The anconeus muscle revisited: double innervation pattern and its clinical implications

xlomafota13 shared this article with you from Inoreader The anconeus muscle revisited: double innervation pattern and its clinical implications Via radiol anat Surg Radiol Anat. 2021 Apr 21. doi: 10.1007/s00276-021-02750-5. Online ahead of print. ABSTRACT PURPOSE: The aim of the present study is to describe in detail the morphology and innervation pattern of the anconeus muscle, bearing in mind clinical implications such as iatrogenic injuries during surgical elbow approaches. METHODS: A cadaveric study was performed; 56 elbows from 28 formalin-fixed cadavers belonging to the Anatomy Department of Universidad Complutense of M adrid were dissected. The triceps-anconeus nerve was located and dissected. A second innervation to the anconeus muscle from a branch of the posterior interosseous nerve (PIN) was occasionally detected. Taking the lateral epicondyle as a landmark, the entry points of both nerves in the muscle were referenced, the triceps-anconeus nerve was referenced at 0°, 30°, 45°, 70° and 90° of elbow flexion, and the PIN branch at 0°. RESULTS: Anconeus muscle was present in all specimens. The triceps-anconeus nerve was present in all of the dissected elbows. A branch from PIN to the anconeus muscle was present in 38 of the 54 elbows (70.4%). There were statistically significant differences in all measurements regarding the specimens' gender, being higher for men. CONCLUSIONS: There is evidence of a high frequency of a double innervation pattern for the anconeus muscle: the main branch of triceps-anconeus muscle depending on the radial nerve, which is liable to being damaged dur ing posterior elbow approaches, and a secondary branch depending on the PIN. There are very few references to this finding in Anatomical literature and none with such a large sample size. PMID:33881559 | DOI:10.1007/s00276-021-02750-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Direct N-butyl-2-cyanoacrylate injections to the head and neck for percutaneous embolized devascularization

xlomafota13 shared this article with you from Inoreader Direct N-butyl-2-cyanoacrylate injections to the head and neck for percutaneous embolized devascularization Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Mar 30;12:131. doi: 10.25259/SNI_154_2021. eCollection 2021. ABSTRACT BACKGROUND: N-butyl-2-cyanoacrylate (NBCA) has been used for vascular malformations since the 1980s; however, few studies have looked at applications, procedural techniques, and outcome throughout many institutions. Herein, we review applications, procedural techniques, previous literature, and outcomes for the use of NBCA specifically through percutaneous technique in treating head and neck vascular pathology. METHODS: An extensive literature review using PubMed database with published literature containing "N-butyl-2-cyanoacrylate embolization," was performed. No date restrictions were used. Cross-checking of articles was conducted to exclude duplicate articles. The articles were screened for their full text and English language availability. We finalized those articles pertaining to the topic. RESULTS: The search yielded 1124 related art icles. When comparing surgical resection to embolization with NBCA for cerebral AVMs, complications were similar in both groups and included hemorrhage (15%), residual AVM (6%), and cerebrospinal fluid leak (3%). Their mortality rate was 3% in both groups. Preoperative percutaneous embolization does show improved surgical outcomes. CONCLUSION: NBCA is a fast-acting liquid embolic material used in the treatment of a variety of vascular malformations and lesions of the head and neck. Investigations surrounding the use of NBCA injections as a new alternative embolic agent began in the 1980's. Administration of NBCA has been shown to be useful in minimizing intraoperative blood loss and controlling acute hemorrhage. Performing percutaneous embolization with NBCA provides a successful alternative for surgeons when transcatheter embolization techniques may prove to be too difficult to perform. Embolization using NBCA will continue to play in integral role in the treatment of maligna nt lesions and vascular malformations. Continued research is warranted to improve safety, outcomes, and further develop clinical applications of NBCA. PMID:33880236 | PMC:PMC8053456 | DOI:10.25259/SNI_154_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Percutaneous fetoscopic spina bifida repair: effect on need for postnatal cerebrospinal fluid diversion, ambulation and bladder catheterization

