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https://www.readbyqxmd.com/read/28187801/management-of-acute-neuromuscular-disorders
#1
E F M Wijdicks
Imminent neuromuscular respiratory failure is recognized by shortness of breath, restlessness, and tachycardia and is often followed by tachypnea, constantly interrupting speech, asynchronous breathing and sometimes paradoxical breathing and use of scalene and sternocleidomastoid muscles. Once a patient presents with such a constellation of signs, there are some difficult decisions to be made and include assessment of the severity of respiratory failure and in particular when to intubate. Failure of the patient to manage secretions as a result of oropharyngeal weakness rather than neuromuscular respiratory weakness may be another reason for acute intubation...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28138234/respiratory-muscle-activity-and-patient-ventilator-asynchrony-during-different-settings-of-noninvasive-ventilation-in-stable-hypercapnic-copd-does-high-inspiratory-pressure-lead-to-respiratory-muscle-unloading
#2
Marieke L Duiverman, Anouk S Huberts, Leo A van Eykern, Gerrie Bladder, Peter J Wijkstra
INTRODUCTION: High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient-ventilator asynchrony (PVA). PATIENTS AND METHODS: Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28135679/an-unusual-case-of-neurogenic-thoracic-outlet-syndrome
#3
Yash Vaidya, Rajan Vaithianathan
INTRODUCTION: Neurogenic thoracic outlet syndrome (nTOS) is the most common manifestation of thoracic outlet syndrome (TOS), accounting for more than 95% of cases. It is usually caused by cervical ribs, anomalies in the scalene muscle anatomy or post-traumatic inflammatory changes causing compression of the brachial plexus. CASE PRESENTATION: We present an unusual case of nTOS caused by a cystic lymphangioma at the thoracic outlet, with only one case reported previously in the literature...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27989967/modified-interscalene-approach-for-resection-of-symptomatic-cervical-rib-anatomical-review-and-clinical-study
#4
Walid Abdel Ghany, Mohamed A Nada, Ahmed F Toubar, Ahmed E Desoky, Hesham Ibrahim, Marwa A Nassef, Mostafa G Mahran
BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVES: in this work we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27979572/a-fourteen-year-experience-with-vascular-anomalies-encountered-during-transaxillary-rib-resection-for-thoracic-outlet-syndrome
#5
Jeniann A Yi, Robert J Johnston, Mark R Nehler, Douglas R Gibula, Kristen Alix, Natalia O Glebova, Charles O Brantigan
BACKGROUND: Transaxillary approach to first rib resection and scalenectomy (TAFRRS) is a well-established technique for treatment of thoracic outlet syndrome (TOS). Although anatomic features encountered during TAFRRS are in general constant, vascular anomalies may be encountered but have not been described to date. Herein we describe vascular abnormalities encountered during TAFRRS. METHODS: We performed a retrospective review of a prospective practice database of 224 operations for TOS performed in 172 patients from March 2000 to March 2014...
December 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27934423/metal-ligand-exchange-in-a-cyclic-array-the-stepwise-advancement-of-supramolecular-complexity
#6
Manik Lal Saha, Michael Schmittel
Herein, we demonstrate how the supramolecular complexity (evaluated by the degree of self-sorting M) evolves in a chemical cycle of cascaded metallosupramolecular transformations, using abiological self-assembled entities as input signals. Specifically, the successive addition of the supramolecular self-assembled structures S1 and (T2 + S2) to the starting supramolecular two-component equilateral triangle T1 (M = 1) first induced a fusion into the three-component quadrilateral R1 (M = 6) and then to the five-component scalene triangle T3 (M = 16)...
December 5, 2016: Inorganic Chemistry
https://www.readbyqxmd.com/read/27928682/morphological-and-genetic-characterization-of-kudoa-whippsi-myxosporea-multivalvulida-from-cheilodactylus-zonatus-in-the-western-pacific-ocean-off-japan-and-two-new-kudoa-spp-k-akihitoi-n-sp-and-k-empressmichikoae-n-sp-from-acanthogobius-hasta-in-the-sea-of
#7
Akihiro Kasai, Aogu Setsuda, Hiroshi Sato
Molecular genetic characterization using the ribosomal RNA (rDNA) gene accrues a wealth of knowledge regarding the true nature of species diversity of Kudoa Meglitsch, 1947 (Myxozoa: Myxosporea: Multivalvulida) and the biogeographical relationships of isolates from different host fish and sea areas. In the present study, we characterized morphologically and genetically three Kudoa spp. with four shell valves and polar capsules (SV/PC), forming pseudocysts in the myofiber of trunk muscles of Cheilodactylus zonatus or Acanthogobius hasta in the natural seawater around Japan...
