Purpose: To train deep learning convolutional neural network (CNN) models for classification of clinically significant Chiari malformation type I (CM1) on MRI to assist clinicians in diagnosis and decision making.

Methods: A retrospective MRI dataset of patients diagnosed with CM1 and healthy individuals with normal brain MRIs from the period January 2010 to May 2020 was used to train ResNet50 and VGG19 CNN models to automatically classify images as CM1 or normal. A total of 101 patients diagnosed with CM1 requiring surgery and 111 patients with normal brain MRIs were included (median age 30 with an interquartile range of 23-43; 81 women with CM1). Isotropic volume transformation, image cropping, skull stripping, and data augmentation were employed to optimize model accuracy. K-fold cross validation was used to calculate sensitivity, specificity, and the area under receiver operating characteristic curve (AUC) for model evaluation.

Results: The VGG19 model with data augmentation achieved a sensitivity of 97.1% and a specificity of 97.4% with an AUC of 0.99. The ResNet50 model achieved a sensitivity of 94.0% and a specificity of 94.4% with an AUC of 0.98.

Conclusions: VGG19 and ResNet50 CNN models can be trained to automatically detect clinically significant CM1 on MRI with a high sensitivity and specificity. These models have the potential to be developed into clinical support tools in diagnosing CM1.

Keywords: Artificial intelligence; Chiari I malformation; Convolutional neural network; Deep learning; Magnetic resonance imaging.

Studies have shown that mental health and oral health may be correlated, with associations demonstrated between mental health problems and tooth loss, periodontal disease, and tooth decay. The COVID-19 pandemic had alarming implications for individuals' and communities' mental and emotional health. This study examined the associations between mental health status, oral health status, and oral healthcare utilization and highlighted the impact of COVID-19 on mental health. Additionally, this study examines specific sociodemographic factors that may amplify oral health disparities. A nationally representative survey was conducted to capture attitudes, experiences, and behaviors related to oral health, mental health, and unmet oral health needs. Eighteen percent of respondents were categorized as having poor mental health. Visiting the dentist in the last year was more common amongst individuals with good mental health. From the logistic regression model, mental health status, age group, race/ethnicity, education, and last dental visit were all significantly associated with of oral health status. Mental health status, age group, and income groups were all significantly associated with unmet oral health need. Future work should focus on the mental-oral health association, including determining ways to improve oral healthcare utilization and oral health status among people with poorer mental health.

Keywords: anxiety; mental health; oral health; psychology; stress; values.

Cigarette butts (CBs) are non-biodegradable residues of synthetic origin, prevalent on beaches all over the world. The study evaluates discarded CBs on an intensely used urban beach, determining variations in physical and chemical characteristics. CBs collected were observed, classified, and visually separated according to a proposed scale of four levels of degradation to test the potential match between physical and chemical decay. CBs (un-smoked, smoked, and discarded) were used to determine the average length (cm) and mass (g) in order to observe changes in these parameters among the levels. Cigarette butts experience consecutive mass loss during environmental exposure. Scanning electron microscopy (SEM) images were obtained to assess physical changes in fibers due to smoking. FTIR-ATR was used to assess CBs new (un-smoked), smoked, and discarded samples in relation to cellulose acetate decay. The FTIR-ATR spectroscopy of the most visually degraded cigarette butts indicated modifications in the spectra when compared to un-smoked cigarettes.

Keywords: Beach litter; Cellulose acetate; Environmental degradation; Marine pollution; Microplastics; Monitoring.

