Background: Secondary injuries are frequent in stroke patients at the acute phase. The early rehabilitation for these patients currently still hasn't received enough attention. Thus it may increase the rate of the secondary disorders. Objectives: To describe the common secondary injuries in stroke patients at the acute phase. Subjects: 90 stroke patients over 18 years old that had experienced hemiplegia less than 30 days, and were treated at Neurology Department, Bach Mai Hospital. Method: Cross-sectional study. Data was analyzed by SPSS software, version 13.0. Results: The rate of the secondary injuries in these patients had reached 80.0%. Among them, the rate of pneumonia is the highest with 30.0%, then urological infections with 17.8%, followed by muscular atrophies, contracture of muscles, stress ulcer, and orthostatic hypotension. There is a close relation between pneumonia and perception impairment: the rate of pneumonia in perception impairment patients was 5.25 folds higher than that in patients without perception impairment (67.9% vs. 12.9%, p< 0.001). Similarly, pneumonia rate in patients with nasogastric tube was 4.2 folds higher than that of patients without nasogastric tube (90.9% vs. 21.5%, p< 0.001). Conclusion: The rate of the secondary injuries in acute stroke patients is high. It is necessary to carry out intensive nursing and rehabilitation for these patients.
secondary injuries ; stroke

Background: Injury surveillance is viewed as an important component of injury prevention. Several data systems in the Philippines exist but have not been analyzed together. Analyzing these readily available data can guide policy making. Objective: This report aimed to describe the epidemiology of injuries in the Philippines using secondary datasets. Method: Death data of 2013 from the Philippines Statistics Authority and injury surveillance data of 2014 from the Department of Health were obtained and recoded. Summary statistics were generated. Results: Injured persons mainly come from the young age group. There were a higher number of males compared to females. Provincial variations in death rates for specific injury types existed. There did not seem to be an obvious pattern in injury occurrence according to month and time of day. High numbers of injuries were reported during daytime but admission and death rates peak at night. Injuries were shown to be an anatomically heterogeneous group with dominance in superficial injuries, head trauma, and hand fractures. Conclusion Analysis of secondary datasets revealed the epidemiology of injuries in the Philippines. Results have implications in health policy and injury prevention.
Epidemiology ; Secondary Data Analysis ; Wounds and Injuries

No abstract available.
Aged ; Bone Neoplasms/diagnosis/*secondary ; Carcinoma, Hepatocellular/diagnosis/etiology/*secondary ; Diagnosis, Differential ; Female ; Fractures, Bone/*diagnosis ; Hepatitis B, Chronic/*complications ; Humans ; Liver Cirrhosis/complications ; *Liver Neoplasms/diagnosis/etiology ; Osteoporosis/complications ; Pelvic Bones/*injuries

Head trauma has been mentioned as an uncommon cause of secondary Parkinsonism. We report a 68-year-old woman who developed a rapidly evolving post-traumatic encephalopathy with predominant akinetic-rigid syndrome. The clinical manifestations were mainly bradykinesia, rigidity, cognitive dysfunction and emotional lability. Brain SPECT showed perfusion defect in the left basal ganglia and thalamus. The parkinsonian symptoms improved moderately with levodopa.
Aged ; Basal Ganglia ; Brain Injuries* ; Brain* ; Craniocerebral Trauma ; Female ; Humans ; Hypokinesia ; Levodopa ; Parkinson Disease, Secondary ; Parkinsonian Disorders ; Perfusion ; Thalamus ; Tomography, Emission-Computed, Single-Photon*

CyberKnife is an image-guided robotic system designed for stereotactic radiosurgery. It uses the combination of robotics and image guidance to deliver concentrated and accurate beams of radiation to intracranial and extracranial targets. Although the frameless nature of the CyberKnife allows tumors in the chest and abdomen to be treated as well, complications associated with CyberKnife treatment have not been established yet due to its short clinical experience. We describe a case of localized esophageal ulcerations after CyberKnife treatment for metastatic hepatic tumor of colon cancer.
Aged ; Colonic Neoplasms/*pathology ; Esophagus/*injuries/pathology ; Humans ; Liver Neoplasms/*secondary/*surgery ; Male ; Radiosurgery/*adverse effects/instrumentation ; *Robotics ; Ulcer/etiology/pathology

