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Exceptionally giant neglected sacral chordoma in a post-poliotic residual paralysis patient - a rare case scenario. 一名脊柱侧弯后残余瘫痪病人体内被忽视的异常巨大骶脊索瘤--罕见病例。
Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/EKNJ6411
Prabodh Kantiwal, Aakarsh Aggarwal, Sandeep K Yadav, Nitesh Gahlot, Abhay Elhence

Chordoma is a rare malignant tumour with an incidence of 0.1 case per 1 lakh population per year. The sacrococcygeal region is the most common site to be involved. Herein, we are reporting a case of sacral chordoma, who is a 32-year-old male patient, a known case of post-polio residual paralysis on the left lower limb, who presented with complaint of pain in the lower back and gluteal region for 2 years with swelling in the gluteal region for 1 year, which was gradually increasing in size for 1 year with associated weight loss. MRI revealed an ill-defined lytic expansile altered signal intensity lesion involving S3 to S5 and coccygeal vertebral bodies measuring 13.2 × 16.2 × 14 cm (ap × tr × cc) with adjacent large lobulated heterogeneous soft tissue component and showed multiple coarse calcifications. The lesion anteriorly displaced and abutted the rectum and was deriving its blood supply from branches of bilateral internal iliac arteries. The patient was planned and underwent wide-margin resection (middle sacrectomy with R0 margins with preservation of both S2 and right S3 nerve roots). Histologic Grade was reported to be G2, moderately differentiated, high grade. Pathologic stage classification was reported as pT3a. Postoperatively patient had the same neurological status and was discharged on advice to do full weight bearing walking and self-intermittent catheterisation and laxatives. He was on routine follow up and improved well symptomatically.

脊索瘤是一种罕见的恶性肿瘤,发病率为每年每 10 万人口中 0.1 例。骶尾部是最常见的受累部位。在此,我们报告一例骶尾部脊索瘤病例,患者男性,32 岁,已知为小儿麻痹症后左下肢残余瘫痪,主诉下背部和臀部疼痛 2 年,臀部肿胀 1 年,肿胀逐渐增大 1 年,伴有体重减轻。核磁共振成像显示,S3至S5椎体和尾椎椎体上有一个界限不清的溶解性膨胀性信号强度改变病灶,大小为13.2 × 16.2 × 14厘米(ap × tr × cc),邻近有大分叶异质软组织成分,并显示多处粗大钙化。病灶向前方移位并与直肠相邻,血液供应来自双侧髂内动脉分支。根据计划,患者接受了广缘切除术(骶骨中段切除术,R0边缘,保留S2和右侧S3神经根)。组织学分级报告为 G2,中度分化,高级别。病理分期为 pT3a。术后患者的神经功能状况与术后相同,出院时医生建议他完全负重行走,并自行间断导尿和服用泻药。他接受了常规随访,症状改善良好。
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引用次数: 0
Evaluation of willingness to obtain of Covid 19 vaccine in patients with multiple sclerosis. 评估多发性硬化症患者获得 Covid 19 疫苗的意愿。
Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI: 10.62347/OCCZ6431
Masoud Ghiasian, Maryam Farhadian, Alireza Salehzadeh

Introduction: Assessing vaccine willingness and understanding sources of vaccine hesitancy in individuals with multiple sclerosis (MS) helps healthcare providers approach patients more effectively while respecting their autonomy to encourage coronavirus disease 2019 (COVID-19) vaccination.

Materials and methods: A descriptive-analytical cross-sectional study using a researcher-made checklist was conducted on MS patients referred to Neshat Clinic of Hamadan during the years 2020-2021. The checklist contained questions about demographic information, MS phenotype, duration of illness, expanded disability status scale (EDSS) score, and COVID-19 vaccination status. The expanded disability status scale (EDSS) is the most commonly used instrument for measuring disability in patients with multiple sclerosis (MS). The EDSS scale ranges from 0 to 10 in increments of 0.5 units, denoting advanced points of disability.

