occiput

BACKGROUND: Cervical collars restrict cervical spine movement to minimise the risk of spinal cord injury. Collars apply mechanical loading to the skin putting it at risk of skin damage. Indeed, cervical collar-related pressure ulcers are unacceptably prevalent, especially at the occiput, mandibles, and chin. Collar design and fit are often key considerations for prevention. METHODS: This comprehensive study evaluated four commercial prehospital and acute care cervical collars...

BACKGROUND: Early palliative/pre-emptive intervention improves clinical outcomes and quality of life for patients with metastatic cancer. A previous signal-seeking randomized controlled trial (RCT) demonstrated that early upfront radiotherapy to asymptomatic or minimally symptomatic high-risk osseous metastases led to reduction in skeletal-related events (SREs), a benefit driven primarily by subgroup of high-risk spine metastasis. The current RCT aims to determine whether early palliative/pre-emptive radiotherapy in patients with high-risk, asymptomatic or minimally symptomatic spine metastases will lead to fewer SREs within 1 year...

INTRODUCTION: Traumatic injuries of the spine requiring surgery are rare in infancy. Fusion procedures in the very young are not well-described at the atlanto-occipital junction or subaxial spine. Here we describe novel segmental posterior instrumentation in a severe spinal column disruption in an infant. CASE PRESENTATION: A 13-month-old male with atlanto-occipital dislocation and severe C6-7 distraction (ASIA impairment scale A) presented after a motor vehicle accident...

Pelvic floor disorders after childbirth have distressing lifelong consequences for women, requiring more than 300,000 women to have surgery annually. This represents approximately 10% of the 3 million women who give birth vaginally each year. Vaginal birth is the largest modifiable risk factor for prolapse, the pelvic floor disorder most strongly associated with birth, and is an important contributor to stress incontinence. These disorders require 10 times as many operations as anal sphincter injuries. Imaging shows that injuries of the levator ani muscle, perineal body, and membrane occur in up to 19% of primiparous women...

CASE: A healthy 5-year-old boy presented with a gradual onset of headaches and acute global right-sided weakness over 10 days. The work-up revealed unstable os odontoideum leading to multiple posterior circulation infarcts with vertebral artery dissection. He underwent antiplatelet therapy, cervical collar immobilization, and delayed occiput to C2 posterior spinal fusion and instrumentation with iliac crest autograft. At 2-year follow-up, the patient had a solid fusion mass, appropriate cervical alignment, and was without neurologic sequelae...

The genus Tropicohilara gen. nov. (Diptera: Empididae: Empidinae: Hilarini) is described and includes the following six new species from Brazil: Tropicohilara amazonensis sp. nov. (type species, Brazil: Amazonas, Manaus); T. bahiensis sp. nov. (Brazil: Bahia, Camacan); T. bella sp. nov. (Brazil: Pernambuco, Jaqueira); T. mineira sp. nov. (Brazil: Minas Gerais, Itamonte); T. paranaensis sp. nov. (Brazil: Paraná, Piraquara); and T. sinclairi sp. nov. (Brazil: Paraná, Morretes). The genus is presently recorded from the Amazonian and Atlantic Forest biomes...

Atlanto-occipital assimilation is an osseous embryological anomaly of the craniovertebral junction in which the atlas (C1) is fused to the occiput of skull. Embryologically, this assimilation may happen due to failure of the segmentation and separation of the caudal occipital and the cranial cervical sclerotome. The segmentation clock is maintained by NOTCH and WNT signalling pathways along with Hox genes and retinoic acid. This condition is likely to be a consequence of mutation in above mentioned genes. The knowledge of this assimilation may be crucial for the clinicians as it may lead to various neurovascular symptoms...

PURPOSE: Dopamine transporter (DAT) imaging is used to support the diagnosis of neurodegenerative parkinsonian disorders. Specific medications have been reported to confound the interpretation of [123 I]I-FP-CIT SPECT scans, but there is limited data. The aim of the current study is to identify potential medication effects on the interpretation of [123 I]I-FP-CIT SPECT scans in routine practice. MATERIALS AND METHODS: Consecutive patients undergoing a [123 I]I-FP-CIT SPECT/CT scan on a 360° CZT camera between September 2019 and December 2022 were included...

Complex craniovertebral junction (CVJ) defects account for a considerable proportion of CVJ diseases. Given the heavily assimilated C1, an unfavorable C1-C2 joint orientation, an overriding C2 superior facet, a low-hanging occiput, and an abnormal vertebral artery course with a high-riding vertebral artery, placement of C1 lateral mass screws might be difficult. To address this, a novel technique for placing C1 lateral mass screws that avoid vertebral artery injury, low-hanging occiput, and overriding C2 superior facet was developed in this study...

Fibromyalgia (FM) is a multicomponent illness and despite its worldwide prevalence, a complete understanding of its aetiology and pathogenesis remains unclear. The goal of the study is to analyze the level of association between elastic properties of tissue measured by strain elastography (SEL) and pain pressure threshold (PPT) in the characteristic painful points described in patients suffering from FM. This was a cross-sectional, observational study. A sample comprised of 42 subjects with FM was recruited from a private care centre...

