIN ◽  
Anderson TIECHER ◽  
Cristina MENEGAT ◽  
Clarice SOARES ◽  
Adelina AIRES ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Standard Method ◽  
Electronic Devices ◽  
Correlation Coefficients ◽  
Standard Technique ◽  
Portable Devices ◽  
Predictive Values ◽  
Subclinical Ketosis ◽  
Significant Difference

SUMMARY The cowside determination of blood β-hydroxybutyrate (BHB) is an important tool for diagnosing subclinical ketosis in dairy cattle. Portable methods to measure BHB have been introduced in the past years. This study evaluated the accuracy of two hand-held electronic devices for blood determination of BHB in dairy cows at early postpartum. A total of 98 blood samples were collected from dairy cows in the first month of lactation and tested with FreeStyle Optium (FSO, Abbott) and KetoVet (KVE, TaiDoc) portable devices according to the manufacturer instructions. Spectrophotometric BHB analysis (Ranbut, Randox) was used as standard method. The incidence of subclinical ketosis was 37.7 % determined by the standard method, 40.8 % determined by the FSO system and 42.8 % detected with the KVE system. The sensitivity and specificity indexes were 88.1% and 98.4% for FSO and 78.7% and 92.4% for KVE, respectively. The Pearson´s correlation coefficients comparing the portable devices to the standard technique were 0.96 for FSO and 0.93 for KVE. No significant difference in BHB values was found between the two portable tests and the standard method. Predictive values (PV) were better using FSO (positive PV 97.3 %, negative PV 92.4%) than using KVE (positive PV 88.1 %, negative PV 85.9 %). Passing-Bablok regressions revealed good agreement between methods. Though FSO system had a better performance than KVE system, the results suggest that the two portable systems have good accuracy and are reliable for measuring BHB.

scholarly journals Impact of Fire Arms Training in a Virtual Reality Environment on Occupational Performance (Marksmanship) in a Polytrauma Population

2019 ◽  
Vol 184 (11-12) ◽  
pp. 832-838 ◽  
Author(s):  
Robert A Oliver ◽  
Jill M Cancio ◽  
Christopher A Rábago ◽  
Kathleen E Yancosek
Keyword(s):  
Medical Records ◽  
Limb Amputation ◽  
Training Procedure ◽  
Occupational Performance ◽  
Training Time ◽  
Technology Application ◽  
Time Points ◽  
Significant Difference ◽  
Firearm Training ◽  
Return To Duty

Abstract Introduction Polytrauma, to include major limb amputation, in a military population presents unique rehabilitation challenges with the overarching goal of restoring function leading to the primary question, “Is this Service Member (SM) capable of returning to duty following rehabilitation?” The US military has a vested interest in maximizing injured SMs occupational performance to allow for return to duty. The purpose of this report is to describe marksmanship (shot grouping and weapon qualification) and return to duty outcomes following a course of VRE-based firearm training in a polytrauma patient population. Methods The medical records, stored in the Armed Forces Health Longitudinal Technology Application (AHLTA), of all patients who received rehabilitative care at the Center for the Intrepid (CFI) to include VRE-based firearms training between 01OCT2015 and 01AUG2016 were manually reviewed for inclusion. Subjects included all adult (18 years and older) SMs (active duty at time of admission) with a diagnosis of polytrauma who had been referred to and treated (received additional services such as physical and or occupational therapy) at the CFI. Approval for this research was received from the Brooke Army Medical Center Department of Clinical Investigation Office of the Institutional Review Board. Results Medical records of 30 SMs with a polytrauma diagnosis met the inclusion criteria. Mean shot group sizes for the M9 and M4 weapon decreased between initial and post training time points for the M9 zero (p = 0.009) and M4 zero (p = 0.020). There was no significant difference between initial and post training time points at the other shooting distances with either weapon. There was an 89% qualification rate for both the M9 (n = 18) and M4 (n = 19) weapons for those who attempted qualification; 43% of the population (n = 13) did not attempt qualification with either weapon. Conclusion SMs with polytrauma demonstrated a high rate of weapon qualification (accuracy) following VRE-based firearm training. Shot group size (precision) at short distances with a M9 pistol and M4 rifle also improved with training. While overall marksmanship appeared to improve, high return to duty rates were not directly related to firearm training or marksmanship. Future efforts need to focus on consistent clinical documentation of firearm training procedure and the establishment of psychometric properties for marksmanship outcome measures.

