scholarly journals Intramedullary glioblastoma multiforme in young patients: A case report and brief review

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Pedro Lukas do Rêgo Aquino ◽  
Erlan Pércio Lopes Rufino ◽  
Assíria Maria Santana Santos ◽  
Luana Cristina Rodrigues de Oliveira Costa ◽  
Camila Flach Weinmann ◽  
...  

Cervical glioblastoma multiforme (GBM) is rare, and its early diagnosis and management is crucial to patient survival. In the young population, it’s even more difficult to diagnose. The main challenges in GBM therapy are associated with the location of the disease and its complex and heterogeneous biology. Here, we present a case of a 35-year-old female patient admitted due to complain of pain in her right lower limb. She reported the evolution of the condition for dysesthesia in upper limbs and lower limbs 4 weeks ago. MRI showed an intramedullary lesion extending from C2 to C5. The patient was managed surgically. The purpose of this report is to document this rare condition, especially in the young age group, and reveal the current knowledge regarding intramedullary GBM.

2018 ◽  
Vol 119 (1) ◽  
pp. 70-75
Author(s):  
Miroslav Průcha ◽  
Alena Šnajdrová ◽  
Pavel Zdráhal

Isolated arteritis of the lower limb vessels is an extremely rare condition. The use of modern vascular imaging techniques substantially facilitates and accelerates the diagnostics. In the isolated lower limb arteritis, it is always necessary to exclude Takayasu’s and giant-cell arteritis. We present the case of a female patient with an isolated lower extremity arteritis without any other symptoms of systemic vascular damage or systemic autoimmune disease. Immunosuppressive therapy is obligatory in this case. Interdisciplinary co-operation is required for rapid diagnosis and successful therapy. Our patient has consented to the publication of this report.


2014 ◽  
Vol 138 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Karuna Garg ◽  
Robert A. Soslow

Context.—Endometrial carcinoma is a disease of older postmenopausal women, and is relatively uncommon in patients younger than 40 years. Endometrial carcinomas in this age group may be familial, associated with Lynch syndrome, or sporadic. Objectives.—To present our current knowledge of endometrial carcinomas in women younger than 40 years. Data Sources.—The review is based on previously published articles on this topic. Conclusions.—Most endometrial carcinomas that occur in this age group are associated with estrogen excess. They are usually low-grade endometrioid carcinomas that present at low stages and are associated with favorable clinical outcomes. Tumors associated with mismatch repair abnormalities and Lynch syndrome appear to be distinct, with worse prognostic factors and, possibly, clinical behavior. Conservative hormonal therapy and ovarian conservation are reasonable considerations in the management of these young patients, but carry the risk of tumor progression, recurrence, and an occult synchronous or metachronous ovarian carcinoma.


2021 ◽  
Vol 29 (2) ◽  
pp. 251-256
Author(s):  
Roman E. Kalinin ◽  
Igor A. Suchkov ◽  
Artem A. Chobanyan ◽  
Aleksandr A. Nikiforov ◽  
Evgenia I. Shumskaya

AIM: This study aimed to determine the influence of 250GA polymorphism in the LIPC gene and 1607insG in the MMP-1 gene on the course of obliterating atherosclerosis of lower limb arteries (OALLA). MATERIALS AND METHODS: Seventy-six individuals were included in this study. In the first group (n = 34), patients with an unfavorable (progressive) course of OALLA and developed critical ischemia of the lower limbs within 5 years from the onset of the disease were included. In the second group (n = 34), patients with a conventionally favorable (non-progressive) course but did not develop critical ischemia of the lower limbs within 5 years from the onset of the disease and did not have a progressive degree of chronic ischemia. In the control group, healthy volunteers (n = 8) without signs of atherosclerosis in all vascular pools were included. In all the patients, LIPC-250GA and MMP-1-1607insG were genotyped. The difference in the observed and expected frequencies was evaluated via a Pearson 2 test with correction for likelihood. RESULTS: Significant differences (p = 0.013) in the 250GA polymorphism of the LIPC gene were found between the observed and expected frequencies compared with those in patients with OALLA and healthy volunteers. The assessment of the first and second groups revealed differences in the observed and expected frequencies (р = 0.004). Heterozygous carriage (GA genotype) was associated with an increased risk of the development of the unfavorable course of OALLA (hazard ratio = 2.133 with 95% confidence interval = 1.2143.748). In the analysis of the 1607insG polymorphism of the MMP-1 gene, statistically insignificant data were obtained compared between the first and second groups (р = 0.128) and between the groups of patients with OALLA and healthy volunteers (р = 0.38). CONCLUSIONS: The heterozygous carrier of LIPC 250GA was associated with an increased risk of an unfavorable OALLA course. This research on this polymorphism could be applied to patients with the newly diagnosed atherosclerosis of the arteries of the lower extremities to determine the prognosis of the disease course, especially in young patients with early manifestation and individuals with a burdened hereditary history. The 1607insG polymorphism of the MMP-1 gene had no effect on the course of OALLA.


