Lower Limbs
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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.


2021 ◽  
Vol 3 (2) ◽  
pp. 40-47
Author(s):  
Arnold V. Popkov ◽  
Dmitriy A. Popkov ◽  
Konstantin V. Trofimov ◽  
Alexander I. Nikiforov ◽  
Alexey А. Isupov

The study concerns a new method of treatment of bone fractures of upper and lower limbs based on osteogenesis stimulation by intramedullary implants with bioactive organic hydroxyapatite (HA). The method decreases consolidation period of diaphyseal fractures to 2-4 times. A technology of osteosynthesis and bone formation dynamics at the fracture zone and around the implant is described.


2021 ◽  
Vol 8 (11) ◽  
pp. 1890
Author(s):  
Alekhya Erubothu ◽  
Sudha Rudrappa ◽  
Pratibha Manjunath Patagar

Multi-system inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 is a new entity affecting a small percentage of children during the COVID-19 pandemic. This usually presents with multi-organ dysfunction, predominantly affecting cardiovascular, muco-cutaneous, and gastrointestinal systems. Till now, neurological manifestations as a part of this spectrum, such as, encephalopathy, inflammatory CNS syndromes, cerebrovascular disease, and Guillain-Barré syndrome (GBS), have been well reported in adults, but there is a paucity of data from the paediatric age group. Here, we present a case of a 6-year-old girl who presented to us with progressive, bilaterally symmetrical ascending weakness of lower limbs followed by upper limbs along with drooling of saliva and dyspnea. Nerve conduction studies showed motor axonal neuropathy suggestive of GBS and child was treated accordingly with intravenous immunoglobulin. On 4th day of admission, the child developed high grade fever spikes, hypotension and diarrhoea. Hence, worked up for MIS-C which revealed elevated inflammatory markers with positive SARS-CoV-19 IgM, IgG antibodies. The diagnosis was hence revised to GBS with MIS-C, the child was then started on methylprednisolone following which the child showed both clinical and biochemical improvement and was then discharged. A high index of suspicion for the possibility of MIS-C should be kept in mind in the present pandemic times, as the immune-mediated damages in MIS-C are potentially treatable with a timely institution of intensive care measures along with the use of steroids, IV-Ig, and plasmapheresis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lijue Ren ◽  
Cuiying Wei ◽  
Feng Wei ◽  
Ruiting Ma ◽  
Yan Liu ◽  
...  

Abstract Background Hypothyroidism is frequent and has various forms of muscle involvement. We report the diagnosis and treatment of a case of rhabdomyolysis, bilateral osteofascial compartment syndrome (OCS) of the lower extremities, and peroneal nerve injury causing bilateral foot drop in a diabetic patient with hypothyroidism. Case presentation A 66-year-old man with diabetes for 22 years was admitted because of drowsiness, tiredness, facial swelling, and limb twitching for 2 months, and red and swollen lower limb skin for 3 days. Serum creatinine kinase (CK), CK-MB, myoglobin (Mb), blood glucose, and HbA1c were elevated. TSH, thyroid peroxidase antibodies, and antithyroglobulin antibodies were elevated. FT3 and FT4 were low. Urine was dark brown. He was diagnosed with hypothyroidism, rhabdomyolysis, and OCS. CK, CK-MB, and Mb returned to normal after treatment with thyroid hormone, insulin, albumin infusion, ceftriaxone, ulinastatin, and hemofiltration, and the redness and swelling of the lower limbs were relieved, but the patient developed dropping feet. The patient recovered well but had to undergo rehabilitation. Conclusion Hypothyroidism may induce rhabdomyolysis, OCS, and other complications. This case reminds us of the importance of screening for hypothyroidism and strengthens the clinicians’ understanding of the disease.


Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7014
Author(s):  
Cristina Brambilla ◽  
Ileana Pirovano ◽  
Robert Mihai Mira ◽  
Giovanna Rizzo ◽  
Alessandro Scano ◽  
...  

Electroencephalography (EEG) and electromyography (EMG) are widespread and well-known quantitative techniques used for gathering biological signals at cortical and muscular levels, respectively. Indeed, they provide relevant insights for increasing knowledge in different domains, such as physical and cognitive, and research fields, including neuromotor rehabilitation. So far, EEG and EMG techniques have been independently exploited to guide or assess the outcome of the rehabilitation, preferring one technique over the other according to the aim of the investigation. More recently, the combination of EEG and EMG started to be considered as a potential breakthrough approach to improve rehabilitation effectiveness. However, since it is a relatively recent research field, we observed that no comprehensive reviews available nor standard procedures and setups for simultaneous acquisitions and processing have been identified. Consequently, this paper presents a systematic review of EEG and EMG applications specifically aimed at evaluating and assessing neuromotor performance, focusing on cortico-muscular interactions in the rehabilitation field. A total of 213 articles were identified from scientific databases, and, following rigorous scrutiny, 55 were analyzed in detail in this review. Most of the applications are focused on the study of stroke patients, and the rehabilitation target is usually on the upper or lower limbs. Regarding the methodological approaches used to acquire and process data, our results show that a simultaneous EEG and EMG acquisition is quite common in the field, but it is mostly performed with EMG as a support technique for more specific EEG approaches. Non-specific processing methods such as EEG-EMG coherence are used to provide combined EEG/EMG signal analysis, but rarely both signals are analyzed using state-of-the-art techniques that are gold-standard in each of the two domains. Future directions may be oriented toward multi-domain approaches able to exploit the full potential of combined EEG and EMG, for example targeting a wider range of pathologies and implementing more structured clinical trials to confirm the results of the current pilot studies.


