scholarly journals Sarcoma Excision and Pattern of Complicating Sensory Neuropathy

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Neil R. Wickramasinghe ◽  
Nicholas D. Clement ◽  
Ashish Singh ◽  
Daniel E. Porter

A potential complication of sarcoma excision surgery is a sensory neurological dysfunction around the surgical scar. This study utilised both objective and subjective sensation assessment modalities, to evaluate 22 patients after sarcoma surgery, for a sensory deficit. 93% had an objective sensory deficit. Light touch is less likely to be damaged than pinprick sensation, and two-point discrimination is significantly reduced around the scar. Results also show that an increased scar size leads to an increased light touch and pinprick deficit and that two-point discriminatory ability around the scar improves as time after surgery elapses. 91% had a subjective deficit, most likely tingling or pain, and numbness was most probable with lower limb sarcomas. Results also demonstrated that there were no significant relationships between any specific subjective and objective deficits. In conclusion, sensory disturbance after sarcoma surgery is common and debilitating. Efforts to minimize scar length are paramount in the prevention of sensory deficit. Sensation may also recover to an extent; thus, sensory reeducation techniques must become an integral aspect of management plans. Finally to obtain a comprehensive assessment of sensory function, both objective and subjective assessment techniques must be utilised.

Author(s):  
Yassir AbdelRazig ◽  
Luh-Maan Chang

The term "quality" is defined as the conformance to predetermined requirements or specifications. These requirements may be simple or complex. They may be set in terms of the end result required or as a detailed description of how work should be executed. Recently, there has been increasing interest in quality assurance in the construction industry. Most current techniques used in infrastructure assessment and quality inspection rely merely on subjective criteria. Such inaccurate or subjective assessment techniques have been identified as critical obstacles to effective infrastructure management. An overview of contract quality warranties for steel bridge coatings is presented as a practical example, and a hybrid assessment model that can be used to quantitatively measure quality attributes is proposed. The hybrid model combines image processing and neural networks for defect (specifically, rust) recognition and measurement and uses statistical analysis for quality acceptance or rejection on the basis of the contract warranty clauses. The hybrid model incorporates human experience through the training stage to benefit from experts’ knowledge and to correct for other external factors.


Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 39-45 ◽  
Author(s):  
Direk Tantigate ◽  
Saichol Wongtrakul ◽  
Torpon Vathana ◽  
Roongsak Limthongthang ◽  
Panupan Songcharoen

Background: In Thailand, brachial plexus injury is a common traumatic injury that affects the function of the upper extremity. The current treatments focus mainly on improving the motor and sensory function. Apart from the motor and sensory deficit, these patients usually suffer from pain. Objective: The purpose of this study was to determine the prevalence and factors that relate to neuropathic pain in patients with brachial plexus injury. Methods: We collected data from March 2008 to July 2011. The DN4 Questionnaire was used to diagnose neuropathic pain in 95 patients. Results: The prevalence of neuropathic pain was as high as 76%. Majority of patients presented with hypoesthesia to pin prick, hypoesthesia to touch and numbness. Severity of neuropathic pain was significantly correlated with the type of brachial plexus injury. There was no difference between demographic characteristics of patients. Conclusion: Our study showed that the prevalence of neuropathic pain was high in brachial plexus injured patients. Therefore, surgeons should be aware of this common, yet underestimated, problem in brachial plexus injured patients.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1462
Author(s):  
Marie-Louise Kulas Søborg ◽  
Jacob Rosenberg ◽  
Jakob Burcharth

Guillain-Barré syndrome (GBS) is an acute ascending peripheral neuropathy, caused by autoimmune damage of the peripheral nerves. GBS can be divided into three subtypes: acute inflammatory demyelinating neuropathy, acute motor axonal neuropathy, and the more rare type, acute motor and sensory axonal neuropathy (AMSAN). Reports of AMSAN with onset after epidural anesthesia and spinal surgery are extremely rare, and the linkage between development of GBS and neuroaxial anesthesia remains conclusively unconfirmed. We present a case in which the patient developed subacute motor and predominantly sensory neuropathy following epidural blockade. The case emphasizes the need of including AMSAN in differential diagnostic considerations to changes in motor and sensory function following epidural anesthesia, allowing accelerated rehabilitation and relevant alleviating therapy.


1981 ◽  
Vol 25 (1) ◽  
pp. 513-517 ◽  
Author(s):  
F. Thomas Eggemeier

Because of their practical utility, subjective measures have been widely used as workload assessment techniques. There has also been increased support in the recent literature for the importance of including subjective measures as part of a comprehensive workload assessment methodology. In spite of the widespread use and importance of subjective techniques, several significant issues which pertain to their development and use remain unresolved. One such issue is related to the development of a generalized subjective workload assessment procedure, while a second issue concerns the need to identify factors or variables that contribute to the subjective experience of workload. This paper discusses both issues and outlines some recent research which is applicable to each area.