Can upper limb taping or exercises improve hand function, writing speed and self-perception of performance in adolescent school children?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Hiba Memon ◽  
Apurv Shimpi ◽  
Ashok Shyam ◽  
Parag Sancheti
Keyword(s):  
Grip Strength ◽  
School Children ◽  
Hand Function ◽  
Group Analysis ◽  
Performance Measure ◽  
Pinch Strength ◽  
Self Perception ◽  
Urban City ◽  
Significant Difference ◽  
Non Parametric

Abstract Background The majority of students spend time in writing, which is a prime performance measure in examinations. Enhancement in handwriting should benefit students to attain better academic performance. Objective To assess the effectiveness of taping and exercises on hand function, writing speed, self-perception of writing and to compare these techniques. Methods A randomized control trial was conducted using cluster sampling in adolescent children across four schools in an urban city. A 4-week intervention study was conducted on 123 students divided into taping, exercise and control groups. Outcome measures were grip strength, pinch strength, 12-min writing speed test and the Writer Self-Perception Scale (WSPS). For intra-group analysis, a paired t-test was used for parametric values and the Wilcoxon signed rank test was used for non-parametric values. For inter-group analysis, one-way analysis of variance (ANOVA) for parametric values and the Kruskal-Wallis test for non-parametric values was used. Results The taping group showed a significant improvement in grip strength (1.79 kg; p = 0.00), pinch strength [1.67 lb (757.4 g); p = 0.00] and writing speed (39.77 words/12 min; p = 0.00). The exercise group showed significant improvement in grip strength (2.09 kg; p = 0.00), pinch strength (1.28 lb; p = 0.00), writing speed (28.38 words/12 min; p = 0.00). In the control group, there was a significant increase in pinch strength (1.023 lb; p = 0.01) and writing speed (12.94 words/12 min; p = 0.02). Inter-group analysis showed significant difference in writing speed (p = 0.002) and grip strength (p = 0.00). There was no significant difference in perception (p = 0.071). Conclusion Taping and exercise are equally effective for enhancement of hand function, writing speed and self-perception in adolescent school children.

Effects of bilateral arm training on upper extremity function in right and left hemispheric stroke

2020 ◽  
pp. 1-9
Author(s):  
Humera Ambreen ◽  
Hina Tariq ◽  
Imran Amjad
Keyword(s):  
Upper Extremity ◽  
Motor Function ◽  
Recovery Of Function ◽  
Hand Function ◽  
Group Analysis ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Bilateral Arm Training

Abstract Objective: This experimental study on 24 stroke patients aimed at evaluating and comparing the effects of bilateral arm training on upper extremity (UE) motor function between right and left hemispheric chronic stroke patients. Methods: Both groups received the same intervention involving 5 functional tasks for 1 hour, 3 days per week, for a total of 6 weeks. Fugl-Meyer Assessment-Upper Extremity and Wolf-Motor Function Test were applied as outcome measures at baseline and after 6 weeks of training to assess the recovery of function in the affected area. Results: Intra-group analysis showed no significant improvement in the wrist and hand function in the left hemispheric stroke (LHS) (p>0.05), while right hemispheric stroke (RHS) patients did not improve significantly in the coordination/speed domain (p>0.05). Inter-group analysis showed no significant difference between right and left hemispheric stroke patients (p>0.05). Conclusion: Bilateral arm training showed beneficial effects in improving UE function in both RHS and LHS patients. Distal UE function in LHS and coordination and speed of movement in RHS patients did not show any significant improvement. Key Words: Stroke, Upper extremity, Recovery of function, Bilateral arm training. Continuous...

