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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 -
Indian Journal of Anaesthesia Jun 2018Pallidotomy is a surgical procedure done widely for Parkinson's disease and various dystonias refractory to medical treatment. The technique involves radiofrequency (RF)...
Pallidotomy is a surgical procedure done widely for Parkinson's disease and various dystonias refractory to medical treatment. The technique involves radiofrequency (RF) thermal coagulation of globus pallidus internus, either unilaterally or bilaterally. The technique has been shown to produce good success. However, the involvement of nearby vital structures can result in new post-operative complications. We encountered a case of delayed emergence from anaesthesia associated with bilateral mydriasis and visual field defects in a patient after bilateral RF thermal lesioning.
PubMed: 29962530
DOI: 10.4103/ija.IJA_27_18 -
Journal of Athletic Training Nov 2023Existing patellofemoral pain (PFP) literature has primarily focused on quadriceps muscle volume, with limited attention given to the lower limbs deep and superficial...
CONTEXT
Existing patellofemoral pain (PFP) literature has primarily focused on quadriceps muscle volume, with limited attention given to the lower limbs deep and superficial muscle volumes in individuals with unilateral and bilateral PFP. This research aims to fill this gap.
OBJECTIVE
To explore superficial and deep lower extremity muscle volume in women with unilateral and bilateral PFP compared to a normative database of pain-free women.
DESIGN
Cross-sectional study.
SETTING
University imaging research center.
PATIENTS OR OTHER PARTICIPANTS
Twenty women with PFP (10 unilateral and 10 bilateral) and 8 pain-free women.
MAIN OUTCOME MEASURE(S)
We quantified lower extremity muscle volume via 3.0 Tesla magnetic resonance imaging. Two separate one-way analyses of variance were performed: (1) unilateral PFP (painful vs. non-painful limb) vs. pain-free control and (2) bilateral PFP (more painful vs. less painful limb) vs. pain-free control.
RESULTS
There were no differences in age and body mass index across groups (P >.05). Compared to pain-free women, both women with unilateral and bilateral PFP had bilaterally smaller volumes of the anterior (iliacus: P ≤ .0004, d = 2.12-2.65), medial (adductor brevis, adductor longus, gracilis, and pectineus: P ≤ .02, d = 1.25-2.24), posterior (obturator externus, obturator internus, and quadratus femoris: P < .05, d = 1.17-4.82), and lateral (gluteus minimus: P ≤ .03, d = 1.16-2.09) hip muscles, and knee extensors (rectus femoris: P ≤.003, d = 1.67-2.16) and flexors (biceps femoris: long and short head: P ≤ .01, d = 1.56-1.93).
CONCLUSIONS
Both women with unilateral and bilateral PFP 25 displayed decreased volume of multiple superficial and deep muscles of the bilateral hips and knees compared with pain-free women. Interventions should bilaterally target lower limb muscles when treating PFP, and hypertrophy exercises for specific muscles should be explored to enhance interventional choices.
PubMed: 38015817
DOI: 10.4085/1062-6050-0330.23 -
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 -
Urology Annals 2021The prevalence rate of upper urinary tract calculi in Saudi Arabia is one of the highest globally. Bilateral renal stone management is an option but is still...
INTRODUCTION
The prevalence rate of upper urinary tract calculi in Saudi Arabia is one of the highest globally. Bilateral renal stone management is an option but is still controversial.
METHODOLOGY
The study was a retrospective study, including 31 patients with bilateral renal or ureteric stones who underwent bilateral same-session ureterorenoscopy (BSS-URS). The data collected included age, gender, body mass index (BMI), stone burden bilaterally, operative time bilaterally, hospital stay, stone location, type of anesthesia, stone history, renal anomaly as well as pre- and postoperative JJ stenting. In addition, data related to complications (ureteric injury, renal failure, urinary tract infection, pain requiring an emergency department visit within 1 week of the procedure), the stone-free rate (defined as £ 3 mm asymptomatic stone fragment identified with computed tomography Kidney, Ureter and Bladder 3 months after surgery was also collected. The data were collected from the electronic patient record system, entered in an Excel spreadsheet, and descriptive analysis was done.
RESULTS
In total, 31 patients were included, with the majority (80.6%, = 25) male. The mean age was 41.6 years, the mean BMI 28.7 ± 5.59, the mean operative time for each renal unit 46.53 ± 25.69 min, and the mean hospital stay 17.87 ± 8.43 h. The majority (96.7%, = 30) received general anesthesia. Less than half (40.3%, = 25) of the renal units had stones in multiple calyces and the majority (90.3%, = 56) of the renal units were stone free at the 3-month follow-up. A small proportion (3.2%, = 2) of the renal units were polycystic. Prestenting was documented in 40.3% ( = 25) of the renal units and the majority (95.2%, = 59) were stented postoperatively.
