-
American Journal of Ophthalmology Case... Sep 2022To describe a patient presenting with frosted branch angiitis soon after small-pox vaccination.
PURPOSE
To describe a patient presenting with frosted branch angiitis soon after small-pox vaccination.
OBSERVATIONS
Frosted branch angiitis (FBA) is an acute onset retinal vasculitis featuring prominent perivascular sheathing in otherwise healthy individuals. FBA has been associated with noninfectious and infectious etiologies. This report describes a twenty-year-old African American female who developed bilateral frosted branch angiitis one week after small-pox vaccination. At presentation, the patient had bilateral, para-central visual field defects and subjective visual disturbances. On dilated exam, the patient demonstrated diffuse vasculitis bilaterally. The patient's field defects and clinical exam responded dramatically to oral prednisone therapy.
CONCLUSIONS AND IMPORTANCE
Acute idiopathic frosted branch angiitis is a rare condition which was temporally associated with small-pox vaccination.
PubMed: 35880209
DOI: 10.1016/j.ajoc.2022.101622 -
BMC Sports Science, Medicine &... Apr 2021Excessive unilateral joint loads may lead to overuse disorders. Bilateral training in archery is only performed as a supportive coordination training and as a variation...
BACKGROUND
Excessive unilateral joint loads may lead to overuse disorders. Bilateral training in archery is only performed as a supportive coordination training and as a variation of typical exercise. However, a series of studies demonstrated a crossover transfer of training-induced motor skills to the contralateral side, especially in case of mainly unilateral skills. We compared the cervical spine and shoulder kinematics of unilateral and bilateral training archers.
METHODS
In this cross-sectional study, 25 (5 females, 48 ± 14 years) bilaterally training and 50 age-, sex- and level-matched (1:2; 47.3 ± 13.9 years) unilaterally training competitive archers were included. Cervical range of motion (RoM, all planes) and glenohumeral rotation were assessed with an ultrasound-based 3D motion analysis system. Upward rotation of the scapula during abduction and elevation of the arm were measured by means of a digital inclinometer and active shoulder mobility by means of an electronic caliper. All outcomes were compared between groups (unilaterally vs. bilaterally) and sides (pull-hand- vs. bow-hand-side).
RESULTS
Unilateral and bilateral archers showed no between group and no side-to-side-differences in either of the movement direction of the cervical spine. The unilateral archers had higher pull-arm-side total glenohumeral rotation than the bilateral archers (mean, 95% CI), (148°, 144-152° vs. 140°, 135°-145°). In particular, internal rotation (61°, 58-65° vs. 56°, 51-61°) and more upward rotation of the scapula at 45 degrees (12°, 11-14° vs. 8°, 6-10°), 90 degrees (34°, 31-36° vs. 28°, 24-32°), 135 degrees (56°, 53-59° vs. 49°, 46-53°), and maximal (68°, 65-70° vs. 62°, 59-65°) arm abduction differed. The bow- and pull-arm of the unilateral, but not of the bilateral archers, differed in the active mobility of the shoulder (22 cm, 20-24 cm vs. 18 cm, 16-20 cm).
CONCLUSIONS
Unilaterally training archers display no unphysiologic movement behaviour of the cervical spine, but show distinct shoulder asymmetris in the bow- and pull-arm-side when compared to bilateral archers in glenohumeral rotation, scapula rotation during arm abduction, and active mobility of the shoulder. These asymmetries in may exceed physiological performance-enhancing degrees. Bilateral training may seems appropriate in archery to prevent asymmetries.
PubMed: 33902697
DOI: 10.1186/s13102-021-00272-6 -
Journal of the American Veterinary... Nov 20216-month-old and 7-month-old spayed female domestic shorthair cats were referred because of complications associated with inadvertent bilateral ureteral ligation and...
Bilateral renal descensus and intravesicular ureteroneocystostomy for treatment of bilateral ureteral ligation and transection that occurred during ovariohysterectomy in two cats.
CASE DESCRIPTION
6-month-old and 7-month-old spayed female domestic shorthair cats were referred because of complications associated with inadvertent bilateral ureteral ligation and transection during ovariohysterectomy.
CLINICAL FINDINGS
Both cats had a 1- to 2-day history of lethargy, inappetence, and vomiting. Initial exam findings included lethargy, signs of abdominal pain, anuria, and dehydration. Clinicopathologic testing revealed azotemia and hyperkalemia. Abdominal ultrasonography revealed peritoneal effusion and bilateral pyelectasia in both cats and retroperitoneal effusion in one. Fluid analysis in both cats supported a diagnosis of uroabdomen.
