Medicine
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Observational Study
Quantification of immobilization-induced changes in human calf muscle using speed-of-sound ultrasound: An observational pilot study.
Short-term immobilization leads to fatty muscular degeneration, which is associated with various negative health effects. Based on literature showing very high correlations between MRI Dixon fat fraction and Speed-of-Sound (SoS), we hypothesized that we can detect short-term-immobilization-induced differences in SoS. Both calves of 10 patients with a calf cast on one side for a mean duration of 41 ± 26 days were examined in relaxed position using a standard ultrasound machine. ⋯ SoS was reduced with the number of days after cast installment (r = -0.553, P = .097). No significant differences were found for muscle layer thickness, subcutaneous fat layer thickness, mean fat echo intensity, or mean muscle echo intensity. Short-term-immobilization led to a significant reduction in SoS in the cast calf compared to the healthy calf, indicating a potential role of SoS as a biomarker in detecting immobilization-induced fatty muscular degeneration not visible on B-mode ultrasound.
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The prone position is commonly used in spinal surgery. There have been many studies on hemodynamic changes in the prone position during general anesthesia. We report a rare case of transient left bundle branch block (LBBB) in a prone position. ⋯ The prone position causes significant hemodynamic changes. A high risk of cardiovascular disease may cause ischemic heart disease and ECG changes. Therefore, careful management is necessary.
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To assess the prevalence and factors associated with mild cognitive impairment (MCI) in patients suffering from psoriatic arthritis (PsA). A cross-sectional evaluation was conducted in consecutive PsA patients. Sociodemographic data and the clinimetric variables related to PsA and psoriasis were collected for each patient. ⋯ MoCA was negatively correlated with age (r = -0.354; P < .0001), HAQ-DI (r = -0.227; P = .026), and fatigue (r = -0.222; P = .029), and positively correlated with psoriasis duration (r = 0.316; P = .001) and DLQI (r = 0.226; P = .008). The multivariate logistic regression analysis revealed the duration of psoriasis (P = .0005), age (P = .0038), PASI (P = .0050), and HAQ-DI (P = .0193) as predictors of the MoCA score. MCI is present in a significant proportion of PsA patients, and is mainly determined by age, cutaneous variables, and disability.
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Botulinum toxin (BTX) injection is a widely used treatment option for dysphagia associated with cricopharyngeal (CP) muscle achalasia, but uniform standards and protocols for administration techniques and injection sites are still lacking. This case study suggests that a unique administration technique involving a combination of ultrasound, electromyography, and balloon guidance for injecting the CP muscle can reduce inadvertent migration of BTX to non-injected tissues and increase the effectiveness and safety of BTX treatment. ⋯ The unique administration technique with triple guidance holds several advantages, suggesting that it may be a promising treatment for CP muscle achalasia.
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In this report, we present an extremely rare case of recurrent monocular exudative retinal detachment without concomitant ocular metastases. This turned out to be the first symptom of squamous cell lung cancer. ⋯ Exudative retinal detachment without tumor metastasis to the eyeball can be one of the first signs of lung cancer in rare cases. Multidisciplinary care and imaging methods with greater accuracy will provide comprehensive care to the patients. It will not only facilitate timely detection and treatment of lung tumors but also for a plethora of oncological diseases.