Microtrauma

  • 文章类型: Journal Article
    利用常规孔眼导管(CEC)进行膀胱引流的间歇性导管插入术(IC)长期以来一直是护理标准。然而,当下尿路组织靠近孔眼时,经常发生粘膜抽吸,导致微创伤.这项研究调查了用具有多个微孔的排水区代替常规孔眼的影响,分布压力在一个更大的区域。较低的压力限制了周围组织吸入这些微孔,显着减少组织微创伤。使用体外模型复制膀胱的腹内压力状况,在引流期间测量导管内压力.当粘膜抽吸发生时,记录导管内图像.随后受影响的组织样品进行组织学研究。发现由粘膜抽吸引起的负压峰值对于CEC非常高,导致膀胱尿路上皮脱落和尿路上皮屏障破坏。然而,具有多孔眼引流区的微孔区导管(MHZC)显示出明显较低的压力峰值,峰值强度低4倍以上,因此诱发的微创伤要小得多。限制或甚至消除粘膜抽吸和导致的组织微创伤可以有助于在体内更安全的导管插入和增加患者的舒适度和顺应性。
    Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    腕管综合征(CTS)是由腕管正中神经受压引起的最常见类型的压迫性神经病。癫痫的特征在于由脑中的异常神经元放电引起的复发性癫痫发作。这项研究旨在调查癫痫和腕管之间是否存在联系,如果是,潜在因素。
    两百名癫痫患者被纳入本研究。患者的癫痫病史,癫痫发作类型,和癫痫发作频率进行了评估。Tinel,Phalen,对主诉与正中神经病相匹配的患者进行了Flick体格检查。癫痫患者和临床诊断腕管综合征完成波士顿腕管综合征问卷,并进行神经传导研究。比较腕管综合征患者癫痫发作类型与发作频率的关系。
    与局灶性运动发作性癫痫相比,在局灶性发作的双侧强直阵挛性癫痫发作中,发现腕管综合征的风险高出88.7倍.癫痫发作频率为每月一次或更多的患者的CTS风险比每周一次或更多的患者低0.704倍(p=0.026)。
    癫痫患者,尤其是那些频繁发作或特定发作类型的人,可能更容易受到重复的手腕屈伸姿势的影响。因此,在临床随访期间,了解癫痫患者是否存在腕管综合征很重要。
    UNASSIGNED: Carpal tunnel syndrome (CTS) is the most common type of entrapment neuropathy caused by compression of the median nerve in the carpal tunnel. Epilepsy is characterised by recurrent seizures caused by abnormal neuronal discharges in the brain.This study aimed to investigate whether there is a link between epilepsy and carpal tunnel and, if so, the underlying factors.
    UNASSIGNED: Two hundred patients with epilepsy were included in this study. The patients\' history of epilepsy, seizure type, and seizure frequency were assessed. The Tinel, Phalen, and Flick physical examination tests were performed on patients with complaints that matched those of median nerve neuropathy. Patients with epilepsy and clinically diagnosed carpal tunnel syndrome completed the Boston Carpal Tunnel Syndrome Questionnaire, and nerve conduction studies were performed. The relationship between seizure type and frequency in patients with carpal tunnel syndrome was compared.
    UNASSIGNED: Compared to focal-aware motor-onset seizures, the risk of detecting carpal tunnel syndrome was 88.7 times higher in focal-onset bilateral tonic-clonic seizures. Patients with a seizure frequency of one per month or more had a 0.704 times lower risk of CTS than those with a frequency of one per week or more (p = 0.026).
    UNASSIGNED: Patients with epilepsy, especially those experiencing frequent seizures or specific seizure types, may be more susceptible to repetitive wrist flexion-extension postures. Therefore, during clinical follow-up, it is important to inquire about the presence of carpal tunnel syndrome in patients with epilepsy.
