Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities

Zika virus (ZIKV), a mosquito-borne flavivirus and member of the Flaviviridae family, was originally isolated from a sentinel primate in Uganda in 1947. ZIKV was associated with mild febrile disease and maculopapular rash in tropical Africa and some areas of Southeast Asia. Since 2007, ZIKV has…

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Exclusive real-time monitoring during recurrent laryngeal nerve dissection in conventional monitored thyroidectomy

Publication date: Available online 30 March 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Xiao-Li Liu, Che-Wei Wu, Yi-Shen Zhao, Tie Wang, Peng Chen, Jing-Wei Xin, Shi-Jie Li, Da-Qi Zhang, Guang Zhang, Yan-Tao Fu, Li-Na Zhao, Le Zhou, Gianlorenzo Dionigi, Feng-Yu Chiang, Hui Sun
During conventional intermittent intraoperative neuromonitoring (IONM) in thyroidectomy, recurrent laryngeal nerve (RLN) injury is detected by an electromyographic (EMG) loss of signal (LOS) after the nerve dissection. Exclusive continuous monitoring during the phase of RLN dissection may be helpful in detecting adverse EMG changes earlier. A total of 208 RLNs at risk were enrolled in this study. Standardized IONM procedures were followed. We continuously stimulated the RLN at the lower exposed end with a stimulator to exclusively monitor the real-time quantitative EMG change during RLN dissection. Once the amplitude decreased by more than 50% of the initial signal, the surgical maneuver was paused and the RLN was retested every minute for 10 minutes to determine amplitude recovery before restarting the dissection. The procedure was feasible in all patients. No LOS was encountered in this study. Nineteen RLNs had an amplitude reduction of more than 50%. Eighteen nerves showed gradual amplitude recovery (16 nerves had a traction injury and two nerves had a compression injury). After 10 minutes, the recovery was complete (i.e., >90%) in eight nerves, 70–90% in seven nerves, and 50–70% in three nerves. Among these 18 nerves, only one nerve developed temporary vocal palsy because it was exposed to unavoidable repeated nerve traction after restarting the dissection. Another nerve showed no gradual recovery from thermal injury, and developed temporary vocal palsy. The temporary and permanent palsy rates were 1% and 0%, respectively. During intermittent IONM, exclusive real-time monitoring of the RLN during dissection is an effective procedure to detect an adverse EMG change, and prevent severe RLN injuries that cause LOS.



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Toric IOL results with femto vs standard cataract surgery

Espaillat A, Pérez O, Potvin R

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Risk factors for tube exposure

Chaku M, Netland PA, Ishida K, Rhee DJ

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Spectral domain optical coherence tomography imaging of subretinal bands

Kothari N, Kuriyan AE, Flynn HW Jr

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Age-related maintenance of eccentric strength: a study of temperature dependence

Abstract

With adult aging, eccentric strength is maintained better than isometric strength leading to a higher ratio of eccentric/isometric force production (ECC/ISO) in older than younger adults. The purpose was to investigate the ECC/ISO during electrical activation of the adductor pollicis during lengthening (20–320° s⁻¹) contractions in 24 young (n = 12, ∼24 years) and old (n = 12, ∼72 years) males across muscle temperatures (cold ∼19 °C; normal ∼30 °C; warm ∼35 °C). For isometric force, the old were 20–30 % weaker in the normal and cold conditions (P < 0.05) with no difference for the warm condition compared to young (P > 0.05). Half-relaxation time (HRT) did not differ across age for the normal and warm temperatures (P > 0.05), but it slowed significantly for old in the cold condition compared with young (∼15 %; P < 0.05), as well, there was a 20 and 40 % increase in muscle stiffness for the young and old, respectively. ECC/ISO was 50–60 % greater for the cold condition than the normal and warm conditions. There was no age difference in ECC/ISO across ages for the normal and warm conditions (P > 0.05), but for the cold, the old exhibited a 20–35 % higher ECC/ISO than did the young for velocities above 60° s⁻¹ (P < 0.05). A contributing factor to the elevated ECC/ISO is an increased proportion of weakly compared to strongly bound crossbridges. These findings highlight the relationship (r = 0.70) between intrinsic muscle contractile speed (HRT) and eccentric strength in old age.

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Self-reported receipt of healthcare professional’s weight management counselling is associated with self-reported weight management behaviours of type 2 diabetes mellitus patients

Weight loss has been shown to influence the health outcomes of type 2 diabetes patients. Providing weight management counselling to diabetes patients may help them adopt appropriate weight management behaviour...

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