Risk factors of osteoporosis in healthy Moroccan men

Background  

Although not as common as in women, osteoporosis remains a significant health care problem in men. Data concerning risk factors of osteoporosis are lacking for the male Moroccan population. The objective of the study was to identify some determinants associated to low bone mineral density in Moroccan men.     

手术减压时间对兔颈脊髓急性损伤并压迫模型的疗效影响

目的制造颈脊髓损伤动物模型,观察颈脊髓损伤后减压时间对脊髓损伤后神经功能恢复的影响。方法选择新西兰大白兔65只,随机分对照组与实验组,实验组进一步分为6个亚组(A、B、C、D、E、F组)。C3椎体前路钻孔开窗,用改良Allen’s法40.0gcm力撞击脊髓,然后从骨窗处置入小螺钉造成脊髓压迫。并在术后18h、24h、2d、3d、5d、7d减压(去除小螺钉)。在术后28d内对改良Tarlov评分,体感诱发电位,细胞凋亡及病理等监测指标进行观察。结果运动学评分和体感诱发电位显示A、B组的神经恢复情况优于其他组,C、D组优于E、F组。而E、F、G组之间无明显差别。组织学显示脊髓受压时间越长,脊髓结构损害越严重。结论本实验显示脊髓损伤后确实存在一个减压的时间窗,该窗口为损伤后3d内,而术后18h内减压可以获得最佳的神经功能恢复。     

Free functioning gracilis transplantation for reconstruction of elbow and hand functions in late obstetric brachial plexus palsy

Background: In late obstetric brachial plexus palsy (OBPP), restoration of elbow and hand functions is a difficult challenge. The use of free functioning muscle transplantation in late OBPP was very scarcely reported. In this study, we present our experience on the use of free functioning gracilis transfer for restoration of elbow and hand functions in late cases of OBPP. Patients and Methods: Eighteen patients with late OBPP underwent free gracilis transfer for reconstruction of elbow and/or hand functions. The procedure was indicated when there was no evidence of reinnervation on EMG and in the absence of local donors. Average age at surgery was 102.5 months. Patients were evaluated using the British Medical Research Council (MRC) grading system and the Toronto Active Movement Scale. Hand function was evaluated by the Raimondi scoring system. Results: The average follow‐up was 65.8 ± 41.7 months. Contraction of the transferred gracilis started at an average of 4.5 ± 1.03 months. Average range of elbow flexion significantly improved from 30 ± 55.7 to 104 ± 31.6 degrees (P <0.001). Elbow flexion power significantly increased with an average of 3.8 grades (P = 0.000147). Passive elbow range of motion significantly decreased from an average of 147 to 117 degrees (P = 0.003). Active finger flexion significantly improved from 5 ± 8.3 to 63 ± 39.9 degrees (P < 0.001). Finger flexion power significantly increased with an average 2.7 grades (P < 0.001). Only 17% achieved useful hand (grade 3) on Raimondi hand score. Triceps reconstruction resulted in an average of M4 power and 45 degrees elbow extension. Conclusion: Free gracilis transfer may be a useful option for reconstruction of elbow and/or hand functions in late OBPP. © 2015 Wiley Periodicals, Inc. Microsurgery 35:350–355, 2015.