Outpatient Physical Therapy Management of a Patient with Thoracic outlet Syndrome and Cervical Radiculopathy: A Case Report

Background and Purpose. Thoracic Outlet Syndrome is a condition that produces symptoms of pain, numbness, and weakness that may affect the arm, shoulder, or neck. Similarly, cervical radiculopathy is a condition resulting from the compression of cervical nerve roots. The purpose of this case report is to describe an appropriate outpatient physical therapy intervention program for a 69-year-old male who has the diagnoses of cervical radiculopathy, impaired cervicothoracic mobility, and thoracic outlet syndrome. Case Description. The patient had a significant past medical history including coronary artery disease, chronic pain, and a C4-C5 fusion. His primary goal was to decrease his pain and neural symptoms. Intervention. Treatment included manual therapy techniques including cervical distraction and mobilizations, therapeutic exercises and therapeutic activities focused on strengthening postural muscles. Outcomes. The patient reported decreased pain, improved cervical range of motion, improved tolerance to activity, and decrease in neural symptom frequency, intensity, and duration. Discussion. This case report may suggest a benefit of conservative physical therapy intervention for the management of Thoracic Outlet Syndrome and cervical radiculopathy

Sensory-motor deficits and neurofilament disorganization in gigaxonin-null mice

International audienceABSTRACT: BACKGROUND: Giant Axonal Neuropathy (GAN) is a fatal neurodegenerative disorder with early onset characterized by a severe deterioration of the peripheral and central nervous system, involving both the motor and sensory tracts and leading to ataxia, speech defect and intellectual disabilities. The broad deterioration of the nervous system is accompanied by a generalized disorganization of the intermediate filaments, including neurofilaments in neurons, but the implication of this defect in disease onset or progression remains unknown. The identification of gigaxonin, the substrate adaptor of an E3 ubiquitin ligase, as the defective protein in GAN allows us to now investigate the crucial role of the gigaxonin-E3 ligase in sustaining neuronal and intermediate filament integrity. To study the mechanisms controlled by gigaxonin in these processes and to provide a relevant model to test the therapeutic approaches under development for GAN, we generated a Gigaxonin-null mouse by gene targeting. RESULTS: We investigated for the first time in Gigaxonin-null mice the deterioration of the motor and sensory functions over time as well as the spatial disorganization of neurofilaments. We showed that gigaxonin depletion in mice induces mild but persistent motor deficits starting at 60 weeks of age in the 129/SvJ-genetic background, while sensory deficits were demonstrated in C57BL/6 animals. In our hands, another gigaxonin-null mouse did not display the early and severe motor deficits reported previously. No apparent neurodegeneration was observed in our knock-out mice, but dysregulation of neurofilaments in proximal and distal axons was massive. Indeed, neurofilaments were not only more abundant but they also showed the abnormal increase in diameter and misorientation that are characteristics of the human pathology. CONCLUSIONS: Together, our results show that gigaxonin depletion in mice induces mild motor and sensory deficits but recapitulates the severe neurofilament dysregulation seen in patients. Our model will allow investigation of the role of the gigaxonin-E3 ligase in organizing neurofilaments and may prove useful in understanding the pathological processes engaged in other neurodegenerative disorders characterized by accumulation of neurofilaments and dysfunction of the Ubiquitin Proteasome System, such as Amyotrophic Lateral Sclerosis, Huntington's, Alzheimer's and Parkinson's diseases

Use of Long-Acting Injectable Antipsychotics in Inpatients with Schizophrenia Spectrum Disorder in an Academic Psychiatric Hospital in Switzerland

Long-acting injectable antipsychotics (LAIs) offer many benefits to patients with schizophrenia spectrum disorder (SSD). They are used with very different frequencies due to questions of eligibility or patients and prescribers’ attitudes towards LAI use. We assessed the prescribing rates of LAIs in a large academic psychiatric hospital with a public service mandate in Switzerland and compared them with other countries and health care systems. To our knowledge, this study is the first to investigate inpatient LAI use in Europe. Medical records of all patients diagnosed with SSD discharged from the Clinic of Adult Psychiatry of the University Hospital of Psychiatry Zurich over a 12 month period from January to December 2019 were evaluated regarding the prescribed antipsychotics at the time of discharge. The rates of use of LAIs among all patients and among patients receiving LAI-eligible antipsychotic substances were assessed retrospectively. We assessed records of 885 patients with SSD. Among all cases, 13.9% received an LAI. Among patients who received antipsychotic medication that was eligible for LAI use (n = 434), 28.1% received an agent as an LAI. LAI use included paliperidone palmitate (69.9%), aripiprazole monohydrate (14.6%), risperidone (4.9%) and first-generation LAIs (9.8%). Compared to international frequencies of LAI administration, the prescription rate of LAIs in SSD patients was low. Further studies will evaluate patient- and prescriber-related reasons for this low rate

