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The subject matter of the present scientific paper is the report of a sustained and persistent therapeutic rehabilitation team-run program in the case of a polytraumatized patient with severe TBI (severe psychomotor agitation and dislogia, bifrontal syndrome, post-traumatic encephalopathy) associated with locomotor and self-care dysfunction, neurogenic bladder and complicated with eso-tracheal fistula after necessity tracheostoma due to subsequent important pulmonary complications that led to a favorable progression despite the limitations imposed by the mental state of the patient during hospitalization and the presence of multiple severe pulmonary complications. [ABSTRACT FROM AUTHOR]

Introduction. The Fugl-Meyer assessment scale for the evaluation of neuro-sensory-motor deficits after stroke represents, by completeness and adequate folding, both conceptually and methodologically, on the physio pathological and clinical-evolutionary reality of disability in this type of pathology, a widely used quantification tool for international level and well appreciated in many works in profile literature. Materials and methods. From the desire to implement the scale within the neurorehabilitation units in our country, some correspondence with the right holders of the use of the scale within the University of Gothenburg was initiated in 2019. Subsequently, the group proposed us to carry out an official translation according to an algorithm for achieving the unitary translation, agreed and recommended by the official administrators of the standardized forms of the scale, which will be included on the official website of the respective university along with other translations. Results. Following the initial steps, a constructive correspondence was maintained with the official administrators of the University of Gothenburg and in accordance with the mutual agreement, we carried out the translation from English into Romanian of the specific forms on the official site. The translation included, at the recommendation of the Gothenberg collective, only the component used for measuring the motor functions for the upper and lower extremities. In addition, Prof. Dr. Roxana Carare was co-opted in the team of. Currently, the confrontation of the translation version of our team with the one made by her (forward from English to Romanian) is underway. Within the confrontation of forward translation, different shades of formulations were found at different levels. Conclusions. In the later stages, the reverse confrontation from Romanian to English (backward) of the two translated variants is considered. At the same time, the coordinator of the administrators of the scale of the University of Gothenburg, Prof. Dr. Margit Alt Murphy, expressed her availability of assistance at all stages of the translation process. [ABSTRACT FROM AUTHOR]

Introduction: Encouraged by the favorable outcomes of previous mediatic national prophylactic campaigns, initiated and sustained by the medical team of Teaching Emergency Hospital "Bagdasar-Arseni" and National TV Channels (ProTv, TVR1) focused on the risk of severe disability after cervical spinal cord injury (CSCI) by diving in unknown waters, we decided to continue increasing awareness education actions. The previous prophylactic campaigns were followed by a statistically significant reduction in the number of young patients admitted to hospital with quadriplegia after diving in unverified waters (26.8% in 2016 and 39% in 2017). Starting from the ISCoS paradigm "Prevention is cure", we have resumed the prophylactic educational actions addressed to healthcare professionals (students, residents, young doctors) in campaigns to prevent CSCI and accidental tetraplegia during summer sports. The objective of the study was to test medical, diving biomechanical level of knowledge and circumstances regarding risks associated with diving in unknown waters, among young kinetotherapy FMAM students (under the age of 35). The study has the Teaching Emergency Hospital "Bagdasar-Arseni" Ethics Committee's approval NO 17464/14.06.2019. Materials and methods: The research was conducted using the questionnaire technique, containing 16 closed questions addressed to a number of 40 students from Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. Results: We observed that most of the young students act precociously: 67.5% swim in special designated places, 77.5% dive with their feet first, versus 22.5% plunge the head first. Students have a low level of knowledge about biomechanics of plunging and the impressive speeds reached during diving. More than two-thirds of them did not answer the question about the speed reached during diving from 1 m (7.5 m/s, equivalent to 27 km/h) (67.5% students), from 10 m platform (17.5 m/s, 63 km/h) (70% students) and diving from 30 m (25 m/s, 90 km/h) (67% students). Regarding the alcohol consumption before diving, 80% of them responded with "no", and only 5% responded with "occasional consumption". Eighteen students (45%) know the main risk of diving in unknown and shallow waters, and 20 students (50%) have responded incorrectly. Conclusions: Young students - future therapists have a low level of knowledge about CSCI risk and the severe disabilities that can occur accidentally by diving. It is mandatory to continue the education prophylactic initiative sustained activity through mass media, started in 2016-2018. [ABSTRACT FROM AUTHOR]