2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Arundhati Guha Thakurta ◽  
Rauf Iqbal

Ageing work force is one of the leading causes behind the reduction in the rate of growth of the labour force in construction industries. Construction industry is a major source of employment worldwide after agriculture, and generally the primary one in urban areas. Manual material handling in construction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body. Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty.  To analyze the level of exertion, ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce. 20 male construction workers in the age group of i) 20 to 30 years (golden age group); ii) 50 years and above were selected from a local construction site in Mumbai. Demographic data like age, height, weight, BMI, body fat, waist hip ratio and risk assessment by questionnaires study comprising QEC, NMQ, VAS, and LEFS were collected. Compared to the golden age group, the elderly subjects were found to feel uncomfortable to their lower back, knee and calf due to the immoderate forces and motions applied to their lower limbs during their daily work. Muscle pliability and proper coordination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures. For elderly workers, age related limitations become an additional factor to maintain their normal work life.


2016 ◽  
pp. 86-93
Author(s):  
M.Yu. Yegorov ◽  
◽  
A.A. Sukhanova ◽  

The objective: study the features of gynecological, physical history, diagnosis and treatment of patients with benign epithelial ovarian tumors (BeEOT) and borderline epithelial ovarian tumors (BEOT), determining the frequency of recurrence of ovarian tumors in the postoperative period. Patients and methods. According to a retrospective analysis of case histories of 112 women with epithelial ovarian tumors (EOT) underwent conservative or radical surgical treatment in a hospital, two groups were formed: I group – patients with benign epithelial ovarian tumors (BeEOT), which amounted to 85 (75.9%) women, and group II – patients with borderline epithelial ovarian tumors (BEOT), which amounted to 27 (24.1%) women. It was found that the main complaints of patients with EOT were pain (49.1%), abdominal distension (17%), and abnormal uterine bleeding (12.5%). The highest incidence of BeEOT (31.8%) observed in the age group of 41–50 years, while the peak incidence of BEOT (44.4%) corresponds to the age group of 51–60 years. Results. In BEOT endocrine pathology occurs significantly more frequently (p<0.05) than in BeEOT – 25.9% vs. 9.4%, respectively. Pathology of pancreatic-hepatobiliary system occurs significantly more frequently (p<0.05) in patients with BEOT compared with BeEOT – 81.5% versus 57.6%, respectively. Venous disorders (varicose veins of the pelvic organs, lower limbs, haemorrhoids) observed in BEOT significantly more frequently (p<0.05) than in BeEOT – 18.5% vs. 5.9%, respectively. EOT most often diagnosed in the period from 1 to 6 months after the first clinical manifestations with an average uptake of medical care 4.6±0.57 months. In assessing of peritoneal exudate cytogram the mesothelium cells are significantly more common for BeEOT (p<0.01) than BEOT – 79.4% versus 40.9%, respectively. Cervicitis is more likely significantly to occur in BeEOT (p<0.01) than in BEOT – 29.4% vs. 7.4%, respectively. The most common histological type among the benign tumors of the ovaries are endometriomas, which occurred in 48.2% of all BeEOT cases, and among the borderline tumors – serous tumors, which accounted for 59.3% of all BEOTs. Conclusion. The use of organ sparing surgery in EOT increases the risk of recurrence, especially in the case of endometrial histology or borderline variant of tumor. Key words: benign and borderline epithelial ovarian tumors, clinical-anamnestic analysis, diagnosis, treatment.


