Breast Cancer Treatment in a Patient with Decubitus Ulcer Infection Secondary to Spina Bifida: Surgical Resection versus Neoadjuvant Chemotherapy

Spina bifida (SB) is a congenital neural tube defect that often presents with neurological disability and decubitus ulcers. A 66-year-old woman with SB presented to our hospital with decubitus ulcers and was treated by a plastic surgeon. She was referred to our department because of a mass measuring 5 × 4 cm in the superolateral quadrant of the right breast. The size of the right axillary lymph node (LN) was 2 × 1 cm. A core-needle biopsy revealed an invasive ductal carcinoma. Total mastectomy and axillary LN dissection were planned. However, 2 days prior to surgery, the size of the mass and the LN rapidly increased to 7 × 4 cm and 3 × 2 cm, respectively. Furthermore, the enlarged LN was close to the thoracodorsal artery. Since complete resection was difficult, neoadjuvant chemotherapy was also administered. On day 11 of neoadjuvant chemotherapy, the patient was febrile and developed a decubitus ulcer infection at the buttock. The neutrophil count was within normal limits; thus, she was not diagnosed with febrile neutropenia. Follow-up computed tomography revealed a shrinking of the mass to 5 × 4 cm after the first cycle of neoadjuvant chemotherapy. After 17 days of antibiotic therapy and drainage, total mastectomy and axillary LN dissection were performed. Due to the risk of recurrence of infection, adjuvant chemotherapy was discontinued and hormone therapy was initiated. In conclusion, indications for chemotherapy should be carefully evaluated in SB patients with lower limb paralysis and decubitus ulcers.

Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism: an uncommon cause of acute muscle paralysis

Hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism is an uncommon clinical phenomenon characterised by lower limb paralysis secondary to hypokalaemia in the background of subclinical hyperthyroidism. In this article, we report a patient who presented with progressive lower limb muscle weakness secondary to hypokalaemia that was refractory to potassium replacement therapy. He has no diarrhoea, no reduced appetite and was not taking any medication that can cause potassium wasting. Although he was clinically euthyroid, his thyroid function test revealed subclinical hyperthyroidism. His 24-hour urine potassium level was normal, which makes a rapid transcellular shift of potassium secondary to subclinical hyperthyroidism as the possible cause. He was successfully treated with potassium supplements, non-selective beta-blockers and anti-thyroid medication. This case report aimed to share an uncommon case of hypokalaemic periodic paralysis secondary to subclinical hyperthyroidism, which to our knowledge, only a few has been reported in the literature.

Lower Limb Joint Nursing and Rehabilitation System Based on Intelligent Medical Treatment

With the aggravation of the problem of aging population, all kinds of lower limb paralysis caused by various diseases occur frequently. People’s demand for lower limb nursing and rehabilitation treatment is growing. In this paper, combined with intelligent medical technology and lower limb kinematics model, this paper proposes to build a lower limb joint nursing and rehabilitation system based on intelligent medical treatment. It is expected that, through the following limb joint rehabilitation robot as the main rehabilitation means, a smart nursing rehabilitation system which can quickly respond to users and realize remote rehabilitation nursing can be designed. First of all, it is clear that the main body of the lower limb joint rehabilitation system consists of the robot body and the state display system. Then, the sensor, amplifier, and data acquisition card are set in the data acquisition system, and the plantar balance force is detected using a FlexiForce film pressure sensor. The final control system mainly includes the main control module program and the lower limb action recognition program. The motor control software adopts PID regulation method, and the lower limb action recognition adopts SVM one-to-one classification method. After the construction of lower limb joint nursing and rehabilitation system, the accuracy rate of action recognition and classification was tested. In the third experiment, the accuracy of all the movements was 100%. Then, the joint displacement and angle changes of the experimenter assisted by the system were analyzed. The experimenter’s knee joint and hip joint show a normal walking state, and the joint angle changes tend to be normal. Ten out of 55 rehabilitation system users were randomly selected for interview survey. The total scores of operation convenience, wearing comfort, intensity suitability, and movement science of the system were 90, 83, 84, and 91, respectively. This shows that the rehabilitation action designed by the system is scientific and easy to operate and can be put into use in rehabilitation training after improving the wearing comfort.

Design of a Generic Wearable-Robot Monitoring System (GWRMS) for Patients with Lower Limb Paralysis

The development of wearable robotic technology has accelerated recently due to active research in industrial technology. Wearable robots are used to help patients with lower-body palsy to walk. This paper reports a generic wearable-robot monitoring system (GWRMS) that supports resource monitoring and status prediction. The GWRMS offers universal support for operating systems that comply with the Portable Operating System Interface (POSIX) application programming interface (API), reducing limitations that arise due to the choice of operating system and processor. This system improves optimisation of a program operating in a robot-embedded system by detecting overhead in the software process of the wearable robot. In addition, it operates using TCP-socket-based monitoring on an on-demand basis only.