RECOVERY OF LUMBOSACRAL PAINS AFTER LUMBAR DISC HERNIATION SURGERY

Background. Lumbar disc herniation is a suffering with increased incidence and a tendency to continuously decrease the age at which it starts. In disc disorders where pain is accentuated during walking and resting and does not give in to medical and physical-kinetic treatment, surgical intervention is required. One of the possible complications in the operated hernia is lumbosacralgia. In this context, we believe that specific post-operative recovery treatment can improve lower back. Aims. The early application of a physical-kinetic program tailored to the particularities of patients with lumbosacralgia after lumbar disc herniation surgery can reduce their specific late symptomatology. Methods. This study, based on the experimental method, was performed from September 2013 to January 2014 on a sample of 42 subjects aged 30-60 years, patients with lumbosacralgia secondary to lumbar disc herniation. Results. The evaluation of the clinical-functional parameters specific to this pathology, registered at the beginning of the recovery treatment and 4 months after it, indicates the decrease and even the disappearance of postoperative lumbar pain, skin paresthesia and muscle contraction. There is evidence of improvement in lumbar mobility and increase the strength of paravertebral muscles. Conclusions. The analysis and interpretation of the values obtained during 4 months of systemic and individualized application of the physical-kinetic program reflects the benefits of early postoperative physiotherapy in patients with operated lumbar disc

An Integrated Approach to the Role of Neurosonology in the Diagnosis of Giant Cell Arteritis

Giant cell arteritis (GCA) is a primary vasculitis that affects especially extracranial medium-sized arteries, such as superficial temporal arteries (TAs). Three findings are important for the ultrasound (US) diagnosis of TA: „dark halo” sign, which represents vessel wall edema, stenosis, and acute occlusions. US has a high sensitivity to detect vessel wall thickening in the case of large vessels GCA. The eye involvement in GCA is frequent and consists in arteritic anterior ischemic optic neuropathies or central retinal arterial occlusion, with abrupt, painless, and severe loss of vision of the involved eye. Because findings of TAs US do not correlate with eye complications in GCA, color Doppler imaging of the orbital vessels is of critical importance (it reveals low end diastolic velocities, and high resistance index), in order to quickly differentiate the mechanism of eye involvement (arteritic, versus non-arteritic). The former should be treated promptly with systemic corticosteroids to prevent further visual loss of the fellow eye

Cerebral Veins and Dural Sinuses Thrombosis: State-of-the-Art Diagnosis

Cerebral veins and dural sinus thrombosis (CVT) represents a rare cause of stroke. In adults, CVT has a higher frequency among cases with inherited thrombophilia, mostly women, patients with malignancy, or infections. Two pathophysiological mechanisms contribute to their clinical presentation: diminution of cerebrospinal fluid absorption and increase of venular and capillary pressure. Four major syndromes have been described as isolated or in combination: intracranial hypertension, focal neurological deficits, seizures, and encephalopathy. Non-enhanced CT (NECT) of the head is the most frequently performed imaging study in the emergency department. Features of CVT on NECT can be divided into direct signs (detection of venous clot within a venous channel) and, more frequently, indirect signs (such as cerebral edema or cerebral venous infarct). CVT diagnosis is confirmed with CT venography, which can be performed immediately after NECT, and detects the venous clot as a filling defect, or magnetic resonance imaging (MRI)/MR venography. Different imaging techniques may need to be combined to avoid pitfalls. Conclusions: CVT is a relatively rare disorder in the general population and due to its wide clinical spectrum is frequently misdiagnosed upon initial examination. The knowledge of variable clinical aspects and imaging signs will be essential in providing a timely diagnosis

Motor Coordination and Its Importance in Practicing Performance Movement

The training of good motor coordination optimizes the motor skills, and these, over time, lead to the improvement of the motor skills specific to the practiced movement. The purpose of this study was to assess the capacity and speed of learning coordinated movements in the context of working in an online system. At the same time, we set out to evaluate the level of motor coordination achieved through training using the eLearning platform Hudl and the Teaching Games for Understanding approach. Thus, three groups of students were analyzed whose motor histories were different. The analysis of the three tested groups was performed in the first year of study and in the third year of study. The training programs have been adjusted/modified according to the COVID-19 pandemic situation, which has determined their application in the online system as well. The results of this study confirm that by assisting learning through computer programs, in the online system, these workouts can be effective. At the same time, the study shows us that, in addition to the natural evolution from childhood and adolescence, an advanced form of motor coordination appears, which is installed through the action of learning

The Relationship between Development of Tourism, Quality of Life and Sustainable Performance in EU Countries