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.
Antiviral Agents/therapeutic use ; Bone Neoplasms/radiography/secondary ; Carcinoma, Hepatocellular/diagnosis/pathology/*therapy ; Catheter Ablation ; Chemoembolization, Therapeutic/*adverse effects ; Hepatitis B/complications/drug therapy ; Humans ; Liver Cirrhosis/etiology ; Liver Neoplasms/diagnosis/pathology/*therapy ; Male ; Middle Aged ; Positron-Emission Tomography ; Soft Tissue Neoplasms/secondary ; Spinal Cord Injuries/*etiology ; Tomography, X-Ray Computed

Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; Male ; Middle Aged ; Phytotherapy ; Radiation Injuries ; prevention & control ; Spinal Neoplasms ; drug therapy ; secondary ; Treatment Outcome

A 37-year-old female, who had received modified radical mastectomy for cancer of her right breast, presented with decreased visual acuity in the left eye after radiation therapy for the management of the metastasis to her right brain 14 months ago. After ocular examination, we diagnosed her as radiation retinopathy. At the time of the first visit, the corrected best visual acuity was 0.4 in the left eye, and fundus examination revealed cotton wool spots and cystoid macular edema (CME). The findings in the right eye were normal except for cotton wool spots in the superior major arch. Fluorescein angiography (FA) showed marked telangiectasia and microaneurysms in her left eye but tiny microaneurysms in her right eye. Subsequent optical coherent tomography (OCT) showed CME. We injected intravitreal triamcinolone acetonide (TA). Two weeks after treatment, the visual acuity was improved to 0.6 and the retinal thickness was decreased. Three months later, the visual acuity in the left eye was dropped to 0.3 due to the recurrence of CME, so we injected intravitreal TA again. Five months later, visual acuity was improved to 0.5 and OCT revealed the improvement of CME. The incidence of radiation retinopathy is higher in the side nearer to radiation, but careful radiation blocking is also required on the opposite side of irradiation site considering the possibility of radiation retinopathy and careful observation is required on both sides of the eyes when performing fundus examination.
Adult ; Brain Neoplasms/*radiotherapy/secondary ; Breast Neoplasms/pathology/radiotherapy/surgery ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucocorticoids/administration & dosage ; Humans ; Radiation Injuries/diagnosis/drug therapy/*etiology ; Retina/pathology/*radiation effects ; Retinal Diseases/diagnosis/drug therapy/*etiology ; Tomography, Optical Coherence ; Triamcinolone Acetonide/administration & dosage

Zoledronic acid has been used for prevention of osteolytic and osteoblastic bone metastasis. This case report illustrates an undesirable consequence from prolonged usage of zoledronic acid in bone metastasis prevention. Periprosthetic acetabular fracture in a patient treated with zoledronic acid for 7 years was reported. The clinical presentation, radiographic and pathological results were described. This is a rare complication after total hip arthroplasty which should not be ignored especially in patients who received long term bisphosphonate.
Acetabulum/*injuries/pathology/surgery ; Aged ; Arthroplasty, Replacement, Hip/*adverse effects ; Bone Density Conservation Agents/*adverse effects/pharmacology ; Bone Neoplasms/prevention & control/secondary ; Bone Remodeling/drug effects ; Breast Neoplasms/pathology ; Diphosphonates/*adverse effects/pharmacology ; Female ; Fractures, Spontaneous/chemically induced/etiology ; Hip Prosthesis ; Humans ; Imidazoles/*adverse effects/pharmacology ; Osteoarthritis, Hip/*surgery ; Periprosthetic Fractures/*chemically induced/etiology ; Prosthesis Failure ; Reoperation

OBJECTIVETo describe a new method of accessory nerve defect reconstruction with sternocleidomastoid muscle-great auricular flap.

METHODSThirty-four cases receiving traditional radical neck dissection were divided into two groups: single neck dissection group (n = 19) and accessory nerve reconstruction group (n = 15). Surgical procedure of the reconstruction was described in detail. Postoperative shoulder functions were compared between the two groups.

RESULTSAccessory nerve reconstruction group experienced much better shoulder function recovery than that in single neck dissection group.

CONCLUSIONSReconstruction of accessory nerve defects with sternocleidomastoid muscle-great auricular nerve flap is simple, effective and complication-free.

Accessory Nerve ; surgery ; Accessory Nerve Injuries ; Adult ; Aged ; Carcinoma, Squamous Cell ; secondary ; surgery ; Ear ; innervation ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; Neck ; Neck Dissection ; methods ; Neck Muscles ; surgery ; Nerve Transfer ; methods ; Surgical Flaps ; Treatment Outcome