Results: Based on the results, 20 individuals (10%) were in the vaccine non-acceptance group, while 181 individuals (90%) were in the vaccine acceptance group. A significant number of relapsing and remitting (RR) type MS patients (90.7%) and all primary progressive (PP) type MS patients (100%) accepted the vaccine. In comparison, vaccine non-acceptance in the secondary progressive (SP) group was relatively higher (20.7%) compared to other types of MS, and this difference was significant (P < 0.05). Additionally, there was a statistically significant relationship between the history of COVID-19 and vaccine acceptance (P < 0.05).

Conclusion: The study results demonstrated a high rate of COVID-19 vaccine acceptance among MS patients. MS phenotype, previous infection experiences, and other influences allow for COVID-19 vaccine acceptance among MS patients. This information can improve health programs and communication strategies for COVID-19 and future possible infectious disease vaccination in individuals with MS.

导言:评估多发性硬化症(MS)患者的疫苗接种意愿并了解其疫苗接种犹豫的原因,有助于医疗服务提供者更有效地接近患者,同时尊重他们的自主权,鼓励他们接种 2019 年冠状病毒病(COVID-19)疫苗:使用研究人员自制的核对表对 2020-2021 年期间转诊至哈马丹内沙特诊所的多发性硬化症患者进行了描述性分析横断面研究。核对表包含人口统计学信息、多发性硬化症表型、病程、扩大残疾状况量表(EDSS)评分和 COVID-19 疫苗接种状况等问题。扩展残疾状况量表(EDSS)是测量多发性硬化症(MS)患者残疾状况最常用的工具。EDSS 量表的范围从 0 到 10,增量为 0.5 个单位,表示残疾的高级点:结果显示,不接受疫苗组有 20 人(10%),而接受疫苗组有 181 人(90%)。大量复发缓解型多发性硬化症患者(90.7%)和所有原发性进展型多发性硬化症患者(100%)接受了疫苗。相比之下,继发性进展(SP)组不接受疫苗的比例(20.7%)相对高于其他类型的多发性硬化症患者,且差异显著(P < 0.05)。此外,COVID-19病史与疫苗接受度之间存在统计学意义上的显著关系(P < 0.05):研究结果表明,多发性硬化症患者对 COVID-19 疫苗的接受率很高。多发性硬化症的表型、既往感染经历和其他影响因素使多发性硬化症患者能够接受 COVID-19 疫苗。这些信息可以改善MS患者接种COVID-19和未来可能的传染病疫苗的健康计划和沟通策略。
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引用次数: 0
Short segment posterior fixation of unstable thoracolumbar vertebral fractures with fractured vertebra augmentation with intermediate pedicle screw - a clinicoradiological analysis. 不稳定性胸腰椎骨折的短节段后方固定,用中间椎弓根螺钉增强骨折椎体--临床放射学分析。
Pub Date : 2024-04-15 eCollection Date: 2024-01-01 DOI: 10.62347/BKEX3282
Sandeep Kumar Yadav, Rajesh Kumar Rajnish, Prabodh Kantiwal, Nitesh Gehlot, Abhay Elhence, Sumit Banerjee, Saurabh Gupta, Laxman Choudary, Anil Meena, Srikanth Eppakayala

Introduction: Unstable thoracolumbar burst fractures are routinely encountered in orthopedic practice. Recently, short-segment fixation with pedicle screw augmentation of the fractured vertebra for unstable thoracolumbar burst fractures has gained popularity. Nonetheless, the maintenance of the kyphotic correction during the follow-up period remains controversial. This study aimed to examine the clinical-radiological outcomes, complications, and functional outcomes of fractured vertebrae augmentation with intermediate pedicle screws in short-segment instrumentation in acute thoracolumbar spine fractures.

Methods: This retrospective study was conducted in the Department of Orthopedics, All India Institute of Medical Sciences, Jodhpur, using medical records from January 2021 to October 2022. Parameters such as local kyphosis correction, loss of kyphotic correction at final follow-up, anterior body height correction (%), and loss of correction (%) at final follow-up were measured as primary outcomes. Various other parameters such as operative time, blood loss, length of hospital stay, and visual analog scale were measured as secondary outcomes.