2021 ◽  
pp. 398-401
Author(s):  
Mohit Bajaj ◽  
Ayush Sopori ◽  
Jeevak V Divakaran ◽  
Naveen Rao ◽  
Seema Sharma

In children, short stature and disproportionate skeletal growth are associated with many syndromes and these syndromes have characteristic radiological changes which help in their diagnosis. However, many of them have no well-defined diagnostic criteria, and thus overlap between apparently distinct syndromes is common. Here, we report a child with characteristic features seen distinct from any other dwarfing syndrome known to us with some of the features similar to Robinow syndrome. Newborn had a broad and prominent forehead, mid-face hypoplasia, hypertelorism, flat nasal bridge, upturned nose, elongated philtrum, protruding tongue, single crease in the left hand, widely spaced nipple, brachydactyly in lower limbs, and disproportionately short rhizomelic upper and lower limbs. Based on these features, a diagnosis of Robinow syndrome was made. The case was the first of his kind admitted to our institute. The diagnosis was made clinically after follow-up.


2021 ◽  
Vol 10 (13) ◽  
pp. e501101321374
Author(s):  
Roberto Cascon ◽  
Amanda Brown ◽  
Diogo Cardozo ◽  
Marcelo Corso ◽  
Leandro de Oliveira Sant'Ana ◽  
...  

Purpose. To analyze and to compare the absolute and relative muscle power of the lower limbs in sedentary elderly subjects with and without heart failure. Methods. The study included 36 elderly subjects (72 ± 6.5 years, 76.8 ± 4.8 kg, 171 ± 9.4 cm) divided into two groups: sixteen patients with heart failure versus twenty patients with coronary artery disease, but without heart failure. The muscle power of the lower limbs was assessed with a half-squat exercise; three repetitions were performed with three seconds of the interval between repetitions as fast as possible in the concentric phase. For the statistical analysis, unpaired Student's t-tests were used to compare the absolute and relative muscular power between groups. Results. Subjects without heart failure had significantly greater absolute (362 ± 18.5 W vs. 438 ± 22.3 W, p = 0.015) and relative (4.6 ± 0.2 W / kg vs. 5.9 ± 0.2 W / Kg, p = 0.001) muscle power versus subjects with heart failure. Conclusion. Heart failure harms the muscular power of the lower limbs in the elderly, which may influence the prognosis and evolution of the disease and capacity functional.


2021 ◽  
Vol 11 (12) ◽  
pp. 2357-2366
Author(s):  
Xiaopeng Guo ◽  
Yingsong Liu ◽  
Mingzhu Wei

We aimed to explore the mechanism by how LX4211 affects bone marrow mesenchymal stem cells (BMSCs) during ischemia-reperfusion (I/R). BMSCs were extracted and treated with LX4211 followed by analysis of cell proliferation and migration by CCK-8, Transwell assay and wound healing tests, cell apoptosis and cycle by flow cytometry, exosomes and VEGFA secretion by immunoenzyme-linked adsorption. BMSCs treated with LX4211 or DMSO were administrated into mice with blood perfusion and capillary or arteriolar density was detected. Treatment with LX4211 significantly inhibited BMSCs proliferation, increased apoptosis and activated AMPK/ACC signaling along with reduced the number of exosomes and VEGFA level and impaired physiological functions. In vivo experiments determined that LX4211 alleviated I/R of lower limbs by inhibiting the muscle retention of BMSCs and paracrine. In conclusion, LX4211 treatment can delay the blood recovery of ischemic non-diabetic mice by reducing the proliferation, migration and impairing paracrine of BMSCs.


2021 ◽  
Author(s):  
Yeli Zhu ◽  
Xiying Zhu ◽  
Wei Li ◽  
Zhaoyong Zhang ◽  
Hui Zheng ◽  
...  

Abstract Objective: Our study aimed to report the clinical features of ATTR-PN with TTR p.Ala117Ser mutation in mainland China. Methods: Thirteen patients from 13 different families diagnosed with p.Ala117Ser ATTR-PN were identified from three centres. Clinical and laboratory data were retrospectively retrieved for analysis. Results: The male/female ratio was 11:2. All patients showed late onset, with the age of onset at 57.8 ± 5.8 years. The initial symptom was numbness of the lower or upper extremities in 9 patients (69.2%). Paraesthesia was present in all patients. Eleven patients (84.6%) had autonomic dysfunction. Cardiac, renal, hepatic, and ocular dysfunctions were noted in 8 (61.5%), 1 (7.7%), 2 (15.4%), and 3 (23.1%) patients, respectively. Nerve conduction studies have shown axonal-type sensorimotor polyneuropathy. The decline in sensory nerve action potentials was more noticeable than in compound muscle action potentials. The nerve damage present in the lower limbs was more severe than that in the upper limbs. Nerve biopsy revealed positive Congo red staining in 7/10 patients (70%). Conclusion: Our study is the largest population report on this rare p.Ala117Ser mutation in mainland China.


2021 ◽  
Author(s):  
Kasey HATCH ◽  
Anke KLEPSER ◽  
Kristina BRUBACHER ◽  
Simeon GILL ◽  
Anura FERNANDO

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