scholarly journals Acute musculoskeletal neck and back pain

2021 ◽  
pp. 81-88
Author(s):  
Y. N. Maksimov ◽  
D. Kh. Khaibullina
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Clinical Manifestations ◽  
Intervertebral Discs ◽  
Economic Problem ◽  
Physical Work ◽  
Economic Losses ◽  
First Case ◽  
Working Age ◽  
Neurological Research

Back and neck pain is widespread in the population. Preferably, patients of working age are sick, which leads to serious economic losses. The transition of pain from acute to chronic increases financial costs, so effective treatment of back pain is an important medical, social and economic problem. Musculoskeletal pain (MSP) prevails among all types of back pain. The source of the MSP can be various structures of the musculoskeletal system: bones, joints, muscles, fascia, tendons, ligaments, intervertebral discs. The provoking factors for the development of the MSP are static and dynamic overloads arising from physical work, long stay in a fixed posture, unprepared movements, hypothermia, vibrations. The leading diagnostic method for the MSP is a physical research of a patient which includes a detailed collection of complaints and anamnesis, inspection in statics and dynamics, carrying out global and special tests, neuroorthopedic and neurological research. In most cases, the analysis of the results obtained allows you to set a clinical diagnosis without appointing additional research methods. Two cases of acute MSP with different localization, clinical manifestations and flow are offered to the discussion. In the first case, the process was localized in the muscles of the law back. In the second patient, the muscular tonic syndrome developed in the muscles of the neck and shoulder belt and was supported by functional blockades of the vertebral motor segments. For the treatment of both patients, NSAID, muscle relaxant, glucocorticoid, as well as non-drug therapy methods were used. For local injection therapy, a drug group of glucocorticoids was used, having a sodium phosphate and betamethazone dipropionate as part of the sodium betamethasone. The combination of two betamethazone salts provides both the rapid and prolonged effect of the drug, which makes it reasonable to use it with acute musculoskeletal pain.

scholarly journals Osteopathic correction in the treatment of pain in the lower back

2020 ◽  
pp. 140-146
Author(s):  
V. O. Belash ◽  
Yu. O. Novikov
Keyword(s):  
Back Pain ◽  
Developed Countries ◽  
Economic Problem ◽  
World Health ◽  
Randomized Controlled ◽  
Lower Back ◽  
The World ◽  
Working Age ◽  
Acute Back Pain ◽  
Health Organization

According to experts of the World Health Organization the lower back pain (LBP) prevalence in developed countries reaches the pandemic size, and it is a serious medical and socio-economic problem. Acute back pain is transformed into chronic in 10–20 % of working age patients′ cases; this causes serious psychological disorders appearing, forms painful behavior and persists even when the initial pain trigger is eliminated. Data from metaanalyses of randomized controlled trials indicate the effectiveness of the osteopathic approach in the treatment of LBP patients. At the same time the osteopathic correction is effective not only for acute pain, but also for chronic pain. A case from clinical practice is described demonstrating the possibility of osteopathic correction of a LBP patient.

scholarly journals Mastitis associated with Prototheca zopfii - an emerging health and economic problem on dairy farms

2016 ◽  
Vol 60 (4) ◽  
pp. 373-378 ◽  
Author(s):  
Dubravka Milanov ◽  
Tamaš Petrović ◽  
Vladimir Polaček ◽  
Ljiljana Suvajdžić ◽  
Jovan Bojkovski
Keyword(s):  
Early Stage ◽  
Clinical Manifestations ◽  
Dairy Farm ◽  
Professional Community ◽  
Economic Problem ◽  
Economic Losses ◽  
Effective Prevention ◽  
Typically Develop ◽  
Prototheca Zopfii ◽  
Effective Prevention Strategies

Abstract Increased incidence of protothecal mastitis has been recorded in several countries in the past ten years. The main goal of this article is to draw the attention of scientific and professional community to the emerging issue of mammary protothecosis. The article collates currently known facts about infection reservoirs, predisposing factors for the development of mastitis, clinical manifestations of the disease, and potential transmission routes within the herd as well as the measures for control and eradication. We would like to point out that identification of protothecal mastitis on a dairy farm is associated with a range of problems. Early detection of infected animals can be difficult because of predominantly subclinical course of early-stage infection, which easily spreads between cows via the milking system. Spontaneous recovery has not been recorded and infected cows typically develop chronic mastitis with granulomatous infiltration and progressive loss of functional parenchyma of the mammary gland. Substantial economic losses and health damages associated with mammary protothecosis strongly emphasise the need for developing effective prevention strategies aimed at control of the infection.

