scholarly journals Paraliticka dislokacija kuka kod cerebralne paralize - hirursko lecenje mekotkivnim postupcima

2005 ◽  
Vol 52 (2) ◽  
pp. 49-53
Author(s):  
Goran Cobeljic ◽  
Zoran Bajin ◽  
S. Milickovic ◽  
Aleksandar Lesic ◽  
O. Krajcinovic
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Excellent Result ◽  
Radiological Finding ◽  
Radiological Findings ◽  
Knee Contracture ◽  
First Time ◽  
Dislocation Of The Hip ◽  
Knee Flexors

Results of a combination of soft tissue procedures performed for the first time in treating paralytic dislocation of the hip in cerebral palsy are presented. All hip flexors and adductors release, along with possible transposition or elongation of knee flexors on the side of the dislocation (if knee contracture exceeded 20) were performed. 75 hips in 57 patients were operated on. 54 patients were analyzed. The average age of the patients was 6.6 years, the average follow-up was 7 years. Excellent result was achieved in 33patients (61%), good in 10 (18,6%), fair in 4 (7,4%) poor in 7 patients (13%). Poor results were registered in patients over 10 years of age and in patients with athetosis. Results were assessed according to clinical finding, radiological finding (migrational percentage) and the ability of patients to walk. When based on radiological findings only, excellent results were achieved in 63 hips (84%). This combination of soft-tissue procedures which includes all muscles that take part in the dislocation proved to be very successful in achieving reposition. It can be recommended to patients suffering from the spastic form of cerebral palsy up to 10 years of age.

scholarly journals Long-term clinical outcomes and radiological findings and their correlation with each other after standard open discectomy for lumbar disc herniation

2015 ◽  
Vol 22 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Il-Nam Son ◽  
Young-Hoon Kim ◽  
Kee-Yong Ha
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Radiological Finding ◽  
Leg Pain ◽  
Radiological Findings ◽  
Group 4 ◽  
Spinal Degeneration ◽  
Over Time ◽  
Group 1

OBJECT This retrospective study was designed to evaluate the clinical outcomes and radiological findings after open lumbar discectomy (OLD) in patients who were followed up for 10 years or longer. METHODS The authors classified 79 patients who had a mean age (± SD) of 53.6 ± 13.6 years (range 30–78 years) into 4 groups according to the length of their follow-up. Patients in Group 1 were followed up for 10–14 years, in Group 2 for 15–19 years, in Group 3 for 20–24 years, and in Group 4 for more than 25 years. In all of these patients, the clinical outcomes were assessed by using patients' self-reported scores on visual analog scales (VASs) measuring back and leg pain and by using scores from the Oswestry Disability Index (ODI). In addition, 10 radiological parameters suggesting degenerative changes or instability at the operated segment were recorded at various time points and used to calculate a numeric radiological finding (NRF) score by rating a presence for each finding of spinal degeneration or instability as 1. RESULTS The authors observed that OLD decreased pain and disability scores in all groups. Numeric radiological findings were highest in Group 4, and a significant correlation was detected between NRFs and VAS scores of back pain (p = 0.039). In this cohort, the reoperation rate was 13.9% during a mean follow-up period of 15.3 years. Clinical outcomes tended to be most favorable in Group 1, representing patients who had OLD most recently, and they tended to deteriorate in the other 3 groups, indicating some worsening of outcomes over time. Degeneration of the spine at the operated level measured with radiographic methods tended to increase over time, but some stabilization was observed. Although spinal degeneration was stable, clinical outcomes deteriorated over time. CONCLUSIONS This cross-sectional assessment of a retrospective cohort indicates that outcomes after OLD deteriorate over time. Increased back pain indicated a worsening of clinical outcomes, and this worsening was correlated with radiological findings of degeneration at the operated segment.

scholarly journals Os Intermetatarseum May not Interfere with Metatarsus Primus Varus Deformity Correction: A Case Report

2018 ◽  
Vol 25 (1) ◽  
pp. 24-28
Author(s):  
Daniel Y. Wu
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Deformity Correction ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Hallux Valgus Deformity ◽  
Os Intermetatarseum ◽  
First Time

It has been believed that the correction of metatarsus primus varus (MPV) deformity of hallux valgus foot using nonosteotomy procedures would be compromised by the presence of os intermetatarseum (OI). Therefore, no soft tissue procedure has ever been reported for the correction of MPV deformity of hallux valgus foot. This is a case report of a female patient with bilateral hallux valgus deformity and also a large OI of her left foot that was corrected, satisfactorily and simultaneously, with a soft tissue technique called syndesmosis procedure, without osteotomy or OI resection. Excellent feet function was observed for 2 years until her last follow-up examination without any symptoms or signs of problems relating to the OI in her left foot. This case report demonstrated for the first time that OI may not interfere with proper MPV deformity correction because it can be preexisting and X-ray can be misleading.

