A new test of resistance in the diagnosis of postero-superior rotator cuff tears.

The aim of this study was to assess the diagnostic accuracy of a new clinical test for the diagnosis of subacromial impingement and full thickness postero-superior rotator cuff tears. One hundred and twenty patients who underwent arthroscopic treatment for acromioplasty or cuff repair were previously submitted to a new test of resistance. The test is performed in the standing position with the involved arm in 90 degrees abduction, 20 degrees -30 degrees anteposition and in external rotation (as for full-can test). Thus, the patient was invited to follow the way of a spiral drawn on a drawing sheet for 20 turns; 1 turn = from the centre to the end of the spiral and vice versa (spiral width = 20 cm). The test was considered positive when the patient was not able to conclude it due to strength decrease or to shoulder pain. Sensitivity, specificity, positive and negative predictive values as well as diagnostic accuracy were calculated for our test of resistance. The test resulted scarcely reliable as detector of subacromial impingement and not very reliable as detector of small tear. When the test is positive there is a high probability that a subacromial disease exists; instead, when it is negative there is a high probability that the patient has not a large or massive cuff tear. The resistance test (Gum-Turn test) adds to our armamentarium of physical examination signs in patients with painful shoulder and furnishes further information on possible dimensions of tendinous tear

Fertilidade do solo, composição mineral e produção do quiabeiro sob lâminas de irrigação e matéria orgânica

The okra is a vegetable that has been gaining expression in the Northeast region, but the information on irrigation management and organic fertilization is still infrequent in the literature, therefore, research in this sense must be developed. In this direction an experiment was developed to evaluate the productive performance of the okra and the chemical attributes of the soil as a function of irrigation slides and soil organic matter, was developed in the field in a Neossolo Flúvico with the cultivar santa cruz 47. The experimental design was a randomized complete block design in a 2 x 5 factorial scheme, with 100 % and 50 % of crop evapotranspiration (ETc) irrigation and five doses of bovine manure to raise soil organic matter content from 18 to 28, 38, 48 and 58 g dm-3 in the productive cycles of 2013/2014 and 2014/2015. The variables studied were the components of soil fertility, contents foliar macronutrients and okra components. Irrigation with the 100 % ETc blade increased soil fertility when compared to the 50 % ETc blade. The soil organic matter increased the fertility potential expressed by OM, P, K, Ca, Mg, S resulting in increased cation exchange capacity, foliar contents of P, K and Mg and in the components of okra production. Greater productivity was obtained with 48 g dm-3 of bovine manure. It is recommended the application of OMS through bovine manure, at the dose of 48 g dm-3.O quiabeiro é uma hortaliça que vem ganhando expressão na região Nordeste, mas, as informações sobre o manejo de irrigação e adubação orgânica ainda são pouco frequentes na literatura. Por isso, pesquisas nesse sentido devem ser desenvolvidas. Nessa sentido, um experimento foi desenvolvido para avaliar o desempenho produtivo do quiabeiro e os atributos químicos do solo em função de lâminas de irrigação e doses de matéria orgânica no solo, em um Neossolo Flúvico com a cultivar Santa Cruz 47. O delineamento utilizado foi em blocos casualizados no esquema fatorial 2 x 5, referente às lâminas de irrigação de 100 % e 50 % da evapotranspiração da cultura (ETc) e cinco doses de esterco bovino para elevar o teor de matéria orgânica do solo de 18 para 28, 38, 48 e 58 g dm-3 nos ciclos produtivos de 2013/2014 e 2014/2015. As variáveis estudadas foram os componentes de fertilidade do solo, teores foliares de macronutrientes e componentes do quibeiro. Os resultados foram submetidos a análises de variância e de regressão. A irrigação com a lâmina de 100 % da ETc aumentou a fertilidade do solo, quando comparado com a lâmina de 50 % da ETc. A matéria orgânica aplicada ao solo aumentou o potencial de fertilidade expresso pela MO, P, K, Ca, Mg, S resultando no aumento da capacidade de troca catiônica, teores foliares de P, K e Mg e nos componentes de produção do quiabeiro. Foi obtida maior produtividade com aplicação de 48 g dm-3 de esterco bovino. Recomenda-se a aplicação de MOS através da adubação com esterco bovino, na dose de 48 g dm-3