TREATMENT AND OUTCOME
Exploratory celiotomy was performed in both cats, and bilateral ureteral ligation and transection was confirmed. Bilateral renal descensus and ureteroneocystostomy with an intravesicular mucosal apposition technique was successfully performed in both cats. Clinicopathologic evaluation performed 1 day after surgery in one cat and 5 days after surgery in the other revealed complete resolution of azotemia. Ultrasonographic examination of the urogenital tract performed approximately 4 months after surgery in the first cat and 1 month after surgery in the second cat revealed complete resolution of renal pelvic dilation bilaterally.
CLINICAL RELEVANCE
Bilateral intravesicular ureteroneocystostomy in conjunction with bilateral renal descensus was used successfully to treat bilateral ureteral transection that occurred in 2 cats during routine ovariohysterectomy. Limited treatment options currently exist for this serious complication, and euthanasia is often considered. This technique, which relies on the use of the natural surrounding tissues for successful treatment, can offer a potential treatment option to correct this uncommon but devastating complication.
Topics: Animals; Cat Diseases; Cats; Female; Hysterectomy; Kidney; Ureter; Ureteral Obstruction
PubMed: 34780350
DOI: 10.2460/javma.20.10.0596 -
Experimental Brain Research Aug 2020The cerebellum is recognised to bilaterally modulate sensorimotor function and has recently been shown to play a role in swallowing. Unilateral cerebellar repetitive... (Randomized Controlled Trial)
Randomized Controlled Trial
The cerebellum is recognised to bilaterally modulate sensorimotor function and has recently been shown to play a role in swallowing. Unilateral cerebellar repetitive trans-cranial magnetic stimulation (rTMS) excites corticobulbar motor pathways to the pharynx but the effects of bilateral versus unilateral cerebellar rTMS on these pathways are unknown. In this three-part cross-over study, healthy participants (n = 13) were randomly allocated to receive unilateral or bilateral 10 Hz cerebellar rTMS. Participants were intubated with pharyngeal electromyography and/or manometry catheters for motor evoked potentials (MEPs) and pressure recordings. In part 1 of the study, single pulse TMS was used to measure baseline motor cortical pharyngeal MEP (PMEP) and hemispheric cerebellar MEP (CMEP) amplitudes, before cerebellar rTMS was administered. Repeat measures of PMEP amplitude were performed at 15-min intervals for an hour post unilateral and bilateral rTMS. Thereafter, in two further studies, a cortical 'virtual lesion' (V/L) was applied prior to cerebellar rTMS with pre and post PMEPs (part 2) and measurements of swallowing accuracy (part 3) using a behavioural task. Compared to baseline, unilateral and bilateral cerebellar rTMS provoked increases in pharyngeal cortical excitation (P = 0.028, 0.0005, respectively). Bilateral rTMS was significantly more effective than unilateral in causing cortical excitation (P = 0.0005) and in reversing the suppressive neurological (P = 0.0005) and behavioural (P = 0.0005) effects of a cortical V/L. Our findings suggest bilateral cerebellar rTMS has greater facilitatory effects on corticobulbar motor pathways to the pharynx than unilateral stimulation with the potential to be a more effective clinical therapy if its effects are reproduced in populations with neurogenic dysphagia.
Topics: Cerebellum; Cross-Over Studies; Deglutition; Electromyography; Evoked Potentials, Motor; Humans; Motor Cortex; Pharynx; Transcranial Magnetic Stimulation
PubMed: 32232540
DOI: 10.1007/s00221-020-05787-x -
Foot and Ankle Surgery : Official... Oct 2022Bosch osteotomy for hallux valgus (HV) deformity has advantages of reduction both the operating time and surgical dissection, and may be performed bilaterally and with...
Bilateral and concomitant pathology' surgeries do not affect the outcomes of mini-open distal linear metatarsal osteotomy (Bosch osteotomy) with manipulation for hallux valgus deformity.
BACKGROUND
Bosch osteotomy for hallux valgus (HV) deformity has advantages of reduction both the operating time and surgical dissection, and may be performed bilaterally and with fewer complications than other surgical procedures as well as early weight-bearing. However, there are few reports on the effects of bilateral simultaneous surgery, simultaneous surgery on concomitant pathologies, and the preoperative HV angle on the postoperative results. The present assessed the factors that might affect the improvement in clinical outcomes following mini-open Bosch osteotomy with manipulation to treat HV deformity.
METHODS
Seventy patients with 110 feet were included. They were divided into groups as follows: unilateral and bilateral simultaneous surgery groups, Bosch osteotomy alone and simultaneous surgeries for concomitant pathologies groups, and preoperative HV angle< 40° and ≥ 40° groups. Subjective clinical outcome scores using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) and the HV and intermetatarsal first and second metatarsal (M1M2) angles according to the anteroposterior (A-P) view of the weighted foot X-ray were assessed preoperatively and at 12 months after surgery.
