difficulty walking
Recently Published Documents


TOTAL DOCUMENTS

101
(FIVE YEARS 35)

H-INDEX

12
(FIVE YEARS 2)

2022 ◽  
Vol 42 ◽  
Author(s):  
Amanda Q. Carvalho ◽  
Cláudia S. Wisser ◽  
Guilherme O. Manfioletti ◽  
Natalia Rigo ◽  
José Cristani ◽  
...  

ABSTRACT: This study describes the spontaneous and experimental salinomycin poisoning associated with the use of florfenicol and warns about the effects of the administration of antibiotics to animals that receive ionophores in the feed as growth promoters. A batch with 1,200 finishing pigs fed a diet containing 30ppm of salinomycin received florfenicol (60ppm via feed) to control respiratory diseases. Twenty-seven pigs had difficulty walking, tip-toe walking, muscle tremors, and anorexia seven days after the start of treatment. Twenty-two animals died, 10 recovered, and two were sent to the Laboratory of Animal Pathology of CAV-UDESC to be necropsied. The experimental reproduction of the disease was carried out to clarify the possible influence of florfenicol on salinomycin poisoning using 12 pigs divided into four groups with three animals each, treated for 16 days with diets containing no additives (Group 1), 50ppm of salinomycin (Group 2), 40ppm of florfenicol (Group 3), and 50ppm of salinomycin and 40ppm of florfenicol (Group 4). Only animals in Group 4 became ill. The clinical disease was reproduced from the ingestion of 24.67mg/kg/LW of salinomycin and 19.74mg/kg/LW of florfenicol. Both natural and experimental salinomycin poisoning associated with the use of florfenicol caused a condition of myopathy characterized in histology by hyaline degeneration and floccular necrosis of skeletal fibers, with macrophage infiltrate, associated with the figures of regeneration in skeletal muscles and multifocal areas of the proliferation of fibroblasts, being more intense in the longissimus dorsi and semimembranosus muscles. Therefore, florfenicol can cause the accumulation of ionophore salinomycin in the animal organism, resulting in a condition of toxic myopathy.


2021 ◽  
Vol 12 ◽  
pp. 609
Author(s):  
Raj Swaroop Lavadi ◽  
B. V. Sandeep ◽  
Manpreet Singh Banga ◽  
Sangamesh Halhalli ◽  
Anantha Kishan

Background: Spinal intramedullary tuberculoma (IMT) is a rare manifestation of extrapulmonary tuberculosis (TB). Presentation of TB in the pediatric age group is a significant contributor to mortality. Case Description: A young vaccinated girl presented to the neurosurgery department with difficulty walking and urinary incontinence. A magnetic resonance imaging performed outside the hospital showed a hyperintense intramedullary lesion extending from T6 to T9. The patient underwent T6–T9 laminoplasty with intramedullary lesion decompression under neuromonitoring. The dense adherence of the lesion to the cord and nerve roots permitted only debulking. Histopathological examination confirmed the diagnosis of tuberculoma. The patient was started on antitubercular treatment and was then subsequently discharged. After 8 months, the patient was reviewed and showed improvement in her symptoms and complete resolution of the lesion on imaging. The patient has now developed hydrocephalus on the latest computed tomography imaging, which may be due to tubercular meningitis or arachnoiditis. Conclusion: Complete resolution of spinal IMT is possible with a combined treatment approach.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1001-1002
Author(s):  
Ladda Thiamwong ◽  
Rui Xie ◽  
Renoa Choudhury ◽  
Joon-Hyuk Park ◽  
Oscar Garcia ◽  
...  

Abstract One-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between perceived fall risk or levels of fear of falling (FOF) and physiological fall risk (balance performance). We aimed to examine the associations among FRA, body composition, and physical activity (PA) using Assistive Health Technology, including the Bioelectrical Impedance Analysis, BTrackS Balance System, and activity monitoring devices. We evaluated 124 older adults with a mean age of 74.81 (SD=7.31, range 60 to 96), 77% were female, and 72% had no history of falls. The multinomial logistic regression was used to analyze the data. FRA was classified into 4 quadrants, and we found 47% of rational FRA (low FOF and normal balance), 19% of incongruent FRA (low FOF despite poor balance), 18% of irrational FRA (high FOF despite normal balance), and 16% congruent FRA (high FOF and poor balance). We found these following variables are associated with FRA: accelerometer-based moderate to vigorous physical activity (MVPA: mins), self-reported PA score (strength & flexibility), had difficulty walking up 10 steps without resting (resistance), had difficulty walking several city blocks (ambulation), left-hand average handgrip strength, CDC fall risk score, Senior Technology Acceptance (STA) score and body composition including Body Fat Mass (BFM), Percent Body Fat (PBF), Body Mass Index (BMI), Whole Body Phase Angle, Skeletal Muscle Mass (SMM) and Skeletal Muscle Index (SMI). Our results support the efficacy of using Assistive Health Technology on screening individuals with maladaptive FRA with targeted interventions to reduce fall risk.


