anatomical classification
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2021 ◽  
Vol 12 ◽  
pp. 623
Author(s):  
Messias Gonçalves Pacheco Junior ◽  
Nicoly Augusta da Silva Quezada dos Santos ◽  
Raphael Tavares Ribeiro ◽  
Jose Alberto Landeiro ◽  
Bruno Lima Pessoa

Background: Congenital anomalies of the atlas are rare and usually occur in conjunction with other congenital variants. They include a wide spectrum of anomalies ranging from clefts to hypoplasia or aplasia of its arches that may contribute to spinal cord compressive syndrome. Case Description: A 54-year-old male presented with the sudden onset of a severe quadriparesis and loss of proprioception after a minor fall. The magnetic resonance (MR) scan showed cord compression at the C1 level attributed to C1 arch hypoplasia. Two months following a decompressive C1 laminectomy without fusion, and the patient was symptom free. Conclusion: Posterior C1 arch hypoplasia is a rare anomaly that can contribute to cervical cord compression and myelopathy. The optimal surgical management may include, as in this case, a posterior decompression without fusion.


2021 ◽  
pp. bjsports-2021-104719
Author(s):  
Carolette Snyders ◽  
David B Pyne ◽  
Nicola Sewry ◽  
James H Hull ◽  
Kelly Kaulback ◽  
...  

ObjectiveTo determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes.DesignSystematic review and meta-analysis.Data sourcesPubMed, EBSCOhost, Web of Science, January 1990–July 2020.Eligibility criteriaOriginal research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill.Results767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).ConclusionsIn 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.PROSPERO registration numberCRD42020160479.


2021 ◽  
Vol 10 (21) ◽  
pp. 5167
Author(s):  
João Manuel Mendez Caramês ◽  
Duarte Nuno da Silva Marques ◽  
Gonçalo Bartolo Caramês ◽  
Helena Cristina Oliveira Francisco ◽  
Filipe Araújo Vieira

This retrospective study analyzed implant survival of immediate implant-supported fixed complete denture (IFCD) treatment options (TOs) based on the level of alveolar atrophy (CC). Records of 882 patients receiving a total of 6042 implants at one private referral clinic between 2004 and 2020 were considered. The mean follow-up period was 3.8 ± 2.7 years. Cumulative implant survival rates (CSRs) were analyzed as a function of CCs and TOs according to Mantel-Haenszel and Mantel-Cox. Hazard risk ratios for implant loss were compared using Cox regression. Confounding factors were identified using mixed Cox regression models. The 2- and 5-year CSRs were 98.2% and 97.9%, respectively. Maxillary 2- and 5-year CSRs were lower (97.7% and 97.3%) compared to mandibular CSRs (99.8% and 98.6%) (p = 0.030 and 0.0020, respectively). The CC did not influence CSRs of IFCDs in the mandible (p = 0.1483 and 0.3014, respectively) but only in the maxilla (p = 0.0147 and 0.0111), where CSRs decreased with increasing atrophy. TOs did not statistically differ in terms of survival rate for a given level of alveolar atrophy. The adaption of IFCD treatments to the level of atrophy and patient-specific risk factors can result in high CSRs, even at different levels of bone atrophy.


2021 ◽  
pp. 26-34
Author(s):  
Mikhail E. Shchepelev ◽  
Tatyana V. Deripasko ◽  
Anastasiya A. Sidorova ◽  
Elena G. Drandrova ◽  
Evgeny V. Moskvichev ◽  
...  

Over the past twenty-five years, the average age of a woman giving birth to the first child has grown significantly around the world. So, in Russia, currently, women begin to bring their reproductive function into action on average at the age of 26-35. This leads to the fact that obstetricians and gynecologists in their practice increasingly face with pregnancy and childbirth complicated by a uterine scar after a previous cesarean section or myomectomy. The formation of a uterine scar after any intervention entails the likelihood of long-term complications, such as a rupture of the uterus along the scar and pregnancy in the uterine scar. According to the latest clinical recommendations for ectopic pregnancy, pregnancy in the uterine scar has been added to the anatomical classification of ectopic pregnancies. The article describes a clinical case of an undeveloped pregnancy in the uterine scar after a cesarean section, it shows the difficulty of timely diagnosis of such pregnancy, which often results in improper management of patients and loss of fertility by women of childbearing age. In the described case, late diagnosis of pregnancy in the uterine scar necessitated organ-resecting surgery – extirpation of the uterus with fallopian tubes.


Author(s):  
Mohammad Abu-Hegazy ◽  
Azza Elmoungi ◽  
Eman Eltantawi ◽  
Ahmed Esmael