Results: The mean correction obtained via surgery in the immediate postoperative period was 13.7±2.3 degrees. The mean loss of correction at the final follow-up was 4.1±2.0 degrees, and the mean final local kyphotic angle was 7.2±2.4 degrees (P<0.05). The mean correction obtained via surgery in the immediate postoperative period was 37.2%±9.0%. The mean loss of correction at the final follow-up was 10.5%±5.3%, and the mean final anterior vertebral body height maintained was 72%±11.0% (P<0.05).

Conclusion: Short-segment posterior fixation with pedicle screw augmentation achieves good correction of local kyphotic angle and anterior vertebral height in the immediate postoperative period, but some loss of correction at final follow-up is common. In our study, the loss of correction corresponded directly to the load-sharing score.

导言:不稳定的胸腰椎爆裂性骨折是骨科临床中经常遇到的情况。最近,用椎弓根螺钉对骨折椎体进行短节段固定治疗不稳定胸腰椎爆裂性骨折的方法越来越受欢迎。然而,在随访期间能否维持畸形矫正仍存在争议。本研究旨在探讨在急性胸腰椎骨折的短节段器械治疗中使用中间椎弓根螺钉进行骨折椎体增量的临床放射学结果、并发症和功能性结果:这项回顾性研究在焦特普尔全印度医学科学研究所骨科进行,使用的是 2021 年 1 月至 2022 年 10 月的病历。作为主要结果,研究测量了局部畸形矫正、最终随访时畸形矫正丧失、前体高度矫正(%)和最终随访时矫正丧失(%)等参数。其他各种参数,如手术时间、失血量、住院时间和视觉模拟量表则作为次要结果进行测量:结果:术后即刻通过手术获得的平均矫正度为(13.7±2.3)度。最后随访时的平均矫正损失为(4.1±2.0)度,最终局部畸形角的平均值为(7.2±2.4)度(PC结论:短节段后路固定加椎弓根螺钉增高术在术后初期能很好地矫正局部椎体后倾角和前方椎体高度,但在最终随访时矫正功能丧失的情况很常见。在我们的研究中,矫正损失与负荷分担评分直接相关。
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引用次数: 0
Single-cell RNA sequencing analysis and Alzheimer's disease: a bibliometric analysis. 单细胞RNA测序分析与阿尔茨海默病:文献计量学分析。
Pub Date : 2023-10-25 eCollection Date: 2023-01-01
Lilach Soreq, Wael Mohamed

Alzheimer's disease (AD) is a devastative disease, the 1st most frequent neurodegenerative disease worldwide. Its prevalence is increasing and early detection methods as well as potential genomic based therapeutics are urgently needed.

Objectives: To better characterize recent seq studies of AD and site recent relevant literature. Using single-cell RNA sequencing, the characteristics of neuronal cell populations in Alzheimer's disease (AD) have not been completely elucidated.

Methods: We conducted a dynamic and longitudinal bibliometric analysis to investigate existing studies on Single-cell RNA sequencing analysis and Alzheimer's Disease and identify data gaps and possible new research avenues.

Results: All AD papers concentrating on Single-cell RNA sequencing analysis were found using the search terms "Alzheimer's Disease", and "Single-cell RNA sequencing analysis" in the PubMed/MEDLINE database. Only English publications published between 2015 and 2023 were chosen using filters.

Conclusions: Original English-language research publications disclosing Single-cell RNA sequencing analysis and Alzheimer's Disease were examined for inclusion. Two sets of independent reviewers discovered and extracted pertinent data. The bibliometric study was carried out using the R software packages Bibliometrix and Biblioshiny. The narrowed search yielded 158 publications, all published between 2015 and 2023. Yet, after applying filters and considering the inclusion requirements, the search results comprise just 51 original articles out of 158 articles. There were 107 articles eliminated. The importance of the discovery of Single-cell RNA sequencing analysis and Alzheimer's Disease a decade ago only grows with time. Our results have important implications for future studies of AD and may help researchers across the world better understand the global context of the Single-cell RNA sequencing analysis and Alzheimer's Disease link. This study puts emphasis on the critical need for more diverse participant demographics in Alzheimer's disease investigations.