scholarly journals Medial rotation deformity of the hip in cerebral palsy: Surgical treatment by derotation femoral osteotomy

2004 ◽  
Vol 51 (3) ◽  
pp. 29-35
Author(s):  
Goran Cobeljic ◽  
I. Djordjic ◽  
Zoran Bajin ◽  
Zoran Vukasinovic ◽  
Aleksandar Lesic
Keyword(s):  
Cerebral Palsy ◽  
Excellent Result ◽  
Original Method ◽  
Precise Determination ◽  
Femoral Osteotomy ◽  
Before And After ◽  
Medial Rotation ◽  
Derotation Osteotomy

Medial rotation deformity of the hip is a problem to patients handicapped by cerebral palsy who are able to walk, because the knees point inward during gait ("kissing patellae") and cause falls and frequent injuries, knee and ankle distorsions. The deformity is a result of an increased femoral neck anteversion. The purpose of the paper is to present the results of an original method of precise determination of the degree of rotation for derotation femoral osteotomy. Indications for this operation were set in pa- tients with spastic form of cerebral palsy over 10 years of age, able to walk, who had difficulties in gait and whose lateral rotation was less than 15 along with the medial rotation of over 70 in the hip on the side of the deformity. Twenty hips in 17 patients able to walk were operated on. The average age was 21 (11 - 42), the average follow-up was 11 years (3-17). The assessment of the results was based on the comparison of the rotational abilities of the hip and individual problems before and after the operation. Excellent result was achieved in 12 (70.6%) patients i.e. 15 (75%) hips; good result was achieved in 3 (17.6%) patients i.e. 3 (15%) hips; unsuccessful result in 2 (11.8%) patients i.e. 2 (10%) hips. Complications aroused in 6 patients i.e. 6 (30%) hips. The conclusion is that derotation osteotomy of the femur is a successful procedure for the treatment of the medial rotation deformity of the hip in patients with the spastic form of cerebral palsy who are able to walk. The above mentioned indications must be respected and the original method of determining the degree of derotation applied. Due to a relatively high percentage of complications, e.g. osteitis, the operation is suggested to patients aged 10 to 15 when possible complications can more easily be cured.

scholarly journals Prophylactic antibiotics in soft-tissue procedures in children with cerebral palsy

2018 ◽  
Vol 12 (3) ◽  
pp. 279-281
Author(s):  
L. R. Perotti ◽  
O. Abousamra ◽  
K. J. Rogers ◽  
F. Miller ◽  
J. P. Sees
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Surgical Site Infections ◽  
Paediatric Population ◽  
Prophylactic Antibiotics ◽  
Level Of Evidence ◽  
Children With Cerebral Palsy ◽  
Antibiotic Group ◽  
Therapeutic Study

Purpose Data on the benefits of perioperative prophylactic antibiotics in the paediatric population are lacking. In this study, we aimed to assess the rate of infection after isolated soft-tissue procedures in patients with cerebral palsy with and without preoperative prophylactic antibiotics between 2009 and 2015. Methods We reviewed the records of all children with cerebral palsy who underwent isolated soft-tissue procedures (on the upper and lower limb) at our hospital between 2009 and 2015. Children with at least 30-day postoperative follow-up were included. Children who had groin incisions were excluded. Results Two groups were identified: the antibiotic group (77 children with 203 incisions and 343 procedures) had one surgical site infection; the no-antibiotic group (48 children with 102 incisions and 177 procedures) had no surgical site infections. Conclusion These results suggest that the use of preoperative antibiotics does not change the rate of postoperative surgical site infections. Level of Evidence Level III therapeutic study

scholarly journals Effects of RTTN Gene Mutations and the Need for Complementary cDNA Analysis for Some Transcripts

2020 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Multidisciplinary Approach ◽  
Genetic Diseases ◽  
Radiological Finding ◽  
Gene Mutations ◽  
Multiple Congenital Anomalies ◽  
Radiological Findings ◽  
Cdna Analysis ◽  
Uncertain Significance ◽  
Gene Transcripts

Introduction: Prenatal WES analysis is currently required in prenatal diagnosis in case of multiple congenital anomalies and in families where some genetic diseases are reported. However, with development of prenatal WES, practitioners are sometimes facing a lot of challenge regarding interpretation of the genetic results. Method: Prenatal WES analysis. Result: Detection of two different RTTN gene transcripts in fetal WES. One of the transcripts showed RTTN homozygous gene mutation while the other transcript was normal. Discussion: This result emphasizes difficulty of genetic counselling in case of absence of prenatal radiological findings or late findings. Conservative fetal follow up was advised because of absence of any positive radiological finding. Conclusion: This article presents the multidisciplinary approach in prenatal and postnatal counselling for cases with quiry fetal genetic findings and illustrates the urgent need for development of transcriptome analysis for the fetus with WES findings of uncertain significance.

