Linfoma no Hodgkin mielorradicular / Spinal cord and radicular non-Hodgkins Lymphoma

Introducción: Los linfomas no Hodgkin (LNH) forman un grupo heterogéneo de neoplasias linfoides. Actualmente se reporta un aumento global de su incidencia. Estos se originan generalmente en los ganglios linfáticos, aunque pueden aparecer fuera de este, entre los que se describe el linfoma primario del sistema nervioso central, que puede afectar la médula espinal, entre otros. Objetivo: Presentar un paciente con diagnóstico de linfoma no Hodgkin con invasión mielorradicular, condición reportada con muy poca frecuencia. Caso clínico: Paciente de 47 años de edad con historia anterior de salud que comienza con neuralgia intercostal, progresivamente aparecen otros síntomas y signos neurológicos con deterioro de la función motora, se diagnostica linfoma no Hodgkin primario del Sistema Nervioso Central, se le realiza tratamiento y obtiene mejoría de los síntomas y control de la enfermedad. Conclusiones: Con el diagnóstico y tratamiento precoz de las lesiones compresivas del Sistema Nervioso Central, entre estas el LNH se puede lograr el control de la enfermedad y garantizar una adecuada calidad de vida con mejor pronóstico(AU)

Introduction: Non-Hodgkin lymphomas form a heterogeneous group of lymphoid neoplasms; a global increase in its incidence is currently reported. These usually originate in the lymph nodes, although they may appear outside the lymph node, among which primary lymphoma of the central nervous system, which can affect the spinal cord, is described, among others. Objective: To present a patient with a diagnosis of non-Hodgkin lymphoma with myelodradicular invasion, a condition reported very infrequently. Clinical case: A 47-year-old patient with a previous history of health that begins with intercostal neuralgia, other neurological symptoms and signs with impaired motor function appear progressively, primary non-Hodgkin lymphoma of the Central Nervous System is diagnosed, treatment is performed and Obtain improvement of symptoms and disease control. Conclusions: With the diagnosis and early treatment of the compressive lesions of the Central Nervous System, among these the NHL can control the disease and guarantee an adequate quality of life with a better prognosis(AU)

The effect of "paraplegic triple needling" combined with rehabilitation training on psychological and daily living ability of patients with spinal cord injury / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of "paraplegic triple needling" and conventional needling on psychological and daily living ability of patients with spinal cord injury.</p><p><b>METHODS</b>A total of 50 patients with spinal cord injury were randomized into an observation group and a control group, 25 cases in each one. Rehabilitation training was applied in the two groups. In the observation group, on the basis of rehabilitation training, "paraplegic triple needling" was added, namely, puncturing the governor vessel (GV) and back- points respectively in the upper and lower segments of the injury plane and locating the key muscle movement points of the lower extremities by the peripheral nerve electrical stimulation device. Electroacupuncture (EA) was given at the points up and down the two sections of the GV points, back- points, the key muscle movement points. In the control group, conventional needling was applied at the points of GV, back- points, Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Yanglingquan (GB 34). The treatment was given once a day, the treatment for a month as one course and a total of 2 course were required. In addition, 25 health checkers were selected at the physical examination center of General Hospital of Chengdu Military Region as a normal control group. The content of peripheral serum 5-hydroxy tryptamine (5-HT) was tested before treatment, 1 course and 2 courses of treatment, The modified Barthel index (MBI) was used to observe the daily living activities, the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the psychological status.</p><p><b>RESULTS</b>In the two groups, the content of serum 5-HT was lower than that in the normal control group before treatment (both <0.05). After one course of treatment, the MBI score and content of serum 5-HT were all increase in the two groups; the HAMA score and HAMD score were all reduced (all <0.05); the results in the observation were better than those in the control group (all <0.05). After 2 courses of treatment, the MBI score and content of serum 5-HT were all increased in the two groups, and the HAMA score and HAMD score were all reduced (all <0.05), but the difference was not significant statistically between the two groups (all >0.05). Pearson correlation analysis showed that the content of serum 5-HT in patients with spinal cord injury was negatively correlated with disease course, HAMA and HAMD score (all <0.05), and positively correlated with MBI score (<0.05).</p><p><b>CONCLUSION</b>There are differences in the content of serum 5-HT between the normal person and the patients with pinal cord injury. The content of serum 5-HT can early predict the depression and anxiety in patients with spinal cord injury. Compared with the conventional needling, "paraplegic triple needling" can improve depression and anxiety in the early stage and improve the daily living ability of patients with spinal cord injury.</p>

