Gramsivertsen8674

Paraneoplastic extraocular muscle enlargement has been reported in a small number of patients with cancers including breast or lymphoma, usually presenting with bilateral multiple muscle involvement. Such myositis may be autoimmune. Furthermore, orbital inflammation is a recognized complication of immune-modulation therapy used to treat melanoma, such as ipilimumab. Extraorbital myositis has been described in myeloma, and polymyositis in melanoma. We present a case of bilateral, asymmetrical extraocular muscle enlargement with spontaneous resolution in a patient with simultaneous new diagnoses of metastatic malignant melanoma and multiple myeloma. A similar episode 7 months before diagnosis also resolved spontaneously. The authors believe this to be the first reported case of paraneoplastic orbital myositis associated with multiple myeloma or untreated malignant melanoma.A 45-year-old female patient who had previously undergone endoscopic dacryocystorhinostomy (EN-DCR) at another surgical center was diagnosed with functional failure after DCR and underwent an uneventful transcanalicular laser-assisted DCR (TCL-DCR). After 5 months, the patient underwent endoscopic examination due to persistent epiphora and dacryocystitis attacks. Endonasal visualization revealed a large dacryolith that filled the ostium and sac and was removed en bloc mechanically with forceps. Carbonized material on the dacryolith's superior part indicated that it was perforated through-and-through by the laser beam during TCL-DCR. The patient's complaints were resolved completely following the removal of the dacryolith. The transcanalicular lacrimal procedures do not allow complete visualization of the contents of the lacrimal sac, and the laser beam can ablate even an undetected dacryolith and may result in unsuccessful DCR, although the surgical course may look completely uneventful.Tear trough implantation may be associated with a number of well-reported complications. To our knowledge, penetration of the lacrimal sac has never been reported as a complication of malar or tear trough implants. We report a case of lacrimal sac penetration discovered at the time of endoscopic dacryocystorhinostomy surgery in a patient who developed epiphora soon after the tear trough implant was placed.

To evaluate the efficacy of multimodal treatment in adenoid cystic carcinoma (ACC) of the lacrimal gland.

A retrospective comparative case series of 40 consecutive patients with ACC of the lacrimal gland without systemic metastasis at the initial presentation and primarily managed by one of the 3 treatment protocols-surgery + external beam radiotherapy (EBRT) (group 1), surgery + EBRT + adjuvant chemotherapy (group 2), and neoadjuvant chemotherapy + surgery + EBRT + adjuvant chemotherapy (multimodal treatment) (group 3) at a tertiary care ocular oncology center. Local tumor control, eye salvage, and systemic metastasis were the primary outcome measures.

The age ranged from 11 to 72 (mean ± SD, 36 ± 13; median, 36) years with 26 (65%) male and 14 (35%) female patients. Twelve (30%) patients belonged to group 1, 8 (20%) to group 2, and 20 (50%) to group 3. Primary surgery included tumor excision in 36 (90%) and orbital exenteration in 4 (10%). Chemotherapy composed of cisplatin + 5 fluorouracil (5FU) for ent with sequential neoadjuvant chemotherapy, followed by surgery, extended-field stereotactic EBRT, and adjuvant chemotherapy seems relatively more effective in providing local tumor control and eye salvage and in minimizing the risk of systemic metastasis in ACC of the lacrimal gland.

Multimodal treatment with sequential neoadjuvant chemotherapy, followed by surgery, extended-field stereotactic EBRT, and adjuvant chemotherapy seems relatively more effective in providing local tumor control and eye salvage and in minimizing the risk of systemic metastasis in ACC of the lacrimal gland.

The study aimed to understand the effects of a set of simple gross motor exercises on pelvic floor muscle (PFM) resting tone (RT) in children with dysfunctional voiding symptomology.

The study compared PFM RT for a single-sample before and after 2 protocols exercise versus relaxation (metric standard).

Participants included 27 children ages 5.00 to 10.92 years. Preintervention PFM RT was similar between the interventions 63% (exercise) and 78% (relaxation) of children decreased PFM RT following intervention. Between-intervention post-minus-prechanges in PFM RT were compared. Between-intervention differences were similar.

Exercise and relaxation protocols were comparable in lowering PFM RT in children with voiding dysfunction. Findings are clinically worthy in that either exercises or relaxation prior to toileting may assist with more complete emptying in children with symptoms.

