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The difficulty of correcting nasal septum deformities using the classical Killian or Cottle techniques or derivatives has led in recent years to new suggestions such as extracorporeal septoplasty or various apposition grafts to counteract refractory deformity of the quadrangular cartilage. Naturally occurring septal deformities result from conflicts in growth between the quadrangular cartilage, perpendicular ethmoidal plate and vomer, which each have their own different evo-devo origin. Septoplasty by disarticulation consistently restores a level septum by completely resolving the growth conflicts. Conserving the quadrangular cartilage is essential for the stability of the nasal pyramid on condition that 1) the lateral flare of the superior edge of both the component septolateral cartilages that suspend it at the roof of the piriform orifice and 2) the height of its anterior edge are respected. The anterior edge is always high enough (except in case of fracture or malformation to project the retrolobular nasal dorsum in proportion to the height of the alar cartilage when it is repositioned on its natural premaxillary base.
Real-time polymerase chain reaction (RT-PCR) remains the gold standard for confirmation of Coronavirus Disease 2019 (COVID-19) despite having many disadvantages. Here, we investigated the diagnostic performance of chest computed tomography (CT) as an alternative to RT-PCR in patients with clinical suspicion of COVID-19 infection.
In this descriptive cross-sectional study, 27,824 patients with clinical suspicion of COVID-19 infection who underwent unenhanced low-dose chest CT from 20 February, 2020 to 21 May, 2020 were evaluated. Patients were recruited from seven specifically designated hospitals for patients with COVID-19 infection affiliated to Shahid Beheshti University of Medical Sciences. In each hospital, images were interpreted by two independent radiologists. CT findings were considered as positive/negative for COVID-19 infection based on RSNA diagnostic criteria. Then, the correlation between the number of daily positive chest CT scans and number of daily PCR-confirmed cases and COVID-19-related risk factor for COVID-19.
The newly described anteroposterior "off-axis view" (OAV) radiograph might help detect a hallux valgus interphalangeus (HVI) deformity more precisely compared to anteroposterior standing radiographs.
A radiographic assessment of HVI angles was performed using preoperative standing anteroposterior and OAV radiographs for 67 ft. Intra- and interobserver agreement for all angles and their correlation with HV severity were analyzed.
The proximal-to-distal phalangeal articular angle showed less intra- and interobserver variance (intraclass correlation coefficient 0.825) than did the other angles. OAV radiographs showed less interobserver reliability than did standing radiographs. HVI was underestimated significantly, by up to 5°, on standing radiographs compared to OAV radiographs (p < 0.001). AD-5584 The mean differences between OAV and standing radiographs were 3.7° and 5.0° for the proximal-to-distal phalangeal articular and hallux interphalangeal angles, respectively, and were more pronounced for moderate-to-severe HV deformities.
Angular measurements of HVI on traditional anteroposterior standing radiographs are significantly smaller than on OAV radiographs. Furthermore, angular measurements on OAV radiographs are associated with higher interobserver reliability. The most precise angle representing an HVI deformity might be the proximal-to-distal phalangeal articular angle.
Our findings may facilitate preoperative decision-making for additional akin osteotomy in HV correction.
Level II.
Level II.Muscle quality is typically defined as muscle strength relative to muscle size. Echo intensity has gained popularity as an index of skeletal muscle quality. There is common agreement that muscle size is related to strength at baseline and echo intensity is purported to impact this relationship. Thus, the purpose of this study was to examine whether echo intensity can be used as a physiological marker for muscle quality by investigating the moderating effect of echo intensity on the relationship between muscle size and strength. A sample of 96 participants was used for the upper body analysis and a separate sample of 96 participants was used for the lower body analysis. Echo intensity, muscle thickness, and strength measurements were measured on each limb. For strength, participants performed unilateral elbow flexion (upper body analysis) and knee extension (lower body analysis) to quantify 1-repetition maximum. Muscle thickness and echo intensity were determined from images captured using B-mode ultrasound. Muscle size correlated with muscle strength for all limbs. However, the relationship between muscle size and strength was not significantly moderated by echo intensity for Arm 1 (b = 0.042, p = 0.54) or Arm 2 (b = -0.002, p = 0.97). At the proximal site, no significant moderating effect of echo intensity was found in Leg 1 (b = 0.037, p = 0.67) or Leg 2 (b = -0.085, p = 0.29). Similarly, no significant moderating effect was observed at the distal site for Leg 1 (b = 0.03, p = 0.69) or Leg 2 (b = -0.026, p = 0.75). The results would indicate that the relationship between muscle size and strength does not depend on echo intensity. Therefore, the use of echo intensity as an index of muscle quality in healthy young adults may need to be reconsidered.
Camera assistance is important for proper visualization of the operative field in laparoscopic surgery. Navigation grid (NG) has been designed to help the camera assistants focus the camera on the target operative field. This is a randomized, controlled trial to study the effect of the NG on performance of camera assistants.
Minimally invasive operations were randomized (11) to either with or without use of NG for the camera assistant. The operations were recorded and the time spent inside and outside of the target area were reported.
A tertiary care teaching hospital.
Fifty-eight operations (30 with and 28 without NG) were recorded. Sixteen camera assistants participated. Time spent outside the target area was significantly less with the use of NG (64.5 ± 63 seconds vs 396 ± 226.5 seconds; p < 0.0001). This impact of NG on performance of the camera assistants was significant regardless of their level of training.
NG improved performance of the camera assistant during laparoscopic abdominal procedures.
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