Most paraplegics will be reliant on a wheelchair as a mode of transportation. Activities of daily living (ADLs) can be quite challenging at first for those with a spinal cord injury (SCI). With the aid of physiotherapists and occupational therapists, individuals with an SCI can learn new skills and adapt previous ones to maximize independence, often living independently within the community. Regeneration of the spinal cord
Olfactory ensheathing cells (OEC) have been transplanted with success into the spinal cord of Polish man named Darek Fidyka, who was the survivor of a knife attack that left him paraplegic in 2010. In 2014, Fidyka underwent pioneering spinal surgery that used nerve grafts, from his ankle, to bridge the gap in his severed spinal cord and OECs to stimulate the spinal cord cells. The surgery was performed in Poland in collaboration with Prof. Geoff Raisman, chair of neural regeneration at University College Londons Institute of Neurology, and his research team. The olfactory cells were taken from the patients olfactory bulbs in his brain and then grown in the lab, these cells were then injected above and below the impaired spinal tissue. Fidyka regained sensory and motor function in his lower limbs, notably on the side of the transplanted OECs. Fidyka first noticed the success three months after the procedure, when his left thigh started gaining muscle mass. MRIs suggest that the gap in his spinal cord has been closed up.
Nummular dermatitis is one of the many forms of dermatitis. it is characterized by round or oval-shaped itchy lesions. The name comes from the Latin word "nummus," which means "coin." Signs and symptoms
Nummular dermatitis is characterized by chronic or relapsing itchy coin-sized ovoid-shaped red plaques. They can occur on the trunk, limbs, face, and hands. Causes
Many contact sensitizers or irritants are known to cause contact dermatitis superimposed on nummular dermatitis. Studies have implicated nickel, cobalt, chromate, and fragrance as likely culprits. Xerosis, or dehydration of skin is also a likely cause. Infection with Staphylococcus aureus bacteria or Candida albicans may also play a role. Diagnosis
Diagnosis of nummular dermatitis is largely via clinical observation. Biopsies are typically not necessary, and cannot be used to rule out other atopic dermatitis or other eczemas. However, patch testing may be employed to rule out irritants (contact dermatitis) as a cause. In children, nummular dermatitis is commonly confused with tinea corporis. Treatment
One of the keys to treatment and prevention involves keeping the skin moisturized. Lotions, creams, and bath oils may help prevent an outbreak. If the condition flares up, a common treatment involves the application of topical corticosteroids. Oral antihistamines may help lessen itching. Avoidance of irritants is a common strategy. More severe cases sometimes respond to ultraviolet light treatment. If the condition occurs only during the sun-less winter months then vitamin D supplement might be an effective treatment. Epidemiology
The prevalence of nummular dermatitis in the United States is approximately 2 per 1,000.