阿尔茨海默病(AD)是一种破坏性疾病,是世界上第一大最常见的神经退行性疾病。其患病率正在增加,迫切需要早期检测方法以及潜在的基于基因组的治疗方法。目的:更好地描述最近的AD序列研究,并整理最近的相关文献。利用单细胞RNA测序,阿尔茨海默病(AD)神经元细胞群的特征尚未完全阐明。方法:通过动态和纵向文献计量分析,对单细胞RNA测序分析与阿尔茨海默病的现有研究进行调查,找出数据缺口和可能的新研究途径。结果:在PubMed/MEDLINE数据库中搜索“Alzheimer's Disease”和“Single-cell RNA sequencing analysis”,可以找到所有关于单细胞RNA测序分析的AD论文。只有2015年至2023年期间发表的英文出版物被筛选。结论:对披露单细胞RNA测序分析和阿尔茨海默病的原始英语研究出版物进行了纳入检查。两组独立的审查人员发现并提取了相关数据。文献计量学研究采用R软件包Bibliometrix和Biblioshiny进行。缩小后的搜索范围产生了158篇论文,全部发表于2015年至2023年之间。然而,在使用过滤器并考虑纳入要求之后,搜索结果中只有158篇原创文章。有107项被淘汰。十年前发现单细胞RNA测序分析和阿尔茨海默病的重要性只会随着时间的推移而增加。我们的研究结果对阿尔茨海默病的未来研究具有重要意义,并可能帮助世界各地的研究人员更好地了解单细胞RNA测序分析与阿尔茨海默病联系的全球背景。这项研究强调了在阿尔茨海默病调查中对更多样化的参与者人口统计的迫切需要。
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引用次数: 0
Leveraging genetic diversity to understand monogenic Parkinson's disease's landscape in AfrAbia. 利用基因多样性了解非洲单基因帕金森病的情况。
Pub Date : 2023-08-15 eCollection Date: 2023-01-01
Wael Mohamed

Parkinson's disease may be caused by a single highly deleterious and penetrant pathogenic variant in 5-10% of cases (monogenic). Research into these mutational disorders yields important pathophysiological insights. This article examines the phenotype, genotype, pathophysiology, and geographic and ethnic distribution of genetic forms of disease. Well established Parkinson's disease (PD) causal variants can follow an autosomal dominant (SNCA, LRRK2, and VPS35) and autosomal recessive pattern of inheritance (PRKN, PINK1, and DJ). Parkinson's disease is a worldwide condition, yet the AfrAbia population is understudied in this regard. No prevalence or incidence investigations have been conducted yet. Few studies on genetic risk factors for PD in AfrAbia communities have been reported which supported the notion that the prevalence and incidence rates of PD in AfrAbia are generally lower than those reported for European and North American populations. There have been only a handful of documented genetic studies of PD in AfrAbia and very limited cohort and case-control research studies on PD have been documented. In this article, we provide a summary of prior conducted research on monogenic PD in Africa and highlight data gaps and promising new research directions. We emphasize that monogenic Parkinson's disease is influenced by distinctions in ethnicity and geography, thereby reinforcing the need for global initiatives to aggregate large numbers of patients and identify novel candidate genes. The current article increases our knowledge of the genetics of Parkinson's disease (PD) and helps to further our knowledge on the genetic factors that contribute to PD, such as the lower penetrance and varying clinical expressivity of known genetic variants, particularly in AfrAbian PD patients.

