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Study design:Between-groups design with repeated measures.Objective:To quantify spastic hypertonia in spinal cord-injured (SCI) individuals.Setting:Rehabilitative Center, Italy.Subjects:29 individuals with a motor complete SCI (American Spinal Injury Association impairment scale grade A or B) and 22 controls.Methods:According to the modified Ashworth scale (MAS), patients were subgrouped as SCI-1 (MAS=1, 1+) and SCI-2 (MAS=2, 3). Passive flexo-extensions of the knee were applied using an isokinetic device (LIDO Active) at 30°, 60°, 90° and 120° s−1. We measured the peak torque, mean torque (MT) and work. Simultaneous electromyography (EMG) was recorded from leg muscles.Results:At the speed of 120° s−1 all SCI-2 patients presented EMG reflex activities in the hamstring muscle. All biomechanical parameter values increased significantly according to speed, but analysis of variance revealed a significant interaction between the angular velocity and group (F(d.f. 6, 138)=8.89, P<0.0001); post hoc analysis showed significantly greater torque parameter values in the SCI-2 group compared with the SCI-1 group and the control group at 90° and 120° s−1. Receiver operating characteristic curves showed that using peak torque values the probability of correctly classifying a patient into SCI-1 and SCI-2 was 95%, compared with 70% for MT and 68% for work.Conclusions:The isokinetic device is useful for distinguishing individuals with a high level of spastic hypertonus. Examination of EMG activity may help ascertain whether increased muscle tone is caused by reflex hyper excitability and to determine whether muscle spasm is present. Peak torque and simultaneous EMG assessment should be considered for the evaluation of individuals with SCI in the rehabilitative context, that is, in measuring therapeutic interventions. [ABSTRACT FROM AUTHOR]

Neurogenic lower urinary tract dysfunctions are common in patients with multiple sclerosis and for most of them urinary dysfunction has the most negative impact on their social life. No correlation exists between clinical urinary symptoms and urodynamic patterns. Abnormal urodynamic patterns may be present in asymptomatic patients. Both clinical and urodynamic findings may change during the course of the illness. Early diagnostic approach and scheduled follow-ups are mandatory in order to prevent upper urinary tract complications and improve quality of life (QoL). [ABSTRACT FROM AUTHOR]

Background and objectives: Thyroid nodules are a common finding in clinical practice and can be either benign or malignant. The aim of this study was to compare laboratory parameters between patients with malignant thyroid nodules and those with benign thyroid nodules. Materials and methods: A total of 845 patients were included, with 251 in the study group (malignant thyroid nodules) and 594 in the control group (benign thyroid nodules). Results: Our results show that there were statistically significant differences in several laboratory parameters, including FT3, FT4, ESR, fibrinogen, WBC, and lymphocyte percentage, between the two patient groups ( p < 0.05). Conclusions: These findings suggest that certain laboratory parameters may be useful in differentiating between benign and malignant thyroid nodules and could aid in the diagnosis and treatment of thyroid cancer. However, further diagnostic tests such as fine-needle aspiration biopsy and imaging studies are typically required for an accurate diagnosis. Routine laboratory tests prove most effective when combined with other diagnostic methods to identify thyroid cancer. Although not conclusive on their own, these tests significantly suggest and guide physicians to suspect malignancy in thyroid nodules. This affirmative answer to our question, "Can routine laboratory tests be suggestive in determining suspicions of malignancy in the case of thyroid nodules?" aligns with the results of our study.

Sonographic demonstration of radial nerve compression by a strict permanent suture, with intra-operative correlation., (© 2022 Wiley Periodicals LLC.)

Study Design: Prospective cohort study., Objectives: To analyze the circadian rhythm and state-dependent modulation of core body temperature (Tcore) in individuals with spinal cord injury (SCI) under controlled environmental conditions., Setting: Institute of the Neurological Sciences of Bologna, Italy., Methods: We assessed 48-h rectal Tcore and sleep-wake cycle by means of video-polygraphic recording in five cervical SCI (cSCI), seven thoracic SCI (tSCI), and seven healthy controls under controlled environmental conditions., Results: cSCI showed higher night-time Tcore values with reduced nocturnal decrease, higher MESOR and earlier acrophase compared with tSCI and controls (p < 0.05 in all comparisons). The mean Tcore values during wake and non-rapid eye movement (NREM) and rapid eye movement (REM) sleep stages were higher in cSCI compared with tSCI and controls (p < 0.05). Tcore variability throughout the 24 h differed significantly between cSCI, tSCI, and controls., Conclusions: cSCI had higher Tcore values without physiological night-time fall compared with controls and tSCI, and a disrupted Tcore circadian rhythm. Furthermore, SCI individuals did not display the physiological state-dependent Tcore modulation. The disconnection of the sympathetic nervous system from its central control caused by the SCI could affect thermoregulation including Tcore modulation during sleep. It is also possible that the reduced representation of deep sleep in people with SCI impairs such ability. Further studies are necessary to evaluate whether improvement of sleep could ameliorate thermoregulation and vice versa.