Steel rod impalement injuries involving the spine: A case report and literature review.
We report a case of steel rod impalement involving the spinal canal and review the literature to enhance the management strategies and to identify the risk factors for possible complications, particularly infection. A 37-year-old male construction worker presented to our emergency department due to falling onto a concrete reinforcing steel rod that penetrated through his perineum to the L4 vertebra. Examination revealed paralysis and sensory loss of the left foot. The rod was removed in the operating room (closed removal) under general anesthesia, followed by laparotomy. Rectal laceration was primarily repaired, and colostomy was performed. In a separate session, laminectomy was performed. At 3 months post-discharge, the patient was ambulatory with armrest based on the same motor examination performed on presentation This case is a good example of careful preoperative planning, multidisciplinary involvement, and appropriately sequenced interventions resulting in an acceptable outcome for an injury with high morbidity and mortality and demonstrates the feasibility and potential benefits of closed removal of the rod in an operating room just before laparotomy. The presence of an intestinal perforation increases the infection risk, but infections can still be prevented in this setting. Shorter time intervals between the incidence and surgery may reduce the infection rate. PMID: 31297784 [PubMed - in process]
CONCLUSION: We conclude that CEUS has the spatial and temporal sensitivity and resolution to visualize local tissue perfusion and vessel architecture, which maybe useful clinically to determine injury extent and severity in patients with SCI. PMID: 32074323 [PubMed - in process]
Journal of Neurotrauma, Ahead of Print.
Spinal Cord, Published online: 21 February 2020; doi:10.1038/s41393-020-0439-1The effects of 10,000 voluntary contractions over 8 weeks on the strength of very weak muscles in people with spinal cord injury: a randomised controlled trial
Glial signals are known to inhibit axonal regeneration and functional recovery after mammalian central nervous system trauma, including spinal cord injury. Such signals include membrane-associated proteins of the oligodendrocyte plasma membrane and astrocyte-derived, matrix-associated proteins. Here, using cell lines and primary cortical neuron cultures, recombinant protein expression, immunoprecipitation and immunoblot assays, transmission EM of exosomes, and axon regeneration assays, we explored the secretion and activity of the myelin-associated neurite outgrowth inhibitor Nogo-A and observed exosomal release of a 24-kD...
The protein Nogo-A has been widely studied for its role in inhibiting axonal regeneration following injury to the central nervous system, but the mechanism by which the membrane-bound Nogo-A is presented intercellularly is not fully understood. New research suggests that a highly inhibitory fragment of Nogo-A is generated by the amyloid precursor protein protease BACE1 and presented on the membranes of exosomes following spinal cord injury. This finding represents a new mode through which Nogo-A may exert its effects in the central nervous system.
ConclusionsDespite published reports showing benefit for pain control in patients with BPA, the overall low quality, retrospective evidence included in this review highlights the need for a rigorous prospective study to further address this indication.
Ventilators are used by patients who lose lung function due to complications from a variety of diseases such as spinal cord injuries, COPD, stroke, pneumonia, and ALS. In addition to dealing with a debilitating situation, patients tend to be hooked t...
Central neuropathic pain (CNP) after spinal cord injury (SCI) is debilitating and immensely impacts the individual. Central neuropathic pain is relatively resistant to treatment administered after it develops, perhaps owing to irreversible pathological processes. Although preemptive treatment may overcome this shortcoming, its administration necessitates screening patients with clinically relevant biomarkers that could predict CNP early post-SCI. The aim was to search for such biomarkers by measuring pronociceptive and for the first time, antinociceptive indices early post-SCI. Participants were 47 patients with acute SCI ...
Conclusions: The results disclosed the protective impacts of PA on PC12 cells to resist H2O2-provoked damage. MEG3, Wnt/β-catenin and PTEN/PI3K/AKT pathways joined in adjusting the activity of PA in H2O2-damaged PC12 cells. PMID: 32064936 [PubMed - in process]
Poliomyelitis is a motor neuron disease of the anterior horn of the spinal cord. It leads to asymmetrical flaccid paralysis and muscle atrophy that reduces the patient's stability and mobility and alters the gait pattern, predisposing to falls. Until the massive clinical application of vaccines, it was quite prevalent in some countries in the 50s and, the people who suffered the epidemic during childhood is nowadays more than 65 years old, constituting a risk groups for traumatological pathology.