在5-10%的病例(单基因)中,帕金森病可能由单一的高度有害和渗透致病性变体引起。对这些突变性疾病的研究产生了重要的病理生理学见解。本文研究了疾病的表型、基因型、病理生理学以及遗传形式的地理和种族分布。公认的帕金森病(PD)因果变异可以遵循常染色体显性遗传(SNCA、LRRK2和VPS35)和常染色体隐性遗传模式(PRKN、PINK1和DJ)。帕金森氏症是一种全球性疾病,但非洲人群在这方面的研究不足。目前尚未进行流行率或发病率调查。很少有关于非洲阿比亚社区帕金森病遗传风险因素的研究报告支持这样一种观点,即非洲阿比亚的帕金森病患病率和发病率通常低于欧洲和北美人群。在AfraAbia,只有少数有文献记载的帕金森病遗传研究,对帕金森病的队列和病例对照研究也非常有限。在这篇文章中,我们总结了先前在非洲进行的单基因PD研究,并强调了数据差距和有希望的新研究方向。我们强调,单基因帕金森病受到种族和地理差异的影响,从而加强了全球倡议的必要性,以聚集大量患者并确定新的候选基因。当前的文章增加了我们对帕金森病(PD)遗传学的了解,并有助于进一步了解导致PD的遗传因素,如已知遗传变异的外显率较低和临床表现力不同,特别是在非洲帕金森病患者中。
{"title":"Leveraging genetic diversity to understand monogenic Parkinson's disease's landscape in AfrAbia.","authors":"Wael Mohamed","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Parkinson's disease may be caused by a single highly deleterious and penetrant pathogenic variant in 5-10% of cases (monogenic). Research into these mutational disorders yields important pathophysiological insights. This article examines the phenotype, genotype, pathophysiology, and geographic and ethnic distribution of genetic forms of disease. Well established Parkinson's disease (PD) causal variants can follow an autosomal dominant (<i>SNCA, LRRK2,</i> and <i>VPS35</i>) and autosomal recessive pattern of inheritance (<i>PRKN, PINK1,</i> and <i>DJ</i>). Parkinson's disease is a worldwide condition, yet the AfrAbia population is understudied in this regard. No prevalence or incidence investigations have been conducted yet. Few studies on genetic risk factors for PD in AfrAbia communities have been reported which supported the notion that the prevalence and incidence rates of PD in AfrAbia are generally lower than those reported for European and North American populations. There have been only a handful of documented genetic studies of PD in AfrAbia and very limited cohort and case-control research studies on PD have been documented. In this article, we provide a summary of prior conducted research on monogenic PD in Africa and highlight data gaps and promising new research directions. We emphasize that monogenic Parkinson's disease is influenced by distinctions in ethnicity and geography, thereby reinforcing the need for global initiatives to aggregate large numbers of patients and identify novel candidate genes. The current article increases our knowledge of the genetics of Parkinson's disease (PD) and helps to further our knowledge on the genetic factors that contribute to PD, such as the lower penetrance and varying clinical expressivity of known genetic variants, particularly in AfrAbian PD patients.</p>","PeriodicalId":72170,"journal":{"name":"American journal of neurodegenerative disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509492/pdf/ajnd0012-0108.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of spinopelvic parameters in patients with lumbosacral transitional vertebra: a cross sectional and comparative study. 腰骶部移行椎患者脊柱骨盆参数的评估:一项横断面和比较研究。
Pub Date : 2023-08-15 eCollection Date: 2023-01-01
Akhil Mathew Jacob, Sandeep Kumar Yadav, Abhay Elhence, Sumit Banerjee, Nitesh Gahlot, Saurabh Gupta, Rajesh Kumar Rajnish, Prabodh Kantiwal, Sarbesh Tiwari

Introduction: Lumbosacral transitional vertebra (LSTV) is the most common congenital anomaly of the lumbosacral junction and is a frequent cause of back pain in young patients with a prevalence of 4.6% to 36% in different regions.

Objective: The objective of this study was to evaluate spinopelvic parameters in patients with lumbosacral transitional vertebra and to compare them with the same parameters of low back ache patients without lumbosacral transitional vertebra.

Methods: This was a cross-sectional and comparative study conducted among low back ache patients presenting to our tertiary care center. Low back ache patients presenting to the outpatient department of AIIMS Jodhpur were screened for LSTV using radiographs. The spinopelvic parameters of those with LSTV were measured using Surgimap software and compared with the parameters of low back ache patients without LSTV. An Independent sample t-test was done and p-values were calculated.

Results: The spinopelvic parameters, pelvic incidence, pelvic tilt and lumbar lordosis differed significantly in the patients with LSTV. Pelvic incidence was higher in the group with LSTV (58.5+9.3) when compared to the group without LSTV (50+8.8) with a p-value (<0.001). Pelvic tilt was higher in the group with LSTV (19.4+8.8) when compared to the group without LSTV (13.6+7.8) with a p-value (0.001). Lumbar lordosis was significantly higher in the group with LSTV (57.6+13.2) when compared to the group without LSTV (50.7+12.2) with a p-value (0.007). No significant differences were obtained in sacral slope and Pelvic-incidence and lumbar lordosis mismatch.