Digital controller design considering hardware constraints: application in a paraplegic patient

INTRODUCTION: A methodology was developed for implementing closed-loop control algorithms and for evaluating the behavior of a system, considering certain component restrictions used in laboratory implementation. METHODS: Mathematical functions representing a model of the biological system were used for knee extension/flexion movements. A Proportional Integral Derivative (PID) controller and another one using the root locus method were designed to control a patient’s leg position by applying functional electrical stimulation (FES). The controllers were simulated in Matlab and ISIS Proteus. After the simulations were performed, the codes were embedded in a microcontroller, and tests were conducted on a paraplegic volunteer. To the best of the authors’ knowledge, this is the first time that ISIS Proteus software resources have been used prior to implementing a closed-loop system designed to control the leg position of patients. RESULTS:This method obviates the application of initial controller tests directly to patients. The response obtained in the experiment with a paraplegic patient complied with the specifications set in terms of the steady-state error, the settling time, and the percentage overshoot. The proposed procedure was successfully applied for the implementation of a controller used to control the leg position of a paraplegic person by electrical muscle stimulation. CONCLUSION:The methodology presented in this manuscript can contribute to the implementation of analog and digital controllers because hardware limitations are typically not taken into account in the design of controllers.

Avaliação cinemática da transferência de paraplégicos da cadeira de rodas / Kinematic assessment of transfer of paraplegic subjects from the wheelchair

OBJETIVO: Avaliar a estratégia das transferências de paraplégicos da cadeira de rodas. MÉTODOS: Participaram do estudo doze sujeitos lesados medulares (T2 a T12), aptos a realizar independentemente a transferência da cadeira de rodas para um tablado com um metro quadrado (m²) de área por meio metro de altura. As imagens de marcadores reflexivos nos pontos anatômicos foram capturadas por seis câmeras de infravermelho ProReflex e processadas através de um software específico (QTrac). Parâmetros cinemáticos do tronco, cabeça, ombros e cotovelos foram avaliados. RESULTADOS: Os dados analisados comparam o lado preferencial do sujeito para realizar a transferência com o lado não preferencial, de acordo com as funções desempenhadas de cada segmento corporal. O deslocamento angular da cabeça no plano sagital (y-z) e ombros no plano transversal (x-y) mostraram significâncias estatísticas (p<0,05). Conclusão: Os dados obtidos neste estudo mostraram que há diferenças na estratégia da transferência dos paraplégicos do lado preferencial em comparação com o lado não preferencial. Nível de Evidência II, Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com padrão de evidência "ouro" aplicado).

OBJECTIVE: To evaluate the transfer strategy of paraplegic subjects from their wheelchairs. METHODS: Twelve thoracic spinal cord injured subjects participated in this study (T2 to T12). The subjects were able to independently transfer from a wheelchair to a one square meter (m2) table, half a meter in height. Images of reflexive anatomic markers were captured by six ProReflex infrared cameras and processed using a QTRac Capture software. Kinematic parameters of the trunk, head, shoulders and elbows were evaluated. RESULTS: The data analyzed compared the subjects' preferential side for performing transfers, according to the functions performed by each body segment. Angular displacement of the head on sagittal plan (y-z), and the shoulders on the transversal plan (x-y), showed statistical differences (p<0.05). Conclusion: the data obtained on this study showed that there are differences in transfer strategies of paraplegic subjects to their preferential side, in comparison with the non-preferential side. Level of Evidence II, Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard).

Research in clinical application of a special stool collector for paraplegic patients / 中国实用护理杂志

Objective To develop a special stool collector for paraplegic patients with constipation,and to observe the clinical effects. Methods 52 paraplegic patients with constipation were divided into group A(30 cases) and group B(22 cases ).Group A used type one stool collector and goup B chose type two stool collector. The time of dealing with defecation, exposure time, pollution area, the usage of urinal pad, toilet paper, clean water before and after the special toilets were observed between the two groups. Results Each indicator significantly changed after using two types of stool collectors in the two groups of patients and above were significantly decreased. Conclusions The special stool collector for the paraplegic patients with constipation can effectively avoid the soakage of the anal and buttocks skin, reduce the environment pollution of the odor, reduce labor intensity and lower care costs.