scholarly journals Reinnervation of the biceps in C5–7 brachial plexus avulsion injuries: results after distal bypass surgery

2004 ◽  
Vol 16 (5) ◽  
pp. 1-4 ◽  
Author(s):  
Stefano Ferraresi ◽  
Debora Garozzo ◽  
Paolo Buffatti
Keyword(s):  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Hand Function ◽  
Elbow Flexion ◽  
Musculocutaneous Nerve ◽  
Biceps Muscle ◽  
Nerve Transfers ◽  
Significant Difference ◽  
Normal Hand ◽  
Nerve Dysfunction

Object The authors report various techniques, and their results, after performing median and ulnar nerve transfers to reanimate the biceps muscle in C5–7 avulsion-related brachial plexus injuries (BPIs). Methods Forty-three adult patients with BPIs of the upper-middle plexus underwent reinnervation of the biceps muscle; neurotization of the musculocutaneous nerve was performed using fascicles from the ulnar nerve (39 cases) and the median nerve (four cases). The different techniques included sectioning, rerouting, and direct suturing of the entire musculocutaneous nerve (35 cases); direct reinnervation of the motor branches of the musculocutaneous nerve (three cases); and reinnervation using small grafts to the motor fascicles that enter the biceps muscle (five cases). Elbow flexion recovery ranged from M2 to M4+, according to the patient's age and the level of integrity of the hand. No surgery-related failure occurred. No significant difference in outcome was related to any of the technical variants. In patients younger than age 45 years and exhibiting a normal hand function a score of M4 or better was always achieved. On average, reinnervation occurred 6 months after surgery. There was no clinical evidence of donor nerve dysfunction. Conclusions When accurate selection criteria are met, the results after this type of neurotization have proved excellent.

Effect of personalized wrist orthosis for wrist pain with three-dimensional scanning and printing technique: A preliminary, randomized, controlled, open-label study

2018 ◽  
Vol 42 (6) ◽  
pp. 636-643 ◽  
Author(s):  
Sang Jun Kim ◽  
Sung Jae Kim ◽  
Yong Ho Cha ◽  
Keun Ho Lee ◽  
Jeong-Yi Kwon
Keyword(s):  
Hand Function ◽  
Three Dimensional ◽  
Wrist Pain ◽  
Control Group ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
High Satisfaction ◽  
Significant Difference ◽  
Experimental Group

Background: Three-dimensional printer technology can produce the personalized orthosis in various forms. Objective: To develop a personalized wrist orthosis using a three-dimensional scanner and three-dimensional printer for patients with wrist pain. Study design: A preliminary, prospective, randomized, open-label study. Methods: A total of 22 patients with wrist pain were randomly assigned to the control and experimental groups. The control group wore a cock-up orthosis and the experimental group wore a three-dimensional-printed wrist orthosis for 1 week. The Patient-Rated Wrist Evaluation, Jebsen Hand Function Test, and Orthotics and Prosthetics Users’ Survey were checked before and 1 week after the application. Results: The Patient-Rated Wrist Evaluation showed significant pain relief in both groups. Two items of the 28 Orthotics and Prosthetics Users’ Survey questions, “Put toothpaste on brush and brush teeth” and “Dial a touch tone phone,” showed high satisfaction scores, with statistically significant difference in the experimental group ( p = 0.036 and 0.004). Conclusion: The three-dimensional-printed wrist orthosis was superior to the cock-up orthosis for two items of the Orthotics and Prosthetics Users’ Survey. Wrist pain was reduced in the group wearing the three-dimensional-printed wrist orthosis as well as the group wearing the cock-up orthosis, so the three-dimensional-printed wrist orthosis could possibly play the same role as the cock-up orthosis. Clinical relevance A three-dimensional-printed wrist orthosis can be a substitute for a conventional ready-made wrist orthosis for patients with wrist pain with more satisfaction.

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