Conclusion: LSTV alters the spinopelvic parameters. Altered spinopelvic parameters predispose to spondylolisthesis, degenerative disc disease, and facet joint arthritis and are important in preoperative planning in spine and pelvic surgeries.

简介:腰骶过渡椎骨(LSTV)是腰骶交界处最常见的先天性异常,也是年轻患者背痛的常见原因,不同地区的患病率为4.6%-36%。目的:本研究的目的是评估有腰骶过渡椎骨的患者的脊柱骨盆参数,并将其与无腰骶过渡脊椎的腰痛患者的相同参数进行比较。方法:这是一项在我们的三级护理中心就诊的腰痛患者中进行的横断面和比较研究。向焦特布尔AIIMS门诊就诊的腰痛患者使用射线照片进行LSTV筛查。使用Surgimap软件测量LSTV患者的脊柱骨盆参数,并与无LSTV的腰痛患者的参数进行比较。进行独立样本t检验,计算p值。结果:LSTV患者的脊柱骨盆参数、骨盆发生率、骨盆倾斜和腰椎前凸均有显著差异。与无LSTV组(50+8.8)(p值(0.001))相比,有LSTV组的骨盆发生率(58.5+9.3)更高。与无LSV组(50.7+12.2)(p值(0.007)相比,LSTV组腰椎前凸显著更高(57.6+13.2)。骶骨斜率、骨盆发生率和腰椎前凸没有显著差异不匹配。结论:LSTV改变了脊柱盆腔参数。脊柱骨盆参数的改变易导致脊椎滑脱、椎间盘退行性疾病和小关节关节炎,在脊柱和骨盆手术的术前计划中很重要。
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引用次数: 0
Prevalence of lumbosacral transitional vertebra in patients with chronic low back pain: a descriptive cross-sectional study. 腰骶过渡椎在慢性腰背痛患者中的患病率:一项描述性横断面研究。
Surendra Kumar Jat, Amit Srivastava, Raskesh Malhotra, Manish Chadha, Anupama Tandon, Anil K Jain

Background: Numerous causes of low back pain have been identified like spondylosis, spondylolysis, spondylolisthesis, facet lesions, discal abnormalities, vertebral instability, degenerative osteoarthritis, etc., These causes of low back pain are seen commonly in >50 years of age. Lumbosacral transitional vertebra (LSTV) is a common congenital anomaly with multitude of intermediate morphologic manifestations between the typical sacral and lumbar vertebra reported by some authors as a cause of low back pain. There are racial differences reported in the literature on the prevalence of LSTV. There is no common consensus in literature about the association between LSTV and low back pain. There is a paucity of literature on the subject in the Indian population, hence the current study was conducted.

Material and methods: 60 cases of low back pain and 60 controls were included in the study. Patients between 18-50 years of age with low back pain of >12 weeks duration who were fulfilling the inclusion criteria were included in the study. The plain radiographs were screened by two observers (one Orthopaedician and one Radiologist) for the presence or absence of lumbosacral transitional vertebra (LSTV) and classification was determined by consensus. The incidence of LSTV was calculated in both the groups (cases and controls) and evaluated for statistical significance.

Results: Prevalence of lumbosacral transitional vertebra (LSTV) was found to be 38.33% in cases group as compared to control group (21.66%) and was statistically significant (p value <0.05). Prevalence of lumbarisation was higher in case group (10%) in comparison to control group (5.0%) but not found to be statistically significant. Prevalence of sacralisation was also found to be higher in case group (28.33%) as compared to control group (16.67%). This was not found to be statistically significant.

Conclusion: The present study showed a higher prevalence of lumbosacral transitional vertebra (LSTV) in case group (38.33%) as compared to control group (21.66%) which was found to be statistically significant. Prevalence of lumbarisation and sacralisation were both found to be higher in the case group in comparison to control group, but the difference was not statistically significant. However, further studies with larger sample would be needed to conclusively determine any association between low back pain and subtypes of LSTV.

