Factors Associated with Medical Device Related Pressure Ulcer Caused by Ankle Foot Orthosis / The Japanese Journal of Rehabilitation Medicine

Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.

Factors Associated with Medical Device Related Pressure Ulcer Caused by Ankle Foot Orthosis / The Japanese Journal of Rehabilitation Medicine

Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.

Peripheral neuropathy induced by drinking water contaminated with low-dose arsenic in Myanmar

BACKGROUND@#More than 140 million people drink arsenic-contaminated groundwater. It is unknown how much arsenic exposure is necessary to cause neurological impairment. Here, we evaluate the relationship between neurological impairments and the arsenic concentration in drinking water (ACDW).@*PARTICIPANTS AND METHODS@#A cross-sectional study design was employed. We performed medical examinations of 1867 residents in seven villages in the Thabaung township in Myanmar. Medical examinations consisted of interviews regarding subjective neurological symptoms and objective neurological examinations of sensory disturbances. For subjective neurological symptoms, we ascertained the presence or absence of defects in smell, vision, taste, and hearing; the feeling of weakness; and chronic numbness or pain. For objective sensory disturbances, we examined defects in pain sensation, vibration sensation, and two-point discrimination. We analyzed the relationship between the subjective symptoms, objective sensory disturbances, and ACDW.@*RESULTS@#Residents with ACDW ≥ 10 parts per billion (ppb) had experienced a "feeling of weakness" and "chronic numbness or pain" significantly more often than those with ACDW  50 ppb). These data suggest a threshold for the occurrence of peripheral neuropathy due to arsenic exposure, and indicate that the arsenic concentration in drinking water should be less than 10 ppb to ensure human health.

Clinical Observation of Large-dose of Methylprednisolone Pulse Therapy for Acute Myelitis / 中国药房

OBJECTIVE:To investigate therapy efficacy of large-dose of methylprednisolone plus therapy for acute myelitis, and it effects on nerve function recovery,pyramidal tract conduction function and sensory disturbance. METHODS:A total of 116 patients with acute myelitis were randomly divided into observation group and control group,with 58 cases in each group. Both group received conventional treatment. Control group was additionally given Dexamethasone sodium phosphate injection 0.4 mg/(kg·d)intravenously,once a day;7 d later,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. Observation group was given Methylprednisolone sodium succinate injection 1000 mg intravenously,once a day;7 d lat-er,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. The treatment course in eaeh group was 1 month. The nerve function recovery time,pyramidal tract conduction function,sensory disturbance scores,clinical ef-ficacy and ADR were compared between 2 groups. RESULTS:After treatment,the response rate of observation group was signifi-cantly higher than that of control group(93.10% vs. 79.31%);the time of muscle strength improvement≥grade 2,walking down the ground,urination and defecation function recovery in observation group were all significantly shorter than control group,with statistical significance(P0.05). CONCLUSIONS:Based on conventional treatment,large-dose of methylprednisolone plus therapy shows good efficacy in the treatment of acute myelitis,which can helps to improve pyramidal tract conduction function of patients with acute myelitis,ease sensory disturbance,promote the nerve functional recovery with good safety.

Observations on the Efficacy of Acupuncture plus Bloodletting Therapy for Post-stroke Sensory Disturbance / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture plus bloodletting therapy for post-stroke limb sensory disturbance.Methods Ninety patients with post-stroke limb sensory disturbance were randomly allocated to treatment and control groups, 45 cases each. The treatment group received acupuncture plus bloodletting therapy and the control group, acupuncture alone. The disease and motor function were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the disease score and the motor function score in the two groups (P<0.05). There were statistically significant post-treatment differences in the disease score and the motor function score between the treatment and control groups (P<0.05). The total efficacy rate was 91.1% in the treatment group and 66.7% in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusions Acupuncture plus bloodletting therapy is an effective way to treat post-stroke sensory disturbance. It can improve the clinical symptoms and motor function in the patients.

Infraorbital Nerve Function Following Tailoring of Medpor(R) in Reconstruction of Inferior Orbital Wall Fracture

PURPOSE: In the orbital floor fracture, sensory impairment due to the damage of the infraorbital nerve is one of the most common symptom and complication. In this report, we have the assumption that tailoring of medpor(R) for decompression may have correlations to the damage and regeneration of the nerve. METHODS: Among patients who had open reduction for pure orbital floor fracture in our hospital from March 2005 to March 2008, we selected 80 cases. In 40 cases, we inserted tailored medpor(R), and in other 40 cases, non-tailored medpor(R) was inserted. Patient's reports were obtained and analyzed, and the pin-prick test and the 2-point discrimination test on the infraorbital nerve regions were done for testing the sensory impairments. RESULTS: The results show that the patients who adopted sculpture of medpor(R) showed higher tendency of recovery of sensory impairments in the patient's subjective report, static touch sensation, static two point discrimination using. And in postoperative 3 months, there are statistically significant recovery of sensory symptoms, signs and the result of sensory tests. CONCLUSION: From these results, tailored medpor(R) in reconstruction of orbital wall fracture may improve recovery of sensory impairments for decreasing of compression of infraorbital nerve.