The screening of a dehydration-responsive chloroplast proteome of chickpea led us to identify and investigate the functional importance of an uncharacterized protein, designated CaPDZ1. In all, we identified 14 CaPDZs, and phylogenetic analysis revealed that these belong to photosynthetic eukaryotes. Sequence analyses of CaPDZs indicated that CaPDZ1 is a unique member, which harbours a TPR domain besides a PDZ domain. The global expression analysis showed that CaPDZs are intimately associated with various stresses such as dehydration and oxidative stress along with certain phytohormone responses. The CaPDZ1-overexpressing chickpea seedlings exhibited distinct phenotypic and molecular responses, particularly increased photosystem (PS) efficiency, ETR and qP that validated its participation in PSII complex assembly and/or repair. The investigation of CaPDZ1 interacting proteins through Y2H library screening and co-IP analysis revealed the interacting partners to be PSII associated CP43, CP47, D1, D2 and STN8. These findings supported the earlier hypothesis regarding the role of direct or indirect involvement of PDZ proteins in PS assembly or repair. Moreover, the GUS-promoter analysis demonstrated the preferential expression of CaPDZ1 specifically in photosynthetic tissues. We classified CaPDZ1 as a dehydration-responsive chloroplast intrinsic protein with multi-fold abundance under dehydration stress, which may participate synergistically with other chloroplast proteins in the maintenance of the photosystem.

An increasing amount of evidence shows that circular RNAs (circRNAs) have critical effects on cancer progression and development; however, the biological function and potential molecular mechanism of circRNAs in hepatocellular carcinoma (HCC) are still unclear. CircRNA sequencing was used to identify differentially expressed circRNAs between HCC tissue and adjacent normal tissue. We found that circ_0001459 expression was significantly elevated in HCC tissue and cell lines. Furthermore, in vitro and in vivo functional experiments were carried out to detect the effects of circ_0001459 on HCC growth and metastasis. Knockdown of circ_0001459 significantly inhibited the proliferation, migration, and invasion of HCC cells, whereas upregulation of circ_0001459 had the opposite effect. Moreover, bioinformatics analysis, dual-luciferase reporter assay, RNA immunoprecipitation, and fluorescence in situ hybridization assays were used to predict and verify the interaction between circ_0001459, miR-6165, and the target gene IGF1R. Downregulation of circ_0001459 decreased IGF1R expression and inhibited epithelial-to-mesenchymal transition, which could be rescued by treatment with a miR-6165 inhibitor. Mechanistically, we revealed that circ_0001459 could sponge miR-6165 and induce the upregulation of its downstream target IGF1R, thus significantly promoting the progression of HCC. Therefore, circ_0001459 could be a new potential therapeutic target for HCC patients.

Keywords: EMT; HCC; IGF1R; circ_0001459; miR-6165.

Background: Abemaciclib is a new oral targeted treatment option for patients with advanced breast cancer. The emerging field of oral antitumor therapeutics presents challenges for both patients and healthcare teams; non-adherence and high inter-individual pharmacokinetic variability can influence response rates.

Methods: For monitoring abemaciclib in human sera, a rapid novel ultra-high-performance liquid chromatography-tandem mass spectrometry method was developed and fully validated. Sample preparation was based on a protein precipitation step followed by on-line solid phase extraction. Chromatographic separation was achieved using a biphenyl column and the isotope labeled standard abemaciclib-d₈ was used for quantification.

Results: The method showed linearity over a wide calibration range from 20.0 to 2500 ng/mL. With accuracies and precisions of ≤13.9% and ≤4.42%, respectively, the validation results were within the criteria of acceptance. The fitness of the method was tested by monitoring abemaciclib levels under compassionate use for a single individual.

Conclusions: The novelty of the presented two dimensional isotope dilution UHPLC-MS/MS method is in the semi-automated sample preparation, which results in negligible matrix effects, thereby allowing the introduction of abemaciclib into robust routine therapeutic drug monitoring (TDM). This method provides an efficient tool to verify the usefulness of personalized anticancer therapy in clinical practice.

Keywords: Abemaciclib; Kinase inhibitor; Oral tumor therapy; Therapeutic drug monitoring; Two dimensional-chromatography; isotope dilution UHPLC-MS/MS.

Objective: To determine the extent to which Black race is associated with the infant mortality rate (< 365 day, IMR) of births to US-born and foreign-born Latinx women.