Abstract Background Electrophysiological techniques have been used for discriminating myoclonus from other hyperkinetic movement disorders and for classifying the myoclonus subtype. This study was carried out on patients with different subtypes of myoclonus to determine the electrophysiological characteristics and the anatomical classification of myoclonus of different etiologies. This study included 20 patients with different subtypes of myoclonus compared with 30 control participants. Electrophysiological study was carried out for all patients by somatosensory evoked potential (SSEP) and electroencephalography (EEG) while the control group underwent SSEP. SSEP was evaluated in patients and control groups by stimulation of right and left median nerves. Results This study included 50 cases with myoclonus of different causes with mean age of 39.3 ± 15.7 and consisted of 23 males and 27 females. Twenty-nine (58%) of the patients were epileptics, while 21 (42%) were non-epileptics. Cases were classified anatomically into ten cases with cortical myoclonus (20%), 12 cases with subcortical myoclonus (24%), and 28 cases with cortical–subcortical myoclonus (56%). There was a significant difference regarding the presence of EEG findings in epileptic myoclonic and non-epileptic myoclonic groups (P = 0.005). Also, there were significant differences regarding P24 amplitude, N33 amplitude, P24–N33 peak-to-peak complex amplitude regarding all types of myoclonus. Primary myoclonic epilepsy (PME) demonstrated significant giant response, juvenile myoclonic epilepsy (JME) demonstrated no enhancement compared to controls, while secondary myoclonus demonstrated lower giant response compared to PME. Conclusion Somatosensory evoked potential and electroencephalography are important for the diagnosis and anatomical sub-classification of myoclonus and so may help in decision-making regarding to the subsequent management.


2021 ◽  
Vol 4 (4) ◽  
pp. 165-180
Author(s):  
S.J. Zinreich ◽  
F.A. Kuhn ◽  
D. Kennedy ◽  
M. Solaiyappan ◽  
A. Lane ◽  
...  

Objective: The microanatomy of the fronto-ethmoidal transition region has been addressed in several classifications. CT stereoscopic imaging (3DCTSI) provides improved display and delineates three defined complex “spaces”, the Frontal Sinus/Frontal Recess Space, the Infundibular Space of the Ethmoid Uncinate Process, and the Ethmoid Bulla Space (FSRS, IS-EUP, EB), none of which were adequately described with the “cell” terminology. We present details on the 3D microanatomy, variability, and prevalence of these spaces. Methods: 3D stereoscopic imaging displays (3DCTSI) were created from 200 datasets. The images were analyzed and categorized by a radiologist (SJZ), and consultant otolaryngologists, focusing on 3D microanatomy of the fronto-ethmoidal transition, the frontal recess/frontal sinus, and drainage pathways, in comparison to established anatomical classification systems. Results: The anterior ethmoid is subdivided into seven groups with the following core properties and prevalence: 1. The horizontal roof of the IS-EUP is attached to the superior half of the frontal process of the maxilla (19%); 2. The IS-EUP extends into the frontal recess (6.5%); 3. The IS-EUP extends into the frontal recess and the frontal sinus (18.5%); 4. A bulla is seen in the medial frontal sinus (3%); 5. The ethmoid bulla and supra bullar space extend into the frontal sinus (7%); 6. Lamellae extend into the FSRS antero-superiorly (25%); 7. FSRS expansion expands below the upper half of the frontal process of the maxilla (FSRS) (21%). Conclusion: 3-D analysis of the detailed anatomy provides important new anatomic information with the increased focus on precision surgery in the region.


2021 ◽  
Vol 23 (4) ◽  
pp. 590-610
Author(s):  
Martine Fohlen ◽  
Delphine Taussig ◽  
Sarah Ferrand-Sorbets ◽  
Mathilde Chipaux ◽  
Georg Dorfmuller

2021 ◽  
Vol 12 ◽  
Author(s):  
Ying Wang ◽  
Weibin Shu ◽  
Aimie Ouyang ◽  
Lei Wang ◽  
Yuping Sun ◽  
...  

BackgroundDue to the complexity of anatomical relationship between superior mesenteric artery (SMA) and left colic artery (LCA), there is no unified anatomical concept of “Riolan’s arch.” There is no consensus as to tie off the inferior mesenteric artery (IMA) at its origin or just below the origin of the left colic artery during radical surgery of sigmoid colon and rectal cancers. The aim of the study is to investigate the anatomy of shortcut anastomotic branches (adjacent branches) of SMA at splenic flexure and to explore how the shortcut pathway (Riolan’s arch) was formed, as the compensation of anastomotic branches between MCA and LCA under pathological conditions and the reconstruction and the mechanism of pathological Riolan’s arch after high ligation of the inferior mesenteric artery.MethodsBetween January 2018 and May 2020, patients with colorectal cancer who underwent CTA before surgery were enrolled in the study. The anatomy of shortcut anastomotic branch of SMA and LCA was investigated by volume rendering technique (VR) and maximum-intensity projection (MIP). GE’s small vessel extraction technology (selected VR) was used to directly display these shortcut anastomotic branches on a map and to establish their three-dimensional anatomical classification. Then, we used the axonometric drawing to make the model more exact. Next, combining with some cases of pathological Riolan’s arch and basing on hydrodynamic principle, we speculate the mechanism of collateral circulation. Finally, based on the retrospective study of high ligation cases and combined principles of fluid mechanics, we show how these shortcut anastomotic branches evolved into Riolan’s arch.ResultsWe report the classification of the ascending branch of LCA (which approaches the splenic flexure) and the left branch of MCA, display these shortcut anastomotic branches on a map, and establish their three-dimensional anatomical classification. We found that Riolan’s arch is a shortcut pathway for the compensation of anastomotic branches, between MCA and LCA under pathological conditions, and that the formation mechanism of shortcut path accords with the principle of hydrodynamics.ConclusionsOur results show the mechanism of pathological Riolan’s arch formation and provide new anatomic thinking for the battle between high and low ligation of IMA in colorectal cancer surgery.


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