scholarly journals Chronic musculoskeletal pain in neurological practice

2021 ◽  
pp. 22-28
Author(s):  
D. Kh. Khaibullina ◽  
Yu. N. Maksimov ◽  
F. I. Devlikamova
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Muscle Relaxant ◽  
Clinical Case ◽  
Pain Treatment ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Pain Syndrome ◽  
Chronic Musculoskeletal Pain ◽  
Herniated Disc

Treatment of musculoskeletal back pain is an essential problem for doctors of many specialties, including neurologists. In some cases, the chronic course of the pain syndrome is accompanied with complaints and clinical manifestations characteristic of neuropathic pain in the absence of significant damage to the neural structures, which is explained by the mechanism of central sensitization. In this case, there may be diagnostic errors in determining the nature of the pain, which entails inadequate therapy that does not lead to the desired result.The presented clinical case is devoted to the treatment of exacerbation of chronic musculoskeletal pain. Treatment of the patient for a herniated disc complicated by radiculopathy, carried out earlier, did not lead to the desired result due to the inconsistency of the diagnosis, inadequacy and lack of systematic therapy. Based on the analysis of the physical and paraclinical studies, the diagnosis was changed to « Lower back pain. Myofascial pain syndrome. Toxic polyneuropathy. Herniated disc LV-SI. Residual radiculopathy S1». Therapeutic measures were adjusted in accordance with the diagnosis. In order to relieve the pain syndrome at the first stage, a combined drug Neurodiclovit, a muscle relaxant, a drug of the SYSADOA group, soft tissue techniques of manual therapy, phonophoresis with glucocorticosteroids, and cognitive behavioral therapy were used. The assessment of the patient’s condition carried out after 7 days showed the effectiveness of the treatment, which allowed to cancel the use of a nonsteroidal anti-inflammatory drug, a muscle relaxant and a glucocorticosteroid. At the post-treatment stage, the patient was prescribed a combination of B vitamins (Neuromultivitis) and therapeutic gymnastics, as well as continued therapy with a slowacting symptomatic agent and non-drug treatment methods. Relief of the pain syndrome in the absence of adverse events confirmed the adequacy and effectiveness of the therapy.The presented clinical case demonstrates the importance of placing emphasis at the stage of diagnosis, taking into account the data of clinical and paraclinical research methods, and also illustrates the possibility of successful conservative therapy for exacerbation of chronic musculoskeletal pain in the practice of a neurologist.

scholarly journals Child Labor and Musculoskeletal Disorders: The Pelotas (Brazil) Epidemiological Survey

2005 ◽  
Vol 120 (6) ◽  
pp. 665-673 ◽  
Author(s):  
Anaclaudia Gastal Fassa ◽  
Luiz Augusto Facchini ◽  
Marinel Mór Dall'Agnol ◽  
David C. Christiani
Keyword(s):  
Back Pain ◽  
Musculoskeletal Disorders ◽  
Musculoskeletal Pain ◽  
Child Labor ◽  
Low Income ◽  
Work Conditions ◽  
Physical Work ◽  
Occupational Risk Factors ◽  
Increased Risk ◽  
Awkward Posture

Objectives. This article describes the prevalence of musculoskeletal pain in several anatomic sites in children and teens, and investigates, while adjusting for potential confounders, the association between musculoskeletal pain and back pain and the following: age, gender, sports practice, use of computer/video games/television, school attendance, intensity of involvement in household domestic activities, care of other children, care of sick/elderly family members, work activities, and workloads. Methods. We conducted a cross-sectional study interviewing 3,269 children aged 10–17 years in the low-income areas of Pelotas, Brazil. Results. The prevalence of pain in the neck, knee, wrist or hands, and upper back exceeded 15%. Workers in manufacturing had a significantly increased risk for musculoskeletal pain (prevalence ratio [PR]=1.31) and for back pain (PR=1.69), while workers in domestic service had 17% more musculoskeletal pain and 23% more back pain than nonworkers. Awkward posture (PR=1.15) and heavy physical work (PR=1.07) were associated with musculoskeletal pain, while monotonous work (PR=1.34), awkward posture (PR=1.31), and noise (PR=1.25) were associated with back pain. Conclusions. Musculoskeletal pain is common among working children and teens. Knowledge of occupational risk factors can support actions to restructure work conditions to reduce or eliminate childhood exposure to hazardous conditions. Our results suggest that strategies to prevent musculoskeletal disorders in child workers should be developed.

