Electrodiagnostic Studies in the Surgical Treatment of Carpal Tunnel Syndrome—A Systematic Review

The aim of our paper was to provide comprehensive data on the role of electrodiagnostic (EDX) studies in the surgical treatment of carpal tunnel syndrome (CTS). An extensive search was conducted through the major electronic database to identify eligible articles. Data extracted included grade of CTS based on neurophysiological testing, preoperative data of EDX studies, time of complete or partial resolution after surgery, postoperative Boston carpal tunnel questionnaire (CTQ) scores, age, sex, intraoperative and postoperative data of EDX studies, time to complete or partial resolution of symptoms, and number of patients without postsurgical improvement. Our main findings revealed that that electrodiagnostic testing is still a powerful tool for diagnosis of CTS. Moreover, it can also detect other pathologies. EDX testing provides a quantitative measure of the physiological function of the median nerve, which may be used to guide surgical treatment. Thirdly, when the outcome of surgery is unsatisfactory, NCS can assist in determining the reason for failure.

P293 Local Mesenchymal Stem Cells injection in Crohn’s disease strictures: a phase I-II, open-label clinical study

Background Intestinal fibrosis is a common complication of Crohn’s disease (CD) leading to progressive bowel stricture formation. Mesenchymal stem cells (MSCs), known for their immunomodulatory, anti-inflammatory and anti-fibrotic properties, could be a potential therapy in this frequently fibro-inflammatory condition. In this phase I–II open-label pilot trial, we aimed to assess safety and efficacy of local MSCs injection in CD strictures. Methods: CD patients with a non-passable stricture, length from 2 to 5 cm, accessible by ileocolonoscopy, but without intestinal obstruction, fistulas, or abscess, could be included. A total of 3X107 allogenic bone-marrow derived MSCs were equally injected in the 4 quadrants of the strictured bowel wall during an ileocolonoscopy. Adverse events and clinical scores (Crohn Disease Activity Index, Short Health Scale and Crohn Disease Obstructive Score) were evaluated at each follow-up visit (at week 4, 12, 24 and 48) while endoscopy was performed at baseline, W12 and W48. The main judgement criteria for efficacy was the complete (defined by the ability to pass the ileocolonoscope) or partial (defined by a diameter increase) resolution of the stricture at 12 weeks. Other efficacy criteria included complete or partial resolution of the stricture at 48 weeks as well as the evolution of clinical scores between weeks 0, 12 and 48. Results Between 2018 and 2020, we performed 11 local MSCs injections in 10 CD patients (6 female; aged to 38-65 years; median 45 years old; 70% were smoker). The strictures’ (3 primary, 7 anastomotic) location was as follows: 7 at an ileo-colonic or ileo-rectal anastomosis, 1 colonic and 2 of the ileocecal valve. MSCs injections were well tolerated but a total of 5 hospitalizations for occlusion were reported (2 secondary to a different stricture than the injected one) leading to a surgical resection for one patient and an endoscopic dilatation for another one. Neither intestinal perforation nor intra-abdominal fistula or abscess was reported. At 12 weeks, 5 patients (45%) presented a stricture improvement with a complete resolution for 2 and a partial resolution for 3. Of the 11 MSCs injections, 6 patients were re-evaluated at week 48 (2 patients still undergoing follow-up, 1 operated, 1 dilated, and 1 lost to follow-up), 4 patients had a complete resolution and 1 had a partial resolution. The evolution of clinical scores between weeks 0, 12 and 48 (Figure 1) was not statistically significant. Conclusion Local MSCs injection in non-passable CD stricture was well tolerated over the short term but several occlusions were reported in the follow-up. Combining the effects of MSCs with the proven effect of endoscopic balloon dilatation could possibly improve the outcome of CD stricture.

Forms of Emotional Knowing and Unknowing: Skepticism and Belief in Dickinson’s Poetry, Rick Anthony Furtak

Continually at issue in Dickinson’s verse are the possibilities and limits of knowing the surrounding world, including the minds of others. Many of her poems give voice to wonder, frustration, and the feeling of illumination or insight, along with other emotional states involved in exploring the promise of knowledge and confronting skeptical questions. My chapter is focused especially on moments in Dickinson’s poetry when an encounter with the natural or human world is portrayed as moving the speaker toward either an intensification or a partial resolution of doubt—a dialectic through which she articulates the affective struggle to make sense of the world and to find herself at home in it. As I show, the philosophical thinking that unfolds in her lyrics is preoccupied with a characteristic human lament about our finite limitations and with a contrary, but intimately related, longing to be reconciled with our finitude.

Sialendoscopy combined with transoral sialodochoplasty for treatment of parotid duct stenosis with megaduct

This study aimed to analyze the surgical outcomes of sialendoscopy combined with transoral sialodochoplasty for the treatment of patients with parotid duct stenosis with megaduct. This study included 13 patients with chronic obstructive sialadenitis caused by type 2 parotid duct stenosis who underwent transoral sialodochoplasty. All patients completed a three-point Likert-type rating scale at 3 months after surgery. Six (46.2%) glands showed complete resolution, and seven (53.8%) showed partial resolution of obstructive symptoms. Megaduct diameter between pre- and postoperative MR sialography significantly decreased after transoral sialodochoplasty (8.05

Abstract 15078: Non-selective but Not Selective His Bundle Pacing Uniquely Resolves Acute and Chronic Right Bundle Branch Block

