Background: Opsoclonus myoclonus syndrome is a rare condition characterized by the amalgamation of multidirectional saccades of eye movements, involuntary myoclonus predominantly affecting trunk and limbs and cerebellar ataxia. Typical malignancies associated with paraneoplatic opsoclonus myoclonus syndrome (POMS) in adults are small cell lung carcinoma and breast cancer with variable outcomes. Case Report: The authors report here a patient with stage IV recurrent right breast cancer, presenting to the hospital with unsteady gait, jerky movements of the limbs and body. She was clinically diagnosed with POMS with positive cerebrospinal fluid anti-Ri antibody. Medical treatment with intravenous methylprednisolone and early initiation of rehabilitation improved her balance, coordination and ataxia. This led to an overall improvement in her physical function. Conclusion: This case illustrates the importance of early recognition, prompt treatment of POMS and initiation of rehabilitation in achieving better functional outcomes.
Purpose: Femoral shaft fractures represent 1.4-1.7% of all fractures in the pediatric population and may be associated with significant morbidity. The purposes of this study are to verify if increasing age and weight are predictive factors of associated injuries and complications in children with femoral shaft fractures.Methods: Retrospective study, including patients with age below 16 years old, admitted in our Department between 2011-2015, with the diagnosis of femoral shaft fracture. Patient demographics, fracture characteristics, associated injuries, treatment methods, time to union, follow-up and complications were collected from the medical records. Statistical significance was set for level of p<0.05.Results: Sixty patients were included. There was a male predominance [n=40]. Age at the time of injury was 6.3±4.9years old. The 61 femoral shaft fractures: observed affected different areas: 12-proximal; 43-middle; 6-distal. The most common etiology was direct trauma after a fall and traffic accident. Associated lesions were found to be significantly higher in older (p=0.01) and heavier (p=0.009) patients. Conservative treatment was the option for 62% of all fractures. The minimum age to surgery was 6 years old and rigid trochanteric entry nailing was only considered above 10 years old. Patients treated conservatively had a significant lower weight (16.4±8.4Kg) than those operated on (42.5±13.8Kg) [p<0.001]. Mean follow-up time was 50.4±56.8weeks and complications were reported in 15% of patients. We did not verify any statistically significant differences between post treatment complications and the treatment method (p=0.803). Conclusions:The age, weight and associated lesions were considered significant factors when choosing the treatment method.
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