RESULTS
The mean HV angle, M1M2 angle and all subscales of the SAFE-Q score showed significant improvement at 12 months after surgery, regardless of simultaneous bilateral surgery, simultaneous surgery for concomitant pathologies, or the preoperative HV angle. On comparing the groups, there were no significant differences in the HV angle at 12 months after surgery. Significant inferiority at 12 months after surgery was found in the intermetatarsal angle in the simultaneous surgery for concomitant pathologies group and in all subscales of the SAFE-Q score in the HV angle ≥ 40° group.
CONCLUSION
Mini-open Bosch osteotomy with manipulation for HV deformity demonstrated good results in both radiological assessments and subjective clinical scores at 12 months after surgery, even for simultaneous bilateral surgery, simultaneous concomitant pathologies' surgery, and severe HV deformity.
LEVEL OF EVIDENCE
Prognostic Level III, retrospective cohort study.
Topics: Bunion; Hallux; Hallux Valgus; Humans; Metatarsal Bones; Osteotomy; Retrospective Studies; Treatment Outcome
PubMed: 35190276
DOI: 10.1016/j.fas.2022.02.009 -
International Environmental Agreements... 2022The transformation from the Kyoto Protocol to the Paris Agreement has been analyzed by international relations scholars, international law, and transnational governance...
UNLABELLED
The transformation from the Kyoto Protocol to the Paris Agreement has been analyzed by international relations scholars, international law, and transnational governance theory. The international relations literature looks at the climate regime from a perspective of power distribution, state interests, institutions, and multilateral negotiations. International law theory focuses on legal analysis and design of international climate agreements. The transnational governance literature examines the participation of transnational actors at different levels of governance. However, each of these theories overlooks a bilateral trend of cooperation in a multilateral setting that arises as part of the construction or reconstruction of the international regime. Why do national and subnational public actors in global climate governance cooperate bilaterally when multilateral cooperation already exists? What type of bilateral cooperative agreements do these actors prefer, and why? Using qualitative methods, combining content analysis subsequent interviews, this research empirically demonstrates the role and importance of bilateral transatlantic cooperation and informal agreements between national and subnational actors in global climate governance. Using the EU-US case study, this research identifies a diagonal dimension of interaction between states and transnational actors. It introduces and defines the terms "translateral cooperation" and "translateral agreements" in the new climate regime.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s10784-022-09575-6.
PubMed: 35370522
DOI: 10.1007/s10784-022-09575-6 -
Clinical Neurophysiology Practice 2022Sialidosis is an inborn error of metabolism. There is evidence that the myoclonic movements observed in this disorder have a cortical origin, but this mechanism does not...
OBJECTIVE
Sialidosis is an inborn error of metabolism. There is evidence that the myoclonic movements observed in this disorder have a cortical origin, but this mechanism does not fully explain the bilaterally synchronous myoclonus activity frequently observed in many patients. We present evidence of a subcortical basis for synchronous myoclonic phenomena.
METHODS
Electromyographic investigations were undertaken in two molecularly and biochemically confirmed patients with sialidosis type-1.
RESULTS
The EMG recordings showed clear episodes of bilaterally synchronous myoclonic activity in contralateral homologous muscles. We also observed a high muscular-muscular coherence with near-zero time-lag between these muscles.
CONCLUSION
The absence of coherence phase lag between the right-and-left homologous muscles during synchronous events indicates that a unilateral cortical source cannot fully explain the myoclonic activity. There must exist a subcortical mechanism for bilateral synchronization accounting for this phenomenon.
SIGNIFICANCE
Understanding this mechanism may illuminate cortical-subcortical relationships in myoclonus.
PubMed: 35800887
DOI: 10.1016/j.cnp.2022.05.004 -
Annals of Neurology May 2022Bilateral synchronous cortical activity occurs during sleep, attention, and seizures. Canonical models place the thalamus at the center of bilateral cortical...
OBJECTIVE
Bilateral synchronous cortical activity occurs during sleep, attention, and seizures. Canonical models place the thalamus at the center of bilateral cortical synchronization because it generates bilateral sleep spindle oscillations and primarily generalized absence seizures. However, classical studies suggest that the corpus callosum mediates bilateral cortical synchronization.
METHODS
We mapped the spread of right frontal lobe-onset, focal to bilateral seizures in mice and modified it using chemo and optogenetic suppression of motor thalamic nucleus and corpus callosotomy.