scholarly journals Low back pain: a case study

2021 ◽  
pp. 384-390
Author(s):  
D. Kh. Khaibullina ◽  
Yu. N. Maksimov ◽  
F. I. Devlikamova
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Case ◽  
Muscle Tension ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Lower Limbs ◽  
Low Back ◽  
Medical Opinion

As defined in the WHO Bulletin (1999), low back pain (LBP) is pain, muscle tension or stiffness localized in the back between the XII pair of ribs and the lower gluteal folds, with or without irradiation in lower limbs. The LBP syndrome is not a nosological unit, but due to its high prevalence, social and economic importance, it has a separate heading in ICD-10 – (M 54.5). Various structures can be the source of LBP: intervertebral discs, facet and sacroiliac joints, muscles, ligaments, tendons, fascia, spinal cord and its roots, peripheral nerves, etc. Depending on which structure the source of pain is, the nature of the pain can have a nociceptive, neuropathic or mixed character, which affects the tactics of patient management. The variety of clinical manifestations of LBP introduces certain difficulties in the process of making a diagnosis and may entail the appointment of treatment methods that are inadequate for the patient’s condition. In such cases, it is advisable to conduct an additional consultation in order to obtain a second medical opinion. The message is devoted to the analysis of a clinical case of LBP. During the examination of the patient, the nature of the pain, initially regarded as neuropathic, began to be interpreted as nociceptive. In accordance with this, a complex treatment was prescribed, which included pharmacological preparations and methods of non-drug therapy. In order to quickly relieve the pain syndrome, the drug dexketoprofen was used according to a stepwise scheme. Obtaining effective anesthesia within 5 days made it possible to abandon further NSAID intake and to continue follow-up treatment with a preparation of B vitamins, a muscle relaxant and SYSADOA in combination with non-drug methods of treatment. The considered clinical case illustrates both the difficulties arising in the diagnosis of LBP and the possibilities of successful conservative therapy of this disease. 

Clinical and Radiographic Correlation (According to CT) in Patients with Degenerative Lumbar Spinal Stenosis

2017 ◽  
pp. 124-130 ◽  
Author(s):  
S. G. Mlyavykh ◽  
A. Y. Aleynik ◽  
A. E. Bokov ◽  
M. V. Rasteryaeva ◽  
M. A. Kutlaeva
Keyword(s):  
Ct Scan ◽  
Spinal Canal ◽  
Clinical Manifestations ◽  
Intervertebral Discs ◽  
Morphometric Parameters ◽  
Neurogenic Claudication ◽  
Clinical Group ◽  
Lumbar Stenosis ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

Сomputed tomography (CT) is widely used in the diagnosis of  degenerative pathology of the lumbar spine, but the relationship  between clinical manifestations of lumbar stenosis and its anatomical prerequisites has not been sufficiently studied to date.The objective: to determine the significance of the morphometric  parameters of lumbar stenosis according to CT scans and to  establish their relationship with the prevailing symptoms of the disease.Material and methods. Seventy-five consecutive patients with  clinically significant lumbar stenosis who underwent CT scan before  surgery were enrolled in this study. The average values of thirteen  different morphometric parameters were calculated at LIII–SI levels of the intervertebral discs and of the pedicels in the axial and sagittal views. The possibility of classification of clinical observations and the correlation of morphometric parameters with the clinical forms of lumbar stenosis were investigated using discriminant and logistic regression analysis. Results. CT scan with high probability allocates patients with  predominant symptoms of neurogenic claudication or bilateral  radiculopathy. The most significant morphometric predictors of this  clinical group are the depth of the lateral recesses and the cross-sectional area of the spinal canal.Conclusion. CT scan significantly expands the informative value of  magnetic resonance imaging and can be used in planning the  decompressive stage of the surgery intervention in patients with lumbar spinal canal stenosis.

