SCHISTOSOMAL MYELORADICULOPATHY IN A NON-ENDEMIC AREA

ABSTRACT Objective: To report a schistosomal myeloradiculopathy case in a non-endemic area. Case description: A previously healthy 11-year-old boy, stricken by an acute loss of strength on his lower limbs, followed by a loss of strength on his upper limbs and upper body, associated with altered sensitivity of the vesical globe formation. The patient’s cerebrospinal fluid analysis showed eosinophilic meningitis, in addition to peripheral eosinophilia. The investigation resulted in a positive serology for Schistosoma mansoni. The treatment included steroids and praziquantel 60mg/kg, with a new dose after a month, as well as physical therapy for rehabilitation. The patient evolved with clinical improvement in the neurological exam, with a medullary section initially at C6, but now at T6. The patient is kept at prednisolone use (30mg/day) and longterm urinary catheter dependence. Comments: The schistosomiasis is endemic in many regions of Brazil; however, it has low incidence in the south of the country. Among its main manifestations, the schistosomal myeloradiculopathy is the most severe ectopic form of the disease, and should be suspected in patients with low back pain, strength and/or sensibility disorder of the lower limbs or urinary tract’s disturbance. Early diagnosis and treatment should be done in order to reduce severe neurological sequelae. Treatment includes schistosomiasis drugs, corticosteroids and/or surgery.

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Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽

10.1024/0301-1526/a000176 ◽

2012 ◽

Vol 41 (2) ◽

pp. 132-135 ◽

Cited By ~ 2

Author(s):

Krohn ◽

Gebauer ◽

Hübler ◽

Beck

Keyword(s):

Computed Tomography ◽

Computed Tomography Angiography ◽

Collateral Circulation ◽

Intestinal Ischemia ◽

Clinical Presentation ◽

Lower Limbs ◽

Upper Body ◽

Descending Aorta ◽

Before And After ◽

Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

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Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

Medical & Clinical Research ◽

10.33140/mcr.02.01.04 ◽

2017 ◽

Vol 2 (1) ◽

Keyword(s):

Case Report ◽

Congenital Syphilis ◽

Eosinophilic Granuloma ◽

Osteolytic Lesion ◽

Lower Limbs ◽

Upper Body ◽

Elective Cesarean Section ◽

Distal Fibula ◽

X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

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A Feasibility Study of Kinematic Characteristics on the Upper Body According to the Shooting of Elite Disabled Archery Athletes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062962 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2962

Author(s):

Tae-Whan Kim ◽

Jae-Won Lee ◽

Seoung-Ki Kang ◽

Kyu-Yeon Chae ◽

Sang-Hyup Choi ◽

...

Keyword(s):

The Body ◽

Lower Limbs ◽

Upper Body ◽

Movement Trajectory ◽

Phase 2 ◽

Kinematic Characteristics ◽

Significant Difference ◽

Athletes With Disabilities ◽

Body Center ◽

Time Required

The purpose of this study is to compare and analyze the kinematic characteristics of the upper limb segments during the archery shooting of Paralympic Wheelchair Class archers (ARW2—second wheelchair class—paraplegia or comparable disability) and Paralympic Standing Class archers (ARST—standing archery class—loss of 25 points in the upper limbs or lower limbs), where archers are classified according to their disability grade among elite disabled archers. The participants of this study were selected as seven elite athletes with disabilities by the ARW2 (n = 4) and ARST (n = 3). The analysis variables were (1) the time required for each phase, (2) the angle of inclination of the body center, (3) the change of trajectory of body center, and (4) the change of the movement trajectory of the bow center by phase when performing six shots in total. The ARW2 group (drawing phase; M = 2.228 s, p < 0.05, holding phase; M = 4.414 s, p < 0.05) showed a longer time than the ARST group (drawing phase; M = 0.985 s, holding phase; M = 3.042 s), and the angle of the body did not show a significant difference between the two groups. Additionally, in the direction of the anteroposterior axis in the drawing phase, the change in the movement trajectory of the body center showed a more significant amount of change in the ARW2 group than in the ARST group, and the change in the movement trajectory of the bow center did not show a significant difference between the two groups.