背景:引起腰痛的原因很多,如颈椎病、峡部裂、椎体滑脱、关节突病变、椎间盘异常、椎体不稳定、退行性骨关节炎等,这些引起腰痛的原因常见于50岁以上的人群。腰骶过渡椎(LSTV)是一种常见的先天性异常,在典型的骶椎和腰椎之间具有多种中间形态表现,一些作者报道了腰痛的原因。文献中关于LSTV患病率的报道存在种族差异。关于LSTV和腰痛之间的关系,文献中没有普遍的共识。在印度人口中缺乏关于这一主题的文献,因此进行了当前的研究。材料与方法:选取60例腰痛患者和60例对照组。年龄在18-50岁之间,腰痛持续时间>12周且符合纳入标准的患者被纳入研究。x线平片由两名观察员(一名骨科医生和一名放射科医生)筛选腰骶过渡椎(LSTV)的存在或不存在,并通过共识确定分类。计算两组(病例组和对照组)的LSTV发生率,并评估有无统计学意义。结果:病例组腰骶段过渡性椎体(LSTV)患病率为38.33%,高于对照组(21.66%),差异有统计学意义(p值)。结论:病例组腰骶段过渡性椎体(LSTV)患病率为38.33%,高于对照组(21.66%),差异有统计学意义。病例组腰化和骶骨化的发生率均高于对照组,但差异无统计学意义。然而,需要更大样本的进一步研究来最终确定腰痛和LSTV亚型之间的任何关联。
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引用次数: 0
Botox injection in treatment of sialorrhea in children with cerebral palsy. 注射肉毒杆菌素治疗脑瘫患儿唾液中毒。
Mohamadreza Ghazavi, Samira Rezaii, Mohadese Ghasemi, Neda Azin, Mohsen Reisi

Background: The occurrence of sialorrhea (drooling) in children with cerebral palsy is one of the important complications of this disease, which is associated with the impaired quality of life of patients and also the dissatisfaction of their parents. Botox injection in the salivary glands is one of the treatment methods that has recently received special attention in these patients, but there are still many challenges regarding its effectiveness and safety. We aimed to test the effectiveness and safety of botulinum toxin type A in reducing sialorrhea in children with cerebral palsy.

Methods: This semi-experimental before-after study was performed on 12 children who suffering from sialorrhea. The ethics code of this project is IR.MUI.MED.REC.1400.774 and the clinical trial registry code is IRCT20220516054868N1 (https://www.irct.ir/trial/64393). In each of the parotid and submandibular glands, an amount of 0.5 U/kg of botulinum toxin type A was injected by ultrasound guidance under general anesthesia. Before and 6 months after the intervention, the severity and frequency of drooling were tested by Drooling Frequency and Severity Scale.

Results: We found a decreasing trend in the severity and frequency scores for drooling within one month; however, after that time, until the end of the 24th week, we saw an increasing trend in the intensity and frequency of this complication. Only two-thirds of parents were satisfied with the therapeutic protocol. Side effects related to botox injection were revealed in 25.0% mostly as dysphagia.

Conclusion: Botox injection in salivary glands is not a definitive and stable treatment in the treatment of sialorrhea in children with cerebral palsy.

背景:脑瘫患儿出现唾液(流口水)是脑瘫的重要并发症之一,不仅影响患者的生活质量,也引起家长的不满。在唾液腺注射肉毒杆菌毒素是最近在这些患者中受到特别关注的治疗方法之一,但其有效性和安全性仍然存在许多挑战。我们的目的是测试A型肉毒毒素在减少脑瘫患儿唾液的有效性和安全性。方法:采用半实验方法对12例儿童唾液病患者进行前后对照研究。本项目伦理规范为IR.MUI.MED.REC.1400.774,临床试验注册码为IRCT20220516054868N1 (https://www.irct.ir/trial/64393)。全麻下超声引导下,在腮腺和颌下腺各注射A型肉毒毒素0.5 U/kg。干预前和干预后6个月,分别采用《流口水频度量表》和《流口水严重程度量表》检测患儿流口水严重程度和流口水频率。结果:1个月内流口水严重程度和频次评分呈下降趋势;然而,在此之后,直到第24周结束,我们看到该并发症的强度和频率呈增加趋势。只有三分之二的家长对治疗方案感到满意。25.0%的患者出现与肉毒杆菌注射有关的不良反应,主要表现为吞咽困难。结论:唾液腺注射肉毒杆菌毒素并不是治疗脑瘫患儿唾液漏的一种明确、稳定的方法。
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引用次数: 0
Nucleus accumbens changes in amyotrophic lateral sclerosis. 肌萎缩性侧索硬化患者伏隔核的变化。
Ioannis N Mavridis, Efstratios-Stylianos Pyrgelis