scholarly journals Upbeat vertical nystagmus after brain stem cavernoma resection: a rare case of nucleus intercalatus/nucleus of roller injury

2020 ◽  
Vol 267 (10) ◽  
pp. 2865-2870
Author(s):  
Torstein R. Meling ◽  
Aria Nouri ◽  
Adrien May ◽  
Nils Guinand ◽  
Maria Isabel Vargas ◽  
...  
Keyword(s):  
Rare Case ◽  
Vascular Malformations ◽  
Clinical Manifestations ◽  
Neurological Injury ◽  
Medial Longitudinal Fasciculus ◽  
Blurred Vision ◽  
Complete Excision ◽  
First Case ◽  
Vertical Nystagmus ◽  
Upbeat Nystagmus

Abstract Introduction CNS cavernomas are a type of raspberry-shaped vascular malformations that are typically asymptomatic, but can result in haemorrhage, neurological injury, and seizures. Here, we present a rare case of a brainstem cavernoma that was surgically resected whereafter an upbeat nystagmus presented postoperatively. Case report A 42-year old man presented with sudden-onset nausea, vomiting, vertigo, blurred vision, marked imbalance and difficulty swallowing. Neurological evaluation showed bilateral ataxia, generalized hyperreflexia with left-sided predominance, predominantly horizontal gaze evoked nystagmus on right and left gaze, slight left labial asymmetry, uvula deviation to the right, and tongue deviation to the left. MRI demonstrated a 13-mm cavernoma with haemorrhage and oedema in the medulla oblongata. Surgery was performed via a minimal-invasive, midline approach. Complete excision was confirmed on postoperative MRI. The patient recovered well and became almost neurologically intact. However, he complained of mainly vertical oscillopsia. The videonystagmography revealed a new-onset spontaneous upbeat nystagmus in all gaze directions, not suppressed by fixation. An injury of the rarely described intercalatus nucleus/nucleus of Roller is thought to be the cause. Conclusion Upbeat nystagmus can be related to several lesions of the brainstem, including the medial longitudinal fasciculus, the pons, and the dorsal medulla. To our knowledge, this is the first case of an iatrogenic lesion of the nucleus intercalatus/nucleus of Roller resulting in an upbeat vertical nystagmus. For neurologists, it is important to be aware of the function of this nucleus for assessment of clinical manifestations due to lesions within this region.

scholarly journals Facial cleft? The first case of manitoba‐oculo‐tricho‐anal syndrome with novel mutations in China: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuchen Gu ◽  
Yimin Khoong ◽  
Xin Huang ◽  
Tao Zan
Keyword(s):  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Clinical Manifestations ◽  
Sporadic Case ◽  
Facial Cleft ◽  
Ocular Manifestations ◽  
First Case ◽  
Whole Exome ◽  
Chinese Girl ◽  
Low Prevalence

Abstract Background Manitoba-oculo-tricho-anal (MOTA) syndrome is a rare syndrome with only 27 cases reported worldwide so far, but none was reported in the population of Eastern Asia. Such extremely low prevalence might be contributed by misdiagnosis due to its similarities in ocular manifestations with facial cleft. In our study, we discovered the first case of MOTA syndrome in the population of China, with 2 novel FRAS1 related extracellular matrix 1 (FREM1) gene stop-gain mutations confirmed by whole exome sequencing. Case presentation A 12-year-old Chinese girl presented with facial cleft-like deformities including aberrant hairline, blepharon-coloboma and broad bifid nose since birth. Whole exome sequencing resulted in the identification of 2 novel stop-gain mutations in the FREM1 gene. Diagnosis of MOTA syndrome was then established. Conclusions We discovered the first sporadic case of MOTA syndrome according to clinical manifestations and genetic etiology in the Chinese population. We have identified 2 novel stop-gain mutations in FREM1 gene which further expands the spectrum of mutational seen in the MOTA syndrome. Further research should be conducted for better understanding of its mechanism, establishment of an accurate diagnosis, and eventually the exploitation of a more effective and comprehensive therapeutic intervention for MOTA syndrome.

