Notes

Will be low measure associated with botulinum contaminant good at handling continual ache within snooze bruxism, alert bruxism, and temporomandibular condition?
Increasingly radical surgery combined with neo-adjuvant radiotherapy present a challenge for the reconstructive surgeon. The study objective was to review outcomes of Vertical Rectus Abdominis Myocutaneous (VRAM) flap-based perineal reconstruction following resectional surgery for pelvic malignancies.

Single-centre retrospective analysis of patients undergoing immediate VRAM flap reconstruction of a perineal/pelvic defect for pelvic malignancy between July 2009 and November 2017. Primary outcome was perineal morbidity (surgical site infection (SSI), flap loss or dehiscence and perineal hernia). Secondary outcomes were length of stay and donor site morbidity (SSI, full-thickness dehiscence and incisional hernia).

A total of 178 patients (96 females) were included. Median age was 67years (range 28-88). The majority were performed for locally advanced rectal adenocarcinoma (n = 122; 68.5%) and 136 (76.4%) patients had received neoadjuvant radiotherapy. Four patients had complete flap loss (2.3%), and 40 had perineal dehiscence (22.5%); however, only, 18 patients required a return to theatre during the admission for perineal-related complications (10.1%). Abdominal dehiscence occurred in six patients (3.4%). Median length of post-operative stay was 15days (6-131). Sixty-day mortality rate was 1.1%. SSI at the midline and perineum occurred in 34 (19.1%) and 38 patients (21.3%), respectively. At 90-day post-operatively, 75.6% of perineal wounds were healed. During a median follow-up of 44.5months, twelve, eleven and 39 patients were diagnosed with perineal, midline and parastomal hernias, respectively (6.9%, 6.2% and 21.9%).

It is important to have accurate knowledge of perineal and donor-site morbidity rates to allow an informed consent process.
It is important to have accurate knowledge of perineal and donor-site morbidity rates to allow an informed consent process.
Supervised pelvic floor muscle training (PFMT), weight loss and exercise are recommended for overweight/obese women with urinary incontinence (UI). This study aimed to implement and evaluate the feasibility, acceptability and effectiveness of a 12-week group exercise and healthy eating program (ATHENA) for overweight/obese women with UI.

This study, using an implementation-effectiveness hybrid type 3 design, was conducted within a Women's Health Physiotherapy outpatient service at an Australian tertiary public hospital. Intervention feasibility and acceptability were assessed through process evaluation of implementation, while clinical effectiveness was assessed via pre-/post-clinical and quality of life surveys. Process data were analyzed using descriptive statistics and effectiveness data were compared pre-/post-intervention using inferential statistics.

Of 156 eligible patients, 37 (24%) agreed to participate; 29 (78%) completed the ATHENA program. selleck inhibitor Median (IQR) age and body mass index were 53 (47-65) years and 30.8 (29.1-34.8) kg/m
respectively. ATHENA was feasible to implement, with all components delivered as intended and high participant satisfaction. Ninety-seven percent of participants reported improved UI symptoms (global rating of change) and significant improvements in overall pelvic floor dysfunction and quality of life utility scores (p = 0.001). While weight did not change, significant improvements were found in body-food choice congruence (intuitive eating scale-2; p < 0.01).

The ATHENA intervention was feasible, acceptable and clinically effective for overweight and obese women with urinary incontinence at a tertiary public hospital in Australia. Further research into longer term outcomes and the cost effectiveness of this group intervention is recommended.

N/A. Ethics approval, HREC/2018/QGC/46582, date of registration 14/11/2018.
N/A. Ethics approval, HREC/2018/QGC/46582, date of registration 14/11/2018.
Cerebellar ataxias are a large and heterogeneous group of disorders. The evaluation of brain parenchyma via MRI plays a central role in the diagnosticassessment of these conditions, being mandatory to exclude the presence of other underlying causes in determining the clinical phenotype. Once thesepossible causes are ruled out, the diagnosis is usually researched in the wide range of hereditary or sporadic ataxias.

We here propose a review of the main clinical and conventional imaging findings of the most common hereditary degenerative ataxias, to helpneuroradiologists in the evaluation of these patients.

Hereditary degenerative ataxias are all usually characterized from a neuroimaging standpoint by the presence, in almost all cases, of cerebellar atrophy. Nevertheless, a proper assessment of imaging data, extending beyond the mere evaluation of cerebellar atrophy, evaluating also the pattern of volume loss as well as concomitant MRI signs, is crucial to achieve a proper diagnosis.

The integration of typical neuroradiological characteristics, along with patient's clinical history and laboratory data, could allow the neuroradiologist toidentify some conditions and exclude others, addressing the neurologist to the more appropriate genetic testing.
The integration of typical neuroradiological characteristics, along with patient's clinical history and laboratory data, could allow the neuroradiologist to identify some conditions and exclude others, addressing the neurologist to the more appropriate genetic testing.
To study the diagnostic utility of the "smoke sign" to detect unsuspected acute pectoralis major tendon injury on routine shoulder MRI.

Retrospective study of 52 shoulder MRI in patients with (38) and without (14) acute pectoralis major injury confirmed on imaging. Two readers independently reviewed shoulder MRI for the presence of the "smoke sign"-feathery soft tissue edema lateral or anterior to short head biceps/coracobrachialis on fluid-sensitive coronal-oblique and sagittal-oblique images, respectively.

The smoke sign was present on shoulder MRI in 24/24 (100%) humeral avulsions, 4/4 (100%) tendon tears, 4/8 (50%) of myotendinous junction injuries, and 0/2 (0%) intramuscular injuries. The smoke sign was present in 0/14 examinations without acute pectoralis major injury.

While dedicated pectoralis MRI remains the preferred method for imaging pectoralis injury, the "smoke sign" can serve as an easy to recognize finding on routine shoulder MRI that can raise the suspicion of an acute pectoralis major tendon injury.
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