Spinal Cord Injury After Conducting Transcatheter Arterial Chemoembolization for Costal Metastasis of Hepatocellular Carcinoma.

Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma.

Filed under: Rehab Centers

Clin Mol Hepatol. 2012 Sep; 18(3): 316-20
Park SJ, Kim CH, Kim JD, Um SH, Yim SY, Seo MH, Lee DI, Kang JH, Keum B, Kim YS

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.
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Shoulder range of motion, pitch count, and injuries among interscholastic female softball pitchers: a descriptive study.

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Int J Sports Phys Ther. 2012 Oct; 7(5): 548-57
Shanley E, Michener LA, Ellenbecker TS, Rauh MJ

Injury rates for softball players are similar to baseball players yet information regarding risk factors, pitching, and physical characteristics for high school windmill softball pitchers is limited. This information is needed to guide prevention, training, and rehabilitation efforts. The purpose of this study was to report descriptive data regarding the physical characteristics and pitching volume experienced by high school softball pitchers during one academic season. A secondary aim was to track and describe upper extremity injuries suffered by high school softball pitchers throughout the course of the 2009 season.Twelve uninjured female softball pitchers (13-18y) from 5 Greenville, South Carolina high schools participated. Prior to the 2009 season, the pitchers’ shoulder internal, external, total arc of rotation and horizontal adduction PROM was measured. During the 10-week season, aggregate pitch counts (pitch volume) and occurrence of upper extremity injury were tracked for each pitcher.Mean preseason internal, external, and total arc of rotation PROM was observed to be similar between the pitchers’ dominant and non-dominant shoulders. The PROM measures of horizontal abduction (HA) appear to demonstrate a side-to-side difference with less HA on the dominant arm of the pitchers who were examined. Subjects threw in an average of 10.1 games (±4.9) during the season. Six pitchers threw in 60% or more of the team’s games and 3 of 12 pitchers pitched less than 25% of games. Pitchers averaged 61.8 pitches per game (±31.5) and 745.8 (±506.4) per season. Pitch count data did not appear to be different between injured and non-injured pitchers.Knowledge of pitch volume can be used to prepare windmill softball pitchers for the seasonal stresses, guide establishment of goals when recovering from injury, or assist in training for an upcoming season. Further research is needed to examine larger samples of pitchers over multiple seasons and years.III.
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Levels of evidence in medicine.

Filed under: Rehab Centers

Int J Sports Phys Ther. 2012 Oct; 7(5): 474-81
McNair P, Lewis G

Levels of evidence allow clinicians to appreciate the quality of a particular research paper quickly. The levels are generally set out in a hierarchical order, which is based largely upon the experimental design. While there are ideal designs for studies examining the effects of interventions, risk factors for a clinical condition or diagnostic testing, in most instances researchers have had to make compromises and these subsequently decrease the quality of their work. This paper provides information concerning how those compromises relate to subsequent levels that are given to a piece of research. It also provides an understanding of issues related to evaluating papers, and suggest ways in which the reader might discern how relevant a paper might be to one’s clinical practice.
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