Author(s):  
Muhammad Iqbal ◽  
Santi Syafril

Background.Brown tumor of Hyperparathyroidism is a metabolic disorder that can affect the entire skeleton and reactive process due to bone resorption caused by primary or secondary hyperparathyroidism (HPT). Brown tumors can occur as solitary or multiple lesions in any bone, most often in the pelvis, ribs, clavicle, mandibula, and extremities. Here, we report the Brown tumor in the lower right limb in patients with primary HPT, and the literature is reviewed. Case presentation. Patients was women 30 years old had married and come with main complains of difficulty walking. This condition has been experienced by patients since diagnosis with lunb of tibia last 8 months and caused pain from hip to lower leg.  On laboratory results, it showed elevated PTH 1.249 (normal 15-65) pg/dL, elevated phosphatase alkali 1156 (normal 40-150) u/dL, elevated Ca 10,8 (n:8,6 -10,3) mg/dL, phosphor 2,1 (3–4,5) mg/dL. Histology examination of tibia lump was a benign lesion of bone (Brown Tumor). Ultrasonography transabdominal result revealed kidney stones with bilateral renal pelvis dilation, nephrolithiasis non-obstructive was found with size 1 cm & left kidney cyst with size 0.6 cm. On Neck USG showed giant cyst lesion on parathyroid glands. Radiologist pelvic examination results showed bone metastasis disease. Head CT Scan examination concluded as suspect metastatic bone. Body bone scans examination showed pathological bone metastatic process. Conclusion. Brown tumor in right lower limb caused by primary HPT


2021 ◽  
Vol 41 (06) ◽  
pp. 717-730
Author(s):  
Christopher G. Tarolli ◽  
Karlo J. Lizarraga

AbstractThe assessment of patients presenting with disorders of gait can be a daunting task for neurologists given the broad potential localization and differential diagnosis. However, gait disorders are extremely common in outpatient neurology, and all neurologists should be comfortable with the assessment, triage, and management of patients presenting with difficulty walking. Here, we aim to present a manageable framework for neurologists to approach the assessment of patients presenting with gait dysfunction. We suggest a chief complaint-based phenomenological characterization of gait, using components of the neurological history and examination to guide testing and treatment. We present the framework to mirror the outpatient visit with the patient, highlighting (1) important features of the gait history, including the most common gait-related chief complaints and common secondary (medical) causes of gait dysfunction; (2) gait physiology and a systematic approach to the gait examination allowing appropriate characterization of gait phenomenology; (3) an algorithmic approach to ancillary testing for patients with gait dysfunction based on historical and examination features; and (4) definitive and supportive therapies for the management of patients presenting with common neurological disorders of gait.


Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012639
Author(s):  
Carles Gaig ◽  
Yaroslau Compta ◽  
Anna Heidbreder ◽  
Maria J Marti ◽  
Maarten J. Titulaer ◽  
...  

Objective:Anti-IgLON5 disease is a recently described neurological disease that shares features of autoimmunity and neurodegeneration. Abnormal movements appear to be frequent and important but have not been characterized and are under-reported. Here we describe the frequency and types of movement disorders in a series of consecutive patients with this disease.Methods:In this retrospective, observational study, the presence and phenomenology of movement disorders were assessed with a standardized clinical questionnaire. Available videos were centrally reviewed by three experts in movement disorders.Results:Seventy two patients were included. In 41 (57%) the main reason for initial consultation was difficulty walking along with one or several concurrent movement disorders. At the time of anti-IgLON5 diagnosis, 63 (87%) patients had at least one movement disorder with a median of three per patient. The most frequent abnormal movements were gait and balance disturbances (52 patients, 72%), chorea (24, 33%), bradykinesia (20, 28%), dystonia (19, 26%), abnormal body postures or rigidity (18, 25%), and tremor (15, 21%). Other hyperkinetic movements (myoclonus, akathisia, myorhythmia, myokymia, or abdominal dyskinesias) occurred in 26 (36%) patients. The craniofacial region was one of the most frequently affected by multiple concurrent movement disorders (23 patients, 32%) including dystonia (13), myorhythmia (6), chorea (4) or myokymia (4). Considering any body region, the most frequent combination of multiple movement disorders consisted of gait instability or ataxia associated with craniofacial dyskinesias or generalized chorea observed in 31(43%) of patients. In addition to abnormal movements, 87% of patients had sleep alterations, 74% bulbar dysfunction, and 53% cognitive impairment. Fifty-five (76%) patients were treated with immunotherapy, resulting in important and sustained improvement of the movement disorders in only seven (13%) cases.Conclusions:Movement disorders are a frequent and leading cause of initial neurological consultation in patients with anti-IgLON5 disease. Although multiple types of abnormal movements can occur, the most prevalent are disorders of gait, generalized chorea, and dystonia and other dyskinesias that frequently affect craniofacial muscles. Overall, anti-IgLON5 disease should be considered in patients with multiple movement disorders, particularly if they occur in association with sleep alterations, bulbar dysfunction, or cognitive impairment.