scholarly journals 369. Clinical Characteristics of the First 177 Patients Admitted with COVID-19 at a Bronx Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S254-S254
Author(s):  
Victoria Bengualid ◽  
Maria Martinez ◽  
Zhenisa Hysenaj ◽  
Debra M Willner ◽  
Judith Berger
Keyword(s):  
Oxygen Saturation ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Altered Mental Status ◽  
Channel Blockers ◽  
First Case ◽  
Overall Mortality

Abstract Background The first case of COVID-19 was admitted on March 15th 2020 to our community based hospital in the Bronx, NY. The aim of this study is to describe the clinical characteristics and outcome of these first COVID-19 patients. Patient Characteristics and Outcome Methods IRB approved retrospective chart review study of all COVID-19 patients admitted during March 2020 focusing on patient characteristics, co-morbidities, clinical manifestations and outcome. Results A total of 177 patients were admitted during March 2020: 57% African American 23.1% Hispanic and 16.9% White. 44.9% female, average age 60 years, and 90% had at least one comorbidity. Outcome was available on all patients except for one who was transferred to another institution for ECMO. Overall mortality was 33%. Clinical presentation: 69.4% presented with cough or shortness of breath, 15.8% with diarrhea, nausea, vomiting or abdominal pain, and 14.6% with myalgia, dizziness or altered mental status. 6.2% presented only with fever. However 59.8% of patients presented with fever and respiratory or gastrointestinal symptoms. Mortality The table compares patients who died vs discharged (either home or to a short term facility). Those that were 65 years or older, hypertensive or presented to the ER with an oxygen saturation of 94% or lower, were more likely to die. Ventilated patients: 31.6% of patients were intubated with a mortality rate of 77%. 22% of these patients were intubated in the first 24 hours. Compared to non-intubated patients, there was no difference in BMI, diabetes, hypertension, COPD/Asthma, use of statins, aspirin or calcium channel blockers. Intubated patients older than 64 years had significantly higher mortality rates (p=0.0001). Conclusion This cohort of COVID-19 patients is unique as almost all received Hydroxychloroquine and Azithromycin. Only 9% received steroids and even fewer received an interleukin-6 inhibitor, convalescent plasma or Remdesivir. African Americans and Hispanics accounted for 80% of patients. Greater than 90% received Medicaid. Overall mortality was 33%. The most common presentation was respiratory followed by gastrointestinal symptoms. The overall mortality was 33% but increased to 77% in intubated patients. Age, hypertension, and ER oxygen saturation correlated with mortality. Disclosures All Authors: No reported disclosures

scholarly journals Minimally invasive debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis: a long‐term follow‐up study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jianbiao Xu ◽  
Leiming Zhang ◽  
Rongqiang Bu ◽  
Yankang Liu ◽  
Kai-Uwe Lewandrowski ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Intervertebral Discs ◽  
Intraoperative Ct ◽  
Long Term Follow Up ◽  
Invasive Method ◽  
Vertebral Bodies ◽  
Adjacent Segments

Abstract Background Spondylodiscitis is an unusual infectious disease, which usually originates as a pathogenic infection of intervertebral discs and then spreads to neighboring vertebral bodies. The objective of this study is to evaluate percutaneous debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis. Methods From January 2002 to May 2017, 23 patients with multilevel spondylodiscitis were treated with minimally invasive debridement and drainage procedures in our department. The clinical manifestations, evolution, and minimally invasive debridement and drainage treatment of this refractory vertebral infection were investigated. Results Of the enrolled patients, the operation time ranged from 30 minutes to 124 minutes every level with an average of 48 minutes. Intraoperative hemorrhage was minimal. The postoperative follow-up period ranged from 12 months to 6.5 years with an average of 3.7 years. There was no reactivation of infection in the treated vertebral segment during follow-up, but two patients with fungal spinal infection continued to progress by affecting adjacent segments prior to final resolution. According to the classification system of Macnab, one patient had a good outcome at the final follow-up, and the rest were excellent. Conclusions Minimally invasive percutaneous debridement and irrigation using intraoperative CT-Guide is an effective minimally invasive method for the treatment of multilevel spondylodiscitis.

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