Purpose In the photography of new-borns, there is an epidemic trend in the posing of 0–14-day-old neonates that induces ethical and competence issues. The aim of this study is to map the key concepts ...underpinning the contraindications of this type of passive positioning of the new-borns. Methods During the search for literature, the following keywords were used in the PubMed database: neonates; new-born; neck position; hyperextension; rotation; atlanto-occipital joint; sudden infant death; prone sleeping position; white noise; and pain perception. Results The white noise applied has been described as a pain perception modulator and an alternative pain reducing method in new-born care. There is evidence warning of the potential danger of passively produced cervical spine positions, considering the primary unstable atlanto-occipital joint during early infancy, the possible compression on vertebral arteries, and the intradural diameter decreasing the effect of extension. These factors may have an impact on healthy motor and cognitive development. Conclusion This perspective suggests that a wider debate should be called for concerning the role of medical professions to control this very dangerous practice, and that future cohort studies are necessary to monitor and follow up on the potential negative effects of this current trend.
Purpose Childhood flexible flat foot is the most common lower limb deformity. Observational evaluation of the underlying elements of reactive balance during static positions is an accepted tool ...besides the timed measures. We aim to assess the effects of combined balance training on the foot function and to test the usefulness of our observational static balance score. Participants and Methods A total of 19 healthy primary school students with flexible flat foot deformity volunteered for the study. We evaluated the foot’s dynamic properties and static postural stability before and after a 20-week combined balance training. On the basis of the observational findings, the time vs. quality observational static balance score was developed. All data were subjected to Wilcoxon’s test and Friedman’s ANOVA to compare the effects of the training on foot trajectory and observational static balance score. Results Better strength and endurance in the foot extensors and improved foot function were noted after the training. Using our observational static balance score, the quality of the balance performance remarkably changed. Conclusion The quality domain of our new scale seems to be a useful tool in daily clinical practice and a more sensitive measure in eyes-closed situations.
Splanchnic vein thrombosis due to co-existing metastatic pancreatic neuroendocrine tumour (pNET) and JAK2V617F mutation is a rare condition.
Here we present a case of a young woman with complete ...remission of a non-functioning grade 2 pNET with unresectable liver metastases, coexisting with JAK2V617F mutation. Splenectomy and distal pancreatectomy were performed. Neither surgical removal, nor radiofrequency ablation of the liver metastases was possible. Therefore, somatostatin analogue (SSA) and enoxaparine were started. Peptide receptor radionuclide therapy (PRRT) was given in 3 cycles 6-8 weeks apart. Genetic testing revealed no multiple endocrine neoplasia type 1 (MEN-1) gene mutations. After shared decision making with the patient, she gave birth to two healthy children, currently 2 and 4 years old. On pregnancy confirmation, SSA treatment was interrupted and resumed after each delivery. Ten years after the diagnosis of pNET, no tumour is detectable by MRI or somatostatin receptor scintigraphy. PRRT followed by continuous SSA therapy, interrupted only during pregnancies, resulted in complete remission and enabled the patient to complete two successful pregnancies.
To determine the effects of diaphragm-strengthening training on the stability limits of the trunk and inspiratory function in patients with low back pain.
A randomized comparative trial including a ...diaphragm training group that took part in conventional training together with diaphragm strengthening, and a control group that took part in conventional training only. Both groups participated in an 8-week training, 2 times/week. All subjects underwent the same measurement protocol before and after the intervention.
The study included 52 subjects with chronic low back pain.
The inspiratory functions (chest excursion, maximal inspiratory pressure, peak inspiratory flow, and volume of inspired air) and stability limits of the trunk with the subject in the sitting position (modified functional and lateral reach test) were assessed.
Maximal inspiratory pressure and stability limit tests showed a statistically significant improvement only in the diaphragm training group. Statistically significant improvements in chest excursion and peak expiratory flow tests were found in both groups; however, the improvement was more greater in the diaphragm training group.
Conventional exercises together with diaphragm training result in a greater improvement than conventional exercises alone in patients with chronic low back pain.