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Seventeen years of American cutaneous leishmaniasis in a Southern Brazilian municipality

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652012000400006 ◽

2012 ◽

Vol 54 (4) ◽

pp. 215-218 ◽

Cited By ~ 1

Author(s):

Wilsandrei Cella ◽

Simone Cristina Castanho Sabaini de Melo ◽

Cátia Millene Dell Agnolo ◽

Sandra Marisa Pelloso ◽

Thaís Gomes Verzignassi Silveira ◽

...

Keyword(s):

Cutaneous Leishmaniasis ◽

Rural Area ◽

Prevalence Rate ◽

Endemic Area ◽

Skin Lesions ◽

Lower Limbs ◽

Age Group ◽

American Cutaneous Leishmaniasis ◽

Incomplete Filling ◽

Residence Location

We reviewed the records of 151 patients diagnosed with American cutaneous leishmaniasis (ACL) from 1993 to 2009 in the municipality of Japura, Paraná, Brazil. Gender, age, occupation, place of residence, location of lesions, type and number of lesions were analyzed. The prevalence rate of ACL was 11.5/10,000 hab, of which 84.7% were male, 58.3% lived in rural area and 49.0% were farmers. The most frequent age group was between 30 to 39 years (26.6%). Skin lesions occurred in 92.7% of the patients with predominance in the lower limbs (23.9%) and 49.1% of the records did not include the number of lesions location due to incomplete filling. A single ulceration was present in 44.4%. Japurá is an endemic area for ACL, requiring public actions and preventive education.

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Use of Kinetic and Kinematic Data to Evaluate Load Transfer as a Mechanism for Flexion Relaxation in the Lumbar Spine

Journal of Biomechanical Engineering ◽

10.1115/1.4025112 ◽

2013 ◽

Vol 135 (10) ◽

Cited By ~ 17

Author(s):

Samuel J. Howarth ◽

Paul Mastragostino

Keyword(s):

Lumbar Spine ◽

Body Mass ◽

Full Range ◽

Added Mass ◽

Erector Spinae ◽

Lower Limbs ◽

Upper Body ◽

Low Back ◽

Kinematic Data ◽

Flexion Relaxation

Flexion relaxation (FR) in the low back occurs when load is transferred from the spine's extensor musculature to its passive structures. This study investigated the influence of added upper body mass on low back kinetics and kinematics at the FR onset. Sixteen participants (eight male, eight female) performed standing full forward spine flexion with 0%, 15%, and 30% of their estimated upper body mass added to their shoulders. Electromyographic data were obtained from the lumbar erector spinae. Ground reaction forces and kinematic data from the lower limbs, pelvis, and spine were recorded. Extensor reaction moments (determined using a bottom-up linked segment model) and flexion angles at the FR onset were documented along with the maximum spine flexion. The angle at the FR onset increased significantly with added mass (p < 0.05). Expressing the FR onset angle as a percent of the full range of trunk flexion motion for that condition negated any differences between the added mass conditions. These findings demonstrate that low back kinetics play a role in mediating FR in the lumbar spine.

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The heart of myofibrillary myopathy

10.5327/1516-3180.457 ◽

2021 ◽

Author(s):

Natália Merten Athayde ◽

Alzira Alves de Siqueira Carvalho

Keyword(s):

