Ultrasound-based Neuropathy Diagnosis in COVID-19 Patients in Post-intensive Care Rehabilitation Settings: A Retrospective Observational Study.

OBJECTIVES: Using ultrasound (US) scanning to examine the correlation between increase of common fibular nerve's (CFN) cross sectional area (CSA) and functional impairment of foot dorsiflexor muscles as an early sign of peripheral neuropathy. DESIGN: Retrospective observational study. SETTING: In-patient rehabilitation unit between November 2020 and July 2021. PARTICIPANTS: Twenty-six inpatients who underwent prolonged hospitalization in intensive care units (ICUs) and were diagnosed with critical illness myopathy and polyneuropathy after SARS-COV-2 infection (N=26). Physical examination and US scanning of the CFN and EMG/ENG were carried out on each patient. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): CFN's CSA at the peroneal head. RESULTS: We verified a significant increase in the CSA of the CFN measured at the peroneal head in more than 90% of the nerves tested. A cut off value of CFN's CSA of 0.20 cm was used to identify pathologic nerves. No correlations with other variables (body mass index, ICU days) were found. CONCLUSION: US scanning of the CFN appears to be an early and specific test in the evaluation of CPN's abnormalities in post COVID-19 patients. US scanning is a reproducible, cost effective, safe, and easily administered bedside tool to diagnose a loss of motor function when abnormalities in peripheral nerves are present.

Mazabraud's syndrome: a new case and review of the literature.

The association between muscular myxomas and fibrous dysplasia is a rare condition known as Mazabraud's syndrome, as reported by Henschen (Verh Dtsch Ges Pathol 21:93-97, 1926) and Mazabraud A and Girard (Rev Rhum Mal Osteoartic 24(9-10):652-659, 1957). We report a case of a 32-year-old woman with multiple myxomas in her right thigh and monomelic fibrous dysplasia. A review of the international literature referring to 67 cases to date was carried out. The syndrome is characterised by the following features: females are twice as likely to be affected as males; the lower limbs are the most frequently affected, fibrous dysplasia is more common in the femur and the pelvis and myxomas in the quadriceps muscle; myxoma is multiple in more than 70% of cases. Although there has never been any continuity between tumours and bone lesions, a significant correlation between dysplastic bone and myxoma has been revealed.

An osteoporotic hip fracture in a 14-year-old girl undergoing chemotherapy and operated for knee osteosarcoma.

Non-weight-bearing, pre- and postsurgical immobilization, neoadjuvant and adjuvant chemotherapy are known to act on bone turnover, causing osteoporosis over short and long time periods. Treatment of fracture insurgence is very difficult because it really depends on being able to choose the right time (i.e., when immunodeficiency is less important). We report a case of spontaneous neck femur fracture during adjuvant chemotherapy in a young girl treated with resection and prosthesis reconstruction for distal femur osteosarcoma. Possible prevention and the correct approach and surgical timing are emphasized considering immunodeficiency following chemotherapy.

The Gore-Tex biomaterial mesh as temporary divisor in two times surgery for spinal and pelvic tumors.

In muscular skeletal spine and pelvic tumor, surgery can be performed by a double anterior and posterior approach to decrease the risk of bleeding and opening the tumor; in first one, neurovascular bundles are divided by the mass; in second one, the tumor is resected by posterior or postero-lateral approach. A Gore-Tex mesh could be used as divisor between neurovascular bundles and the tumor to decrease the adhesion formation risk and facilitate tumor removal during second operation if performed after more days. The cohort was composed by a consecutive series of 11 patients underwent to surgery for spine and pelvic tumor where Gore-Tex mesh spacer was placed. In this study, efficiency and tolerability of Gore-Tex mesh were evaluated. No case of adhesion between Gore-Tex mesh and surrounding structures is reported, no case of migration or complications occurred. Gore-Tex mesh use can be considered a useful and safe procedure to decrease the risk of adhesion formation between tumor and surrounding tissue so that to allow the tumor removal easier.