Methods: Stratified and multivariable binominal log-linear regression analyses were performed on the 2010-2013 National Center for Health Statistics linked birth-death certificate files of singleton infants.

Results: The IMR of births to US-born Black Latinx women (N = 54,542) exceeded that of births to US-born White Latinx women (N = 1,320,084): 5.7/1000 vs 4.2/1000, RR = 1.4 (1.2, 1.5). In contrast, the IMR of births to foreign-born Black Latinx women (N = 35,544) approximated that of births to foreign-born White Latinx women (N = 1,372,172): 3.8/1000 vs 3.6/1000, RR = 1.0 (0.9, 1.2) The adjusted (controlling for maternal age, education, prenatal care, high parity, and region of residence) RR of infant mortality for births to US-born and foreign-born Black (versus non-Latinx White) Latinx women equaled 1.4 (1.2, 1.6) and 1.0 (0.8, 1.2), respectively. The adjusted RR of infant mortality for births to US-born and foreign-born White (versus non-Latinx White) Latinx women equaled 1.0 (0.9, 1.0) and 0.8 (0.7, 0.8), respectively.

Conclusions: Black race is associated with a 1.4-fold higher IMR among births to US-born Latinx women. A similar phenomenon does not occur among foreign-born Latinx women. These intriguing findings highlight that the social construct of Black race across the life-course of Latinx women are detrimental to infant outcome.

Keywords: Black race; Infant mortality; Latinx; Nativity.

Silver nanowire (Ag NW) has been considered as the promising building block for the fabrication of transparent electromagnetic interference (EMI) shielding films. However, the practical application of Ag NW-based EMI shielding films has been restricted due to the unsatisfactory stability of Ag NW. Herein, we proposed a reduced graphene oxide (rGO) decorated Ag NW film, which realizes a seamless integration of optical transparency, highly efficient EMI shielding, reliable durability and stability. The Ag NW constructs a highly transparent and conductive network, and the rGO provides additional conductive path, showing a superior EMI shielding effectiveness (SE) of 33.62 dB at transmittance of 81.9%. In addition, the top rGO layer enables the hybrid film with reliable durability and chemical stability, which can maintain 96% and 90% EMI SE after 1000 times bending cycles at radius of 2 mm and exposure in air for 80 days. Furthermore, the rGO/Ag NW films also possess fast thermal response and heating stability, making them highly applicable in wearable devices. The synergy of Ag NW and rGO grants the hybrid EMI shielding film multiple desired functions and meanwhile overcomes the shortcomings of Ag NW. This work provides a reference for preparing multifunctional integrated transparent EMI shielding film.

Keywords: Electromagnetic interference shielding; Flexible; Reduced graphene oxide; Silver nanowire; Transparent.

This protocol outlines the process of preparing Saccharibacteria (TM7) and applying ligature with and without TM7 onto a mouse molar, and measuring the subsequent bone resorption and inflammation. This ligature model is particularly useful in studying the pathogenicity of specific bacteria that do not typically colonize the mouse oral cavity. This is especially true in the case of TM7 bacteria that prefer to grow on the surface of other bacteria. For complete details on the use and execution of this protocol, please refer to Chipashvili et al. (2021).

Keywords: Immunology; Microbiology; Model Organisms.

Colibactin is a chemically unstable small-molecule genotoxin that is produced by several different bacteria, including members of the human gut microbiome^1,2. Although the biological activity of colibactin has been extensively investigated in mammalian systems³, little is known about its effects on other microorganisms. Here we show that colibactin targets bacteria that contain prophages, and induces lytic development through the bacterial SOS response. DNA, added exogenously, protects bacteria from colibactin, as does expressing a colibactin resistance protein (ClbS) in non-colibactin-producing cells. The prophage-inducing effects that we observe apply broadly across different phage-bacteria systems and in complex communities. Finally, we identify bacteria that have colibactin resistance genes but lack colibactin biosynthetic genes. Many of these bacteria are infected with predicted prophages, and we show that the expression of their ClbS homologues provides immunity from colibactin-triggered induction. Our study reveals a mechanism by which colibactin production could affect microbiomes and highlights a role for microbial natural products in influencing population-level events such as phage outbreaks.