An Electromagnetically Excited Silicon Nitride Beam Resonant Accelerometer

A resonant microbeam accelerometer of a novel highly symmetric structure based on MEMS bulk-silicon technology is proposed and some numerical modeling results for this scheme are presented. The accelerometer consists of two proof masses, four supporting hinges, two anchors, and a vibrating triple beam, which is clamped at both ends to the two proof masses. LPCVD silicon rich nitride is chosen as the resonant triple beam material, and parameter optimization of the triple-beam structure has been performed. The triple beam is excited and sensed electromagnetically by film electrodes located on the upper surface of the beam. Both simulation and experimental results show that the novel structure increases the scale factor of the resonant accelerometer, and ameliorates other performance issues such as cross axis sensitivity of insensitive input acceleration, etc

Bioaktive Restaurationsmaterialien in der Zahnerhaltung

Over the last years, bioactive glass particles have been successfully incorporated in dental restorative materials. Remineralizing effects on dental hard tissue and antibacterial properties are promising properties of these customized composites. A few materials doped with bioactive fillers are already available on the dental market. Nevertheless, further research is required to fine-tune bioactive composites for biomimetic restorative approaches. Sind mit bioaktiven Füllpartikeln modifizierte Komposite zukunfts weisende Materialien? Dieser Artikel informiert über ihre wichtigsten Eigenschafte

Effect of Bioactive and Antimicrobial Nanoparticles on Properties and Applicability of Dental Adhesives

The aim of the study was to examine the applicability of bioactive and antibacterial nanoparticles to an experimental adhesive. The adhesive (60 wt% BisGMA, 15 wt% TEGDMA, 25 wt% HEMA) was mixed with combinations of 5 wt% methacryl-functionalized polyhedral oligomeric silsesquioxane (MA-POSS) and one kind of bioactive/antibacterial nanoparticles: 1 wt% core-shell silica-silver nanoparticle (SiO2@Ag), 1 wt% bioactive glass with bismuth (BAG-Bi) or 1 wt% calcium phosphate (CAP). Pure adhesive served as control. The physicochemical (degree of conversion (DC), linear shrinkage (LS), shear and complex viscosity, water sorption (WS), sol fraction (SF)), biological (antimicrobial effect) and bioactive (mineral precipitation) properties were investigated. DC and LS remained unchanged. The combination of BAG-Bi/MA-POSS resulted in a significantly increased WS and SF compared to control. In addition, the combination of CAP/MA-POSS slightly increased the shear viscosity of the adhesive. The addition of the nanoparticles did not influence the antimicrobial effects compared to the pure adhesive. Improved mineral inducing capacity could be detected in all nanoparticle combinations. The combination of bioactive and/or antibacterial nanoparticles showed improved mineral inducing capacity, but no antibacterial properties. The material properties were not or only slightly affected. Keywords: POSS; SiO2@Ag; antimicrobial nanoparticles; bioactive glass; bioactive nanoparticles; calcium phosphate; dental adhesive

Selbstadhäsive Komposite – Halten sie, was sie versprechen?

Self-adhesive composites promise simplified application and reliable adhesion to dental hard tissues without prior conditioning or application of an adhesive system. Their working principle is based on specific functional monomers. Although they may reach acceptable sealing capability in minimally invasive cavities, study results showed significantly reduced bond strength to enamel and dentin compared to conventional adhesive systems. Thus, the use of self-adhesive composites requires critical individual consideration

Short- and long-range interactions in the HIV-1 5′ UTR regulate genome dimerization and packaging

RNA dimerization is the noncovalent association of two human immunodeficiency virus-1 (HIV-1) genomes. It is a conserved step in the HIV-1 life cycle and assumed to be a prerequisite for binding to the viral structural protein Pr55Gag during genome packaging. Here, we developed functional analysis of RNA structure-sequencing (FARS-seq) to comprehensively identify sequences and structures within the HIV-1 5′ untranslated region (UTR) that regulate this critical step. Using FARS-seq, we found nucleotides important for dimerization throughout the HIV-1 5′ UTR and identified distinct structural conformations in monomeric and dimeric RNA. In the dimeric RNA, key functional domains, such as stem-loop 1 (SL1), polyadenylation signal (polyA) and primer binding site (PBS), folded into independent structural motifs. In the monomeric RNA, SL1 was reconfigured into long- and short-range base pairings with polyA and PBS, respectively. We show that these interactions disrupt genome packaging, and additionally show that the PBS–SL1 interaction unexpectedly couples the PBS with dimerization and Pr55Gag binding. Altogether, our data provide insights into late stages of HIV-1 life cycle and a mechanistic explanation for the link between RNA dimerization and packaging.Peer Reviewe

Reducing Public Health Risk During Disasters: Identifying Social Vulnerabilities

Abstract All regions of the US experience disasters which result in a number of negative public health consequences. Some populations have higher levels of social vulnerability and, thus, are more likely to experience negative impacts of disasters including emotional distress, loss of property, illness, and death. To mitigate the impact of disasters on at-risk populations, emergency managers must be aware of the social vulnerabilities within their community. This paper describes a qualitative study which aimed to understand how emergency managers identify social vulnerabilities, also referred to as at-risk populations, in their populations and barriers and facilitators to current approaches. Findings suggest that although public health tools have been developed to aid emergency managers in identifying at-risk populations, they are not being used consistently. Emergency managers requested more information on the availability of tools as well as guidance on how to increase ability to identify at-risk populations