CONCLUSION
BSS-URS is a safe and a highly effective management option for bilateral renal stones.
PubMed: 34759642
DOI: 10.4103/UA.UA_128_20 -
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 -
International Journal of Reproductive... Apr 2021Several conflicting results have been reported on the survival and function of transplanted ovaries.
Follicular development and the expression of BAX and vascular endothelial growth factor in transplanted ovaries in uni- and bilateral ovariectomized mice: An experimental study.
BACKGROUND
Several conflicting results have been reported on the survival and function of transplanted ovaries.
OBJECTIVE
Evaluation of the follicular development and the expression of vascular endothelial growth factor (VEGF) and Bcl-2-associated X protein (BAX) in ovaries transplanted into uni- and bilaterally ovariectomized mice.
MATERIALS AND METHODS
In this experimental study, 40 female NMRI mice (21-days-old, 12-15 gr) were ovariectomized uni- and bilaterally (n = 20/ group), while the 8-wk-old mice were considered as intact control group (n = 6). 5 weeks after transplantation at the proestrus stage, the morphology of recovered transplanted ovaries and the proportion of follicles were studied at different developmental stages. The apoptosis cell death by pro-apoptotic protein BAX and the expression of VEGF were evaluated using immunohistochemistry.
RESULTS
In the bilaterally ovariectomized mice, among the 455 counted normal follicles, a lower rate of primordial and primary follicles and a higher rate of preantral and antral follicles were observed (p = 0.002). However, the percentages of preantral and antral follicles, and the corpus luteum were significantly lower in the intact control group (among the 508 counted normal follicles in this group) compared to other transplanted groups (p = 0.002). The number of BAX-positive cells in all groups was not significantly different. The VEGF expression was prominent in vessels of the corpus luteum, and also in the theca layer of large follicles of studied groups.
CONCLUSION
Early discharge of ovarian reserve was prominent in the bilaterally ovariectomized group but the incidence of apoptotic cells and VEGF expression as angiogenic factor did not differ in both ovariectomized mice. Thus, unilaterally ovariectomy has less side effects on the ovarian reserve compared to bilateral ovariectomy.
PubMed: 33997595
DOI: 10.18502/ijrm.v19i4.9062 -
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 -
Journal of Clinical Medicine Sep 2021Deficits in maximal and explosive knee extensor strength, which are usually assessed with unilateral tasks, are substantial in patients with knee osteoarthritis (KOA)....
Deficits in maximal and explosive knee extensor strength, which are usually assessed with unilateral tasks, are substantial in patients with knee osteoarthritis (KOA). The aim of this study was to investigate the clinical relevance of unilateral vs. bilateral tasks for assessing knee extensor strength in patients with KOA. This was achieved primarily by comparing unilateral and bilateral inter-limb strength asymmetries and secondarily by examining the relationship between unilaterally and bilaterally measured strength, and performance-based and self-reported function. Twenty-four patients with unilateral KOA (mean age: 65 ± 7 years) performed isometric gradual and explosive maximal voluntary contractions to assess, respectively their maximal and explosive strength. Performance-based and self-reported function were also evaluated with standard functional tests and questionnaires, respectively. Inter-limb asymmetries of maximal and explosive strength did not differ significantly between unilateral (mean asymmetry: 26 ± 15%) and bilateral tasks (22 ± 21%). In the same way, the relationships between knee extensor strength-measured either unilaterally or bilaterally-and performance-based or self-reported function were not influenced by the type of task. In conclusion, it does not seem to make a difference in terms of clinical relevance whether maximal and explosive knee extensor strength are evaluated with unilateral or bilateral tasks in KOA patients.
PubMed: 34640371
DOI: 10.3390/jcm10194353 -
Neuroscience Insights 2021Hypertrophic olivary degeneration is a rare condition caused by a lesion in the Guillain-Mollaret triangle which leads to trans-synaptic degeneration resulting in the... (Review)
Review
Hypertrophic olivary degeneration is a rare condition caused by a lesion in the Guillain-Mollaret triangle which leads to trans-synaptic degeneration resulting in the degenerative hypertrophy of the inferior olivary nucleus. This condition presents clinically with palatal tremor but can also produce ocular myoclonus or cerebellar signs. While any lesion that occurs within the Guillian-Mollaret triangle and results in the deafferentation of the inferior olive can lead to hypertrophic olivary degeneration, the most common etiologies include ischemic and hemorrhagic stroke, vascular malformation, neoplasm, and iatrogenic injury related to surgery. We report a series of 7 patients who presented with this condition bilaterally on MRI imaging, including 1 case which represents the first report of toxoplasmosis leading to the development of bilateral hypertrophic olivary degeneration and only the third reported case, unilateral or bilateral, related to an infectious etiology.
PubMed: 34485912
DOI: 10.1177/26331055211007445