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  • 文章类型: Journal Article
    这项研究旨在通过研究饮食诱导的肥胖(DIO)小鼠通过有规律的跑步方案暴露于神经创伤的影响来模拟人类Charcot神经病性关节病的变化。
    在6周龄时获得48只雄性野生型C57BL/6J小鼠,并分为2组进行饮食分配。经过一周的适应期,一半的小鼠随意摄入高脂肪饮食(60%脂肪,kcal)以促进神经性饮食诱导的肥胖,而另一半是对照小鼠,并摄入年龄匹配的标准低脂肪对照饮食(10%脂肪,kcal).在12周龄时,每组一半的动物接受了高强度倾斜跑步机跑步方案,先前已被证明会引起神经创伤。定期进行感官测试和射线照相分析。杀死后进行组织病理学分析。
    DIO小鼠的体重明显升高,更高的身体脂肪百分比,与在整个实验中饲喂正常饮食的野生型对照小鼠相比,骨矿物质密度较低(每组P<.001)。DIO小鼠在第1周表现出显著降低的感觉功能(P=0.005),并且随着时间的推移而恶化,到第10周时,需要增加20.6%的力量来撤回爪子(P<.001)。与正常饮食的小鼠相比,在所有时间点跑的DIO小鼠表现出更大的中足半脱位和骨不稳定性(P<.001)。组织病理学分析显示,与运行的对照相比,运行的DIO小鼠表现出显著的变化(每个参数P<.001)。
    观察到的变化类似于在人类糖尿病Charcot神经病性关节病中发现的关节破坏中或之前观察到的最早变化。
    目前尚无治疗Charcot神经病性关节病的标准。这项研究建立了一种动物模型的方案,可用于研究和比较治疗这种疾病的干预措施。
    This study aimed to mimic the changes from Charcot neuropathic arthropathy in humans by examining the effects of exposing diet-induced obese (DIO) mice to neurotrauma through a regimented running protocol.
    Forty-eight male wild-type C57BL/6J mice were obtained at age 6 weeks and separated into 2 groups for diet assignment. After a 1-week acclimation period, half of the mice consumed a high-fat diet (60% fat by kcal) ad libitum to facilitate neuropathic diet-induced obesity whereas the other half were control mice and consumed an age-matched standard low-fat control diet (10% fat by kcal). At age 12 weeks, half of the animals from each group were subjected to a high-intensity inclined treadmill running protocol, which has been previously demonstrated to induce neurotrauma. Sensory testing and radiographic analyses were periodically performed. Histopathologic analyses were performed post killing.
    DIO mice had significantly higher bodyweights, higher body fat percentages, and lower bone mineral density than wildtype control mice that were fed a normal diet throughout the experiment (P < .001 for each). DIO mice displayed significantly reduced sensory function in week 1 (P = .005) and this worsened over time, requiring 20.6% more force for paw withdrawal by week 10 (P < .001). DIO mice that ran demonstrated greater midfoot subluxation and tarsal instability over all time points compared with normal-diet mice that ran (P < .001). Histopathologic analyses revealed that DIO mice that ran demonstrated significant changes compared with controls that ran (P < .001 for each parameter).
    Changes akin to the earliest changes observed in or before joint destruction identified in diabetic Charcot neuropathic arthropathy in humans were observed.
    There is currently no standard of treatment for patients with Charcot neuropathic arthropathy. This study establishes a protocol for an animal model that can be used to study and compare interventions to treat this disease.
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  • 文章类型: Case Reports
    运动损伤发生在体育运动中,或锻炼。然而,有一些病变通常与运动有关,在像泰拳这样要求苛刻的身体运动中,还没有发现典型的病变。我们对文献进行了叙述性回顾,以突出这项运动的典型病变,以分析这些疾病的鉴别诊断。
    一位28岁的女性,泰拳运动员16年来,有6个月的历史,在右胫骨干phy端外侧部分持续疼痛。压力伤害之间的区别,恶性骨肿瘤,和肿瘤样病变后重复的微创伤后的运动活动可能是困难的。诊断方法涉及常规X射线,echotomography,计算机断层扫描,和磁共振成像扫描有争议的发现。活检证实最终诊断为非骨化性纤维瘤。
    本病例报告的目的是展示一名专业泰拳运动员胫骨疼痛的诊断中的挑战,并讨论这类患者在文献中人口有限的临床表现。我们的案例说明,即使是现代成像技术也不能总是区分由运动引起的肿瘤和肿瘤样病变;同时记住我们永远不应该过于关注特定的特征遗忘,甚至是罕见的病变如金刚烷胺瘤。
    UNASSIGNED: Sports injuries occur during sport athletic activities, or exercising. However, there are some lesions which are typically associated to sports, in such a demanding and physical sport like Muay Thai that no typical lesion has been detected yet. We performed a narrative review of the literature to highlight the typical lesions of this sport to analyze the differential diagnosis of those conditions.
    UNASSIGNED: A 28-year-old female, Muay Thai athlete since 16 years, presented with a 6 months history of a persistent pain in the metaphyseal lateral part of the right tibia. Differentiation between stress injuries, malignant bone tumors, and tumor-like lesions after repetitive microtrauma following sport activities can be difficult. The diagnostic approach involved conventional X-ray, echotomography, computed tomography scan, and magnetic resonance imaging scan with controversial findings. The biopsy confirmed the final diagnosis of non-ossifying fibroma.