2003 ◽  
Vol 28 (4) ◽  
pp. 289-294 ◽  
Author(s):  
R. R. BINDRA ◽  
J. J. DIAS ◽  
C. HERAS-PALAU ◽  
P. C. AMADIO ◽  
K. C. CHUNG ◽  
...  

An overview of the current state of outcome measurement after hand surgery is presented. The paper focuses on the development, application and strengths and weaknesses of subjective assessment techniques. It also reviews the existing questionnaires and suggests recommendations for use in research or clinical practice.


Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 288-291 ◽  
Author(s):  
Charles E. Poletti ◽  
William H. Sweet

Abstract Two cases of progressive, occipital lancinating pain and dysesthesias associated with a sensory deficit of the C2 dermatome are presented. Symptoms were relieved, and C2 sensory function restored by releasing a hypertrophied atlanto-epistrophic ligament entrapping the C2 root and ganglion. The normal anatomy and abnormal surgical findings are described. C2 entrapment by the atlanto-epistrophic ligament is discussed in reference to other C2 lesions causing occipital pain. We conclude that some patients whose progressive occipital pain is accompanied by a C2 sensory deficit are suffering from entrapment of the C2 root and ganglion amenable to surgical decompression.


2020 ◽  
Vol 48 ◽  
Author(s):  
Ana Caroline Colveiro ◽  
Júlia Silva Rauber ◽  
Angel Ripplinger ◽  
Mathias Wrzesinski ◽  
Marcelo Luís Schwab ◽  
...  

Background: The goals of physical therapy are to maximize functional recovery, improve mobility, and restore well-being and quality of life. In the veterinary literature, there is a dearth of data on physical therapy in small animal practice. Therefore, this study aimed to identify the main neurological and orthopedic diseases in canine and feline patients seen at the physical therapy service of an animal hospital. Concomitantly, we collected demographic and clinical information on patients, including sex, breed, physical therapy modalities, number and frequency of physical therapy sessions, duration of treatment, and rate of functional recovery.Materials, Methods & Results: The records of animals with neurological and orthopedic diseases seen at the Physical Therapy department of a university-affiliated animal hospital were reviewed. The animals were divided into two groups: I) dogs and cats with neurological diseases and II) dogs and cats with orthopedic diseases. Both groups were distributed according to species, age, sex and race. Dogs and cats were classified into three age groups: puppies (≤ 1 year old), adults (> 1 year and ≤ 10 years old) and elderly (> 10 years old). A total of 384 records were retrieved, of which 370 (96.4%) were of dogs and 14 (3.6%) of cats. Neurological cases accounted for 66% of the total (n = 253), with 243 cases in dogs (96%) and 10 in cats (4%). Among orthopedic cases (n = 131, accounting for the remaining 34%), 127 were in dogs (97%) and only 4 in cats (3%). In the neurological dysfunction group, intervertebral disc disease (72.4%) was the most common diagnosis. Among the orthopedic disorders, femur fracture (23.1%) was most prevalent. In group I (neurological), 66.7% of outcomes in canine patients and 44.4% in felines were considered satisfactory. In group II (orthopedic), 61% of outcomes in dogs and 66.7% in cats were considered satisfactory.Discussion: Physical therapy has many applications in small-animal practice. After spinal cord decompression surgery in dogs with IVDD, for instance, it helps maintain and recover motor and sensory function, and is considered safe and well-tolerated in dogs after thoracolumbar hemilaminectomy with disc fenestration. Physical therapy also plays an important role after surgical repair of fractures and dislocations, aiding recovery of range of motion and return to functional activity. The most probable explanation for the wide variation in number of physical therapy sessions can be explained by owners’ satisfaction with the level of recovery achieved by the animal, often leading to discontinuation of physical therapy. The high rate of unsatisfactory outcomes in feline patients can be explained by the type of injury (spinal trauma) and the degree of neurological dysfunction. Adult female dogs were most likely to be referred to the physical therapy sector, and the Dachshund and Poodle breeds were most prevalent. Patients in the neurological dysfunction group had the highest average duration and number of sessions. Massage, stretching, passive joint mobilization, and neuromuscular electrical stimulation (NMES) were the most commonly used modalities in all physical therapy protocols. Satisfactory functional recovery was achieved in more than 60% of cases in both groups. The absence of a control group and the lack of standardization of physical therapy modalities precluded a more definitive confirmation of the results obtained in terms of functional recovery.


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