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The main reason for this neurological pathology is obstetric assistance during childbirth. Happy is the woman who gave birth with the help of nature, and not the midwife. Excessive vigorous activity of medical personnel to extract the fetus is completely unjustified.

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Often forceps or a vacuum extractor were used in these children. In the pathogenesis of the development of peripheral paralysis, the following are also important:

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Duchenne-Erb palsy The most common type. It occurs when the upper fibers of the brachial plexus or the spinal roots of the C5-6 segment are damaged. The proximal part of the arm does not perform a motor function. The muscles of the shoulder girdle and forearm suffer (deltoid, brachial, brachioradialis, biceps, large and small round), their tone is reduced.

NOTE: Typical clinic: the arm is in an adducted and extended position, the forearm is pronated, the shoulder is lowered and turned inward, the palm is bent. Tilt the head to the paretic arm. There is no reflex from the biceps, palmar-oral. Reduced or completely absent active mobility of the shoulder and elbow joints. The child can move his fingers.  .

A sharp weakening of the muscles of the girdle of the upper limb often becomes the cause of subluxation of the shoulder.

If, in addition, the accessory nerve is injured or the sternocleidomastoid muscle is torn, the baby has torticollis. Klumpke-Dejerine paralysis Occurs due to damage to the lower-middle fibers of the nerve plexus of the shoulder or spinal roots CVII-ThI. Disturbed innervation of all muscles of the hand. The arm lies along the body, unbent. The forearm is pronated.

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The prognosis depends on the depth of damage to the nerve structures. A minor injury begins to recover from the first days of sildenafil, and by the age of 3-4 months the baby moves his arm in full. Sometimes muscle weakness persists for a long time. It becomes noticeable when the child begins to reach for the toy, raises his hands up. If irreversible degeneration of nerve fibers, muscle atrophy, complete recovery of function may not occur.

A typical clinical picture makes it possible to make a diagnosis already at the first examination. From this moment begins a long continuous complex of therapeutic measures:

Total paralysis of Kerer The most difficult type of viagra paralysis. The entire brachial plexus was injured or the spinal roots were torn off at the level of CV-ThI. There is marked hypotension of the muscles of the hand. She hangs like a whip, practically motionless. The skin is pale, cold to the touch. Absence of all reflexes.

To prevent contracture, already in the maternity hospital, the paretic arm is fixed with a splint in the position of the shoulder at a right angle with external rotation (gradually starting from 60-70o so as not to cause pain in the baby).

A positive result is observed from electrophoresis with prozerin, potassium iodide, aminophylline. Thermal procedures (applications of paraffin, ozocerite, hot wraps) are best done 40-50 minutes before massage or gymnastics. Electrical stimulation of the affected muscle groups from 9 months. Of the medicines, the appointment of B vitamins, dibazol, prozerin is indicated. Children with severe forms of obstetric paralysis undergo microsurgical treatment of the brachial sildenafil.

A complex of therapeutic exercises and massage is individually developed for each child.

In the neonatal period, only passive movements are available, but active games are added with age. Raising the arm, abducting it back, external rotation and supination should be trained.

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Typical clinic: the arm is in an adducted and extended position, the forearm is pronated, the shoulder is lowered and turned inward, the palm is bent.

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Duchenne-Erb palsy The most common type. It occurs when the upper fibers of viagra plexus or the spinal roots of the C5-6 segment are damaged. The proximal part of the arm does not perform a motor function. The muscles of the shoulder girdle and forearm suffer (deltoid, brachial, brachioradialis, biceps, large and small round), their tone is reduced.

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A general allergic reaction to insulin may take the form of an urticarial itchy rash, angioedema, bronchospasm, gastrointestinal disorders, polyarthralgia, changes in the hematopoietic system (plateletvessels, hemorrhage in the spinal membranes • depletion of vertebrobasilar blood flow.

Sometimes the reaction is manifested by a papular rash, an infiltrate in the subcutaneous tissue at the injection site, very rarely there is aseptic tissue necrosis of the type of the Arthus phenomenon. In the genesis of allergic reactions of the immediate type, circulating antibodies of the IgE and IgG classes play a leading role.

It is expressed in hyperemia and swelling of a skin area with a diameter of 1-5 cm, accompanied by burning, itching or Viagra pills.

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A local allergic reaction to insulin occurs at the site of insulin injection, more often after 1-2 weeks from the start of treatment, usually acutely (within 1 hour after injection, rarely after 6-24 hours).

  • There are local (local) and general (generalized) allergic reactions to insulin.
  • This chapter discusses the treatment of allergic reactions to less purified insulin preparations.
  • According to the observations of A.V. Dreval (1974), antibody formation is more intense in severe diabetes and microangiopathy, as well as with the introduction of drugs of prolonged action.
  • The formation of antibodies to insulin is genetically controlled, which partly explains the unequal tolerance of the same insulin in different patients.
  • However, due to the fact that, as a rule, highly refined insulins are currently used, a decrease in the frequency of this complication can be expected.

In most cases, they are associated with the presence of protein impurities with significant antigenic activity in insulin preparations. Allergic reactions can occur to the use of any insulin.