    UNASSIGNED: The purpose of this case report is to exhibit the challenges in the diagnosis of a professional Muay Thai athlete with tibial pain and to discuss the clinical presentation of this type of patients with a limited population in the literature. Our case illustrates that even modern imaging techniques cannot always distinguish between tumor and tumor-like lesions caused by sports; meanwhile remembered us that we should never be too focused on a particular characteristic forgetting even rare pathologies as adamantinoma.
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  • 文章类型: Journal Article
    丛状神经纤维瘤是一种罕见的良性肿瘤,是神经纤维瘤病的一种特殊亚型。本报告是文献综述,其中一例患者因轻微创伤而在右下面部神经纤维瘤切除部位观察到面部出血。通过PubMed搜索,使用术语((面部血肿)或(面部出血))和(神经纤维瘤病),确认了86篇文章,最终选择5篇相关文章(6例患者)。六个病人中,其中2人曾接受过栓塞治疗.然而,因此,所有患者均接受开放手术切除血肿.提到的止血方法是血管结扎(5例),低血压麻醉(两名患者),术后输血(4例)。总之,在神经纤维瘤病患者中,自发性或轻微创伤性出血是可能的.在大多数情况下,它可以通过在降压麻醉下的血管结扎来解决。可选地,可以使用预先栓塞和补充组织粘合剂。
    Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas. The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.
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  • 文章类型: Journal Article
    距骨的骨软骨损伤(OLTs)是发生在physis闭合之前的病变,通常与急性踝关节创伤有关。由于最初损伤后出现的肿胀和炎症,这些病变通常难以诊断。越来越多的文献评估了OLT在成年人口中的影响。然而,在青少年人群中研究这些病变的文献很少。这次审查的目的是提供对OLT的透彻了解,特别关注青少年人口。我们评估了有关各种手术治疗结果的最新文献;儿科患者的方式。虽然小儿OLT手术治疗后的结果通常是有利的,这一人口统计调查的缺乏令人震惊。需要进一步的研究,以更好地告知从业者和家庭关于这些结果,因为治疗计划高度依赖于所讨论的个体患者。
    Osteochondral lesions of the talus (OLTs) are lesions that occur before the physis closes and are frequently associated with acute ankle trauma. These lesions are often difficult to diagnose due to swelling and inflammation that are present after the initial injury. A growing body of literature has assessed the effects of OLTs in the adult population. However, the literature examining these lesions in the juvenile population is sparse. The purpose of this review is to provide a thorough understanding of OLTs, with a specific focus on the juvenile population. We evaluate the recent literature regarding the outcomes of various surgical treatment; modalities in the pediatric patient. While the outcomes after surgical treatment of pediatric OLTs are generally favorable, the paucity of investigation in this demographic is alarming. Further research is needed to better inform practitioners and families regarding these outcomes, as treatment plans are highly dependent on the individual patient in question.
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  • 文章类型: Randomized Controlled Trial
    OBJECTIVE: To evaluate the effect of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement (OTM) during en masse anterior retraction.
    METHODS: Twenty patients were randomly allocated into experimental and control group of 10 each. In the control group, en masse retraction was performed with sliding mechanics with a coil spring. In the experimental group after alignment and levelling, MOPs were performed mesially and distally to all six anterior teeth in the interdental cortical region on the labial aspect of both arches. MOPs were performed at the beginning of space closure (T0) and 1 month after beginning of space closure (T1). En masse retraction was performed with sliding mechanics with a coil spring. Measurements were recorded on digital models made from scanned plaster casts at the beginning of space closure (T0) and monthly at each follow-up visit for the next 4 months (T1, T2, T3, T4). The monthly rate of OTM, the overall rate of OTM, and the difference between OTM in the MOP period (T0-T2) and post-MOP (T2-T4) period in the experimental and control group were evaluated. A visual analogue scale (VAS) was used to evaluate patients\' pain experience.
    RESULTS: The overall rate of OTM was significantly greater in the experimental group for both arches in the MOP period (T0-T2) and also in the post-MOP period (T2-T4) as compared to the control group. Within the experimental group, the rate of OTM in the MOP period was significantly greater than in the post-MOP period, which in turn was greater than that of the control group. The patients reported only mild discomfort for 24 h after performing the MOPs, which then gradually decreased.
    CONCLUSIONS: The use of MOPs is effective in increasing the rate of en masse tooth retraction in both the maxillary and the mandibular arch. The rate of tooth movement was greater even in the post-MOP period as compared to the control group.
    UNASSIGNED: ZIELSETZUNG: Untersucht werden sollten die Auswirkungen von Mikro-Osteoperforationen (MOPs) auf die Geschwindigkeit der kieferorthopädischen Zahnbewegung (OTM) während einer En-masse-Retraktion im Frontzahnbereich.