Blood homocysteine levels are increased in hepatocellular carcinoma patients with portal vein thrombosis. A single centre retrospective cohort study

Abstract Background Portal vein thrombosis (PVT) is reported in 10–40% of hepatocellular carcinoma (HCC) patients. The development of PVT is a multifactorial process, resulting from a reduction in portal blood flow and hypercoagulability. Methods We evaluated 44 HCC patients with PVT, 50 HCC patients without PVT and 50 healthy subjects. Homocysteine (Hcy), Vitamin B6, Vitamin B12 and folate were measured. Results Hcy in HCC patients with PVT is significant higher than the patients without PVT and controls subjects. Conclusion Total Hcy is a sensitive marker of PVT in patients with HCC

Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

n/

Red nucleus structure and function: from anatomy to clinical neurosciences

The red nucleus (RN) is a large subcortical structure located in the ventral midbrain. Although it originated as a primitive relay between the cerebellum and the spinal cord, during its phylogenesis the RN shows a progressive segregation between a magnocellular part, involved in the rubrospinal system, and a parvocellular part, involved in the olivocerebellar system. Despite exhibiting distinct evolutionary trajectories, these two regions are strictly tied together and play a prominent role in motor and non-motor behavior in different animal species. However, little is known about their function in the human brain. This lack of knowledge may have been conditioned both by the notable differences between human and non-human RN and by inherent difficulties in studying this structure directly in the human brain, leading to a general decrease of interest in the last decades. In the present review, we identify the crucial issues in the current knowledge and summarize the results of several decades of research about the RN, ranging from animal models to human diseases. Connecting the dots between morphology, experimental physiology and neuroimaging, we try to draw a comprehensive overview on RN functional anatomy and bridge the gap between basic and translational research

Sea-level variability and change along the Norwegian coast between 2003 and 2018 from satellite altimetry, tide gauges, and hydrography

Sea-level variations in coastal areas can differ significantly from those in the nearby open ocean. Monitoring coastal sea-level variations is therefore crucial to understand how climate variability can affect the densely populated coastal regions of the globe. In this paper, we study the sea-level variability along the coast of Norway by means of in situ records, satellite altimetry data, and a network of eight hydrographic stations over a period spanning 16 years (from 2003 to 2018). At first, we evaluate the performance of the ALES-reprocessed coastal altimetry dataset (1 Hz posting rate) by comparing it with the sea-level anomaly from tide gauges over a range of timescales, which include the long-term trend, the annual cycle, and the detrended and deseasoned sea-level anomaly. We find that coastal altimetry and conventional altimetry products perform similarly along the Norwegian coast. However, the agreement with tide gauges in terms of trends is on average 6 % better when we use the ALES coastal altimetry data. We later assess the steric contribution to the sea level along the Norwegian coast. While longer time series are necessary to evaluate the steric contribution to the sea-level trends, we find that the sea-level annual cycle is more affected by variations in temperature than in salinity and that both temperature and salinity give a comparable contribution to the detrended and deseasoned sea-level variability along the entire Norwegian coast. A conclusion from our study is that coastal regions poorly covered by tide gauges can benefit from our satellite-based approach to study and monitor sea-level change and variability

Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results

BACKGROUND: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin. METHODS: Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy. RESULTS: Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes. CONCLUSION: Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects

In vivo probabilistic atlas of white matter tracts of the human subthalamic area combining track density imaging and optimized diffusion tractography