Introduction: While acute (Ac) right bundle branch block (RBBB) may be in proximal HB (lead fixation injury) and chronic (Ch) RBBB in distal HB, they both cause terminal QRS delay. Both types of RBBB may be corrected with non-selective (NS) His bundle pacing (HBP), however the mechanism is unknown. Hypothesis: To study the role of high (5V) and low (1V) pacing voltage as well as presence of pre-excitation (in NS-HBP) in resolving Ac and chronic Ch-RBBB. Methods: Of the thirty-nine patients (27 ChRBBB and 12 AcRBBB), 25 ChRBBB and 10 AcRBBB patients showed NS-HBP at 5V and 11/25 ChRBBB and 6/12 AcRBBB patients transitioned to selective (S)-HBP at 1V. Four patients showed S-HBP at 5V and 1V. Results: 1)During NS-HBP at 5V: (In 25 ChRBBB and 10 Ac-RBBB) Complete resolution occurred 12/25ChRBBB and in all 10 AcRBBB. A partial resolution of ChRBBB occurred 13/25 ChRBBB.2. During NS-HBP at 1V: (6/14 ChRBBB and 2/4 AcRBBB showed complete resolution at 1V, remainder showed incomplete RBBB3. During S-HBP at 5V : (2 ChRBBB 2 AcRBBB) only 1 AcRBBB showed resolution of RBBB. 4. During S-HBP at 1V : All 13 ChRBBB and 8 AcRBBB did not show resolution os RBBB including 11 Ch-RBBB and 6 Ac-RBBB RBBB which resolved during 5V NS-HBP, abruptly recurred on transition to S-HBP at a mean of 2.4±0.8V. Conclusions: 1)The lack of RBBB resolution with S-HBP suggests that pacing site was proximal to site of block, however, from the same site NS-HBP either completely or incompletely resolved both Ac- and Ch-RBBB. 2) Partial resolution of RBBB in NS-HBP may be explained by right ventricular free wall pre-excitation when site of Ch-RBBB is distal.3) Complete resolution of both acute and Ch-RBBB in NS-HBP, more so at high pacing voltage, suggest that peri-Hisian tissues may behave more like a specialized conduction tract which uniquely resolves conduction block.

Partial resolution of cerebrovascular stenosis after conservative treatment of moyamoya disease

Relatamos o caso de um paciente masculino, 28 anos de idade, sem histórico de descendência oriental, que procurou atendimento após apresentar dois quadros de hemiparesia esquerda reversível em um intervalo de seis meses. Lesões isquêmicas não foram evidenciadas nas tomografias computadorizadas (TC) de crânio. O diagnóstico de doença de moyamoya foi confirmado por meio da angiografia cerebral diagnóstica com subtração. A revascularização cirúrgica foi proposta, porém recusada pelo paciente. Iniciou-se tratamento não invasivo com mono-antiagregação plaquetária e rosuvastatina, obtendo-se regressão parcial da estenose.

Partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary polyvinylchloride stent

Case summary A 3-year-old male neutered domestic shorthair cat presented for further investigation of a swollen left eyelid and a hard, non-painful bony swelling over the left frontal sinus. Physical examination revealed no nasal discharge or airflow through the left nostril. A CT of the head revealed a left frontal sinus obstruction with expansile remodelling and osteolucency. Drainage of the frontal sinus obstruction was alleviated via placement of a temporary polyvinylchloride (PVC) stent that was left in place for 6 weeks. Purulent material removed from the frontal sinus returned a positive culture for Pseudomonas aeruginosa susceptible to marbofloxacin that was continued for 4 weeks, and for an additional 2 weeks after stent removal. A left-sided mucoid nasal discharge returned 3 months after removal of the stent. Repeat CT performed 20 months after surgery found the presence of a gas-filled frontal sinus and partial resolution in the amount of fluid within the mid and rostral nasal cavity. A repeat positive culture for P aeruginosa was also obtained. The exact cause of the chronic unilateral sinonasal obstruction remains unclear, but an underlying chronic rhinitis with secondary obstructive frontal sinusitis or sinus mucocoele with secondary nasal extension was suspected. Relevance and novel information Chronic rhinosinusitis in cats can be a challenging condition to treat and cure. This case illustrates the partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary PVC stent.

Incongruity and resolution

This chapter returns to the incongruity theory of humor and presents its most common conceptualization, the incongruity-resolution model. A semantic definition of incongruity, based on the violation of expectations, is provided. The discussion of the resolution of the incongruity is then addressed. A distinction is made between full and partial resolution and between foregrounded and backgrounded incongruities. Finally, the linearity of the incongruity-resolution model is discussed, using the Isotopy Disjunction Model, which is the linguistics-based proposal that offers the most insight in the linear processing of humor.

Remedios por falta de conformidad en contratos de compraventa y de suministro de elementos digitales con varias prestaciones = Remedies for non-conformity in contractsof sale and supply of digital items with several elements

Resumen: El comentario analiza, esencialmente, de qué manera la compraventa de varios bienes o el suministro de varios elementos digitales incide en los remedios por falta de conformidad con el con­trato. La previsión de la cantidad como criterio de conformidad avala, de entrada, la hipótesis, mientras que el modelo de la resolución parcial permite ensayar escenarios en los que concurran, simultáneamen­te, varios remedios.Palabras clave: cantidad, falta de conformidad, resolución, suspensión, acumulación de remedios, contrato mixtoAbstract: The comment analyses how the sales of several goods or the supply of several digital elements affects the remedies due to lack of conformity with the contract. The quantity as a requirement for the conformity presupposes that case. On the other hand, the partial resolution model can be exten­ded to other remedies and allows test cases of cumulation of remedies.Keywords: quantity, lack of conformity, termination, withholding, cumulation of remedies, mixed contract.