ABSTRACT
STUDY DESIGN: A case report defining an interventional procedure. OBJECTIVES: To reveal the role of the ultrasonography in nerve blocks at difficult anatomical locations of the obturator nerve. SETTING: The study was conducted in Ankara, Turkey. METHODS: A paraplegic patient with lower limb adductor spasticity treated with phenol block using the guidance of ultrasonography. RESULTS: After treatment of the adductor spasticity by obturator nerve block the patient achieved an upright standing position with a walker. Hygienic care was improved and spasticity-related pain was reduced. CONCLUSION: Ultrasound is a challenging tool for nerve blocks. Ultrasound guidance seems as an essential approach for the blocking of the nerves with variable anatomical courses, such as the obturator nerve.
Subject(s)
Muscle Spasticity/therapy , Nerve Block/methods , Paraplegia/physiopathology , Adult , Central Nervous System Agents/therapeutic use , Humans , Male , Muscle Spasticity/etiology , Muscle Spasticity/physiopathology , Obturator Nerve/diagnostic imaging , Obturator Nerve/physiopathology , Pain Management/methods , Paraplegia/etiology , Phenol , Spinal Cord Injuries/complications , Spinal Cord Injuries/physiopathology , Ultrasonography, InterventionalABSTRACT
STUDY DESIGN: Retrospective case survey. OBJECTIVE: To examine incidence and clinical characteristics of hepatitis B infection in individuals with spinal cord injury (SCI). SETTING: Inpatient clinic within a physical medicine and rehabilitation hospital specialized in rehabilitation. PARTICIPANTS: A total of 161 patients with SCI. INTERVENTIONS: Patients' records were investigated and the status of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), anti-hepatitis B surface antigen positivity, alanine aminotransferase levels, duration of hospitalization and cost were recorded. MAIN OUTCOME MEASURES: Incidence of acute hepatitis B. RESULTS: Six patients were diagnosed with acute hepatitis B on the first hospitalization for rehabilitation. A total of 11 patients (4.2%) were HBsAg positive with a previously established diagnosis of hepatitis B virus infection, 1 patient (0.4%) was anti-HCV positive. After a follow-up of 6 months, three of the acute hepatitis B patients progressed into chronic hepatitis B stage. In acute hepatitis B patients' initiation of the rehabilitation was delayed, duration of hospitalization was increased. CONCLUSIONS: After SCI, patients are at high risk of acute hepatitis B infection. A high rate of chronicity may be associated with impaired immune response, secondary to neurological deficit. Screening and vaccination protocols may prevent the spread of the hepatitis B infection, healthcare losses and financial loss.