The human subthalamic area is a region of high anatomical complexity, tightly packed with tiny fiber bundles. Some of them, including the pallidothalamic, cerebello-thalamic, and mammillothalamic tracts, are relevant targets in functional neurosurgery for various brain diseases. Diffusion-weighted imaging-based tractography has been suggested as a useful tool to map white matter pathways in the human brain in vivo and non-invasively, though the reconstruction of these specific fiber bundles is challenging due to their small dimensions and complex anatomy. To the best of our knowledge, a population-based, in vivo probabilistic atlas of subthalamic white matter tracts is still missing. In the present work, we devised an optimized tractography protocol for reproducible reconstruction of the tracts of subthalamic area in a large data sample from the Human Connectome Project repository. First, we leveraged the super-resolution properties and high anatomical detail provided by short tracks track-density imaging (stTDI) to identify the white matter bundles of the subthalamic area on a group-level template. Tracts identification on the stTDI template was also aided by visualization of histological sections of human specimens. Then, we employed this anatomical information to drive tractography at the subject-level, optimizing tracking parameters to maximize between-subject and within-subject similarities as well as anatomical accuracy. Finally, we gathered subject level tracts reconstructed with optimized tractography into a large-scale, normative population atlas. We suggest that this atlas could be useful in both clinical anatomy and functional neurosurgery settings, to improve our understanding of the complex morphology of this important brain region

Correlation between Arctic river discharge and sea ice formation in Laptev Sea using sea surface salinity from SMOS satellite

European Geosciences Union (EGU) General Assembly 2020, 4-8 May 2020During the last 3 decades, the Arctic rivers have increased their discharge around 10%, mainly due to the increase of the global atmospheric temperature. The increase of the river discharge carries higher loads of dissolved organic matter (DOM) and suspended matter (SM) entering to the Arctic Ocean. This results in increased absorption of solar energy in the mixed layer, which can potentially contribute to the general sea ice retreat. Observation based studies (e.g. Bauch et al., 2013) showed correlation between river water discharge and local sea ice melting on the Laptev sea shelf due to the change on the ocean heat. Previous studies are based with a limited number of observations, both in space and in time. Thanks to the ESA SMOS (Soil Moisture and Ocean Salinity) and NASA SMAP (Soil Moisture Active Passive) missions we have daily the sea surface salinity (SSS) maps from the Arctic, which permit to observe the salinity variations due to the river discharges. The Arctic sea surface salinity products obtained from SMOS measurements have been improved considerable by the Barcelona Expert Center (BEC) team thanks to the project Arctic+Salinity, funded by ESA. The new version of the product (v3) covers the years from 2011 up to 2018, have a spatial resolution of 25km and are daily maps with 9 day averages. The Arctic+ SSS maps provide a better description of the salinity gradients and a better effective spatial resolution than the previous versions of the Arctic product, so the salinity fronts are better resolved. The quality assessment of the Arctic+SSS product is challenging because, in this region, there are scarce number of in-situ measurements. The high effective spatial resolution of the Arctic+ SSS maps will permit to study for the first time scientific physical processes that occurs in the Arctic. We will explore if a correlation between the Lena and Ob rivers discharge with the sea ice melting and freeze up is observed with satellite data, as already stated with in-situ measurements by Bauch et al. 2013. Salinity and sea ice thickness maps from SMOS and sea ice concentration from OSISAF will be used in this study. Bauch, D.,Hölemann, J. , Nikulina, A. , Wegner, C., Janout, M., Timokhov, L. and Kassens, H. (2013): Correlation of river water and local sea-ice melting on the Laptev Sea shelf (Siberian Arctic) , Journal of Geophysical Research C: Oceans, 118 (1), pp. 550-561 . doi: 10.1002/jgrc.2007

Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders

Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15–20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2%) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4%) were low responders (DOSS score increase of ≤2 levels). The effect of the first treatment usually lasted longer than 4 months (67%), and in some cases up to a year. The treatment efficacy remained high also after the second injection: 31 patients (46.3%) qualified as high responders and other 22 patients (32.8%) showed a low response. Only in the parkinsonian syndromes group we observed a reduction in the percentage of high responders as compared with the first treatment. Side effects were mostly mild and reported in non-responders following the first injection. A severe side effect, consisting of ingestion pneumonia, was observed following the second BTX injection in two patients who had both been non-responders to the first. Non-responders were characterized electromyographically by higher values of the oropharyngeal interval. Conclusion: These findings confirm the effectiveness of IncobotulinumtoxinA injection in the treatment of neurogenic dysphagia due to hyperactivity and relaxation failure of the UES. Caution should be used as regards, the re-injection in non-responders to the first treatment