    METHODS: Zwanzig Patienten wurden randomisiert in eine Versuchs- und eine Kontrollgruppe mit jeweils 10 Patienten eingeteilt. In der Kontrollgruppe wurde die En-masse-Retraktion mit einer Gleitmechanik und einer Zugfeder durchgeführt. In der Versuchsgruppe wurden nach der Ausrichtung und Nivellierung MOPs mesial und distal an allen 6 Frontzähnen in der interdentalen Kortikalregion auf der labialen Seite beider Zahnbögen durchgeführt. Die MOPs wurden zu Beginn des Lückenschlusses (T0) und einen Monat nach Beginn des Lückenschlusses (T1) durchgeführt. Die En-masse-Retraktion wurde mit einer Gleitmechanik und einer Zugfeder durchgeführt. Die Messungen wurden auf digitalen Modellen aufgezeichnet, die aus eingescannten Gipsabdrücken zu Beginn des Lückenschlusses (T0) und monatlich bei jeder Nachuntersuchung in den nächsten 4 Monaten (T1, T2, T3, T4) erstellt wurden. Die monatliche OTM-Rate, die Gesamtrate der OTM und der Unterschied zwischen der OTM in der MOP-Periode (T0-T2) und in der Post-MOP-Periode (T2-T4) in der Versuchs- und in der Kontrollgruppe wurden bewertet. Zur Einschätzung des Schmerzempfindens der Patienten wurde eine visuelle Analogskala (VAS) verwendet.
    UNASSIGNED: Die Gesamtrate der OTM war in der Versuchsgruppe für beide Zahnbögen in der MOP-Periode (T0-T2) und auch in der Post-MOP-Periode (T2-T4) im Vergleich zur Kontrollgruppe signifikant höher. In der Versuchsgruppe war die OTM-Rate in der MOP-Periode signifikant höher als in der Post-MOP-Periode, die wiederum höher war als die der Kontrollgruppe. Die Patienten berichteten über 24 h lang nach Durchführung der MOP andauernde, nur geringe, dann allmählich abnehmende Beschwerden.
    UNASSIGNED: Die Anwendung von MOPs ist effektiv, um die Geschwindigkeit einer En-masse-Retraktion von Zähnen sowohl im Ober- als auch im Unterkiefer zu erhöhen. Die Geschwindigkeit der Zahnbewegung war sogar in der Zeit nach der MOP höher als in der Kontrollgruppe.
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  • 文章类型: Journal Article
    目的:大脚趾甲(CMGT)的先天性排列不良是指甲器械的特发性偏差。CMGT使患者容易遭受反复的压力,微创伤,和继发性并发症。这项研究的目的是回顾当前发表的照片,以确定CMGT变体与消失的甲床(DNB)之间的关系。
    方法:在PubMed和Google中使用大脚趾甲的先天性不对准术语进行搜索,消失的甲床,并进行了横向指甲偏移。在总共35篇文章中发现的53张照片中,23由于图片分辨率低或角度差而被取消资格。对剩余的30张照片进行评价。在30张照片中的22张发现了与营养不良和DNB相关的纯指甲不对齐。30例中有4例显示出远端指骨的纯偏离,与指甲营养不良,但最小的DNB。其余4例表现为脚趾偏差和指甲单位偏差的组合,并伴有不同程度的DNB。
    结论:DNB与所有形式的纯CMGT相关。此外,在8张照片中注意到远端指骨的排列不良。这对于进一步的研究和治疗以纠正继发性并发症具有潜在的意义。
    OBJECTIVE: Congenital malalignment of the great toenail (CMGT) is an idiopathic deviation of the nail apparatus. CMGT predisposes patients to recurrent stress forces, microtrauma, and secondary complications. The purpose of this study was to review the current published photographs to determine the relationship between variants of CMGT and the disappearing nail bed (DNB).
    METHODS: A search in PubMed and Google using the terms congenital malalignment of the great toenail, disappearing nail bed, and lateral nail deviation was performed. Of the 53 photographs found in a total of 35 articles, 23 were disqualified due to low picture resolution or poor angle. The remaining 30 photographs were evaluated. Pure nail malalignment with associated dystrophy and DNB was found in 22 of 30 photographs. Four of 30 cases demonstrated pure deviation of the distal phalanx, with nail dystrophy but minimal DNB. The remaining 4 cases demonstrated a combination of toe deviation and nail unit deviation with varying degrees of DNB.
    CONCLUSIONS: DNB was associated with all forms of pure CMGT. Moreover, a variant of malalignment of the distal phalanx was noted in 8 photographs. This has potential implications for further studies and treatment to correct secondary complications.
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