February 2017: Parasitology Research
https://www.readbyqxmd.com/read/27813035/-thoracic-outlet-syndrome-a-case-of-scalene-muscle-hypertrophy-in-long-term-follow-up-of-diagnosis-of-cervical-discopathy
#8
Damla Yürük, Güngör Enver Özgencil, Ahmet Yılmaz, Merve Hayriye Kocaoğlu, Sırrı Sinan Bilgin, İbrahim Aşık
Described in this article is diagnosis and treatment of mixed type of thoracic outlet syndrome (TOS) resulting from scalene muscle hypertrophy. Many diseases should be considered in the differential diagnosis to definitively diagnose this syndrome, and it is necessary to ask about activities of daily life, in addition to adding provocative tests to physical examination and examining electrophysiological and imaging results. Once diagnosed, even if complaints decrease with conservative treatment, surgery may be required...
July 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/27664077/exercise-enhanced-ultrasound-guided-anterior-scalene-muscle-pectoralis-minor-muscle-blocks-can-facilitate-the-diagnosis-of-neurogenic-thoracic-outlet-syndrome-in-the-high-performance-overhead-athlete
#9
Michael M Bottros, Jacob D AuBuchon, Lauren N McLaughlin, David W Altchek, Karl A Illig, Robert W Thompson
No abstract text is available yet for this article.
January 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27597900/a-cadaveric-investigation-of-the-dorsal-scapular-nerve
#10
Vuvi H Nguyen, Hao Howe Liu, Armando Rosales, Rustin Reeves
Compression of the dorsal scapular nerve (DSN) is associated with pain in the upper extremity and back. Even though entrapment of the DSN within the middle scalene muscle is typically the primary cause of pain, it is still easily missed during diagnosis. The purpose of this study was to document the DSN's anatomy and measure the oblique course it takes with regard to the middle scalene muscle. From 20 embalmed adult cadavers, 23 DSNs were documented regarding the nerve's spinal root origin, anatomical route, and muscular innervations...
2016: Anatomy Research International
https://www.readbyqxmd.com/read/27565607/reporting-standards-of-the-society-for-vascular-surgery-for-thoracic-outlet-syndrome
#11
Karl A Illig, Dean Donahue, Audra Duncan, Julie Freischlag, Hugh Gelabert, Kaj Johansen, Sheldon Jordan, Richard Sanders, Robert Thompson
Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. The treatment of NTOS, in particular, has been hampered by lack of data, which in turn is the result of inconsistent definitions and diagnosis, uncertainty with regard to treatment options, and lack of consistent outcome measures...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27565596/reporting-standards-of-the-society-for-vascular-surgery-for-thoracic-outlet-syndrome-executive-summary
#12
Karl A Illig, Dean Donahue, Audra Duncan, Julie Freischlag, Hugh Gelabert, Kaj Johansen, Sheldon Jordan, Richard Sanders, Robert Thompson
Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. The treatment of NTOS, in particular, has been hampered by lack of data, which in turn is the result of inconsistent definitions and diagnosis, uncertainty with regard to treatment options, and lack of consistent outcome measures...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27517072/anatomical-variations-of-brachial-plexus-in-adult-cadavers-a-descriptive-study
#13
Mohammadreza Emamhadi, Shahrokh Yousefzadeh Chabok, Fariborz Samini, Babak Alijani, Hamid Behzadnia, Fariborz Ayati Firozabadi, Zoheir Reihanian
BACKGROUND: Variations of the brachial plexus are common and a better awareness of the variations is of crucial importance to achieve successful results in its surgical procedures. The aim of the present study was to evaluate the anatomical variations of the brachial plexus in adult cadavers. METHODS: Bilateral upper limbs of 32 fresh cadavers (21 males and 11 females) consecutively referred to Guilan legal medicine organization from November 2011 to September 2014, were dissected and the trunks, cords and terminal nerves were evaluated...
June 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27516542/continuous-positive-airway-pressure-treatment-does-not-normalize-the-prolonged-reflex-inhibition-to-inspiratory-loading-in-obstructive-sleep-apnea
#14
Nicholas P S Murray, David K McKenzie, Simon C Gandevia, Jane E Butler
In obstructive sleep apnea (OSA), the short-latency inhibitory reflex (IR) of inspiratory muscles to airway occlusion is prolonged in proportion to the severity of the OSA. The mechanism underlying the prolongation may relate to chronic inspiratory muscle loading due to upper airway obstruction or sensory changes due to chronic OSA-mediated inflammation. Continuous positive airway pressure (CPAP) therapy prevents upper airway obstruction and reverses inflammation. We therefore tested whether CPAP therapy normalized the IR abnormality in OSA...
