Immediate effects of real-time postural biofeedback on spinal posture,muscle activity,and perceived pain severity in adults with neck pain

BackgroundPrevious studies have investigated various types of postural biofeedback devices on different body regions to improve posture; however, they focused only on healthy adults without a history of chronic musculoskeletal disorders. In addition, those postural biofeedback devices used in previous studies are often designed for experimental research. The designs are usually bulky with many wires, which is not practical for everyday use.Research questionThe aim of this study was to determine the immediate effect of a commercially available real-time postural biofeedback device on spinal posture, muscle activity, and perceived pain severity in adults with neck pain.Methods21 adults who had chronic or recurrent nonspecific neck pain for more than 3 months and whose pain was induced or aggravated by prolonged computer work were enrolled in this study. Spinal posture (head tilt, neck flexion, cervical and thoracic angles), muscle activity (cervical erector spinae, upper trapezius, and thoracic erector spinae), and self-reported neck and shoulder pain were measured during computer typing tasks, with and without biofeedback.ResultsCompared with the non-biofeedback condition, the biofeedback condition significantly decreased neck flexion, upper cervical, and lower thoracic angles and lowered the activity of the cervical erector spinae. Self-reported neck pain was not influenced by the application of biofeedback, but significantly increased over the 1-hour typing task.SignificanceThe application of a commercially available wearable real-time biofeedback device improves sitting posture and reduces muscular activity in adults with nonspecific neck pain during computer work. Future studies should examine the long-term effects of wearable real-time postural biofeedback devices for prevention and management of neck pain.     

Maximal calf circumference reflects calf muscle mass measured using magnetic resonance imaging

BackgroundCalf circumference (CC) has been used as a surrogate for calf muscle mass, which facilitates venous blood return to the heart through active skeletal muscle. However, the correlation between CC and calf muscle mass has not been extensively examined. This study aimed to examine the relationship between CC and calf muscle mass considering differences in sex and physique in elderly individuals.MethodsA total of 124 community-dwelling elderly individuals ≥60 years of age (61 men, mean [±SD] age 74.3 ± 5.7 years) were enrolled. Maximal CC was measured using a tape measure with the subject supine. The cross-sectional area of skeletal muscle tissues was measured using magnetic resonance imaging from the point of greatest calf circumference to 5 cm proximal and distal. Calf muscle mass was calculated by multiplying the area of each slice by slice thickness (5 mm).ResultsCC was strongly correlated with calf muscle mass in male and female subjects (male: r = 0.908, P < 0.001; female: r = 0.892, P < 0.001). Multiple regression analysis revealed that CC and body mass index (BMI) were independent associate factors of calf muscle mass. The following estimation formulae were derived: (male) calf muscle mass (cm³) = 47.82 × CC (cm)−12.50 × BMI (kg/m²) −732.80; (female) calf muscle mass (cm³) = 32.23 × CC (cm) −4.85 × BMI (kg/m²) −429.94.ConclusionsA strong correlation was found between CC and calf muscle mass according to magnetic resonance imaging. Sex differences and BMI should be considered for accurate estimation of calf muscle mass using CC.     

Cervical mass as the first clinical manifestation of unsuspected metastatic seminoma

The authors reported a case of a 27‐year‐old man with a nontender left neck mass that had grown quite rapidly within few weeks. FNAB and CT were not consistent to establish the definite diagnosis. After excisional biopsy, the histopathological examination and the immunohistochemical study of the specimen revealed a cervical metastasis of seminoma. The patient was treated with chemotherapy with a complete clinical remission. This uncommon case-report can represent a great diagnostic and therapeutic challenge and should be considered in the differential diagnosis of every cervical masses occurring in young males patients. Diagnostic delays are unfortunately common and may lead to metastatic spread and worse prognosis.     

等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致的上气道梗阻患者13例

目的 评估内镜下等离子射频辅助双侧声带后端切断术治疗双侧声带麻痹导致上气道梗阻患者的疗效。 方法 回顾性分析13例双侧声带麻痹导致的上气道梗阻患者的病例资料,其中男6例、女7例,27~73岁,所有患者均接受等离子射频辅助双侧声带后端切断术。总结评估该手术的临床疗效。 结果 13例随访时间1年1个月~2年11个月,所有患者无严重并发症发生。一次拔管率为84.44%(10/13),二次手术拔管率为88.89%(11/13),拔管时间1~3个月,中位数1个月,上气道梗阻均未复发。 结论 内镜下等离子射频辅助双侧声带切断术操作简单、手术风险小,同时治疗双侧声带麻痹效果可靠,是双侧声带麻痹导致上气道梗阻的有效治疗方法之一,也可作为其他治疗失败的补救治疗措施。     

CRP monitoring in fractured neck of femur. A waste of resource?

AimWe aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively.Study Design and MethodsRetrospective analysis was carried out on all NOF#'s admitted for surgical fixation between August 2015 and July 2016 in a district general hospital. Primary analysis included serum CRP levels until day 7 post-operatively, with secondary analysis of any documented evidence of post-operative complications (medical and surgical) within 30 days post-operatively.ResultsA total of 365 patients were surgically treated for NOF#’s over the study period. CRP serum levels peaked over the first two days post-operatively to median (IQ range) of 226 mg/L (158–299 mg/L), decreasing to 67 mg/L (45.5–104 mg/L) by day 7 post-operatively. 116 patients had documented post-operative complications within 30 daysof operation. CRP levels in patients with and without complications showed no statistical significance in day-1, day-2 and day-3 post-operatively. However, a significant difference was demonstrated on day-4 (p = 0.017), day-5 (p = 0.003), day-6 (p = 0.02) and day-7 (p = 0.031).ConclusionsDuring the first three days of the postoperative period we cannot recommend routine CRP serum blood test monitoring in NOF# patients, as it is not diagnostic in the acute inflammatory phase for medical or surgical complications.