Nonlinear, multiplication-like operations carried out by individual nerve cells greatly enhance the computational power of a neural system^1-3, but our understanding of their biophysical implementation is scant. Here we pursue this problem in the Drosophila melanogaster ON motion vision circuit^4,5, in which we record the membrane potentials of direction-selective T4 neurons and of their columnar input elements^6,7 in response to visual and pharmacological stimuli in vivo. Our electrophysiological measurements and conductance-based simulations provide evidence for a passive supralinear interaction between two distinct types of synapse on T4 dendrites. We show that this multiplication-like nonlinearity arises from the coincidence of cholinergic excitation and release from glutamatergic inhibition. The latter depends on the expression of the glutamate-gated chloride channel GluClα^8,9 in T4 neurons, which sharpens the directional tuning of the cells and shapes the optomotor behaviour of the animals. Interacting pairs of shunting inhibitory and excitatory synapses have long been postulated as an analogue approximation of a multiplication, which is integral to theories of motion detection^10,11, sound localization¹² and sensorimotor control¹³.

Preimplantation genetic testing (PGT) for monogenic disorders and assisted reproductive technology have evolved and progressed in tandem. PGT started with single-cell polymerase chain reaction (PCR) followed by fluorescent in situ hybridisation for a limited number of chromosomes, later called 'preimplantation genetic diagnosis (PGD) version 1'. This review highlights the various molecular genetic techniques that have evolved to detect specific inherited monogenic disorders in the preimplantation embryo. Literature review in English was performed in PubMed from 1990 to 2021, using the term 'preimplantation genetic diagnosis'. With whole-genome amplification, multiple copies of embryonic DNA were created. This helped in avoiding misdiagnosis caused by allele dropout. Multiplex fluorescent PCR analysed informative short tandem repeats (STR) and detected mutations simultaneously on automated capillary electrophoresis sequencers by mini-sequencing. Comparative genomic hybridisation (CGH) and array CGH were used for 24 chromosome aneuploidy screening. Subsequently, aneuploidies were detected by next-generation sequencing using single-nucleotide polymorphism arrays, while STR markers were used for haplotyping. 'PGD version 2' included accurate marker-based diagnosis of most monogenic disorders and detection of aneuploidy of all chromosomes. Human leukocyte antigen matching of embryos has important implications in diagnosis and cure of haemoglobinopathies and immunodeficiencies in children by means of matched related haematopoietic stem cell transplantation from an unaffected 'saviour sibling' obtained by PGT.

Keywords: Haplotyping; haematopoietic stem cell transplantation; human leucocyte antigen matching; preimplantation genetic diagnosis; preimplantation genetic testing; preimplantation genetic testing for monogenic disorders PGT-M (evolving); saviour sibling; technologies.

Background: Insufficient nutrition and inappropriate diet have been related to many diseases. Although the literature confirms the hypothesis that particular nutritional factors can influence the quality of semen, until today, there are no specific dietary recommendations created for infertile males. Since the male contribution to the fertility of a couple is crucial, it is of high importance to determine the dietary factors that can affect male fertility.

Aim: The aim of the present study was to evaluate differences in sperm quality parameters, sperm oxidative stress values and sperm acrosome reaction between vegan diet consumers and non-vegans.

Setting and design: Prospective study in a University Medical School.

Materials and methods: The present study was undertaken to evaluate the sperm quality parameters of vegan diet consumers (10 males who had a strictly vegetable diet with no animal products) and compare them with non-vegans (10 males with no diet restrictions). Semen quality was assessed following the World Health Organization (2010) criteria. Acrosome and DNA integrity has been evaluated using the immunofluorescence technique.