Author(s):  
Allaoua Brahmia ◽  
Ridha Kelaiaia

Abstract To establish an exercise in open muscular chain rehabilitation (OMC), it is necessary to choose the type of kinematic chain of the mechanical / biomechanical system that constitutes the lower limbs in interaction with the robotic device. Indeed, it’s accepted in biomechanics that a rehabilitation exercise in OMC of the lower limb is performed with a fixed hip and a free foot. Based on these findings, a kinematic structure of a new machine, named Reeduc-Knee, is proposed, and a mechanical design is carried out. The contribution of this work is not limited to the mechanical design of the Reeduc-Knee system. Indeed, to define the minimum parameterizing defining the configuration of the device relative to an absolute reference, a geometric and kinematic study is presented.


2019 ◽  
Vol 34 (10) ◽  
pp. 650-668 ◽  
Author(s):  
David Kachlik ◽  
Vaclav Pechacek ◽  
Gabriela Hnatkova ◽  
Lukas Hnatek ◽  
Vladimir Musil ◽  
...  

Latin anatomical terminology of venous perforators (communications between superficial and deep venous systems of the lower limb) was adopted as late as 2001 as an appendix to the official nomenclature following the clinicians’ request. Terminologia Anatomica, last version of the Latin anatomical nomenclature, published in 1998, unfortunately contains no terms concerning these veins. During the 14th World Congress of the International Union of Phlebology, a consensus document was laid to expand the nomenclature of the lower limb veins, above all 36 new terms for perforators of the lower limb, both in Latin and English languages. This consensus document will be incorporated in the next version of the Terminologia Anatomica. But there are more constant and well-described ones, especially in the foot, and this article reviews in particular the current knowledge on the anatomy of the venous perforators of the whole lower limb.


2021 ◽  
Vol 6 (1) ◽  
pp. 16
Author(s):  
Kara B. Bellenfant ◽  
Gracie L. Robbins ◽  
Rebecca R. Rogers ◽  
Thomas J. Kopec ◽  
Christopher G. Ballmann

The purpose of this study was to investigate the effects of how limb dominance and joint immobilization alter markers of physical demand and muscle activation during ambulation with axillary crutches. In a crossover, counterbalanced study design, physically active females completed ambulation trials with three conditions: (1) bipedal walking (BW), (2) axillary crutch ambulation with their dominant limb (DOM), and (3) axillary crutch ambulation with their nondominant limb (NDOM). During the axillary crutch ambulation conditions, the non-weight-bearing knee joint was immobilized at a 30-degree flexion angle with a postoperative knee stabilizer. For each trial/condition, participants ambulated at 0.6, 0.8, and 1.0 mph for five minutes at each speed. Heart rate (HR) and rate of perceived exertion (RPE) were monitored throughout. Surface electromyography (sEMG) was used to record muscle activation of the medial gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) unilaterally on the weight-bearing limb. Biceps brachii (BB) and triceps brachii (TB) sEMG were measured bilaterally. sEMG signals for each immobilization condition were normalized to corresponding values for BW.HR (p < 0.001) and RPE (p < 0.001) were significantly higher for both the DOM and NDOM conditions compared to BW but no differences existed between the DOM and NDOM conditions (p > 0.05). No differences in lower limb muscle activation were noted for any muscles between the DOM and NDOM conditions (p > 0.05). Regardless of condition, BB activation ipsilateral to the ambulating limb was significantly lower during 0.6 mph (p = 0.005) and 0.8 mph (p = 0.016) compared to the same speeds for BB on the contralateral side. Contralateral TB activation was significantly higher during 0.6 mph compared to 0.8 mph (p = 0.009) and 1.0 mph (p = 0.029) irrespective of condition. In conclusion, limb dominance appears to not alter lower limb muscle activation and walking intensity while using axillary crutches. However, upper limb muscle activation was asymmetrical during axillary crutch use and largely dependent on speed. These results suggest that functional asymmetry may exist in upper limbs but not lower limbs during assistive device supported ambulation.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Borges ◽  
M Lemos Pires ◽  
R Pinto ◽  
G De Sa ◽  
I Ricardo ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.


Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.


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