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https://www.readbyqxmd.com/read/28810893/subcutaneous-emphysema-of-the-leg-after-hardware-removal-and-bone-allografting-for-infected-non-union-of-the-distal-femur
#1
Vincenzo Denaro, Umile Giuseppe Longo, Giuseppe Salvatore, Vincenzo Candela, Nicola Maffulli
BACKGROUND: Infected non-unions of the supracondylar region of the femur are uncommon. Even though hardware removal is a common procedure, it may lead to complications, including neurovascular injury, refracture, worsening pain or recurrence of deformity. CASE PRESENTATION: We report on a male who developed subcutaneous emphysema of the leg after hardware removal and bone allografting for an infected non-union of the distal femur. He was managed by debridement of the surgical wound, antibiotic therapy, multiple fasciotomies, and application of a VAC (vacuum-assisted closure) system...
August 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28808631/painless-swollen-calf-muscles-of-a-75-year-old-patient-caused-by-bilateral-venous-malformations
#2
Roderick S M Piekaar, Eline W Zwitser, Paul P A Hedeman Joosten, Joris A Jansen
A 75-year-old man presented with knee pain due to medial osteoarthritis of the knee in the orthopedic outpatient clinic. Conservative treatment was started with steroid infiltration. Besides his knee complaint reported a bilateral painless swollen calf muscle without traumatic cause, and also without any pain at night, fever or medical illness. On physical examination the soleus muscle had a swollen aspect in both calfs. The skin appeared normal without deformities and the arterial pulsations were intact. An X-ray did not show abnormalities in the tibia...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28808608/intrathecal-catheter-associated-inflammatory-mass-in-a-neurofibromatosis-type-1-patient-receiving-fentanyl-and-bupivacaine
#3
Derek G Southwell, Joseph A Osorio, Christopher S Liverman, Lauren M Friedman, Ramana K Naidu, Lawrence R Poree, Melanie M Henry, Line Jacques
BACKGROUND: Catheter-associated inflammatory masses (CIMs) are a rare but serious complication of intrathecal drug delivery devices. CIM formation is influenced by local medication concentration, which is determined in part by flow dynamics at the catheter tip. Underlying spinal pathologies, such as neoplasms, may alter flow at the catheter tip, thereby contributing to CIM formation. Moreover, they may also complicate the clinical and radiologic diagnosis of a CIM. CASE DESCRIPTION: A 36-year-old man with neurofibromatosis type 1 presented to our emergency department with complaints of increased back pain and leg weakness...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28808583/successful-spinal-cord-stimulation-for-neuropathic-below-level-spinal-cord-injury-pain-following-complete-paraplegia-a-case-report
#4
Tim A Reck, Gunther Landmann
INTRODUCTION: Neuropathic pain is common in patients with spinal cord injury (SCI) and often difficult to treat. We report a case where epidural spinal cord stimulation (SCS) below the level of injury has been successfully applied in a patient with a complete spinal cord lesion. CASE PRESENTATION: A 53-year-old female presented with neuropathic below-level SCI pain of both lower legs and feet due to complete SCI below T5. Time and pain duration since injury was 2 years...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28808515/palpitations-as-a-presenting-feature-of-multisystem-sarcoidosis
#5
Richie Manikat, Julieta Gilson, Mahesh Krishnamurthy, Koroush Khalighi
Introduction: Sarcoidosis is described as a systemic condition characterized by non-caseating granulomas in multiple organs. In this report, we present an unusual manifestation of cardiac sarcoidosis and review management strategies. Case presentation: A 29-year-old African-American man presented with weight loss, fatigue, dyspnea, palpitations, night sweats, painless left eye redness and bilateral leg pain over the course of three months. His physical exam revealed left conjunctival congestion and bilateral crackles on auscultation...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28807742/a-cost-utility-analysis-of-dynesys-dynamic-stabilization-versus-instrumented-fusion-for-the-treatment-of-degenerative-lumbar-spine-diseases
#6
Kan Liu, Wei Sun, Qiang Lu, Jiying Chen, Jiaguang Tang
BACKGROUND: Symptomatic chronic low back and leg pain resulting from lumbar spine degenerative disorders is highly prevalent in China, and for some patients, surgery is the final option for improvement. Several techniques for spinal non-fusion have been introduced to reduce the side-effects of fusion methods and hasten postoperative recovery. In this study, the authors have evaluated the cost-effectiveness of Dynesys posterior dynamic stabilization system (DY) compared with lumbar fusion techniques in the treatment of single-level degenerative lumbar spinal conditions...