scholarly journals Paralytic dislocations of the hip in adolescence: Orthopaedic treatment

2009 ◽  
Vol 137 (11-12) ◽  
pp. 697-701
Author(s):  
Goran Cobeljic
Keyword(s):  
Cerebral Palsy ◽  
Soft Tissue ◽  
Walking Ability ◽  
Lower Side ◽  
Leg Length ◽  
Bone Surgery ◽  
Tractus Iliotibialis ◽  
Ambulatory Patients ◽  
Soft Tissue Surgery ◽  
Dislocation Of The Hip

Paralytic dislocation of the hip in adolescence is not typical, but presents a serious problem whether diagnosed primarily in adolescence or due to the lack of treatment or failed treatment in earlier age. It is characteristic of cerebral palsy and myelomeningocele. If the paralytic dislocation of the hip in adolescence is asymmetric, then pelvic obliquity, leg-length discrepancy, imbalance in sitting position, scoliosis and secondary spondylosis with all its consequences ensue. Complications like hip pains due to secondary arthrosis and walking ability impairment are frequent in ambulatory patients. The dislocation is the result of muscle imbalances in the hip region. The diagnosis is based on Illness history, clinical examination, neurological examination and radiography. Treatment is mostly operative, except in cases of pelvic symmetry and absence of difficulties. Pelvic and/or femoral osteotomy with or without open reduction of the hip is done in ambulatory patients with cerebral palsy. Soft-tissue surgery, hip flexors release and tenotomy of the hip adductors, are done in non-ambulatory patients with cerebral palsy. In patients with myelomeningocele soft-tissue surgery, hip flexors release and tractus iliotibialis resection on the lower side of the pelvis, are done regardless of the ability to walk. The same bone surgery procedures as in cerebral palsy are done only in ambulatory patients with unilateral dislocations if soft-tissue surgery failed.

scholarly journals Effects of RTTN Gene Mutations and the Need for Complementary cDNA Analysis for Some Transcripts

2020 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Multidisciplinary Approach ◽  
Genetic Diseases ◽  
Radiological Finding ◽  
Gene Mutations ◽  
Multiple Congenital Anomalies ◽  
Radiological Findings ◽  
Cdna Analysis ◽  
Uncertain Significance ◽  
Gene Transcripts

Introduction: Prenatal WES analysis is currently required in prenatal diagnosis in case of multiple congenital anomalies and in families where some genetic diseases are reported. However, with development of prenatal WES, practitioners are sometimes facing a lot of challenge regarding interpretation of the genetic results. Method: Prenatal WES analysis. Result: Detection of two different RTTN gene transcripts in fetal WES. One of the transcripts showed RTTN homozygous gene mutation while the other transcript was normal. Discussion: This result emphasizes difficulty of genetic counselling in case of absence of prenatal radiological findings or late findings. Conservative fetal follow up was advised because of absence of any positive radiological finding. Conclusion: This article presents the multidisciplinary approach in prenatal and postnatal counselling for cases with quiry fetal genetic findings and illustrates the urgent need for development of transcriptome analysis for the fetus with WES findings of uncertain significance.

scholarly journals Intrasellar Arachnoid Cyst, a Rare Radiological Finding: Report of a Case.

2021 ◽  
Author(s):  
Alejandro Augusto Ortega Rodriguez ◽  
José Luís Caro Cardera ◽  
Jordi de Manuel-Rimbau Muñoz
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Arachnoid Cyst ◽  
Radiological Finding ◽  
Arachnoid Cysts ◽  
Arachnoid Membrane ◽  
Radiological Findings ◽  
Sellar Lesions ◽  
Plausible Theory

Abstract Intrasellar arachnoid cysts are uncommon radiological findings, generally incidental and clinically silent. We present the case of 70 year-old female who was treated of meningitis due to cerebrospinal fluid nasal fistulae. She was diagnosed of intrasellar arachnoid cyst and managed conservatively because no neurologic, hormonal, symptomatic either CSF fistulae appeared during follow-up. The origin of intrasellar arachnoid cysts is unclear; although an incomplete diaphragma sellae through basal arachnoid membrane herniates may be a plausible theory. Conservative treatment is the usual option, but if hormonal, visual or intracranial hypertension symptoms appeared, surgery may be the best therapy. This entity should be in the differential diagnosis of cystic sellar lesions with other benign cysts and tumors as craniopharyngioma.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

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