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[PMID]: 29443416
[Au] Autor:Jende JME; Groener JB; Oikonomou D; Heiland S; Kopf S; Pham M; Nawroth P; Bendszus M; Kurz FT
[Ad] Address:Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
[Ti] Title:Diabetic neuropathy differs between type 1 and type 2 diabetes: Insights from magnetic resonance neurography.
[So] Source:Ann Neurol;, 2018 Feb 14.
[Is] ISSN:1531-8249
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To visualize and quantify differences of microstructural nerve damage in distal symmetric diabetic neuropathy (DPN) between type 1 diabetes (T1D) and type 2 diabetes (T2D), and to detect correlations between neuropathic symptoms and serological risk factors. METHODS: Three-tesla magnetic resonance neurography of the sciatic nerve was performed in 120 patients (T1D, n = 35; T2D, n = 85) with either DPN (n = 84) or no DPN (n = 36). Results were subsequently correlated with clinical, serological, and electrophysiological patient data. RESULTS: T2-weighted (T2w)-hyperintense lesions correlated negatively with tibial compound motor action potential (r = -0.58, p < 0.0001) and peroneal nerve conduction (r = 0.51, p = 0.0002), and positively with neuropathy disability score (NDS; r = -0.54, p < 0.0001), neuropathy symptom score (NSS; r = 0.52, p < 0.0001), and HbA1c level (r = 0.23, p = 0.014). T2w-hypointense lesions correlated positively with NDS (r = 0.28, p = 0.002), NSS (r = 0.36, p < 0.0001), and serum triglycerides (r = 0.34, p = 0.0003), and negatively with serum high-density lipoprotein (HDL; r = -0.48, p < 0.0001). For DPN in T1D, elevated values of T2w-hyperintense lesions (19.67 ± 4.13% vs 12.49 ± 1.23%, p = 0.027) and HbA1c (8.74 ± 0.29% vs 7.11 ± 0.16%, p < 0.0001) were found when compared to T2D. For DPN in T2D, elevated T2w-hypointense lesions (23.41 ± 2.69mm vs 11.43 ± 1.74mm , p = 0.046) and triglycerides (220.70 ± 23.70mg/dl vs 106.60 ± 14.51mg/dl, p < 0.0001), and lower serum HDL (51.29 ± 3.02mg/dl vs 70.79 ± 4.65mg/dl, p < 0.0001) were found when compared to T1D. INTERPRETATION: The predominant type of nerve lesion in DPN differs between T1D and T2D. Correlations found between lesion type and serological parameters indicate that predominant nerve lesions in T1D are associated with poor glycemic control and loss of nerve conduction, whereas predominant lesions in T2D are associated with changes in lipid metabolism. These findings may be helpful for future studies on the underlying pathophysiological pathways and possible treatments for DPN in T1D and T2D. Ann Neurol 2018.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1002/ana.25182

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[PMID]: 29291403
[Au] Autor:Senger JLB; Verge VMK; Macandili HSJ; Olson JL; Chan KM; Webber CA
[Ad] Address:Department of Surgery, University of Alberta, Alberta, Canada.
[Ti] Title:Electrical stimulation as a conditioning strategy for promoting and accelerating peripheral nerve regeneration.
[So] Source:Exp Neurol;302:75-84, 2017 Dec 29.
[Is] ISSN:1090-2430
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The delivery of a nerve insult (a "conditioning lesion") prior to a subsequent test lesion increases the number of regenerating axons and accelerates the speed of regeneration from the test site. A major barrier to clinical translation is the lack of an ethically acceptable and clinically feasible method of conditioning that does not further damage the nerve. Conditioning electrical stimulation (CES), a non-injurious intervention, has previously been shown to improve neurite outgrowth in vitro. In this study, we examined whether CES upregulates regeneration-associated gene (RAG) expression and promotes nerve regeneration in vivo, similar to a traditional nerve crush conditioning lesion (CCL). Adult rats were divided into four cohorts based on conditioning treatment to the common peroneal (fibular) nerve: i) CES (1h, 20Hz); ii) CCL (10s crush); iii) sham CES (1h, 0Hz); or iv) naïve (unconditioned). Immunofluorescence and qRT-PCR revealed significant RAG upregulation in the dorsal root ganglia of both CES and CCL animals, evident at 3-14days post-conditioning. To mimic a clinical microsurgical nerve repair, all cohorts underwent a common peroneal nerve cut and coaptation one week following conditioning. Both CES and CCL animals increased the length of nerve regeneration (3.8-fold) as well as the total number of regenerating axons (2.2-fold), compared to the sham and naïve-conditioned animals (p<0.001). These data support CES as a non-injurious conditioning paradigm that is comparable to a traditional CCL and is therefore a novel means to potentially enhance peripheral nerve repair in the clinical setting.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

