Evaluation of morphological characteristics, motor and sensory abilities of the arm, and assessment of the factors of influence on the same in patients who have been operated after peripheral nerve injury

Uvod: Ova studija obuhvata ispitivanje morfoloških karakteristika, moto- ričkih i senzornih sposobnosti ruke kod pacijenata koji su operisani zbog povrede perifernih nerava iste. Pacijenti i metode istraživanja: U studiju su uključena 164 pacijenta ope- risana u periodu od 12 godina, kod kojih je evaluirano morfofunkcionalno stanje ruku. Dobijeni podaci su grupisani na osnovu različitih kriterijuma i međusobno poređeni, a kao kontrolna grupa neretko su služili rezultati testova nepovređenog ekstremiteta. Statistička obrada podataka izvršena je u statističkom paketu “SPSS 18.0“. Za opis parametara od značaja korišćene su metode deskriptivne statistike. U zavi- snosti od normalnosti raspodele podataka, analiza podataka vršena je primenom parametarskih i neparametarskih testova. U slučajevima analize kategoričkih varija- bli primenjivani su Hi-kvadrat test i Frimen-Haltonova ekstenzija Fišerovog tač- nog testa. Hipoteze su testirane na nivou statističke značajnosti (alfa nivo) od 0.05. Rezultati: Od 164 pacijenta njih 137 (83.5%) su bili muškog, a 27 (16.5%) ženskog pola; 28.7% ispitanika imalo je povrede brahijalnog pleksusa, dok je 71.3% imalo povrede nerava nadlaktice i podlaktice. Prosečna starost pacijenata u vreme povrede iznosila je 31.7 godina (od 7 meseci do 59 godina). Pacijenti sa povredama brahijalnog pleksusa imali su statistički značajno slabiji morfo-funkcionalni oporavak u odnosu na pacijente sa distalnim povredama (p < 0.05). Pacijente sa totalnom paralizom odlikovala je potpuna disfunkcija šake. Prisustvo bola nije se statistički značajno razlikovalo u odnosu na lokaciju povre- de (p > 0.05), iako su pacijenti sa povredama brahijalnog pleksusa imali zastupljenije bolove jakog intenziteta (p < 0.05). Nije pronađen uticaj udruženih povreda na kona- čan funkcionalni ishod. Zaključak: Povrede perifernih nerava uzrokuju značajan disabilitet povređe- nog ekstremiteta. Najslabije rezultate imaju pacijenti sa povredama brahijalnog pleksusa, posebno oni sa totalnom paralizom.Introduction: This study comprises morphological characteristics, motor and sensory abilities of the arms and hands in patients operated due to the peripheral nerve injury. Patients and methods: The study has involved 164 patients having been operated during a 12-years period. Morpho-functional conditions of the arms were evaluated in tested patients. The obtained data were grouped according to different criteria and compared to each other. Results of the uninjured extremities were often used as a control group. Statistical analysis was performed using the statistical package "SPSS 18.0". For description of the parameters of interest we used the methods of descriptive statistics. Depending on the normality of the data distribution, data analysis was also performed using parametric and non-parametric tests. In cases of analysis of categorical variables, the Chi-Square Test and Freeman-Halton extension of Fisher's Exact Test were used. Hypotheses were tested at the level of statistical significance (alpha level) of 0.05. Results: Out of 164 patients, 137 (83.5%) were male and 27 (16.5%) were female; 28.7% of patients had brachial plexus injuries, while 71.3% had injuries of the upper arm and forearm. The average age of patients at the time of injury was 31.7 years (from 7 months to 59 years). Patients with the brachial plexus injuries had significantly weaker morpho-functional recovery compared to patients with distal injuries (p < 0.05). Patients with total paralysis were characterized by complete hand dysfunction. The presence of pain didn’t significantly differ according to the location of the injury (p > 0.05), although patients with injuries of brachial plexus had more severe pains (p < 0.05). The influence of associated injuries on the final functional outcome wasn’t found. Conclusion: Peripheral nerve injuries cause significant disability of the injured extremity. The worst results are in patients with brachial plexus injuries, especially by those with total paralysis

Etiology and mechanisms of ulnar and median forearm nerve injuries

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%), while only 18 (18.2%) were females, both mainly with nerve injuries of the distal forearm – 75 (75.6%). Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis

Epidemiologija ozljeda živaca podlaktice – retrospektivna studija

The aim of this study was to investigate the mechanisms and etiologic factors of forearm nerve injuries. This retrospective survey included all patients treated surgically in Clinical Department of Neurosurgery, Clinical Center of Serbia, from January 1, 2000 to December 31, 2010. All relevant data were collected from medical records. Statistical procedures were done using the PASW 18 statistical package. Our study included 104 patients that underwent surgery after forearm nerve injury. The majority of admitted patients were male (n=84; 80.8%) and only 20 (19.2%) were female. Ulnar nerve injury predominated with 70 cases, followed by median nerve with 54 (51.9%) cases and radial nerve with only 5 cases. Transection was the dominant mechanism of injury and it occurred in 84.6% of cases. Injury by a sharp object was the most frequent etiologic factor and it occurred in 62 (59.6%) patients, while traffic accident and gunshot injuries were the least common etiologic factor of forearm nerve injury, occurring in 7 (6.7%) and 6 (5.8%) cases, respectively. Associated injuries of muscles and tendons, bones and blood vessels occurred in 20 (19.2%), 16 (15.4%) and 15 (14.4%) patients, respectively. The etiology and mechanism of peripheral nerve injury are of great importance when choosing the right course of treatment in each individual patient because timing and type of treatment are closely related to these factors.Cilj ovoga rada bio je procijeniti mehanizme i etiološke čimbenike ozljeda perifernih živaca podlaktice. Ova retrospektivna studija je obuhvatila sve bolesnike kirurški liječene u Klinici za neurokirurgiju Kliničkog centra Srbije u razdoblju od 1. siječnja 2000. do 31. prosinca 2010. godine. Svi relevantni podaci su dobiveni iz medicinske dokumentacije. Statistička obrada podataka je načinjena primjenom statističkog paketa PASW 18. U našoj studiji koja je uključivala 104 bolesnika operirana zbog povrede perifernog živca podlaktice većinu su činili muškarci (n=84; 80,8%), dok je bilo samo 20 (19,2%) žena. Najčešće ozlijeđeni živac bio je ulnarni živac u 70 slučajeva, potom medijani živac u 54 (51,9%) slučaja, dok je najrjeđe bio ozlijeđen radijalni živac i to u 5 slučajeva. Transekcija živca je bila dominantni mehanizam ozljede živca, a utvrđena je u 84,6% bolesnika. Lezija živca oštrim predmetom je bila najčešći etiološki čimbenik utvrđen kod 62 (59,6%) bolesnika, dok su prometni traumatizam i ozljeda vatrenim oružjem bili najrjeđi etiološki čimbenici ozljede perifernog živca podlaktice i javili su se u 7 (6,7%) odnosno 6 (5,8%) slučajeva. Udružene ozljede mišića i tetiva, kostiju i krvnih žila nađene su u 20 (19,2%), 16 (15,4%) odnosno 15 (14,4%) slučajeva. Etiologija i mehanizam ozljede perifernih živaca veoma su važni za odabir pravog načina liječenja kod svakog pojedinog bolesnika, jer su vrijeme i vrsta kirurške operacije usko vezani za ove čimbenike

The New Setup in the Belgrade Low-Level and Cosmic-Ray Laboratory

The Belgrade underground laboratory consists of two interconnected spaces, a ground level laboratory and a shallow underground one, at 25 m.w.e.. The laboratory hosts a low-background gamma spectroscopy system and cosmic-ray muon detectors. With recently adopted digital data acquisition system it is possible to study simultaneously independent operation of two detector systems, as well as processes induced by cosmic-ray muons in germanium spectrometers. Characteristics and potentials of present experimental setup, together with some preliminary results for the flux of fast neutrons and stopped muons are reported.Comment: 12 pages, 16 figure

Measurement of the charge ratio of atmospheric muons with the CMS detector

We present a measurement of the ratio of positive to negative muon fluxes from cosmic ray interactions in the atmosphere, using data collected by the CMS detector both at ground level and in the underground experimental cavern at the CERN LHC. Muons were detected in the momentum range from 5 GeV/c to 1 TeV/c. The surface flux ratio is measured to be 1.2766 +/- 0.0032 (stat.) +/- 0.0032 (syst.), independent of the muon momentum, below 100 GeV/c. This is the most precise measurement to date. At higher momenta the data are consistent with an increase of the charge ratio, in agreement with cosmic ray shower models and compatible with previous measurements by deep-underground experiments. (C) 2010 Published by Elsevier B.V

Transverse-Momentum and Pseudorapidity Distributions of Charged Hadrons in pp Collisions at root s=7 TeV

Charged-hadron transverse-momentum and pseudorapidity distributions in proton-proton collisions at root s = 7 TeV are measured with the inner tracking system of the CMS detector at the LHC. The charged-hadron yield is obtained by counting the number of reconstructed hits, hit pairs, and fully reconstructed charged-particle tracks. The combination of the three methods gives a charged-particle multiplicity per unit of pseudorapidity dN(ch)/d eta vertical bar(vertical bar eta vertical bar LT 0.5) = 5.78 +/- 0.01(stat) +/- 0.23(stat) for non-single-diffractive events, higher than predicted by commonly used models. The relative increase in charged-particle multiplicity from root s = 0.9 to 7 TeV is [66.1 +/- 1.0(stat) +/- 4.2(syst)]%. The mean transverse momentum is measured to be 0.545 +/- 0.005(stat) +/- 0.015(syst) GeV/c. The results are compared with similar measurements at lower energies