2021 ◽  
Vol 103-B (6) ◽  
pp. 1040-1046
Author(s):  
Edward J. Dickenson ◽  
Nick Parsons ◽  
Damian R. Griffin

Aims We report the long-term outcomes of the UK Heel Fracture Trial (HeFT), a pragmatic, multicentre, two-arm, assessor-blinded, randomized controlled trial. Methods HeFT recruited 151 patients aged over 16 years with closed displaced, intra-articular fractures of the calcaneus. Patients with significant deformity causing fibular impingement, peripheral vascular disease, or other significant limb injuries were excluded. Participants were randomly allocated to open reduction and internal fixation (ORIF) or nonoperative treatment. We report Kerr-Atkins scores, self-reported difficulty walking and fitting shoes, and additional surgical procedures at 36, 48, and 60 months. Results Overall, 60-month outcome data were available for 118 patients (78%; 52 ORIF, 66 nonoperative). After 60 months, mean Kerr-Atkins scores were 79.2 (SD 21.5) for ORIF and 76.4 (SD 22.5) for nonoperative. Mixed effects regression analysis gave an estimated effect size of -0.14 points (95% confidence interval -8.87 to 8.59; p = 0.975) in favour of ORIF. There were no between group differences in difficulty walking (p = 0.175), or on the type of shoes worn (p = 0.432) at 60 months. Additional surgical procedures were conducted on ten participants allocated ORIF, compared to four in the nonoperative group (p = 0.043). Conclusion ORIF of displaced intra-articular calcaneal fractures, not causing fibular impingement, showed no difference in outcomes at 60 months compared to nonoperative treatment, but with an increased risk of additional surgery. Cite this article: Bone Joint J 2021;103-B(6):1040–1046.


Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 53
Author(s):  
Peggy M. Cawthon ◽  
Stephanie L. Harrison ◽  
Tara Rogers-Soeder ◽  
Katey Webber ◽  
Satya Jonnalagadda ◽  
...  

How different measures of adiposity are similarly or differentially related to mobility limitation and mortality is not clear. In total, 5849 community-dwelling men aged ≥65 years (mean age: 72 years) were followed mortality over 10 years and self-reported mobility limitations (any difficulty walking 2–3 blocks or with climbing 10 steps) at six contacts over 14 years. Baseline measures of adiposity included weight, BMI and percent fat by DXA. Appendicular lean mass (ALM, by DXA) was analyzed as ALM/ht2. Proportional hazards models estimated the risk of mortality, and repeated measures generalized estimating equations estimated the likelihood of mobility limitation. Over 10 years, 27.9% of men died; over 14 years, 48.0% of men reported at least one mobility limitation. We observed U-shaped relationships between weight, BMI, percent fat and ALM/ht2 with mortality. There was a clear log-linear relationship between weight, BMI and percent fat with incident mobility limitation, with higher values associated with a greater likelihood of mobility limitation. In contrast, there was a U-shaped relationship between ALM/ht2 and incident mobility limitation. These observational data suggest that no single measure of adiposity or body composition reflects both the lowest risk of mortality and the lowest likelihood for developing mobility limitation in older men.


2021 ◽  
Vol 23 (1) ◽  
pp. 67-72
Author(s):  
Lelya P. Cherenova ◽  
Anna V. Matsuy ◽  
Igor V. Cherenov

Clinical and epidemiological characteristics of botulism in the Astrakhan region for the period from 2013 to 2019 are presented. 37 people with a diagnosis of Botulism were under observation. It was found that most often (28 (75.7%) cases) patients associated their disease with the use of canned home-made products. Canned vegetables (cucumbers, tomatoes, vegetable salad, eggplant, cabbage) were consumed by 18 (48.7%) people, mushrooms 10 (27%), dried fish 7 (18.9%), herring-balyk 1 (2.7%) and home-made liver pate-1 (2.7%) patient. The incubation period in the observed patients was on average 2.4 days. It lasted 12 days in 24 (64.9%) patients, 3-5 days in 12 (32.4%) patients, and 6 days in 1 (2.7%) patient. According to the severity of the condition, 17 (45.9%) patients were hospitalized in the intensive care unit. Severe course of the disease was in 17 (45.9%) patients, moderate-in 20 (54.1%) patients. Early and persistent symptoms in all patients were marked muscle weakness, in 78.4% of patients dizziness, in 83.8% of patients difficulty walking and unsteadiness of gait. In 34 (91.9%) patients, the most pronounced symptoms were ophthalmoplegic: blurred vision, fog, flies in front of the eyes, inability to read the text. In General, up to 10 cases of botulism are registered annually in the Astrakhan region. Almost half of the patients (45.9%) have severe botulism. The disease is mostly sporadic and is associated with the use of canned vegetables and home-made mushrooms. In addition, cases of botulism associated with the use of dried fish have become more frequent in the Astrakhan region. Late hospitalization was observed in 1/3 of patients (11 (29.7%) cases) with botulism. This is due to untimely diagnosis at the pre-hospital stage and late access of patients to medical care.


Sign in / Sign up

Export Citation Format

Share Document