October 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27472855/the-clinical-and-emg-assessment-of-the-effects-of-stabilization-exercise-on-nonspecific-chronic-neck-pain-a-randomized-controlled-trial
#15
Fariba Ghaderi, Mohammad Asghari Jafarabadi, Khodabakhsh Javanshir
BACKGROUND: Neck pain is an important cause of disability. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Stabilization exercise has been the topic of many studies. OBJECTIVE: To compare the effects of stabilization and routine exercises on chronic neck pain. METHODS: Forty patients were randomly assigned into either stabilization or routine exercise groups and undertook a 10-week training program. Electromyographic (EMG) activity was recorded from Sternocleidomastoid (SCM), Anterior Scalene (AS) and Splenius Capitis (SC) muscles bilaterally...
July 22, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27460516/human-intersegmental-reflexes-from-intercostal-afferents-to-scalene-muscles
#16
Rachel A McBain, Janet L Taylor, Robert B Gorman, Simon C Gandevia, Jane E Butler
What is the central question of this study? The aim was to determine whether specific reflex connections operate between intercostal afferents and the scalene muscles in humans, and whether these connections operate after a clinically complete cervical spinal cord injury. What is the main finding and its importance? This is the first description of a short-latency inhibitory reflex connection between intercostal afferents from intercostal spaces to the scalene muscles in able-bodied participants. We suggest that this reflex is mediated by large-diameter afferents...
October 1, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27444863/ultrasonographic-identification-of-fibromuscular-bands-associated-with-neurogenic-thoracic-outlet-syndrome-the-wedge-sickle-sign
#17
Zsuzsanna Arányi, Anita Csillik, Josef Böhm, Thomas Schelle
Thoracic outlet syndrome (TOS) is a disorder characterized by compression of the lower trunk of the brachial plexus, most often in association with anomalous congenital fibromuscular bands in the scalenic region. Early diagnosis is important, because the neurologic deficit associated with TOS may be irreversible. Using high-resolution ultrasound, we investigated 20 consecutive patients with clinical signs suggestive of TOS (all females, average age: 40.4 ± 14.9 y) and 25 control patients. In 19 patients, we identified a hyper-echoic fibromuscular structure at the medial edge of the middle scalene muscle, which indented the lower trunk of the brachial plexus ("wedge-sickle sign")...
October 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27428783/occipitocervical-fixation-a-single-surgeon-s-experience-with-120-patients
#18
Eduardo Martinez-Del-Campo, Jay D Turner, Samuel Kalb, Leonardo Rangel-Castilla, Luis Perez-Orribo, Hector Soriano-Baron, Nicholas Theodore
BACKGROUND: Occipitocervical junction instability can lead to serious neurological injury or death. Open surgical fixation is often necessary to provide definitive stabilization. However, long-term results are limited to small case series. OBJECTIVE: To review the causes of occipitocervical instability, discuss the indications for surgical intervention, and evaluate long-term surgical outcomes after occipitocervical fixation. METHODS: The charts of all patients undergoing posterior surgical fixation of the occipitocervical junction by the senior author were retrospectively reviewed...
October 2016: Neurosurgery
https://www.readbyqxmd.com/read/27422596/does-increased-superficial-neck-flexor-activity-in-the-craniocervical-flexion-test-reflect-reduced-deep-flexor-activity-in-people-with-neck-pain
#19
Gwendolen Jull, Deborah Falla
BACKGROUND: The craniocervical flexion test assesses the deep cervical flexor muscles (longus capitis, longus colli). Ideally, electromyography (EMG) studies measure activity in both deep and superficial (sternocleidomastoid, anterior scalene) flexors during the test, but most studies confine recordings to superficial muscle activity as the technique to record the deep muscles is invasive. Higher activity of the superficial flexors has been interpreted as an indicator of reduced deep flexor activity in people with neck pain but how close the inverse relationship is during this test is unknown...
September 2016: Manual Therapy
https://www.readbyqxmd.com/read/27390425/effects-of-stretching-the-scalene-muscles-on-slow-vital-capacity
#20
Juncheol Lee, Sehee Hwang, Seungim Han, Dongwook Han
[Purpose] The purpose of this study was to examine whether stretching of the scalene muscles would improve slow vital capacity (SVC). [Subjects and Methods] The subjects of this study were 20 healthy female students to whom the study's methods and purpose were explained and their agreement for participation was obtained. The SVC was measured using spirometry (Pony FX, COSMED Inc., Italy). The intervention used was stretching of the scalene muscles. Stretching was carried out for 15 min, 10 times at per each portion of scalene muscles: the anterior, middle, and posterior parts...
June 2016: Journal of Physical Therapy Science
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