Statistical analysis: All variables were analysed by IBM SPSS version 24. Mean differences among groups were compared by Mann-Whitney U-test.

Results: Obtained results showed that total sperm count (224.7 [117-369] vs. 119.7 [64.8-442.8]; P = 0.011) and the percentage of rapid progressively motile sperm were significantly higher in the vegan group compared with the non-vegan group (1 [0-7] vs. 17.5 [15-30]; P < 0.0001). Furthermore, the oxidation-reduction potential (0.4 [0.3-0.9] vs. 1.5 [0.6-2.8]; P < 0.0001) and the proportion of spermatozoon with DNA damage (14.7 [7-33.5] vs. 8.2 [3-19.5]; P = 0.05) were significantly higher in the non-vegan group in comparison to the vegan group.

Conclusions: Results obtained in this study provide additional evidence about the favourable effect of a plant-based diet on sperm parameters. To confirm our preliminary findings, further studies including larger cohorts are warranted.

Keywords: Acrosome reaction; diet; oxidation-reduction potential; sperm quality; vegan.

Oocyte cryopreservation is a boon for women undergoing assisted reproductive technology. With the evolution in the technique of cryopreservation over the last three decades, there has been an exponential rise in the number of oocyte cryopreservation cycles for diverse indications. Apart from cancer patients, it has also been promoted as a mode of fertility insurance to overcome the age-related decline in fertility as well as post-surgical decline following endometriosis surgery. The objective of the review is to evaluate its clinical applications, ideal age at freezing, optimal oocyte number, freezing method of choice, efficacy, safety and recent advances. In the last decade, vitrification has surpassed slow freezing for oocyte cryopreservation. Although closed system of vitrification provides the aseptic environment, open vitrification is commonly followed in practice. Early to mid-thirties is a reasonable age group for planned oocyte cryopreservation, although it might be recommended at a younger age, in patients with diminished ovarian reserve. The patients should be motivated to preserve around 14-20 mature oocytes for successful live birth. Various studies have shown comparable fertilisation and pregnancy rates between Intracytoplasmic sperm injection with fresh and frozen-thawed oocytes. The available evidence has shown no increase in the incidence of congenital abnormalities in babies born through vitrified oocytes. In the future, image analysis using artificial intelligence, and spindle visualisation using poloscope may further enhance the outcome of oocyte cryopreservation.

Keywords: Fertility preservation; oocyte cryopreservation; social egg freezing.

Background: Acute kidney injury (AKI) is one of the most frequent but anticipated potential complications. The objective of this meta-analysis was to evaluate the AKI incidence following mannitol administration in traumatic brain injury (TBI) patients worldwide.

Objective: So in this study, authors will discuss the incidence of AKI related to the provision of mannitol in TBI cases so it is expected to provide a better prevention of complications.

Methods: We were using meta-analysis. Studies were searched throughout Pubmed, Cochrane, JNS in December 2017. Studies that were included ranged from 2009-2018. Keywords were "renal" or "kidney" and "traumatic brain injury". Inclusion criteria were full-text observational study or randomized control trial, subjects in study were newly diagnosed AKI after TBI, GCS < 13, with age range 15-100 years old, survived and followed at least for 30 days after discharge, and given mannitol at least 1g/kg BW/day for at least 3 days. From 648 studies, total 4 studies were eligible for this study. Statistical analysis was done by using Review Manager 5.

Results: From those 4 studies, it is shown than the pooled risk ratio AKI incidence following mannitol administration in traumatic brain injury (TBI) was 1.57. The pooled risk ratio had wide heterogeneity (I² = 0.95 and 1, p< 0.05) so random effect model was used.

Conclusion: AKI appeared more frequent in patient with TBI with mannitol administration. It still needs more multicentre and long term period researches in the future to get better understanding AKI in TBI following mannitol administration.

Keywords: Acute kidney injury; Mannitol; Traumatic brain injury.