A case of 67-year-old male patient with superficial papular neuroma (SPN) on the occiput is reported. This is the second report of SPN and the first with clinical images. Histologically, in the superficial dermis and periadnexa, the specimen exhibits a nodule of bland spindle cells with an S-shaped and spindle nucleus, surrounded by eosinophilic collagen fibers and scattered mast cells, which forms focally peripheral nerve-like structures. Lichen simplex chronicus-like changes are observed. Immunostaining result revealed that the tumor cells are positive for S-100, neurofilament, collagen IV, and CD34 but negative for Melan A, epithelial membrane antigen, and glial fibrillary acidic protein...

INTRODUCTION: The pelvis plays a major role in the orientation of total hip arthroplasty (THA) implants and consequently, on the postoperative stability of the new hip joint. The relationship between the spine and pelvis affects the functional orientation of the acetabular cup, although this relationship differs between individuals and the positions encountered in everyday life. We believe this should be factored in when planning the THA procedure. This led us to conduct an in vivo ultrasound study to document the values of pelvic tilt in standing, sitting and lying positions in patients who have advanced hip osteoarthritis, before and after they undergo THA...

This study aimed to determine gravitational and dynamic torques and muscle activity of the neck across a series of design parameters of head mounted displays (mass, center of mass, and counterweights) associated with virtual and augmented reality (VR/AR). Twenty young adult participants completed five movement types (Slow and Fast Flexion/Extension and Rotation, and Search) while wearing a custom-designed prototype headset that varied the three design parameters: display mass (0, 200, 500, and 750 g), distance of the display's center of mass in front of the eyes (approximately 1, 3, and 5 cm anteriorly), and counterweights of 0, 166, 332, and 500 g to balance the display mass of 500 g at 7 cm...

INTRODUCTION: There are many risk factors for obstetric anal sphincter injury (OASIS) and the interaction between these risk factors is complex and understudied. The many observational studies that have shown a reduction of OASIS rates after implementation of perineal support have short follow-up time. We aimed to study the effect of integration of active perineal support and lateral episiotomy on OASIS rates over a 15-year period and to study interactions between risk factors known before delivery...

Cervical laceration (CL), although infrequent, is an often-unrecognized complication of vaginal birth and can cause significant blood loss in the immediate postpartum period. The rate of clinically significant CL ranges from 0.14% to 0.2% of births. Nulliparity, operative vaginal birth, occiput posterior position of the fetus, induction of labor, and episiotomy have been cited as possible risk factors. Much of the available literature regarding CL, however, is dated or anecdotal, and there are varying and inconsistent risk associations with its occurrence...

BACKGROUND: The upper cervical spine is a major focus of damage by rheumatoid arthritis (RA). Specific screening for mobility of the upper cervical spine, which is essential for direct laryngoscopy, is lacking. Herein, we present a case of RA with Cormack-Lehane grade IV, which was not predicted by preoperative examination. CASE PRESENTATION: A 66-year-old woman with RA was scheduled for a right total knee arthroplasty and right elbow synovectomy. She had a long history of RA without symptoms related to the cervical spine or spinal cord...

INTRODUCTION: The diseases causing chronic diffuse alopecia and having similar clinical findings, namely chronic telogen effluvium, androgenetic alopecia, and the alopecia with overlapping features, should be differentiated. Recently, diffuse variants of lichen planopilaris have been described with histopathologic features of lichen planopilaris but clinically presenting with diffuse hair loss mostly in an androgenetic pattern. OBJECTIVES: To determine the accurate diagnosis underlying chronic diffuse alopecia in women by evaluating histopathologic findings...

We present new reconstructions of subcephalic musculature for the stem chondrichthyan Pucapampella, the tetrapodomorph fish Eusthenopteron, and the Devonian tetrapod Ichthyostega. These reconstructions are based on macroscopic dissections of the head muscles of an archaic shark Heptranchias and an archaic actinopterygian Polypterus, that are combined with functional considerations and a reappraisal of not widely known theoretical concepts from the past. The subcephalic, as well as the supracephalic, musculature is formed by four anterior myomeres...

BACKGROUND AND AIM: Direct posterior reduction and manipulation of the C1-2 joints, accompanied by placement of spacers, is the state-of-the-art technique for treating basilar invagination (BI) and atlantoaxial dislocation (AAD). The hindrance of occiput to reaching up to the true atlantoaxial facets (AAF) during the surgery remains challenging for cage placement. The aim of this study was to explore an objective and precise method of measuring the effect of the hindrance of occiput to reaching up to the true AAF and cage placement during surgery...

Orchidaceae, one of the most numerous families in the world's flora, have evolved various pollination strategies to favour cross-pollination, such as deceptive pollination and pollinarium reconfiguration. Among the terrestrial orchids of the Mediterranean, only species belonging to the genus Serapias show a strategy defined as shelter imitation. The floral elements form a tubular structure that insects use during their resting phases. The purpose of this article was to clarify the mechanisms that guarantee pollination with particular attention to the morphological interactions between orchids and pollinators and whether pollinaria reconfiguration is necessary in the promotion of cross-pollination in Serapias ...