  3 / 11626 MEDLINE  
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[PMID]: 29254445
[Au] Autor:Jarrell K; McDonald E; Shakked R; Nicholson K; Kasper V; Raikin SM
[Ad] Address:1 Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
[Ti] Title:Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery.
[So] Source:Foot Ankle Int;39(3):332-337, 2018 Mar.
[Is] ISSN:1944-7876
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The increasing scope and complexity of foot and ankle procedures performed in an outpatient setting require more intensive perioperative analgesia. Regional anesthesia (popliteal and saphenous nerve blocks) has been proven to provide satisfactory pain management, decreased postoperative opioid use, and earlier patient discharge. This can be further augmented with the placement of a continuous-flow catheter, typically inserted into the popliteal nerve region. This study investigated the use of a combined popliteal and saphenous continuous-flow catheter nerve block compared to a single popliteal catheter and single-injection saphenous nerve block in postoperative pain management after ambulatory foot and ankle surgery. METHODS: A prospective study was conducted using 60 patients who underwent foot and ankle surgery performed in an outpatient setting. Demographic data, degree of medial operative involvement, American Society of Anesthesiologists physical classification system, anesthesia time, and postanesthesia care unit time were recorded. Outcome measures included pain satisfaction, numeric pain scores (NPS) at rest and with activity, and opioid intake. Patients were also classified by degree of saphenous nerve involvement in the operative procedure, by the surgeon who was blinded to the anesthesia randomization. RESULTS: Patients in the dual-catheter group took significantly less opioid medication on the day of surgery and postoperative day 1 (POD 1) compared to the single-catheter group ( P = .02). The dual-catheter group reported significantly greater satisfaction with pain at POD 1 and POD 3 and a significantly lower NPS at POD 1, 2, and 3. This trend was observed in all 3 subgroups of medial operative involvement. CONCLUSION: Patients in the single-catheter group reported more pain, less satisfaction with pain control, and increased opioid use on POD 1, suggesting dual-catheter use was superior to single-injection nerve blocks with regard to managing early postoperative pain in outpatient foot and ankle surgery. LEVEL OF EVIDENCE: Level II, prospective cohort study.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1177/1071100717744331

  4 / 11626 MEDLINE  
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[PMID]: 29505010
[Au] Autor:Sun DH; Zhao Y; Zhang JT; Zhu D; Qi BC
[Ad] Address:Department of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, China.
[Ti] Title:Anterolateral tibial plateau osteotomy as a new approach for the treatment of posterolateral tibial plateau fracture: A case report.
[So] Source:Medicine (Baltimore);97(3):e9669, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: It is challenging to visualize and reduce a posterolateral tibial plateau fracture through an anterolateral approach as the tibial plateau fragments are often covered by the fibular head and ligamentous structures. PATIENT CONCERNS: In this case report, we describe a patient with a depression fracture of the posterolateral quadrant combined with a split fracture of the posteromedial quadrant and an avulsion fracture of the tibial intercondylar eminence. DIAGNOSES: Tibial plateau fracture(AO type 41-B3). INTERVENTIONS: A posteromedial approach combined with an anterolateral approach and an osteotomy involving the proximal tibiofibular joint of the tibial plateau was used to expose, reduce, and fix the fracture. OUTCOMES: There was no risk of injury to the common peroneal nerve or ligaments. The patient is recovering well and is satisfied with the function of the injured knee. LESSONS: We recommend anterolateral tibial plateau osteotomy for the treatment of posterolateral tibial plateau fractures in clinical practice.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1097/MD.0000000000009669