August 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28805564/deep-brain-stimulation-and-nonmotor-symptoms
#7
Elliot Hogg, Jeffrey Wertheimer, Sarah Graner, Michele Tagliati
Deep brain stimulation (DBS) is currently the treatment of choice for advanced Parkinson's disease (PD). Several brain targets, including the subthalamic nucleus and the globus pallidus internus, have been successfully employed, with excellent motor outcomes. Despite less established knowledge, DBS may be a powerful tool for managing a wide variety of nonmotor symptoms (NMS) in PD patients, either directly or indirectly due to motor benefit or reduction of dopaminergic drug load. After an assessment of global nonmotor outcomes of DBS, as measured by currently available clinical scales and questionnaires, this chapter will address DBS effects on four main NMS categories: neurobehavioral, including cognitive and neuropsychiatric symptoms, autonomic dysfunction, including orthostatic hypotension, constipation, and urinary dysfunction, sleep disturbances, including insomnia, REM sleep behavior disorder, and restless leg syndrome, to conclude with sensory symptoms, mainly focusing on pain...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28801956/evidence-of-er-stress-and-upr-activation-in-patients-with-brody-disease-and-brody-syndrome
#8
V Guglielmi, N C Voermans, A Oosterhof, D Nowis, B G van Engelen, G Tomelleri, G Vattemi
Brody disease (BD, OMIM #601003) is an inherited skeletal muscle disease clinically characterized by exercise-induced impairment of muscle relaxation and stiffness due to the delay in the Ca(2+) re-uptake in the sarcoplasmic reticulum (SR)[1, 2]. The delayed muscle relaxation mainly affects legs, harms, hands and eyelids and usually improves after a few minutes rest [1-3]. Patients frequently report myalgia, painless or mildly painful cramps whereas recurrent rhabdomyolysis have been described in a few cases [2, 3]...
August 12, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28799972/increased-pain-sensitivity-in-accident-related-chronic-pain-patients-with-comorbid-posttraumatic-stress
#9
Henrik Bjarke Vaegter, Tonny Elmose Andersen, Mathea Harvold, Per Grunwald Andersen, Thomas Graven-Nielsen
OBJECTIVES: Posttraumatic stress disorder (PTSD) is prevalent in chronic pain, and associated with increased pain, hyperalgesia and psychological distress. This study aimed to investigate anti-nociceptive and pro-nociceptive pain mechanisms, pain intensity, and psychological distress (depression, anxiety, pain catastrophizing, and fear of movement) in patients with accident-related chronic spinal pain with (N=44) and without (N=64) comorbid PTSD characteristics. METHODS: Cuff algometry was performed on lower legs to assess pressure pain threshold (cPPT), tolerance (cPTT), temporal summation of pain (TSP: increase in pain scores to ten repeated stimulations), and conditioning pain modulation (CPM: increase in cPPT during cuff pain conditioning on the contralateral leg)...
August 9, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28798039/physical-activity-during-adolescence-and-the-development-of-cam-morphology-a-cross-sectional-cohort-study-of-210-individuals
#10
Antony Palmer, Scott Fernquest, Mo Gimpel, Richard Birchall, Andrew Judge, John Broomfield, Julia Newton, Mark Wotherspoon, Andrew Carr, Sion Glyn-Jones
INTRODUCTION: Cam morphology is a strong risk factor for the development of hip pain and osteoarthritis. It is increasingly thought to develop in association with intense physical activity during youth; however, the aetiology remains uncertain. The study aim was to characterise the effect of physical activity on morphological hip development during adolescence. METHODS: Cross-sectional study of individuals aged 9-18 years recruited from Southampton Football Club Academy (103 male) with an age-matched control population (52 males and 55 females)...
August 10, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28797281/the-efficacy-of-transcutaneous-electrical-nerve-stimulation-on-the-improvement-of-walking-distance-in-patients-with-peripheral-arterial-disease-with-intermittent-claudication-study-protocol-for-a-randomised-controlled-trial-the-tens-pad-study
#11
Florent Besnier, Jean-Michel Sénard, Vincent Grémeaux, Mélanie Riédel, Damien Garrigues, Thibaut Guiraud, Marc Labrunée
BACKGROUND: In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking...
August 10, 2017: Trials
https://www.readbyqxmd.com/read/28795238/efficacy-and-safety-of-sofosbuvir-based-interferon-free-therapy-the-management-of-rheumatologic-extrahepatic-manifestations-associated-with-chronic-hepatitis-c%C3%A2-virus-infection
#12
A A Shahin, H S Zayed, M Said, S A Amer
BACKGROUND: The use of pegylated interferon alpha (IFN) has been of concern in chronic hepatitis C virus (HCV) patients with rheumatologic extrahepatic manifestations (EHM) due to the immunostimulatory effects of IFN. AIM: To study the efficacy and safety of sofosbuvir-based, IFN-free antiviral therapy in chronic HCV patients with rheumatologic EHM. MATERIAL AND METHODS: Group A included 24 patients with arthropathy (arthralgia or arthritis, n = 15) or vasculitis (n = 9) who received sofosbuvir and ribavirin (n = 17) or sofosbuvir and simeprevir (n = 7)...
