Foreign body in the thoracic spine due to a nail gun penetrating injury: A case report

Rationale: Spinal cord injuries could be catastrophic because they may result in severe neurovascular complications. Here, we present a case of thoracic spine-penetrating injury by a nail-gun. Patient concerns: A 60-year-old male presented to our emergency department with complaints of progressive right chest pain for 1 week that was preceded by back pain. He had a medical history of hypertension and denied any trauma history. He had alert consciousness and stable vital signs. He was a carpenter. Upon physical and neurological examination, no obvious wounds or vesicle formation were noted, and the patient was neurologically intact. Diagnosis: Laboratory test results showed abnormally elevated D-dimer levels. Electrocardiography showed normal sinus rhythm. Chest radiography showed no mediastinal widening. Chest computed tomography was performed. The formal radiology report indicated a foreign body in the T4-5 spinal cord and upper back. Interventions: A neurosurgeon was consulted with suggestion of operation. We performed T4-5 laminectomy and foreign body removal. The foreign body, stuck to the spinal cord with dural rupture, was removed and found to be a 5 cm-long broken nail. Outcomes: The pain resolved immediately post operation. Lessons: Surgical removal of the foreign body is recommended if neurovascular complications or cerebrospinal fluid (CSF) leak is detected. Obtaining the patient's complete history, including occupation, might be helpful in determ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Abstract Spinal cord injury (SCI) can have profound effects on the autonomic and cardiovascular systems, notably with injuries above high-thoracic levels that result in the development of autonomic dysreflexia (AD) characterized by volatile hypertension in response to exaggerated sympathetic reflexes triggered by afferent stimulation below the injury level. Pathophysiological changes associated with the development of AD include sprouting of both nociceptive afferents and ascending propriospinal 'relay' neurons below the injury, as well as dynamic changes in synaptic inputs onto sympathetic preganglionic neurons. ...
Source: Experimental Neurology - Category: Neurology Authors: Tags: Exp Neurol Source Type: research
AbstractA patient presenting with marked elevation in blood pressure and concurrent headache often presents a diagnostic challenge for even the most seasoned clinician. When marked hypertension and headache occur in a patient with a history of upper spinal cord injury, the patient should be presumed to have autonomic dysreflexia until proven otherwise. Autonomic dysreflexia can at times trigger headaches, hypertension, and variations in pulse, as well other autonomic signs and symptoms. Autonomic dysreflexia is a medical emergency for which appropriate treatment may be life-saving. In this review, we address the historical...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
(CNN) — People were curious about the keto diet, ALS and endometriosis in 2018. Those are just a few of the health-related topics that had Internet surfers in the United States turning to Dr. Google with questions this year, according to a top 10 list from the search engine giant. The data, based on search terms, was collected from January to mid-December. Last year, some of the top health-related questions searched on Google included what causes hiccups, how to stop snoring, how long flu lasts and what is lupus. Some of the top health-related questions on Google in 2016 were related to Zika, traumatic brain injuries...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Offbeat Google Local TV Source Type: news
In this study, we analyzed FGF21 levels and alterations in the expression of genes encoding components of the FGF21-responsive molecular machinery in adipose tissue from aged individuals so as to ascertain whether altered FGF21 responsiveness that develops with aging jeopardizes human health and/or accelerates metabolic disturbances associated with aging. We studied a cohort of 28 healthy elderly individuals (≥70 years) with no overt signs of metabolic or other pathologies and compared them with a cohort of 35 young healthy controls (≤40 years). Serum FGF21 levels were significantly increased in elderly indiv...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
We present a 31 year-old woman with T3 AIS A spinal cord injury who developed recurrent AD while receiving duloxetine and amitriptyline combination therapy for neuropathic pain. After excluding other AD generators, duloxetine was discontinued and the AD episodes resolved. While secondary hypertension is a known side effect of amitriptyline and duloxetine, neither drug has been previously associated with AD. One potential mechanism for inhibition of duloxetine metabolism is discussed. Unexplained AD in at-risk patients receiving duloxetine and amitriptyline should prompt consideration of an adverse reaction to combination therapy.
Source: PMandR - Category: Rehabilitation Source Type: research
Authors: LaVela SL, Etingen B, Miskevics S, Heinemann AW Abstract OBJECTIVE: To examine variables associated with satisfaction with life (SWL) in individuals with a spinal cord injury (SCI). DESIGN: Cross-sectional, national survey to assess SWL, demographic and injury characteristics, health care utilization, chronic conditions (obesity, diabetes, heart problems, lung problems, hypertension, high cholesterol), symptoms (poor sleep, pain, depression), social support, grief/loss, and independence. SETTING/PARTICIPANTS: Community-dwelling Veterans with SCI. Outcome Measures/Analyses: Bivariate analyses were c...
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
Aim and objectivesTo predict the risk factors related to newly diagnosed psychiatric disorders resulting from spinal cord injuries (SCIs). BackgroundSCIs are a common result of devastating accidents; they can have an essential negative impact on the psychological health of those so afflicted. Psychiatric disorders commonly occur worldwide and are often associated with pain and disability; however, few studies have investigated the risk factors of psychiatric disorders among persons with SCIs. DesignA retrospective cohort study design with data obtained from the Taiwan Health Insurance Research Database (THIRD). THIRD invol...
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: ORIGINAL ARTICLE Source Type: research
Abstract AimTo predict the risk factors related to newly diagnosed psychiatric disorders resulting from spinal cord injuries (SCIs) BackgroundSCIs are a common result of devastating accidents; they can have an essential negative impact on the psychological health of those so afflicted. Psychiatric disorders commonly occur worldwide, and are often associated with pain and disability; however, few studies have investigated the risk factors of psychiatric disorders among persons with SCIs. DesignA retrospective cohort study design, with data obtained from the Taiwan Health Insurance Research Database (THIRD). THIRD involves t...
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
Conclusion Hyperexcitability of T5 and T6 sympathetic preganglionic fibers appears to be the main etiology of LPR. SNEPI can reduce LES relaxation and improve blood flow to the mucosa, thereby increasing the stability of the vagus reflex and laryngopharyngeal mucosal defense factors. To the best of our knowledge, this case represents the first report of a patient with LPR refractory to PPIs who was successfully treated with SNEPI alone. SNEPI can be considered as an alternative to anti-reflux procedures. References 1. Vakil N, van Zanten SV, Kahrilas P, et al. Global Consensus Group. The Montreal definition and classificat...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue Medical Issues Neurologic Systems and Symptoms Neurology antireflux procedure autonomic regulation laryngopharyngeal reflux refractory Sympathetic nerve entrapment point injection Source Type: research
Say hello to MassDevice +5, a bite-sized view of the top five medtech stories of the day. This feature of MassDevice.com’s coverage highlights our 5 biggest and most influential stories from the day’s news to make sure you’re up to date on the headlines that continue to shape the medical device industry. Get this in your inbox everyday by subscribing to our newsletters.   5. FDA approves Valencia’s eCoin neurostim trial Valencia Technologies said today it won investigational device exemption approval from the FDA to begin a trial of its eCoin neurostimulator for treating drug-resistant hypert...
Source: Mass Device - Category: Medical Equipment Authors: Tags: News Well Plus 5 Source Type: news
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