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Orthopaedics and musculoskeletal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
14.20. Which of the following complications occur(s) more frequently in association with supracondylar fracture of the humerus than with other limb fractures?Osteomyelitis.Peripheral nerve injury.Volkmann's ischaemic contracture.Fat embolism.Non-union.
Positions in neurosurgery
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Zilvinas Zakarevicius, Mikhail Gelfenbeyn, Irene Rozet
The mechanism of perioperative peripheral nerve injury is multifactorial. Local mechanical insults on the nerve with stretching, pressure, or transection, and duration of the insult are damaging to the nerve. Other factors include perfusion, inflammation, metabolism, and underlying neuronal reserve. All of these may potentially alter neuronal integrity during the surgery and neuronal health intraoperatively. Prolonged immobilization under anesthesia per se may cause neuronal damage. Despite all the precautions taken during positioning, peripheral nerve injury, especially during prolonged cases, is never 100% predictable or preventable (5).
Critical Care of the Trauma Patient
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
High-priority occult injuries: Brain, spinal cord and peripheral nerve injury.Thoracic aortic injury.Intra-abdominal or pelvic injury.Vascular injuries to the extremities.Cerebrovascular injuries – occult carotid/vertebral artery injury.Cardiac injuries.Aerodigestive tract injuries – ruptured bowel.Occult pneumothorax.Compartment syndrome – foreleg, thigh, buttock or arm.Eye injuries (remember to remove the patient's contact lenses).Other occult injuries – hands, feet, digits or joint dislocations.Vaginal tampons.
Neuromuscular disorders in women and men with spinal cord injury are associated with changes in muscle and tendon architecture
Published in The Journal of Spinal Cord Medicine, 2023
Larissa Santana, Emerson Fachin-Martins, David Lobato Borges, Jonathan Galvão Tenório Cavalcante, Nicolas Babault, Frederico Ribeiro Neto, João Luiz Quagliotti Durigan, Rita de Cássia Marqueti
Invasive electromyography has identified neuromuscular electrophysiological disorders (NED) in individuals with complete and incomplete SCI.16–19 The most significant effect on nerve waveform amplitude suggests a predominant axonal involvement. However, there are no definitive findings on neuromuscular function changes observed in individuals with chronic SCI.17,18 Among the modalities used to evaluate peripheral nerve lesions, the Stimulus Electrodiagnosis Test (SET) is a non-invasive examination that quantifies nerve and muscle evoked responses using specific parameters of neuromuscular electrical stimulation (NMES) to measure the rheobase, chronaxie, accommodation, and accommodation index.20–22 Invasive electromyography has been indicated as a relevant test to determine peripheral nerve injury level and severity.23 However, the feasibility of this test may be limited due to its considerable cost, need for a skilled physician, and the inherent risk of an invasive test.24 NED can also be diagnosed by SET, which presents sensitivity ranging from 88% to 100% compared to needle electromyography.21 The chronaxie needs to be considered in the proposal of NMES protocols for experimental and rehabilitation purposes.21,24,25 In addition, a possible mechanism for non-responsivity to NMES parameters has not yet been elucidated after SCI.
Neutrophil peptide-1 promotes the repair of sciatic nerve injury through the expression of proteins related to nerve regeneration
Published in Nutritional Neuroscience, 2022
Fei Yu, Yusong Yuan, Hailin Xu, Suping Niu, Na Han, Yajun Zhang, Xiaofeng Yin, Yuhui Kou, Baoguo Jiang
Peripheral nerve injury is common in the field of trauma, and the current treatment outcomes for it are not favorable. Peripheral nerve injury often causes limb dysfunction or disability, placing a heavy burden on patients and their families [20]. In order to improve outcomes for patients, it is crucial to restore the continuity of injured nerves as soon as possible. Traditional drug therapies have had some success in achieving this. However, with the continued development of new technology, researchers have discovered additional therapies that can better promote the repair of injured peripheral nerves. Defensins, which are small bioactive molecular peptides, have been widely used for the treatment of peripheral nerve injury. NP-1, an alpha-defensin, is of particular interest to researchers in the field of nerve injury, as our previous study [17] showed that continuous injection of NP-1 into the gluteus maximus muscle can promote the repair and regeneration of injured sciatic nerves. Researchers have also found that NP-1 can improve the regeneration rate and conductivity of nerve fibers during early stages of sciatic nerve regeneration [16]. To further study the effect of a single topical administration of NP-1 on the repair of peripheral nerve injury, we established a crush injury model of sciatic nerve injury in rats and observed the effect of a single intermuscular injection of NP-1 on the functional recovery of injured nerves.
Effects of Theranekron and alpha-lipoic acid combined treatment on GAP-43 and Krox-20 gene expressions and inflammation markers in peripheral nerve injury
Published in Ultrastructural Pathology, 2021
Leman Sencar, Gülfidan Coşkun, Dilek Şaker, Tuğçe Sapmaz, Samet Kara, Alper Çelenk, Sema Polat, Derviş Mansuri Yılmaz, Y. Kenan Dağlıoğlu, Sait Polat
Peripheral nerve injury is still a serious health problem today. The effects of various factors have been extensively studied in peripheral nerve regeneration following injury. The widespread usage of microsurgery applications and development of histological and immunohistochemical methods greatly increased the success of nerve repair in PNI.24,25 Furthermore, effectiveness of neurotropic factors, steroids, hormones, various chemicals and low frequency magnetic field applications on nerve regeneration have been reported in many studies. However, regeneration after PNI is not complete and an effective treatment protocol has not been established to provide functional recovery after injury. The most important target is to eliminate the structural changes in the injured nerve, to restore the normal structure and to achieve functional recovery as a result. In the literature, many substances have been applied for therapeutic purposes and their results have been published.26 However, research on the effectiveness of treatment protocols continues intensively. In the present study, we investigated the efficiency of Theranekron and ALA treatment in an experimental model of sciatic nerve crush injury in rats, and found that a combined treatment of Theranekron and ALA caused an increase in the number of myelinated nerve fibers in the sciatic nerve. Furthermore, this combined treatment reduced TNF-α and IL-6 expressions, and upregulated Krox-20 and Gap-43.