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Thoracic Radicular Pain Caused by Extravertebral Gas and Fluid Collections Associated with Osteoporotic Vertebral Fracture Containing a Vacuum Cleft.

The present study documents a phenomenon, which has received little attention despite its potential clinical importance. An 87-year-old woman presented with barely reported extravertebral gas and fluid collections probably originating from the contents of the adjacent cleft within the T10 collapsed osteoporotic vertebra. Her chief complaint was intractable pain radiating over the left thorax suggestive of intercostal neuralgia. The pain intensified when sitting up from a lateral decubitus position, correlating with a posture-related radiologic change of the intravertebral cleft, which appeared with a decubitus position and disappeared with a sitting position. Because these extravertebral collections were located where the 10th thoracic nerve root just exits the intervertebral foramina, her chest pain of a posture-dependent nature most likely resulted from nerve root compression by extravertebral gas and fluid forced out of the vertebral cleft. Posterior spinal fusion with pedicle screw instrumentation resulted in a complete resolution of the chest pain with disappearance of the extravertebral gas and fluid accumulations. An awareness of the possibility that the intravertebral cleft could communicate with the extravertebral space close to the nerve root will help avoid neurologic complications caused by bone cement leakage during vertebroplasty.

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Total knee arthroplasty in a case of diffuse idiopathic skeletal hyperostosis; challenges in ligament balancing and deformity correction.

Diffuse skeletal idiopathic hyperostosis is a non-inflammatory systemic skeletal condition in which there is ossification of ligaments, tendons, and joint capsule. Although the radiological changes and clinical manifestation of diffuse idiopathic skeletal hyperostosis (DISH) in the spine have been well defined in the literature, the changes in the knee and their implications on knee replacement are unclear.

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Effects of serratus anterior plane block for postoperative analgesia after thoracoscopic surgery compared with local anesthetic infiltration: a randomized clinical trial.

Serratus anterior plane (SAP) block is a relatively novel technique that can block the lateral cutaneous branches of the intercostal nerves as well as the long thoracic nerve.

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[Features of the sinusitis course in pregnant women].

The purpose of the work was to study the sinusitis diagnostic and clinical features in pregnant women. The pregnant women group (27 human) with sinusitis from 816 pregnant women with nasal congestion and/or nasal discharge was analyzed. The examination included: taking anamnesis, ENT examining, clinical blood test. The frequency of sinusitis in pregnant women with complaints of nasal congestion and/or nasal discharge is 4.7%. The development of sinusitis was associated with inadequate treatment of chronic rhinitis during pregnancy in a third of cases. The course of sinusitis was characterized by the absence of intoxication and fever, in 78% of cases – by the absence of facial pain. In 74% of cases, the onset of the disease was erased. In pregnant women with sinusitis, in comparison with pregnant women with manifestations of chronic rhinitis, had a significant increase in ESR and a tendency to an increase of neutrophils. CONCLUSION: The development of sinusitis in pregnant women in a third of cases is due to the ineffective treatment of chronic rhinitis, and the erased clinical picture of the disease suggests the need for a thorough assessment of the anamnestic and clinical symptoms of the disease.

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The Association of Renal Agenesis and Ipsilateral Seminal Vesicle Cyst: Zinner Syndrome Case Report.

Zinner syndrome is a rare congenital malformation characterized by the association of an ipsilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. This case is one of the first to be reported in the Kingdom of Saudi Arabia.

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Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany.

Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient and marginalized groups such as asylum seekers and refugees (ASR). We aim to advance current health monitoring approaches and obtain reliable estimates on health status and access to essential healthcare services among ASR in Germany's third largest federal state, Baden-Württemberg.

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Bilateral Internuclear Ophthalmoplegia in a Young Woman with Vertebral Artery Dissection.

Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO.

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Successful Bony Healing For An Adult Patient With Isthmic Spondylolysis At Terminal Stage After Conservative Treatment: A Case Report.

Spondylolysis, a defect or fracture of the pars interarticularis due to mechanical stress, is a common cause of lower back pain (LBP) in children and adolescents. Although conservative treatment has been shown to be most effective for young patients at early or progressive stage, few studies have reported the outcomes of conservative treatment for adult spondylolysis at terminal stage. We present the possibility of bony healing in the isthmic defect at terminal stage after conservative treatment.

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Jinmaitong Ameliorates Diabetic Peripheral Neuropathy Through Suppressing TXNIP/NLRP3 Inflammasome Activation In The Streptozotocin-Induced Diabetic Rat Model.

Jinmaitong (JMT) has been used to prevent and treat diabetic peripheral neuropathy (DPN) for decades. The present study aimed to elucidate the effects of JMT on thioredoxin-interacting protein (TXNIP) and Nod-like receptor protein 3 (NLRP3) inflammasome activation in the streptozotocin (STZ)-induced rat model.

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Aspirin-Mediated Attenuation of Intervertebral Disc Degeneration by Ameliorating Reactive Oxygen Species and .

Intervertebral disc (IVD) degeneration (IDD) is a major cause of low back pain. The pathogenesis of IDD is associated with the disturbance of reactive oxygen species (ROS) equilibrium, inflammation, and matrix loss. Aspirin is a nonsteroidal anti-inflammatory drug that effectively inhibits inflammation and oxidative stress and has been widely used for the treatment of back pain. Therefore, we hypothesize that aspirin reverses the IDD process via antioxidative and anti-inflammatory effects on the AMPK signaling pathway. , aspirin diminished cellular oxygen free radicals (ROS, nitric oxide (NO)) and inflammatory cytokines (interleukin- (IL-) 1 and IL-6 and tumor necrosis factor alpha (TNF-)) induced by lipopolysaccharides (LPS) in nucleus pulposus cells (NPCs). We found that aspirin preserved the extracellular matrix (ECM) content of collagen type II (COL2) and aggrecan while inhibiting the expression of matrix-degenerating enzymes, including matrix metalloproteinase 3 and 13 (MMP-3 and MMP-13) and A disintegrin and metalloproteinase with thrombospondin motifs 4 and 5 (ADAMTS-4, ADAMTS-5). Aspirin significantly promoted the ratios of p-AMPK to AMPK and p-ACC to ACC expression in NPCs. Furthermore, pretreatment with the AMPK inhibitor compound C abrogated the antioxidant effects of aspirin. , an IDD model was established in Sprague-Dawley rats via percutaneous disc puncture with the 20-gauge needle on levels 8-9 and 9-10 of the coccygeal vertebrae. Imaging assessment showed that after aspirin treatment, improvements in disc height index (DHI) ranged from 1.22-fold to 1.54-fold and nucleus pulposus signal strength improved from 1.26-fold to 1.33-fold. Histological analysis showed that aspirin treatment prevented the loss of COL2 and decreased MMP-3 and MMP-13, inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), IL-1, and TNF- expression in the IVD tissues. These results suggest that treatment with aspirin could reverse the IDD process via the AMPK signaling pathway, which provides new insights into the potential clinical applications of aspirin, particularly for IDD treatment.

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