xlomafota13 shared this article with you from Inoreader Percutaneous fetoscopic spina bifida repair: effect on need for postnatal cerebrospinal fluid diversion, ambulation and bladder catheterization Via leak of cerebrospinal fluid Ultrasound Obstet Gynecol. 2021 Apr 20. doi: 10.1002/uog.23658. Online ahead of print. ABSTRACT BACKGROUND: A trial comparing prenatal with postnatal open spina bifida (OSB) repair established that prenatal surgery was associated with better postnatal outcome. However, in the trial the fetal surgery was carried out through hysterotomy. Minimally invasive approaches are being developed to mitigate the risks of open maternal fetal surgery. OBJECTIVE: To investigate the impact of a novel neurosurgical technique for repair of feta; OSB, the skin-over-biocellulose for antenatal fetoscopic repair (SAFER) via percutaneous fetoscopy, on long-term postnatal outcomes. STUDY DESIGN: Descriptive data for all patients undergoing fetoscopic OSB repair and available 12- and 30-month follow-up for assessment of need for cerebrospinal fluid (CSF) diversion and bladder catheterization and ambulation, respectively. A total of 170 consecutive patient s were treated prenatally at eight centers via percutaneous fetoscopic OSB repair using a biocellulose patch between the neural placode and skin/myofascial flap, without suture of the duramater. A total of 103 babies had follow-up at 12 months of age and 59 had follow-up at 30 months of age. Univariate and multivariate logistic regression analysis was used to examine the effect on CSF diversion at 12 months, and ambulation and bladder catheterization at 30 months. Potential co-factors were gestational age at fetal surgery and delivery, preoperative ultrasound findings of anatomical level of the lesion, cerebral lateral ventricle diameter, lesion type and presence of bilateral talipes, as well as postnatal findings of CSF leak at birth, motor level, bilateral talipes and reversal of hindbrain herniation. Significance was set at p<0.05. RESULTS: At 12-months of age 53.4% (55/103) of babies did not require ventriculoperitoneal shunt or third ventriculostomy. At 30-months of ag e, 54.2% (32/59) of the children were ambulating independently and 61% (36/59) did not require chronic intermittent catheterization of the bladder. Multiple logistic regression analysis demonstrated that significant prediction for CSF diversion was provided by anatomical and functional motor level of the lesion, lateral ventricle size and type of lesion (myeloschisis). Significant predictors of ambulatory status were prenatal bilateral talipes and anatomical and functional motor level of the lesion. There were no significant predictors for the need of bladder catheterization. CONCLUSION: Children that underwent prenatal OSB repair via the percutaneous fetoscopic SAFER technique achieved long-term neurological outcomes similar to those reported in the literature after hysterotomy-assisted OSB repair. This article is protected by copyright. All rights reserved. PMID:33880811 | DOI:10.1002/uog.23658 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes and Utility of Intracranial Free Tissue Transfer

xlomafota13 shared this article with you from Inoreader Outcomes and Utility of Intracranial Free Tissue Transfer Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Apr 21:34894211008699. doi: 10.1177/00034894211008699. Online ahead of print. ABSTRACT OBJECTIVE: Complications associated with intracranial vault compromise can be neurologically and systemically devastating. Primary and secondary repair of these deficits require an air and watertight barrier between the intracranial and extracranial environments. This study evaluated the outcomes and utility of using intracranial free tissue transfer as both primary and salvage surgical repair of reconstruction. METHODS: A retrospective review was performed of all subjects who underwent intracranial free tissue transfer as primary or salvage repair. RESULTS: A total of 13 intracranial free tissue transfers were performed on 11 subjects: osteocutaneous radial forearm free flaps (n = 6), partial myofascial rectus abdominis flaps (n = 5), temporoparietal fascia flap (n = 1), and serratus anterior myofascial flap (n = 1). Primary reconstruction was performed on 4 subjects with the remaining being salvage repair. Indications for surgery included neoplasm (n = 6 of 11), ballistic trauma (n = 3 of 11), motor vehicle accident (n = 1 of 11), and infection (n = 1 of 11). Three subjects required additional surgical repair for CSF leak and pneumocephalus, with 2 subjects requiring an additional free tissue transfer at a different site. CONCLUSION: In our experience, free tissue transfer is an effective primary and salvage surgical technique in the reconstruction of complex intracranial problems. PMID:33880969 | DOI:10.1177/00034894211008699 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do Professionals Who Use the Voice in a Journalistic Context Benefit from Humming as a Semi-occluded Vocal Tract Exercise?