Liječenje projektilnih ozljeda brahijalnog pleksusa

Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. The aim was to evaluate functional recovery after surgical treatment of these injuries. Our series included 68 patients with 202 nerve lesions treated with 207 surgical procedures. Decision on the treatment modality (exploration, neurolysis, graft repair, or combination) was made upon intraoperative finding. Results were analyzed in 60 (88.2%) patients with 173 (85.6%) nerve lesions followed-up for two years. Functional recovery was evaluated according to functional priorities. Satisfactory functional recovery was achieved in 90.4% of cases with neurolysis and 85.7% of cases with nerve grafting. Insufficient functional recovery was verified in ulnar and radial nerve lesions after neurolysis, and in median and radial nerve lesions when graft repair was done. We conclude that the best time for surgery is between two and four months after injury, except for the gunshot wound associated with injury to the surrounding structures, which requires immediate surgical treatment. The results of neurolysis and nerve grafting were similar.Ozljede projektilima su među najrazornijim ozljedama u općoj traumatologiji. Traumatske ozljede brahijalnog pleksusa najteže su ozljede perifernog živčanog sustava, a najkompliciranije se liječe kirurški. Ipak, projektilno ranjavanje je drugi najčešći mehanizam ozljede brahijalnog pleksusa. Cilj je bio procijeniti funkcionalni oporavak nakon kirurškog liječenja ovih ozljeda. Naša studija je obuhvatila 68 bolesnika s 202 ozljede živaca liječenih u 207 kirurških zahvata. Odluka o načinu liječenja (eksploracija, neuroliza, direktna reparacija graftom ili kombinacija) donesena je na osnovi intraoperacijskog nalaza. Rezultati su analizirani u 60 (88,2%) bolesnika sa 173 (85,6%) lezije živaca nakon kojih je slijedilo razdoblje praćenja u trajanju od dvije godine. Funkcionalni oporavak ocijenjen je prema funkcionalnim prioritetima. Zadovoljavajući funkcionalni oporavak postignut je u 90,4% neuroliza i 85,7% reparacija graftom. Slučajevi s nedovoljnim funkcionalnim oporavkom bili su povezani s neurolizom ulnarnog i radijalnog živca ili reparacijom graftom srednjih i proksimalnih lezija. Zaključujemo da je najbolje vrijeme za kirurški zahvat između dva i četiri mjeseca nakon ozljede, osim kada postoje udružene ozljede okolnih struktura, što zahtijeva neodložno kirurško liječenje. Rezultati neurolize i reparacije graftom bili su slični

Commissioning and Performance of the CMS Pixel Tracker with Cosmic Ray Muons

The pixel detector of the Compact Muon Solenoid experiment consists of three barrel layers and two disks for each endcap. The detector was installed in summer 2008, commissioned with charge injections, and operated in the 3.8 T magnetic field during cosmic ray data taking. This paper reports on the first running experience and presents results on the pixel tracker performance, which are found to be in line with the design specifications of this detector. The transverse impact parameter resolution measured in a sample of high momentum muons is 18 microns

The prevalence of spine deformities and flat feet among 10-12 year old children who train basketball - cross-sectional study [Prevalencija deformiteta kralježnice i ravnih stopala među djecom starom 10-112 godina koja treniraju košarku - poprečno presječno istraživanje]

The aim of this study is to estimate the prevalence of spine and feet deformities among children who are regularly involved in basketball trainings, as well as finding differences in the prevalence of those deformities between children of different gender and age. The study included a total of 64 children, of which 43 were boys and 21 were girls, ages 10-12. All subjects have been regularly participating in basketball trainings for at least one year. Postural disorder is defined as an irregularity in posture of the spine and feet, and it is assessed by visual methods from the front, side and rear side of the body. The prevalence of spinal deformities in our group was 53.13%. The boys had a significantly higher prevalence than girls, 65.1% compared to 28.57% (p=0.006). There was no significant difference in prevalence of spine deformities between children of different ages. The prevalence of feet deformities was 64.06%. There was a statistically significant difference between the sexes, where boys had a significantly greater prevalence of the feet deformities than girls, 83.7% compared to 23.81% (p=0.001). Flat feet were the most common in 10 year old children (85.71%). In conclusion, it can be said that despite regular participation in basketball training, subjects in this study have high prevalence of deformities; especially boys who stand out with the high prevalence of flat feet