RESULTS
Seizures from the right cortex spread faster to the left cortex than to the left thalamus. The 2 thalami have minimal monosynaptic commissural connections compared to the massive commissure corpus callosum. Chemogenetic and closed-loop optogenetic inhibition of the right ventrolateral thalamic nucleus did not alter inter-hemispheric seizure spread. However, anterior callosotomy delayed bilateral seizure oscillations.
INTERPRETATION
Thalamocortical oscillations amplify focal onset motor seizures, and corpus callosum spreads them bilaterally. ANN NEUROL 2022;91:682-696.
Topics: Animals; Cerebral Cortex; Corpus Callosum; Electroencephalography; Humans; Mice; Rodentia; Seizures; Thalamus
PubMed: 35226367
DOI: 10.1002/ana.26338 -
Journal of Medicine and Life Feb 2022A staged ureteroscopic procedure is generally preferred to treat bilateral renal stones. In this study, we evaluated the feasibility of bilateral same-session flexible...
A staged ureteroscopic procedure is generally preferred to treat bilateral renal stones. In this study, we evaluated the feasibility of bilateral same-session flexible ureteroscopy (BS-fURS) in renal stones. A total of 81 patients underwent bilateral BS-fURS between March 2014 and March 2021 for bilateral renal stones. The mean stone burden per patient was 17±4 (range 7-27 mm). The average stone density was 1240 HU (970 to 1510). We used 4 types of ureteroscopes: Olympus URF-V2 (34 cases), Storz Flex X2 (30 cases), single-use PUSEN PU 3022 (12 cases), and single-use PUSEN - PU 3033A (5 cases). We specifically set our Holmium laser for dusting, pop-corning, and fragmenting. We found 31 calcium oxalate monohydrate cases, 11 calcium oxalate dehydrate cases, 17 uric acid cases, and 22 magnesium ammonium phosphate cases. The mean operating time was 77 min. (range 52 to 85) for both renal units. The SFRs were evaluated between 1 and 3 months with computed tomography (fragments >3 mm were defined as residual). Double J stenting (6Fr.) was applied bilaterally in 8 cases (9.87%) and unilateral in 34 cases (41.97%). The overall SFRs after 1 and 2 procedures were 81.48% (66/81 cases) and 92.59% (75/81 cases), respectively. Postoperative complications after an overall 96 procedures were Clavien I-II (18.75%) and Clavien III (3.12%). Urinary tract infections were observed in 13 cases (16.04%) without any case of urosepsis. Our experience suggested some BS-fURS advantages as a single anesthetic session and potentially reduced cost associated with treatment. BS-fURS seem feasible, especially for medium-sized bilateral renal stones in high-volume centers.
Topics: Female; Humans; Kidney Calculi; Lasers, Solid-State; Lithotripsy, Laser; Male; Retrospective Studies; Treatment Outcome; Ureteroscopes; Ureteroscopy; Urinary Tract Infections
PubMed: 35419108
DOI: 10.25122/jml-2021-0385 -
Acta Otorhinolaryngologica Italica :... Jun 2023Bilateral selective reinnervation of the larynx aims to restore both vocal cord tone and abductor movements in patients with bilateral vocal cord palsy.
OBJECTIVE
Bilateral selective reinnervation of the larynx aims to restore both vocal cord tone and abductor movements in patients with bilateral vocal cord palsy.
METHODS
Four females and one male treated by bilateral selective reinnervation of the larynx were included in the present study. In all cases, both posterior cricoarytenoid muscles were reinnervated using the C3 right phrenic nerve root through the great auricular nerve graft, while adductor muscle tone was bilaterally restored using the thyrohyoid branches of the hypoglossal nerve through transverse cervical nerve grafts.
RESULTS
After a minimum follow-up of 48 months, all patients were successfully tracheostomy free and had recovered normal swallowing. At laryngoscopy, the first patient recovered a left unilateral partial abductor movement, the second had complete bilateral abductor movements, the third did not show improvements of abductor movements, but symptomatology was improved, the fourth recovered partial bilateral abductor movements and the fifth case did not show improvements and needed posterior cordotomy.
CONCLUSIONS
Bilateral selective laryngeal reinnervation, although a complex surgical procedure, offers a more physiologic recovery in the treatment of bilateral vocal fold paralysis. Selection criteria still needs to be precisely defined to avoid unexpected failures.
Topics: Female; Humans; Male; Vocal Cord Paralysis; Recurrent Laryngeal Nerve; Vocal Cords; Laryngeal Muscles; Phrenic Nerve; Electromyography
PubMed: 37204843
DOI: 10.14639/0392-100X-N2395