Background: Smartphone has become a very popular necessity among students. An individual has to look at their phone's small monitor and perform repetitive movements in an awkward posture for a prolonged duration.

Objectives: To assess the prevalence of musculoskeletal pain and associated risk factors in university students because of smartphone usage.

Subjects and methods: A cross-sectional study was conducted with 2000 university students using a semi-structured questionnaire comprising demographic profile, smartphone usage characteristics, presence of musculoskeletal pain, and specific area of pain according to the body region.

Results: Among the 2000 students, 44.05% reported musculoskeletal pain. The most common sites of pain were the neck (34.2%), thumb (17.45%), lower back (16.7%), and elbow (16.6%). There was an association between prevalence of musculoskeletal pain with the size of the smartphone (P = 0.005), the predominant purpose of smartphone usage (P = 0.002), position preferred while using smartphone (P = 0.000), and the level at which smartphone is held during usage (P = 0.05). Logistic regression analysis revealed that the strongest predictor of musculoskeletal pain was the size of the smartphone.

Conclusion: The study reported that the prevalence of pain in smartphone users is high with common sites being neck, thumb, and lower back region. Also, the size of the smartphone had a significant association with musculoskeletal pain.

Keywords: Pain; prevalence; risk; smartphone; students.

Introduction: Work-related musculoskeletal disorders (WRMSD) are considered the main cause of occupational diseases. Health care workers, nursing assistants, and service forces that perform manual labor are the most vulnerable to musculoskeletal disorders, especially low back pain, due to the nature of their jobs. The purpose of this study was to compare the effectiveness of corrective exercise training to ergonomic principles training on low back pain in nursing assistants and service forces.

Methods: A nonrandomized clinical trial study was done on 75 staff (nursing assistants and service forces) with low back pain. The participants were divided into three groups: corrective exercise training, ergonomic principles training, and control group. Pain intensity and disability questionnaires were completed before and after 8 weeks of intervention by each group and analyzed.

Results: The mean intensity of pain after intervention in corrective exercises group (3.8 ± 1.5) was markedly less than the ergonomic group (4.7 ± 1.4) and control group (5.5 ± 1.7) (P = 0.001). The mean disability score after intervention in the corrective exercises group (17.3 ± 9.6) was significantly less than the ergonomic group (21.8 ± 12.6) and control group (25.3 ± 11.2) (P < 0.001).

Conclusion: While corrective exercises training and ergonomic principles training both have a significant effect on reducing the severity of pain and disability caused by low back pain, corrective exercises training is more effective than ergonomic principle training.

Keywords: Corrective exercises; ergonomic principles; low back pain; nursing assistants; service forces.

Background: Even though Evidence-Based Practice is a complex process, it's application has been recognized worldwide as a lever of improvement of the provided health services.

Objective: This study investigates the factors which influence the implementation of Evidence-Based Practice and their correlation with nurses' socio-demographic characteristics.

Methods: This is a cross-sectional study for which data were collected through an anonymous questionnaire. The study sample included 302 nurses from six public hospitals in Cyprus. Data collection was conducted from April 2018 to July 2018.

Results: According to the nurses, the biggest obstacle for the application of Evidence-Based Practice is the lack of authority/power to change care procedures (83.8%), followed by the view that the results were not applicable in the nurses' environment (81.5%).

Conclusion: The identification of factors affecting the implementation of Evidence-Based Practice can serve as a basis for improving the quality of healthcare, as well as for developing strategies for resolving existing problems. This study showed that there is a need to create opportunities for the use of Evidence-Based Practice by nurses.

Keywords: Barriers; Evidence-Based Practice; Factors; Nursing.