Relationships between tourism development, quality of life and sustainable performance are very important topics and benchmarks in long-term policies and strategies at global, regional and local levels. Starting from the concerns expressed by researchers and international organizations, as well as the characteristics of the European region, our research aims to identify these relationships in the context of increasing pressure from stakeholders on the adoption of decisive measures in order to limit the negative effects manifested globally in the context of climate change. Using cluster analysis, we managed to identify relevant groups of countries, based on the selected variables. The results of the study highlight the existence of a positive relationship between the development of tourism and the increase of the quality of life, as between the level of sustainable performance and tourism intensity, opening the possibility of future research on the causal relationships between the selected variables and the promotion of coherent public policies that support the sustainable development

Achieving Sustainable Development Goals (SDG): Implementation of the 2030 Agenda in Romania

Romania needs a change of the current development paradigm to face the challenges of the 21st century. As a member of the European Union, leaders in Romania are is interested in implementing the principles of sustainable development at a national level to reduce development gaps, to increase citizens’ well-being, and to preserve a clean environment. The purpose of this research is to determine the implementation status of the 2030 Agenda sustainable development goals (SDG) in Romania and to explore to what extent Romania will be able to reach, for the 2030 horizon, EU average values for the selected indicators. The research is based on 107 indicators that monitored the Sustainable Development Goals (SDGs). Eurostat database (sustainable development indicators) was the source of data in terms of their availability and integrity. The research results showed that the implementation status of SDG is sub-optimal. In the case of 40 indicators out of the 107 analyzed, forecasts indicate the possibility of reaching the EU average values by 2030. However, the country can remain on the path to sustainable development only by involving all stakeholders and increasing concrete and well-targeted measures to improve SDG indicators

A Comprehensive Overview of Broca’s Aphasia after Ischemic Stroke

Aphasia denotes an acquired central disorder of language, which alters patient’s ability of understanding and/or producing spoken and written language. The main cause of aphasia is represented by ischemic stroke. The language disturbances are frequently combined into aphasic syndromes, contained in different vascular syndromes, which may suffer evolution/involution in the acute stage of ischemic stroke. The main determining factor of the vascular aphasia’s form is the infarct location. Broca’s aphasia is a non-fluent aphasia, comprising a wide range of symptoms (articulatory disturbances, paraphasias, agrammatism, anomia, and discrete comprehension disorders of spoken and written language) and is considered the third most common form of acute vascular aphasia, after global and Wernicke’s aphasia. It is caused by a lesion situated in the dominant cerebral hemisphere (the left one in right-handed persons), in those cortical regions vascularized by the superior division of the left middle cerebral artery (Broca’s area, the rolandic operculum, the insular cortex, subjacent white matter, centrum semiovale, the caudate nucleus head, the putamen, and the periventricular areas). The role of this chapter is to present the most important acquirements in the field of language and neurologic examination, diagnosis, and therapy of the patient with Broca’s aphasia secondary to ischemic stroke

Aphasic Syndromes in Cerebral Venous and Dural Sinuses Thrombosis—A Review of the Literature

Aphasia is an acquired central disorder of language that affects a person’s ability to understand and/or produce spoken and written language, caused by lesions situated usually in the dominant (left) cerebral hemisphere. On one hand aphasia has a prevalence of 25–30% in acute ischemic stroke, especially in arterial infarcts. On the other hand, cerebral venous and dural sinuses thrombosis (CVT) remains a less common and underdiagnosed cause of ischemic stroke (0.5–1% of all strokes). Aphasia has been observed in almost 20% of patients who suffered CVT. The presence of aphasia is considered a negative predictive factor in patients with stroke, severe language disorders corresponding to arduous recovery. Taking into consideration data from the literature, aphasia is also considered a predictive factor for patients with CVT; its absences, together with the absence of worsening after admission, are determinants of complete recovery after CVT. This review has as the principal role of gathering current information from the literature (PubMed database 2012–2022) regarding the clinical features of aphasic syndromes and its incidence in patients with CVT. The main conclusion of this review was that aphasic syndromes are not usually the consequence of isolated thrombosis of dural sinuses or cerebral veins thrombosis. The most frequent form of CVT that determines aphasia is represented by the left transverse sinus thrombosis associated with a posterior left temporal lesion (due to left temporal cortical veins thrombosis), followed by the superior sagittal sinus thrombosis associated with a left frontal lesion (due to left frontal cortical veins thrombosis). Only a few cases are presenting isolated cortical veins thrombosis and left thalamus lesions due to deep cerebral vein thrombosis. We also concluded that the most important demographic factor was the gender of the patients, women being more affected than men, due to their postpartum condition