As proprioceptive training is popular for injury prevention and rehabilitation, we evaluated its effect on balance parameters and assessed the frequency spectra of postural sway linked with the ...various sensory channels. We recorded the Center of Mass displacement of 30 healthy student research participants (mean age = 21.63; SD = 1.29 years) with a single force plate under eyes open (EO) and eyes closed (EC) positions while standing on either a firm or foam surface, both before and after an 8-week balance training intervention on a foam surface with EC. We subjected the data to frequency power spectral analysis to find any differences between the frequency bands, linked with various sensory data. On the foam surface in the EC condition, the sway path decreased significantly after proprioceptive training, but, on the firm surface in the EC condition, there was no change. On the foam surface in the EC condition, there was also a significant decrease in frequency power postproprioceptive training in the medium-to-low frequency band. While our data indicate better posttraining balance skills, improvements were task specific to the trained condition, with no transfer of the acquired skill, even to a similar, easier condition. As training improved the middle-low frequency band, linked with vestibular signals, this intervention is better described as balance than “proprioceptive” training.
Introduction Dysthyroid optic neuropathy (DON) is a rare, severe form of thyroid eye disease, in which decreased visual acuity is accompanied by characteristic MRI findings. The treatment of DON has ...always been a challenge. Case presentation In a patient in whom visual acuity deteriorated on the left eye, mannitol 20% 200 mL followed by furosemide 40 mg 6 h later, administered daily, were initiated on the day of admission. Visual function by ophthalmology methods, and orbital compartment volumes and water content by MRI were followed. Intravenous diuretics resulted in an immediate therapeutic response. Visual acuity improved from 20/50 to 20/25 after 2 days of treatment. MRI revealed decreasing water content of both the muscle and connective tissue compartments without any volume changes. Subsequently, corticosteroids and orbital irradiation were started. Orbital decompression surgery was not required. Discussion/conclusion Edematous swelling of orbital tissues is an established contributor of local pressure increase in thyroid eye disease. Diuretics reduce orbital pressure and, if confirmed by others, may be useful additions to the standard of care in sight-threatening DON.
Key Clinical Message
The association of neuromyelitis optica concurrently with two other autoimmune diseases is rare. Neuromyelitis optica should be taken into consideration when evaluating the ...symptoms of the patient as a differential diagnostic aspect.
Intravenous thrombolysis (IVT) improves acute ischemic stroke (AIS) outcomes, but with limited success. In addition, ethanol potentiates the effect of r-tPA in ischemia models.
The effect of acute ...alcohol consumption on IVT outcomes was investigated in a retrospective cohort study. AIS patients with detectable blood alcohol concentration (BAC) during IVT were included (alcohol group;
= 60). For each case, 3 control subjects who underwent IVT but denied alcohol consumption were matched in terms of age, sex, affected brain area, and stroke severity. Outcomes were determined using the NIHSS at 7 days and the modified Rankin scale (mRS) at 90 days.
Patients were younger and had a less severe stroke than in a standard stroke study. Favorable long-term outcomes (mRS 0-2) occurred significantly more frequently in the alcohol group compared to controls (90% vs. 63%,
< 0.001). However, the rates of hemorrhagic transformation were similar. Multiple logistic regression models identified elevated BAC as a significant protective factor against unfavorable short-term (OR: 0.091, 95% CI: 0.036-0.227,
< 0.001) and long-term outcomes (OR: 0.187, 95% CI: 0.066-0.535,
= 0.002). In patients with BAC > 0.2%, significantly lower NIHSS was observed at 3 and 7 days after IVT vs. in those with 0.01-0.2% ethanol levels.
Elevated BAC is associated with improved outcomes in IVT-treated AIS without affecting safety.
Wood, as a biological material, is sensitive to environmental conditions and microorganisms; therefore, wood products require protective measures to extend their service life in outdoor applications. ...Several modification processes are available for the improvement of wood properties, including commercially available solutions. Among the chemical treatments, acetylation by acetic anhydride is one of the most effective methods to induce chemical changes in the constitutive polymers at the cellular wall level. Acetylation reduces wood shrinkage-swelling, increases its durability against biotic agents, improves UV resistance and reduces surface erosion. However, even if the expected service life for external cladding of acetylated wood is estimated to be 60 years, the aesthetics change rapidly during the first years of exposure. Hybrid, or fusion, modification includes processes where the positive effect of a single treatment can be multiplied by merging with additional follow-up modifications. This report presents results of the performance tests of wood samples that, besides the modification by means of acetylation, were additionally protected with seven commercially available coatings. Natural weathering was conducted in Northern Italy for 15 months. Samples were characterized with numerous instruments by measuring samples collected from the stand every three months. Superior performance was observed on samples that merged both treatments. It is due to the combined effect of the wood acetylation and surface coating. Limited shrinkage/swelling of the bulk substrate due to chemical treatment substantially reduced stresses of the coating film. Hybrid process, compared to sole acetylation of wood, assured superior visual performance of the wood surface by preserving its original appearance.
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