Protein A ◽

Cardiac Pacemaker ◽

Fatty Degeneration ◽

Lower Limbs ◽

Clinical Approach ◽

Limb Weakness ◽

Muscle Mri ◽

Morphological Findings ◽

Neurological Exam ◽

Determining Factor

Context: Myofibrillar myopathies (MFM) represent a heterogeneous group of disorders of skeletal and cardiac muscle caused by mutations in genes that encode proteins of sarcomere. Diagnosis is a challenge due to clinical and genetic variability. Case report: Woman, 36 years old, presenting stumbles and falls for 3 years evolving with proximal limb weakness. At age 30, she fainted and a cardiac pacemaker was implanted. Non-consanguineous parents. Neurological exam: proximal and distal weakness in lower limbs and distal atrophy; osteotendinous reflexes normal. Bilateral scapula alata. Exams: CPK = 457 U / l; EMG: myopathic pattern. Muscle MRI: diffuse and heterogeneous fatty degeneration, marked in sartorius, gracilis and semitedinous. Panel NGS myopathies: pathogenic variant, c.1175T> C, missense in heterozygosis in desmin gene. CONCLUSION: The diagnosis of MFM is based on the morphological findings of muscle biopsy with the presence of protein aggregates as a determining factor. Currently, genetic testing by NGS has facilitated early diagnosis allowing for a more appropriate clinical approach. The desmin gene was the first one described to be associated with this group of myopathies. It encodes the desmin protein, a member of the intermediate filament family present in cardiac and skeletal muscle. Several phenotypes are related to desmin gene: isolated dilated cardiomyopathy; scapuloperoneal weakness and distoproximal weakness with cardiac alterations. Desminopathy is a rare cause of cardiomyopathy and / or myopathy. The diagnosis should be thought in patient with muscle weakness and cardiac changes.

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Measurement of Human Gait Symmetry using Body Surface Normals Extracted from Depth Maps

Sensors ◽

10.3390/s19040891 ◽

2019 ◽

Vol 19 (4) ◽

pp. 891 ◽

Cited By ~ 1

Author(s):

Trong-Nguyen Nguyen ◽

Huu-Hung Huynh ◽

Jean Meunier

Keyword(s):

Body Surface ◽

Lower Limbs ◽

Upper Body ◽

Whole Body ◽

Human Gait ◽

Gait Symmetry ◽

Symmetry Index ◽

Depth Maps ◽

Abnormal Gait ◽

3D Information

In this paper, we introduce an approach for measuring human gait symmetry where the input is a sequence of depth maps of subject walking on a treadmill. Body surface normals are used to describe 3D information of the walking subject in each frame. Two different schemes for embedding the temporal factor into a symmetry index are proposed. Experiments on the whole body, as well as the lower limbs, were also considered to assess the usefulness of upper body information in this task. The potential of our method was demonstrated with a dataset of 97,200 depth maps of nine different walking gaits. An ROC analysis for abnormal gait detection gave the best result ( AUC = 0.958 ) compared with other related studies. The experimental results provided by our method confirm the contribution of upper body in gait analysis as well as the reliability of approximating average gait symmetry index without explicitly considering individual gait cycles for asymmetry detection.

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An Approach to Human Walking Analysis Based on Balance, Symmetry and Stability Using COG, ZMP and CP

Applied Sciences ◽

10.3390/app10207307 ◽

2020 ◽

Vol 10 (20) ◽

pp. 7307

Author(s):

Seonghye Kim ◽

Toshiyuki Murakami

Keyword(s):

Personal Characteristic ◽

Center Of Gravity ◽

Lower Limbs ◽

Upper Body ◽

Human Walking ◽

Joint Rotation ◽

Gait Parameters ◽

Zero Moment ◽

Crossing Point

The parameters of walking have been studied from the viewpoints of joint rotation and translation of body. The balance and symmetry of walking are indispensable features to understand for healthy walking, while also being a personal characteristic. However, quantification has not been easy to carry out in the case of the conventional gait parameters COG (center of gravity) and ZMP (zero moment point). In this approach, the CP (crossing point) is proposed to quantify the concept of symmetry and balance by comparing it to the COG and ZMP. The CP is estimated based on the intersection between the hip line and the ankle line. While the hip line is fixed on the upper body where the COG is, the ankle line is altered depending on the each footfall, where the ZMP is. Therefore, the values of COG, ZMP, and CP have similar or different tendencies in terms of whether balanced walking results in symmetry or not. The validity of this is verified by carrying out a simulation with robot walking, and an experiment using human walking. Through additional experiments, it was noticed that the CP was able to improve the role of COG and ZMP in terms of not only stability, but also its relationship with the movement range of the lower limbs.