Immunization is recommended for people with diabetes mellitus (DM), but little information is available on their seropositivity rates. To determine the impact of glucose tolerance state on seropositivity rate after hepatitis B vaccination, we included 7645 adult participants from the National Health and Nutrition Examination Survey 2005-2016 who reported three doses of hepatitis B vaccine and were seropositive for anti-hepatitis B surface antibody (≥ 12.0 mIU/mL), after exclusion of those positive for anti-hepatitis B core antibody and/or hepatitis B surface antigen. We classified the states of glucose tolerance as normal glucose tolerance (NGT, 61.68%), abnormal glucose tolerance (AGT, 26.02%), or DM (13.30%). We observed a stepwise decline in hepatitis B seropositivity rate from NGT (53.64%) to AGT (45.52%) to DM (28.84%) (P < 0.0001). We confirmed these results after standardization for age and BMI (P < 0.0001 for all subgroup analyses) and in subgroup analyses by gender and racial/ethnic group. Dysregulated glucose metabolism is associated with a decreased seropositivity rate after hepatitis B vaccination. Our observations suggest that regular follow-up screening for anti-hepatitis B surface antibody, with additional booster vaccination as necessary, is especially important in patients with DM. Whether a similar phenomenon exits for other vaccines, especially COVID-19, remains to be investigated.

Introduction: Distal clavicular osteolysis (DCO) is a musculoskeletal pathology characterized by shoulder pain. Given the high prevalence of shoulder pain due to rotator cuff and subacromial injuries, DCO is often overlooked. Conservative therapy is indicated prior to surgical intervention. However, no literature has described conservative management of DCO in detail. This report will outline conservative management details for DCO to guide future research and clinicians.

Case presentation: A 24-year-old female hockey player presented with trauma-induced injury, where she was diagnosed with type II acromio-clavicular joint separation. She presented 5-months later with residual pain and limitations in ranges of motion (ROM). Radiographic images revealed DCO.

Management and outcome: Management entailed strict rest from overhead activities followed by rehabilitation and manual therapy. 6-months later the patient reported resolution of symptoms, improved ROMs, and activities of daily living.

Summary: DCO can be difficult to diagnose given its limited etiological understanding, low incidence, and poor radiographic sensitivity. DCO diagnosis should be considered in cases with unresolving shoulder pain.

Introduction: L’ostéolyse de l’extrémité externe de clavicule (OEEC) est une pathologie musculosquelettique caractérisée par des douleurs d’épaule. La fréquence des douleurs d’épaule dues à des lésions de la coiffe des rotateurs et des lésions sous-acromiales est élevée, mais l’OEEC est souvent inaperçue. Un traitement conservateur est indiqué avant l’intervention chirurgicale. Comme aucune littérature ne décrit en détail le traitement conservateur de cette pathologie, nous présentons un compte rendu détaillé de ce traitement pour guider les recherches futures et les cliniciens.

Présentation du cas: Une joueuse de hockey de 24 ans s’est présentée avec une blessure traumatique à l’épaule. On a diagnostiqué une disjonction acromio-claviculaire de type II. Elle s’est présentée 5 mois plus tard avec des douleurs résiduelles et des limitations de l’amplitude des mouvements. Les radiographies ont révélé une OEEC.

Prise en charge et résultats: La prise en charge a consisté en un arrêt complet des activités au-dessus de la tête, suivi d’une rééducation et d’une thérapie manuelle. Six mois plus tard, la patiente n’avait plus de symptômes, avait repris ses activités quotidiennes et l’amplitude de ses mouvements s’était améliorée.

Résumé: L’OEEC peut être difficile à diagnostiquer parce que nos connaissances sur son étiologie sont limitées, que sa fréquence peu élevée et que cette pathologie est difficile à visualiser sur les radiographies. Le diagnostic d’une OEEC doit être envisagé dans les cas de douleurs d’épaule qui ne disparaissent pas.

Keywords: acromio-clavicular separation; chiropractic; chiropratique; disjonction acromioclaviculaire; douleur à l’épaule; ostéolyse post-traumatique de l’extrémité externe de la clavicule; post traumatic distal clavicle osteolysis; rehabilitation; rééducation; shoulder pain.