Introduction. Persons living in wheelchair are often target of hetero-aggressive behavior. The aggressors perceive persons in wheelchair as easy victims. Obiectives Acquisition of adapted self-defense techniques and procedures by young paraplegic persons, independed in wheelchair, to counteract some possible hetero-aggressive behavior against them. Material and methods. A young male person, former sportsman (familiarised with wrestling techniques), living with T11 AIS-A (complete) paraplegia after a spinal cord injury and independent in wheelchair, was instructed some various taekwondo techniques and maneuvres: blocking an attack with the hand at the head region (Olgul Jireugi), hand block (Olgul Maki), hand counteratack (Momntong Jireugi), foot attack at the head region (Olgul Dollyo Chagi), hand block (Sonnal Olgul Maki), hand counterattack (Arae Jireugi). The young female who plays the role of attacker has black belt in taekwondo, therefore the maneuvres were performed in total safety, without endangering the pacient. Both protagonists of this presentation have given written consent to be photographed and filmed, for academic purpose. The paper has the approval of the Ethics Committee of "Bagdasar-Arseni" Clinical Emergency Hospital, n.o. 17464/14.06.2019. Results: We realized photographs and films depicting the aforementioned taekwondo techniques, to demonstrate some possible scenarios of aggression. Discussion Acquisition of martial art techniques and procedures by paraplegic people, independent in wheelchair, is essential and may improve their safety, participation, self-esteem and quality of life. Conclusions: Prevention, as a self defense method, is essential. The best way is to avoid conflictual situations, but ideal is to be prepared for any situation. [ABSTRACT FROM AUTHOR]

Introduction. Schizophrenia is a surprisingly common chronic psychiatric illness in the general population affecting 1 in 100 people worldwide. Although the symptoms widely differ from one case to another, schizophrenia is quite difficult to recognize because the patient can behave normally and appropriately in different social situations. Studies in the literature highlight that the majority of the patients with SCI and pre-existing schizophrenia have suffered accidents as a result of voluntary height adjustments. Also, 37.5% of the suicide attempts with SCI are caused by schizophrenia and depression. The main difficulties encountered in the recovery of these patients are the psychiatric manifestations. At the same time, the risk of suicide in patients with schizophrenia after suffering from SCI is higher than those with SCI without schizophrenia. Therefore, the recovery of the patients with SCI and schizophrenia is a complex process which requires the control of the psychiatric symptoms. A multidisciplinary team is required for such a purpose. Material and method. Having the patient's consent and approval of the Ethics Committee of “Bagdasar-Arseni” Clinical Emergency Hospital, N.O. 3159/30.01.2020, the paper presents the case of a 23-year-old female patient with AIS/ Frankel B flaccid paraplegia after TVML after falling from height (affirmative through window-suicide attempt) operated on, in a polytraumatic context. The patient is known with schizophrenia and she was being monitored by a psychiatrist at the time of the accident, but she voluntarily discontinued treatment during that period. The patient was clinically and functionally evaluated, according to the standardized protocols implemented in our clinic, through the assessment scales (ASIA, FIM, FAC, QoL, Ashworth and Penn) and also paraclinically, in order to evaluate her biological reserve and her bearing availability of the recovery program. Results and discussions. The patient presented a slowly favorable evolution (slowed down by her severe motor deficit, but also by her psychiatric symptoms such as affective ability with depressive, negative behavior, depersonalization). Conclusions. The main difficulties encountered in the recovery of these patients are the psychiatric manifestations. Therefore, the recovery of patients with SCI and schizophrenia is a complex process that first requires the control of psychiatric symptoms. A multidisciplinary team is required for such a purpose. [ABSTRACT FROM AUTHOR]