August 9, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28794369/adult-onset-chronic-recurrent-multifocal-osteomyelitis-with-high-intensity-of-muscles-detected-by-magnetic-resonance-imaging-successfully-controlled-with-tocilizumab
#13
Hiroe Sato, Yoko Wada, Eriko Hasegawa, Yukiko Nozawa, Takeshi Nakatsue, Tomoyuki Ito, Takeshi Kuroda, Takako Saeki, Hajime Umezu, Yoshiki Suzuki, Masaaki Nakano, Ichiei Narita
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder that generally occurs in children and predominantly affects the long bones with marginal sclerosis. We herein report two cases of adult-onset CRMO involving the tibial diaphysis bilaterally, accompanied by polyarthritis. Magnetic resonance imaging (MRI) showed both tibial osteomyelitis and high intensity of the extensive lower leg muscles. Anti-interleukin-6 therapy with tocilizumab (TCZ) effectively controlled symptoms and inflammatory markers in both patients...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28791051/a-unique-case-for-spinal-cord-stimulation-successful-treatment-of-small-fiber-neuropathy-pain-using-multiple-spinal-cord-stimulators
#14
Maxim Eckmann, Alexander Papanastassiou, Mark Awad
Spinal cord stimulators have commonly been used to treat multiple pain conditions. This case report represents a unique case of using multiple spinal cord stimulators for widespread small fiber neuropathy pain. This case report concerns patient JJ who first presented with generalized neuropathic pain. His pain was an intermittent burning, stinging quality that originally focused in both of his feet and progressed to include his legs and arms and eventually involved his entire body. The pain would last moments to hours at least daily...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28789628/patellar-tendinopathy-in-young-elite-soccer-clinical-and-sonographical-analysis-of-a-german-elite-soccer-academy
#15
Gerrit Bode, Thorsten Hammer, N Karvouniaris, M J Feucht, L Konstantinidis, N P Südkamp, A Hirschmüller
BACKGROUND: The prevalence of patellar tendinopathy is elevated in elite soccer compared to less explosive sports. While the burden of training hours and load is comparably high in youth elite players (age < 23 years), little is known about the prevalence of patellar tendinopathy at this age. There is only little data available on the influence of age, the amount of training, the position on the field, as well as muscular strength, range of motion, or sonographical findings in this age group...
August 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28781912/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#16
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with lumbar disc disease may present with low back pain, pain that radiates down into the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies [(magnetic resonance imaging (MRI) and computed tomographic (CT) examinations] to determine whether there is any significant nerve root or thecal sac compression. METHODS: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28780620/outcome-of-surgery-for-degenerative-lumbar-scoliosis-an-observational-study-using-the-swedish-spine-register
#17
Tian Cheng, Paul Gerdhem
PURPOSE: The outcome of surgery for degenerative lumbar scoliosis was studied in the Swedish Spine register. METHODS: 209 patients (mean age 66 years) were identified; 45 had undergone decompression and/or fusion of one segment (minor group) and 164 had undergone fusion of two or more segments, with or without decompression (major group). RESULTS: VAS back pain, VAS leg pain, ODI and EQ-5D index improved after surgery in both groups (p < 0...
August 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28779960/efficacy-and-safety-of-etanercept-in-the-treatment-of-sciatica-a-systematic-review-and-meta-analysis
#18
REVIEW
Shangfei Jing, Chenyuan Yang, Xiaofei Zhang, Shuzheng Wen, Yuankui Li
Etanercept might be promising to alleviate sciatica caused by lumbar disc herniation and spinal stenosis. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy of etanercept in patients with sciatica. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and Controlled clinical trials (CCT) assessing the efficacy of etanercept on sciatica caused by lumbar disc herniation and spinal stenosis were included...
August 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28777956/frontal-plane-kinematics-predict-three-dimensional-hip-adduction-during-running
#19
Mark W Creaby, Scott Le Rossignol, Zachary J Conway, Eva Ageberg, Matthew Sweeney, Melinda M Franettovich Smith
OBJECTIVES: To investigate if frontal plane kinematics are predictive of three dimensional (3D) hip adduction and hip internal rotation during running. STUDY DESIGN: Cross-sectional. SETTING: Biomechanics laboratory. PARTICIPANTS: Thirty healthy male runners aged 18-45 years. MAIN OUTCOME MEASURES: Two dimensional (2D) angles in the frontal plane (peak pelvic obliquity, peak hip adduction, peak femoral valgus, peak knee valgus and peak tibial valgus) and 3D hip adduction and hip internal rotation during stance phase of running were obtained...
June 15, 2017: Physical Therapy in Sport
https://www.readbyqxmd.com/read/28770561/evaluation-of-a-muscle-pump-activating-device-for-non-healing-venous-leg-ulcers
#20
Connie Harris, Rochelle Duong, Gwen Vanderheyden, Beth Byrnes, Renee Cattryse, Ava Orr, David Keast
This evaluation involves an innovative muscle pump-activating device (geko™) as an adjunctive therapy with best practices for non-healing venous leg ulcers (VLUs). Stimulating the common peroneal nerve (at the fibular head), the geko™ device creates a response that acts as foot and calf muscle pumps, increasing venous, arterial and microcirculatory flow. The aim was to evaluate and determine if the geko™ is effective in this population and if it should be added to the medical supply formulary. In all, 12 patients with 18 recalcitrant VLUs (defined as less than 30% reduction in wound size in 30 days with best practices) in two community settings in Ontario consented to the evaluation and were treated with the geko™ for up to 20 weeks...
August 2, 2017: International Wound Journal
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