Lateral Antebrachial Cutaneous Nerve Entrapment After Shoulder Arthroscopy: A Case Report.

The lateral antebrachial cutaneous nerve (LABCN) is a distal sensory branch of the musculocutaneous nerve that innervates the radial aspect of the forearm. Cases of LABCN injury from trauma and chronic compression have been reported. A case of musculocutaneous nerve injury after a biceps tenodesis has also been reported. This case report describes an LABCN injury and forearm pain after a biceps tenodesis procedure. Using a multifaceted diagnostic approach of electrodiagnostics and magnetic resonance neurography, the site of compression was appropriately localized. The patient ultimately achieved relief after a surgical decompression.

Vitamin K: fracture prevention and beyond.

Morbidity and decreased function related to osteoporosis, fracture, cardiovascular disease, stroke, and peripheral vascular disease are encountered by clinicians daily. Although we have seen vast advancement in treatment and management of these conditions, preventative practice has unfortunately served a lesser role in patient care. Increasing the dietary intake of vitamin K may have substantial utility in the prevention of these disease states. Since the discovery of vitamin K in 1935, its primary role was thought to be involved in the synthesis of clotting factors II, VII, IX, and X. Recently, its function in other metabolic pathways has emerged, leading to exploration of its significance beyond coagulation. Vitamin K is essential to bone physiology and prevention of atherosclerosis. It is involved in bone remodeling, cell signaling, apoptosis, arterial calcification, and chemotaxis, and it has anti-inflammatory effects. Conversely, warfarin, a potent vitamin K inhibitor, has demonstrated adverse effects on bone remodeling and atherosclerosis. Natural forms of vitamin K are available in multiple dietary sources, and some structural forms are more readily available for use in metabolic pathways than are others. With regard to supplementation, the specific form of vitamin K is often not disclosed, and the recommended daily value is potentially less than what is physiologically required. On the basis of a review of the literature, it appears advantageous to encourage patients to eat a diet rich in vitamin K; however, the benefit of vitamin K supplementation alone is yet to be thoroughly conveyed.

Acute inpatient rehabilitation of 55 patients after liver transplantation.

OBJECTIVE: Acute rehabilitation for patients who have had liver transplants is often necessary to restore functional mobility, but no studies, except for case reports, have documented the complications, outcomes, or predictors of success of an acute inpatient rehabilitation program. Our objective was to examine each of these areas related to rehabilitation after liver transplantation. DESIGN: We performed a chart review of 55 patients who received a liver transplant and were treated on our acute rehabilitation service. We examined several factors, including age, reason for transplant, length of acute hospital stay, length of acute inpatient rehabilitation stay, FIMtrade mark scores, albumin levels, medical complications, and discharge disposition. RESULTS: Patients undergoing rehabilitation after liver transplantation required multiple medical interventions, including liver biopsy, ultrasound, blood transfusions, and dialysis. Several patients (15%) were transferred to the acute care hospital for medical problems. Both a low albumin and a long length of stay in the acute care hospital correlated with a longer stay in rehabilitation and less efficient rehabilitation. Longer rehabilitation stays correlated positively with FIM gain (P < 0.001, r = 0.534). Significant improvements in FIM scores (P < 0.001) during acute inpatient rehabilitation were noted in patients who were discharged to home. We also found that age, albumin level, and length of stay in the hospital did not predict discharge disposition. CONCLUSION: Patients who have had liver transplants can achieve significant functional gains in acute rehabilitation. Rehabilitation professionals should be aware of potential complications and factors that may affect the rehabilitation of this patient population.