Introduction. Disc herniation occurs most commonly in the lumbar region (95% of the cases). The current trend is to have surgery on patients with disc herniation if the kinetic treatment was not beneficial. The data from the literature suggest that early active recovery after lumbar disc herniation is more beneficial than a traditional, less active training program. Material and method. Having the patient's consent and the approval of the Ethics Committee of “Bagdasar-Arseni” Clinical Emergency Hospital, N.O. 17464 / 14.06.2019, the paper presents the case of a 75-year-old patient with paraparesis after multilevel lumbar disc herniation, spinal canal stenosis and spondylolisthesis iteratively operated, in pluripathological context (hyperplastic type II obesity, hypertension, prostate adenocarcinoma operated in 2015, Clostridium enterocolitis). The patient was clinically and functionally evaluated, according to the standardized protocols implemented in our clinic, through the assessment scales (ASIA, FIM, FAC, QoL, Ashworth and Penn) and also paraclinically, in order to evaluate his biological reserve and his bearing availability of the recovery program. Results and discussions. The patient presented a slowly favorable evolution (slowed down not only by his multiple abovementioned comorbidities) from a dysfunctional point of view. Conclusions. Early active recovery after lumbar disc herniation surgery is more beneficial than a traditional, less active training program for operated herniated discs. [ABSTRACT FROM AUTHOR]

Introduction: Oxidative stress is one of the main mechanisms involved in the pathophysiology of inflammatory and neurodegenerative diseases of the CNS. The association between psoriasis and cardiovascular disease is an etiopathogenic dilemma, many studies have shown an increased risk of cardiovascular morbidity in patients with psoriasis, compared to the general population. The prevalence of gout is 6% men and 2% women. Gout is a risk factor for multiple pathologies including cardiovascular disease, being the equivalent of diabetes on vascular pathology. The association of gout with myocardial infarction or stroke is not very clear, the relationship between uric acid and prognostic of stroke remains debatable. Uric acid is the end product of purine catabolism, and the main endogenous blood antioxidant; it potentiates the neuroprotective effects of rt-PA (tissue plasminogen activator). Despite the above, an increased level of uric acid can be considered as an independent risk factor for stroke. Too high or too low uric acid concentrations are associated with a negative prognosis of stroke. Although uric acid is an endogenous primary antioxidant with neuroprotective potential, patients with cerebral ischemia and excessively high levels of uric acid (> 380 µmol / L), or too low uric acid (≤250 μmol / L), are at risk of 2-3 times higher for poor prognosis of stroke, compared with patients with normal uric acid levels (250-380 μmol / L). Case presentation. A 47-year-old male patient was admitted in subacute stage of capsulo- thalamic ischemic stroke (October 31, 2019). Neurological examination revealed predominantly left hemiplegia, locomotor deficiency, hemihypoesthesia, left-sided homonymous hemianopsy. The medical history: capsulo-thalamic ischemic stroke, HTA-E st III (neglected, diagnosed in December 2018), chronic tophaceous gout (diagnosis in 1998, treated with Colchicine and Milurit), psoriatic arthropathy (2016), cholecystectomy (2001), chronic smoking, for over 30 years. The patient has deformed gouty tufts at the level of the right achilles tendon (with local suppuration), left achillian tendon, hallux bilateraly, the right elbow joint, right hand. It was evaluated clinically and functionally, according to the standardized protocols implemented in our clinic (ADL, IADL, Barthel, MMSE, FIM, QOL, Asworth Penn, FAC, Stratify risk scale, GOS-E, modified Rankin, MOCA) and paraclinic by laboratory analysis, joints radiographs (hands, elbows ankle joints), cerebral CT. The patient received a complex neuromuscular recovery program (synergistic association of neurotrophic factors, metabolic modulating medication, kinetotherapy). No corticosteroid medication was needed in topical application on the psoriatic lesions. The evolution was favorable with neurological improvement, reflected by the neurological evolution and quantified by the upward curve of the clinical scores. Improvement of the short distance walking, static and dynamic balance were obtained; at discharge he performed independent walking on short distances with a tetrapod stick. Secondary prophylaxis addressed the control of the risk factors that could be influenced: the metabolic dysfunction (diet and medication), optimization of blood pressure, smoking (health education and patient's will); psoriasis is the only less influential etiopathogenic risk factor. Conclusions: The current standard of management of patients with stroke and multiple comorbidities (gout, psoriasis, HTA, chronic tobacco) is represented by the multidisciplinary approach, for secondary and tertiary prophylaxis, in order to improve their quality of life. [ABSTRACT FROM AUTHOR]