Amyotrophic lateral sclerosis (ALS), a representative example of motor neuron disease, is a progressive and fatal neurodegenerative disorder. The nucleus accumbens (NA) is the ventral striatum's main part and is considered as a modulator of the human brain's reward network. The purpose of this article is to review the current knowledge regarding NA changes in ALS patients. The NA involvement in ALS includes volumetric, cellular and molecular changes. There are recent imaging and pathological studies revealing NA atrophy in ALS, a finding which seems to be related to neuronal loss and protein deposition in this area. The clinical significance of NA atrophy in these patients is not currently fully understood. Perhaps it could be correlated with apathy, behavioral disturbances and cognitive impairment that ALS patients sometimes manifest.

肌萎缩性侧索硬化症(ALS)是一种进行性、致死性神经退行性疾病,是运动神经元疾病的代表。伏隔核(NA)是腹侧纹状体的主要部分,被认为是人脑奖赏网络的调节器。本文的目的是回顾目前关于ALS患者NA变化的知识。NA参与ALS包括体积、细胞和分子的变化。最近的影像学和病理学研究显示ALS患者的NA萎缩,这一发现似乎与该区域的神经元丢失和蛋白质沉积有关。NA萎缩在这些患者中的临床意义目前尚不完全清楚。也许它可能与肌萎缩侧索硬化症患者有时表现出的冷漠、行为障碍和认知障碍有关。
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引用次数: 0
SKINTED: an uncommon cutaneous complication of total knee replacement. SKINTED:全膝关节置换术中一种罕见的皮肤并发症。
Vikram K Mahajan, Vikas Sharma, Neeraj Sharma, Ritu Rani, Monika Chandel

Surgery of the knee, injury to the infrapatellar branch of the saphenous nerve, traumatic eczematous dermatitis (SKINTED) involving the skin lateral to the surgical incision/scar area is a site- and procedure-specific diagnosis associated with total knee replacement surgery. It results from autonomic denervation following surgical trauma to the nerve and occurs months to years after surgical trauma. It needs to be differentiated from post traumatic eczema/dermatitis, neuropathic dermatitis and contact dermatitis/sensitization due to topical therapies or implant material. Herein, we report a case of 70-year-old woman having no preexisting medical or dermatological disorder of significance presenting with eczematous lesions around both knees lateral to the incision site developing few months after bilateral total knee replacement surgery. Treatment with twice daily application of betamethasone dipropionate 0.05% cream, gabapentine 100 mg/d PO and liberal use of bland emollient cream given over 2 months was remittive without recurrence during more than one year of follow up. Since its exact prevalence, pathophysiology and clinical course remain uncertain its awareness remains relevant to both dermatologists and orthopedic surgeons to address unnecessary anxiety and dissatisfaction of the patient.

膝关节手术、髌下隐神经分支损伤、外伤性湿疹性皮炎(SKINTED)累及手术切口/疤痕区外侧皮肤,是与全膝关节置换术相关的部位和手术特异性诊断。它是由手术损伤神经后的自主神经失支配引起的,发生在手术创伤后数月至数年。它需要与创伤后湿疹/皮炎、神经性皮炎和接触性皮炎/敏感化区分,因为局部治疗或植入材料。在此,我们报告一例70岁的女性,先前没有明显的医学或皮肤疾病,在双侧全膝关节置换术后几个月,双膝切口外侧出现湿疹病变。每日两次应用0.05%二丙酸倍他米松乳膏,加巴喷丁100mg /d PO,并自由使用温和润肤乳膏治疗2个月以上,随访1年多无复发。由于其确切的患病率、病理生理学和临床病程仍不确定,皮肤科医生和骨科医生对其认识仍然相关,以解决患者不必要的焦虑和不满。
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引用次数: 0
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American journal of neurodegenerative disease
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