Exercise and relaxation protocols were comparable in lowering PFM RT in children with voiding dysfunction. Findings are clinically worthy in that either exercises or relaxation prior to toileting may assist with more complete emptying in children with symptoms.

To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum.

A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis.

Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at http//links.lww.com/PPT/A342).

Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at http//links.lww.com/PPT/A342).

This study aimed to investigate whether the movements and postures of 3- to 5-month-old infants with torticollis differ from those of infants without torticollis and to determine the relationship between clinical characteristics and the Motor Optimality Score (MOS) in torticollis.

Participants were 40 infants with torticollis and 40 infants developing typically without torticollis. The infants were evaluated with detailed general movement assessment.

There were significant differences in the MOS and subcategory scores for age-adequate movement repertoire and observed postural patterns between groups. Clinical characteristics were not related to the reduction in the MOS.

Infants with torticollis have differences in movements and postures at 3 to 5 months of age compared with controls. Strategies supporting the movement repertoire of infants with torticollis can be added to rehabilitation programs for infants with the lower MOS to optimize their motor development.

Infants with torticollis have differences in movements and postures at 3 to 5 months of age compared with controls. Strategies supporting the movement repertoire of infants with torticollis can be added to rehabilitation programs for infants with the lower MOS to optimize their motor development.

This study aimed to investigate the effectiveness of different physical therapy protocols on the autonomic modulation of heart rate, time of invasive mechanical ventilation (IMV), and length of hospital stay.

This was a randomized clinical study with 20 children on IMV in an intensive care unit (ICU), between July 2018 and September 2019. The control group (n = 10) performed the hospital's physical therapy protocol and the experimental group (n = 10) performed the physical therapy protocol based on physical exercise.

Higher values of heart rate variability were found in the experimental group, both in individual and intergroup analyses. There was a significant reduction in the time of IMV and ICU stay.

There was an improvement in heart rate variability, reduced time on mechanical ventilation and length of stay in the ICU in individuals who performed the study protocol.

There was an improvement in heart rate variability, reduced time on mechanical ventilation and length of stay in the ICU in individuals who performed the study protocol.

The management of severe radiocapitellar joint pathologies in young patients is challenging. Radial head arthroplasty (RHA) is a treatment option in the adult population, but most surgeons avoid implementing it in younger patients, and there are no published results for patients younger than 16 years.

Our retrospective cohort describes 5 patients (4 male 1 female) who underwent cementless modular RHA at an average age of 14 years (range 13 to 15). find more The preoperative diagnoses were post-traumatic radiocapitellar incongruity and arthrosis because of previous Salter-Harris type 3 or 4 fractures of the radial head in 3 cases; and axial instability of the forearm following failed radial head excision in 2 cases. Because of the complexity of the elbow pathology in these cases, all underwent concomitant procedures including contracture release (5 cases), corrective ulnar osteotomy (2 cases), distal ulnar shortening osteotomy, excision of radioulnar synostosis, microfracture of the capitellum, and partial excision lications still exist. Considering the lack of other reliable treatment options, RHA may be indicated in this challenging patient population.

Level IV therapeutic study-case series.

Level IV therapeutic study-case series.

The aim was to study the application value of flexible endoscopic examination of swallowing (FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effect in acute stoke patients with dysphagia.

A total of 525 patients with acute stoke who were hospitalized from October 2015 to January 2021 in the Rehabilitation Medicine Department of our hospital underwent FEES for analyzing the characteristic performance. Twenty-one cases of them were examined by video fluoroscopic swallow study and compared with the results of FEES for evaluating the reliability of the FEES, the reliability of diagnosis of dysphagia, and the consistency of the 2 methods. The effect of rehabilitation was evaluated by comparing the FEES test results before and after treatment.

In 525 patients, the FEES revealed 378 cases of aspiration (139 cases were silent aspiration), showing a higher detection rate than water swallow test. Patients with potential cricopharyngeus achalasia got the same results through both of examinations. FEES can provide more positive indicators, guide clinical rehabilitation treatment and objectively assess the effect of rehabilitation.

Acute stoke patients with dysphagia have characteristic pharyngeal and laryngeal performance. FEES is simple to operate and has high application value in the diagnosis and treatment of dysphagia.

Acute stoke patients with dysphagia have characteristic pharyngeal and laryngeal performance. FEES is simple to operate and has high application value in the diagnosis and treatment of dysphagia.