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The Relationship between Isometric Force-Time Characteristics and Dynamic Performance: A Systematic Review

Sports ◽

10.3390/sports8050063 ◽

2020 ◽

Vol 8 (5) ◽

pp. 63 ◽

Cited By ~ 2

Author(s):

Danny Lum ◽

G. Gregory Haff ◽

Tiago M. Barbosa

Keyword(s):

Isometric Force ◽

Dynamic Performance ◽

Lower Limbs ◽

Upper Body ◽

Original Research ◽

Dynamic Performances ◽

Time Variables ◽

Force Time ◽

The Relationship ◽

Body Dynamic

The purpose of this article was to review the data on the relationship between multi-joint isometric strength test (IsoTest) force-time characteristics (peak force, rate of force development and impulse) and dynamic performance that is available in the current literature. Four electronic databases were searched using search terms related to IsoTest. Studies were considered eligible if they were original research studies that investigated the relationships between multi-joint IsoTest and performance of dynamic movements; published in peer-reviewed journals; had participants who were athletes or active individuals who participate in recreational sports or resistance training, with no restriction on sex; and had full text available. A total of 47 studies were selected. These studies showed significant small to large correlations between isometric bench press (IBP) force-time variables and upper body dynamic performances (r2 = 0.221 to 0.608, p < 0.05) and significant small to very large correlation between isometric squat (ISqT) (r2 = 0.085 to 0.746, p < 0.05) and isometric mid-thigh pull (IMTP) (r2 = 0.120 to 0.941, p < 0.05) force-time variables with lower body dynamic performances. IsoTest force-time characteristics were shown to have small to very large correlations with dynamic performances of the upper and lower limbs as well as performance of sporting movements (r2 = 0.118 to 0.700, p < 0.05). These data suggest that IsoTest force-time characteristics provide insights into the force production capability of athletes which give insight into dynamic performance capabilities.

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Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain

British Journal of Pain ◽

10.1177/2049463720961413 ◽

2020 ◽

pp. 204946372096141

Author(s):

Sarah J Drabble ◽

Jaqui Long ◽

Blessing Alele ◽

Alicia O’Cathain

Keyword(s):

Clinical Encounter ◽

The Body ◽

Lower Limbs ◽

Upper Body ◽

Pain Experience ◽

Face To Face ◽

The United Kingdom ◽

Type Pattern ◽

Emotional Aspects ◽

Pain Experiences

Introduction: Prior research into endometriosis-related pain has focused on specific aspects of the pain experience such as cyclical pain, emotional aspects of pain and certain types of pain such as dysmenorrhea and dyspareunia. However, research has paid less attention to the diversity and complexity of women’s pain experiences, which can lead to failure to recognise some symptoms as part of endometriosis and poor symptom management. Methods: We conducted qualitative semi-structured face-to-face interviews with 20 women in the United Kingdom recruited from an endometriosis self-help group with a diagnosis of endometriosis via laparoscopy. A topic guide framed questions around experiences of pain. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using inductive thematic analysis. Results: Women experienced multiple types of pain that they felt were caused by endometriosis and affected many different parts of the body including bowel, bladder, lungs, kidneys, nerves, upper body, lower limbs and head. These pains consisted of different conceptual categories: type, pattern and intensity. These categories came together to create a complex, interrelated experience for each individual that we termed ‘constellations of pain’ because each woman had a complex set of pain categories and no two individuals appeared to have the same pain experience. Conclusion: The complexity and diversity of endometriosis-related pain found in this study has implications for improving diagnosis, medical and non-medical pain management and improving the clinical encounter between women and healthcare professionals.

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