xlomafota13 shared this article with you from Inoreader Do Professionals Who Use the Voice in a Journalistic Context Benefit from Humming as a Semi-occluded Vocal Tract Exercise? Via Journal of Voice Many vocal enhancement and rehabilitation programs for voice professionals define vocal exercises without analyzing their effects on that specific population in which they will be applied, in the established dose and often without considering the presence and absence of vocal alteration. Journalists have sought the voice clinic due to new professional vocal demands and a vocal program is being elaborated. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Comprehensive Outcome Framework of a Cochlear Implant Program at a University Hospital in Chennai: A Preliminary Report

xlomafota13 shared this article with you from Inoreader A Comprehensive Outcome Framework of a Cochlear Implant Program at a University Hospital in Chennai: A Preliminary Report Via Otolaryngology Indian Abstract The primary goal of the study was to assess the progress achieved across different implant age groups (0–2 years, 2.1–4 years and 4.1–6 years) using a comprehensive test battery approach targeting areas such as Audition, Speech Perception, Speech Intelligibility and Speech-Language.This cross-sectional study evaluated the outcomes of 40 children who underwent cochlear implantation at Sri Ramachandra Medical Centre, Chennai. A battery of tests included aided audiogram, Categorical Auditory Performance, Meaningful Auditory Integration Scale; Picture speech identification test in Tamil; Speech Intelligibility Rating Scale and Communication Developmental Eclectic Approach to Language Learning (COMDEALL) were administered to evaluate their auditory, speech perception, speech intelligibility and speech and language skills, respectively. The results of the study suggested that children implanted between 0 and 2 years of age demonstrated better performance in all tasks including audition, speech perception and intelligibility as well as speech and language when compared to the other two older groups. Children implanted between 0 and 2 years reached target milestones early in life similar to their hearing peers. However, children between (2.1– 4 years) also performed well and results indicated that they could catch up with intensive training. The present study reestablished the findings that early implantation (0–2 years) facilitates optimal progress when compared to implantation at later ages within the age range of 0–6 years. It also facilitates parent counseling regarding the realistic expectations with reference to different ages of implantation View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Examination of the Relation Between Audiometric Configuration and Hematological Parameters in Idiopathic Sudden Sensorineural Hearing Loss

xlomafota13 shared this article with you from Inoreader Examination of the Relation Between Audiometric Configuration and Hematological Parameters in Idiopathic Sudden Sensorineural Hearing Loss Via Otolaryngology Indian Abstract Among the hematological parameters, neutrophil/lymphocyte ratio (NLR) and platelet/ lymphocyte ratio (PLR) have been associated with inflammatory state, microvascular damage and ischemia. It is well-known that these ratios increase in idiopathic sudden sensorineural hearing loss (ISSHL). In ISSHL, different audiographic features may reflect different disease mechanisms. This study aimed to investigate whether there were differences in NLR and PLR among patient groups with different audiometric configurations. Patients meeting the study inclusion criteria were divided into four groups according to their audiogram configurations. Mean NLR and PLR values of the patient groups were compared among themselves and versus control group. The study was conducted with 166 participants. Mean NLR values were 3.07 ± 2.48, 3.30 ± 2.70, 5.24 ± 3.71, 3.57 ± 3.19 and 1.51 ± 0.68 for ascending, flat, descending and total/subtotal audiometric configuration g roups and control group, respectively. Mean PLR values were 145.2 ± 126.7, 130.9 ± 57.8, 192.2 ± 94.4, 143.7 ± 70.8 and 94.1 ± 24.7 for ascending, flat, descending, total/subtotal audiometric configuration groups and control group, respectively. Both NLR and PLR were significantly greater in patients from all configuration groups than in control group (p < 0.05). In addition, the group with descending audiometric configuration showed significantly higher mean NLR and PLR compared to other audiometric configuration groups (p < 0.05). The highest level of inflammation was detected in the ISSHL patient group with high frequency hearing loss and descending audiographic configuration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery

xlomafota.13 shared this article with you from Inoreader Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery Via Latest Results for Clinical and Translational Oncology Abstract Purpose To report long-term results of a randomized trial comparing accelerated partial breast irradiation (APBI) to whole-breast irradiation (WBI) in terms of efficacy, toxicity, and cosmesis. Methods and materials WBI group was treated with 3D conformal external irradiation, 2 Gy daily/fraction, 5 fractions/week, to a total dose of 50 Gy. APBI group was treated with 3D conformal external irradiation 3.75 Gy/fraction, twice a day, 5 fractions/week, to a total dose of 37.5 Gy in the APBI group. Patients were followed up every 6 months up to 5 years and yearly thereafter. During follow-up visits, the clinician evaluated chronic toxicity and scored cosmetic results with a four-scale system. Results After a median follow-up of 10.3 years, 43 patients in each group (84%) are alive without disease. One patient died after disease progression in the APBI arm, and there was no death in the WBI arm. The rest of the patients died from another disease different than breast cancer, similarly between groups. There was greater fibrosis in the APBI group (9 patients grade 1 and one grade 2) compared to WBI (3 patients grade 1 and one grade 2); p = 0.18. Regarding cosmesis, in APBI group, 19 and 21 (43.2 and 47%) patients had excellent or good results, similar to the WBI group with 18 patients (40.9%) in each cosmesis outcome. The WBI group did not have any patient with poor cosmesis but the APBI had 3 (6.8%; p = 0.24). Conclusion After a follow-up of 10 years, there were no differences in efficacy between the 2 treatment arms. Despite slight greater toxicity in the APBI group, the cosmesis was similar and satisfactory in both groups. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Challenges and future directions in breast cancer care in Fukushima prefecture in Japan: correspondence to “A survey on the current status of clinical resources for diagnosis and treatment of breast cancer in rural hospitals of the Tohoku region in Japan”

xlomafota.13 shared this article with you from Inoreader Challenges and future directions in breast cancer care in Fukushima prefecture in Japan: correspondence to "A survey on the current status of clinical resources for diagnosis and treatment of breast cancer in rural hospitals of the Tohoku region in Japan" Via Latest Results for Breast Cancer View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anisotropic Mechanical Properties of the Human Uterus Measured by Spherical Indentation

xlomafota.13 shared this article with you from Inoreader Anisotropic Mechanical Properties of the Human Uterus Measured by Spherical Indentation Via Latest Results for Annals of Biomedical Engineering Abstract The mechanical function of the uterus is critical for a successful pregnancy. During gestation, uterine tissue grows and stretches to many times its size to accommodate the growing fetus, and it is hypothesized the magnitude of uterine tissue stretch triggers the onset of contractions. To establish rigorous mechanical testing protocols for the human uterus in hopes of predicting tissue stretch during pregnancy, this study measures the anisotropic mechanical properties of the human uterus using optical coherence tomography (OCT), instrumented spherical indentation, and video extensometry. In this work, we perform spherical indentation and digital image correlation to obtain the tissue's force and deformation response to a ramp-hold loading regimen. We translate previously reported fiber architecture, measured via optical coherence tomography, into a constitutive fiber composite material model to describe the equilibrium material behavior during indentation. We u se an inverse finite element method integrated with a genetic algorithm (GA) to fit the material model to our experimental data. We report the mechanical properties of human uterine specimens taken across different anatomical locations and layers from one non-pregnant (NP) and one pregnant (PG) patient; both patients had pathological uterine tissue. Compared to NP uterine tissue, PG tissue has a more dispersed fiber distribution and equivalent stiffness material parameters. In both PG and NP uterine tissue, the mechanical properties differ significantly between anatomical locations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Methodology for Evaluation of WIAMan Injury Assessment Reference Curves Using Whole Body Match-Paired Data

xlomafota.13 shared this article with you from Inoreader Methodology for Evaluation of WIAMan Injury Assessment Reference Curves Using Whole Body Match-Paired Data Via Latest Results for Annals of Biomedical Engineering Abstract Development of the Warrior Injury Assessment Manikin (WIAMan) capability has included the creation of injury assessment reference curves (IARCs) specific to under-body blast (UBB) loading mechanisms and injuries. The WIAMan IARCs were created from high-rate vertical loading tests of component post-mortem human surrogates (PMHS) and analogous components of the WIAMan anthropomorphic test device (ATD). Validation of the WIAMan IARCs is required prior to the WIAMan ATD being utilized for injury assessment in live-fire vehicle test events. A portion of the validation process involves evaluating the ability of the IARCs to predict injury at the system level (whole body). This study evaluates a methodology to assess the performance of the WIAMan IARCs using match-paired tests of whole body PMHS and the WIAMan ATD. The methodology includes a qualitative analysis designed to identify false-positive and false-negative ATD predictions, as well as a quantitative analysis th at utilizes area under the receiver-operating characteristic curve (AROC) and Brier score indices to grade IARC performance. Three WIAMan IARCs were used to exemplify the proposed methodology and results are provided. Attributes of the false-prediction, AROC, and Brier score portions of the methodology are presented, with results indicating the new methodology is thorough and robust in evaluation of IARCs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.