New therapeutic perspectives in neurorehabilitation: transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) is a non-invasive tool for the electrical stimulation of neural tissue, including the cerebral cortex, and is an excellent method to study brain physiology. Trains of stimuli (repetitive TMS) can modify excitability of the cerebral cortex at the stimulated site and also at remote areas along anatomo-functional connexions. Repetitive TMS is used to modulate cortical excitability in a frequency-dependent manner, for a period of time that outlasts the duration of stimulation, inducing plastic changes in the brain. Repetitive TMS may become an additional tool for early rehabilitation and might be useful for promoting cortical plasticity in neurologic patients. Its utility have been demonstrated by many clinical studies in various disabling conditions, as stroke, Parkinson disease, multiple sclerosis, spinal cord injuries, and many more, where rTMS opens a new field of therapeutic possibilities

SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticit

Rehabilitation and clinical evolution aspects in a case of Osteoid Osteoma

Abstract: Introduction. Osteoid osteoma represents about 3% of all primary bone tumors and 11% of all benign bone tumors. Data from the literature suggest that a neuromuscular rehabilitation program after osteoid osteoma surgery is very beneficial and improves the general quality of life. Material and methods. A 30-year-old male patient with intermittent right shoulder pain radiating to the right hand, and recurrent myalgias in the past year presented to our neuro-logical department. The neurological examination highlighted limitation of the abduction of the right upper limb. The paraclinical investigations included plain radiography of the right upper limb and electroneurography, which were normal, and native cervical MRI which revealed discrete C5 disc overflow, without visible signs of compression. The patient presented limited initial response to NSAIDs, so his treatment was changed to corticoster-oid therapy. Further, the patient was guided to undergo a rheumatological examination where a musculoskeletal ultrasound was performed, showing no any specific modifica-tion. Additionally, we indicated a native right shoulder MRI, which revealed a signal mod-ification of the proximal humeral diaphysis. We further indicated an MRI scan with con-trast of the upper right limb, which revealed a nidus at the top one-third of the humerus. Additionally, a CT scan with contrast of the same region displayed images that were high-ly suggestive of osteoma. The patient was referred to the orthopedics department, where a complete resection of the tumor was performed, and the pathology report confirmed the fi-nal diagnosis of osteoid osteoma. Conclusions. Recovery after osteoid osteoma surgery is more beneficial if the neuromuscu-lar rehabilitation program, that has an important role in increasing muscle strength, is combined with orthopedic devices and pain medication

Histological aspects of the esophagus in guinea pigs (Cavia porcellus)

The aim of this study is the detailed description of the esophageal microscopic structure in guinea pigs. Fragments from the cervical, thoracic and abdominal segments of the esophagus were processed for classical paraffin embedding and the sections were stained by hematoxylin-eosin and Goldner’s trichrome methods. The esophagus in guinea pigs is lined by keratinized stratified squamous epithelium and there are no glands in the lamina propria and the submucosa. The muscularis mucosae is formed by smooth muscle cells disposed longitudinally. The muscularis externa is formed by striated muscle cells disposed on 3 layers in the first 2 thirds of the esophagus, while in some regions of the abdominal segment’s circumference, the cells form 4 layers