  5 / 11626 MEDLINE  
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[PMID]: 28468849
[Au] Autor:Lyle MA; Nichols TR; Kajtaz E; Maas H
[Ad] Address:School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia mlyle@ap.gatech.edu.
[Ti] Title:Musculotendon adaptations and preservation of spinal reflex pathways following agonist-to-antagonist tendon transfer.
[So] Source:Physiol Rep;5(9), 2017 May.
[Is] ISSN:2051-817X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Tendon transfer surgeries are performed to restore lost motor function, but outcomes are variable, particularly those involving agonist-to-antagonist muscles. Here, we evaluated the possibility that lack of proprioceptive feedback reorganization and musculotendon adaptations could influence outcomes. Plantaris-to-tibialis anterior tendon transfer along with resection of the distal third of the tibialis anterior muscle belly was performed in eight cats. Four cats had concurrent transection of the deep peroneal nerve. After 15-20 weeks, intermuscular length and force-dependent sensory feedback were examined between hindlimb muscles, and the integrity of the tendon-to-tendon connection and musculotendon adaptations were evaluated. Three of the transferred tendons tore. A common finding was the formation of new tendinous connections, which often inserted near the original location of insertion on the skeleton (e.g., connections from plantaris toward calcaneus and from tibialis anterior toward first metatarsal). The newly formed tissue connections are expected to compromise the mechanical action of the transferred muscle. We found no evidence of changes in intermuscular reflexes between transferred plantaris muscle and synergists/antagonists whether the tendon-to-tendon connection remained intact or tore, indicating no spinal reflex reorganization. We propose the lack of spinal reflex reorganization could contribute the transferred muscle not adopting the activation patterns of the host muscle. Taken together, these findings suggest that musculotendon plasticity and lack of spinal reflex circuitry reorganization could limit functional outcomes after tendon transfer surgery. Surgical planning and outcomes assessments after tendon transfer surgery should consider potential consequences of the transferred muscle's intermuscular spinal circuit actions.
[Mh] MeSH terms primary: Feedback, Physiological
Muscle, Skeletal/physiology
Reflex
Spinal Cord/physiology
Tendons/physiology
[Mh] MeSH terms secundary: Animals
Cats
Efferent Pathways/physiology
Female
Muscle, Skeletal/innervation
Peroneal Nerve/physiology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:IM
[Da] Date of entry for processing:170505
[St] Status:MEDLINE

  6 / 11626 MEDLINE  
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[PMID]: 29503139
[Au] Autor:Margulis M; Ben Zvi L; Bernfeld B
[Ad] Address:Orthopedic Surgeon, Department of Orthopedic Surgery, Lady Davis Carmel Medical Center, Haifa, Israel.
[Ti] Title:Bilateral Common Peroneal Nerve Entrapment After Excessive Weight Loss: Case Report and Review of the Literature.
[So] Source:J Foot Ankle Surg;, 2018 Mar 02.
[Is] ISSN:1542-2224
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We report a case of excessive weight loss causing bilateral common peroneal nerve entrapment in a 60-year-old patient. The bilateral peroneal involvement suggested a systemic cause. Excessive weight loss during a relatively short period can cause changes in the tissues surrounding the common peroneal nerve and lead to its entrapment in the peroneal tunnel. Our patient underwent successful surgical decompression with significant improvement.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  7 / 11626 MEDLINE  
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[PMID]: 29309980
[Au] Autor:Keser N; Akpinar P; Is M; Aktas I
[Ad] Address:Department of Neurosurgery, TR University of Health Sciences, Istanbul Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey. Electronic address: nskeser@gmail.com.
[Ti] Title:Irreversible Footdrop as a Consequence of Neglected Knee Pain in an Adolescent with a Peroneal Intraneural Ganglion Cyst.
[So] Source:World Neurosurg;111:307-310, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Peroneal intraneural ganglion cysts (IGCs) are nonneoplastic lesions. They are responsible for a small number of footdrop cases, which occur after additional nerve damage. The earliest patient symptom related to IGCs is knee pain. CASE DESCRIPTION: A 17-year-old boy developed pain in the left knee, which progressively worsened over 14 months. He did not seek any medical assistance during this time. The patient subsequently was involved in a bicycle accident, and 3 months later he was unable to raise his left foot and was referred to our clinic for footdrop. Surgery was performed, but the weakness persisted. We could not detect any functional reinnervation on electromyography 12 months after surgery. CONCLUSIONS: The most important factors in determining the prognosis of IGCs are the extent of the nerve trauma and the early diagnosis and treatment of the IGC. Detection of almost complete functional denervation on electromyography may indicate that it is too late for surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  8 / 11626 MEDLINE  
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[PMID]: 29266337
[Au] Autor:Connolly B; Maddocks M; MacBean V; Bernal W; Hart N; Hopkins P; Rafferty GF
[Ad] Address:King's College London, Division of Asthma, Allergy and Lung Biology, Department of Respiratory Medicine, UK.
[Ti] Title:Nonvolitional assessment of tibialis anterior force and architecture during critical illness.
[So] Source:Muscle Nerve;, 2017 Dec 20.
[Is] ISSN:1097-4598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness. METHODS: Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission. RESULTS: Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = -88.5 ± 78.8 mm , P = 0.002) and rectus femoris (Δ = -126.1 ± 129.1 mm , P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0-14.4] kg vs. 8.6 (IQR, 6.7-19.2) kg, P = 0.9). DISCUSSION: Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly "acquired" and questions our understanding of muscle function during critical illness. Muscle Nerve, 2018.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher
[do] DOI:10.1002/mus.26049