A BATTERY OF FIELD TESTS FOR PREDICTING THE GENERAL PHYSICAL FITNESS LEVEL OF MALE PARAPLEGICS IN ACTIVE DAILY LIFE / 体力科学

<b>Purpose:</b> To investigate the factorial structure of physical fitness of male paraplegics with thoracic or lumbar spinal cord injury and to develop a battery of field tests for predicting their general physical fitness level.<b>Methods:</b> Fifty-three active male paraplegics with spinal cord injury (PSCI) (age range: 18-54; spinal cord injury level: T4 to L4) were examined. Thirteen feasible variables were selected using physical fitness components based on the International Committee for the Standardization of Physical Fitness Tests and previous PSCI studies. Factor analysis was applied to 14 variables; 13 of these involved physical fitness tests stratified by age to determine the factorial structure of physical fitness variables. Multiple regression analysis was performed to obtain a linear regression equation using a representative variable for each factor in the factorial structure as an independent variable. A first principal component score was obtained by principal component analysis using each variable as a dependent variable.<b>Results:</b> For factorial structure, wheelchair driving ability (3-minute shuttle run), body composition (sebum thickness), respiratory function (vital capacity) and shoulder joint extension force factors were obtained. The results of multiple regression analysis involved 5 variables (the 4 above-mentioned variables plus age); and the first principal component score of each subject from all variables provided a significant linear regression equation (r = 0.934, <i>P</i> ＜0.01) when the body composition factor was excluded.<b>Conclusions:</b> The representative measurement variables obtained from the factorial structure allowed for the development of a battery of field tests for predicting general physical fitness level of PSCI.

Clinical Results of Radiofrequency Dorsal Root Entry Zone Coagulation for Paraplegic Pain

OBJECTIVE: Dorsal root entry zone(DREZ) operation has been the most common surgical treatment for paraplegic pain in the past, but the results differ according to the patients. In this study, we attempt to analyze the results from the patients by the different patterns of the pain before the surgery. METHODS: A total of twelve paraplegic patients have undergone a total of thirteen radiofrequency DREZ coagulation procedures between April 1994, and March 2003. The patients were divided depending on patients' subjective description on the character, frequency, and range of pain. RESULTS: The patients were divided into the two groups, postoperatively: improvement of more than 75% of pain was defined as treatment success, and any level less than 75% of improvement was defined as treatment failure. Eight of the ten mechanical pain group cases were regarded as treatment success, and remaining two cases with thermal type of pain as treatment failure. Also, one case with combined pain failed to obtain any favorable outcome. Intermittent pain group (6 of 7 cases), continuous pain group (2 of 6 cases), and localized pain group (7 of 11 cases) showed treatment success, respectively. However, diffuse pain group (1 of 2 cases) resulted in poor outcome. CONCLUSION: Radiofrequency DREZ coagulation is more effective in managing intermittent and/or mechanical pain than continuous and/or thermal pain in the paraplegic patients following spinal cord injury.

3-D center of gravity mapping:a new method for assessment of FES-assisted paraplegic walking efficiency / 中华物理医学与康复杂志

Objective To explore a new method for assessing the walking efficiency of the paraplegic patients assisted by functional electrical stimulation (FES). Methods The measurement system based on a standard walker was developed. During FES assisted walking of the paraplegic, the real time of the upper limb support were obtained and transformed into a 3 D center of gravity (CG) motion map with a paraplegic upper body mechanical model to describe the CG motion locus. Then the FES efficiency indicated by walking balance condition was assessed objectively and quantitatively. Results In this design, the pilot study of a paraplegic patient undergoing walking training with FES showed that the force accuracy was better than 1.01%, nonlinearity was less than 0.8%, and crosstalk was less than 3.2%. Conclusion The results showed that this system may be used as 1) an evaluation index of FES assisted paraplegic walking efficiency, 2) a balance control indicator during FES assisted paraplegic walking training and 3) a feed back signal to choose an efficient FES pattern and sequence.

Long-term Effects of Tangshan Earthquake on Psychosomatic Health of Paraplegic Suffers / 中国心理卫生杂志

Objective: To study the long-term effect of Tangshan earthquake on psychosomatic health of paraplegic suffers. Method: 64 paraplegic suffers of Tangshan earthquake and 64 normal controls were interviewed and assessed with self made questionnaire for psychosomatic health, SCL-90, SAS, SDS, CMI (Cornell Medical Index) and SSRS (Social Support Rating Scale). Results: 6 patients (9%) were diagnosed as PTSD according to CCMD-2-R, this rate was higher than that of normal citizen experienced the earthquake. 32 patients had Acute Stress Reaction. At present, patients' group had poorer mental health than control reflected by SCL-90, SAS, SDS and CMI. Conclusion: The severity of trauma both mentally and physically has great influence on mental health of suffers even after 25 years.