  9 / 11626 MEDLINE  
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[PMID]: 29439133
[Au] Autor:Collinson JM; Lindström NO; Neves C; Wallace K; Meharg C; Charles RH; Ross ZK; Fraser AM; Mbogo I; Oras K; Nakamoto M; Barker S; Duce S; Miedzybrodzka Z; Vargesson N
[Ad] Address:School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen AB25 2ZD, UK m.collinson@abdn.ac.uk.
[Ti] Title:The developmental and genetic basis of 'clubfoot' in the peroneal muscular atrophy mutant mouse.
[So] Source:Development;145(3), 2018 Feb 08.
[Is] ISSN:1477-9129
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Genetic factors underlying the human limb abnormality congenital talipes equinovarus ('clubfoot') remain incompletely understood. The spontaneous autosomal recessive mouse 'peroneal muscular atrophy' mutant (PMA) is a faithful morphological model of human clubfoot. In PMA mice, the dorsal (peroneal) branches of the sciatic nerves are absent. In this study, the primary developmental defect was identified as a reduced growth of sciatic nerve lateral motor column (LMC) neurons leading to failure to project to dorsal (peroneal) lower limb muscle blocks. The mutation was mapped and a candidate gene encoding LIM-domain kinase 1 ( ) identified, which is upregulated in mutant lateral LMC motor neurons. Genetic and molecular analyses showed that the mutation acts in the EphA4-Limk1-Cfl1/cofilin-actin pathway to modulate growth cone extension/collapse. In the chicken, both experimental upregulation of by electroporation and pharmacological inhibition of actin turnover led to defects in hindlimb spinal motor neuron growth and pathfinding, and mimicked the clubfoot phenotype. The data support a neuromuscular aetiology for clubfoot and provide a mechanistic framework to understand clubfoot in humans.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review

  10 / 11626 MEDLINE  
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[PMID]: 29437598
[Au] Autor:Kwong PWH; Ng GYF; Chung RCK; Ng SSM
[Ad] Address:Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
[Ti] Title:Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower-Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial.
[So] Source:J Am Heart Assoc;7(4), 2018 Feb 08.
[Is] ISSN:2047-9980
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) has been used to augment the efficacy of task-oriented training (TOT) after stroke. Bilateral intervention approaches have also been shown to be effective in augmenting motor function after stroke. The purpose of this study was to compare the efficacy of bilateral TENS combined with TOT versus unilateral TENS combined with TOT in improving lower-limb motor function in subjects with chronic stroke. METHODS AND RESULTS: Eighty subjects were randomly assigned to bilateral TENS+TOT or to unilateral TENS+TOT and underwent 20 sessions of training over a 10-week period. The outcome measures included the maximal strength of the lower-limb muscles and the results of the Lower Extremity Motor Coordination Test, Berg Balance Scale, Step Test, and Timed Up and Go test. Each participant was assessed at baseline, after 10 and 20 sessions of training and 3 months after the cessation of training. The subjects in the bilateral TENS+TOT group showed greater improvement in paretic ankle dorsiflexion strength (ß=1.32; =0.032) and in the completion time for the Timed Up and Go test (ß=-1.54; =0.004) than those in the unilateral TENS+TOT group. However, there were no significant between-group differences for other outcome measures. CONCLUSIONS: The application of bilateral TENS over the common peroneal nerve combined with TOT was superior to the application of unilateral TENS combined with TOT in improving paretic ankle dorsiflexion strength after 10 sessions of training and in improving the completion time for the Timed Up and Go test after 20 sessions of training. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02152813.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Cl] Clinical Trial:ClinicalTrial
[St] Status:In-Data-Review


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