An evaluation of predictors for success of two-duct ligation for drooling in neurodisabilities

Journal of Neurology - Drooling is dependent on various clinical variables. However, while drooling proves refractory to two-duct ligation in 40% of patients, predictors for treatment success are...     

Electrophysiological correlates of visual impairments after traumatic brain injury

Our aims were to investigate: (i) the VEP correlates of functional visual impairments following traumatic brain injury (TBI), in particular of the reduced spatial form perception; and (ii) the VEP correlates of visual sustained arousal in TBI patients. We used two approaches: (i) the analysis of latency and amplitude of the peaks; and (ii) the study of the correlations among the latencies of the peaks as a label of temporal synchronization. Thirty-five severe TBI outcome inpatients and 35 matching controls were studied. Pattern-reversal VEPs were recorded at Oz-Fz and Cz-A1, first without counting, then with counting of the reversals. Seven peaks of the waveform at Oz and eight peaks at Cz were measured. We found several differences in amplitude and latency between patients and controls, and between nocount/count. The temporal binding of the peaks within each channel and between the two channels was calculated by correlation matrices, and tested by factor analysis. Results indicated that the synchronization of the peaks within each channel did not differ between patients and controls. The temporal covariation between peaks occurring at Oz and Cz, however, was highly significantly altered in patients. This suggests that visual impairments in TBI patients may be due to a deranged synchronization of the activity of different brain regions.     

Azygoesophageal recess

Knowledge of the normal radiologic appearance and manifestations of disease in the azygoesophageal recess can facilitate the detection and diagnosis of intrathoracic disease. The azygoesophageal recess is located lateral or posterior to the esophagus and anterior to the spine. It extends from the anterior turn of the azygous vein to the aortic hiatus. The configuration of the azygoesophageal recess is normally a smooth arc convex to the left. Because the right lung extends into the recess, pathology in this region can often be detected radiographically and typically manifests as increased opacity and/or as a contour abnormality. In adults, convexity directed to the right and immediately below the level of the azygous vein on a frontal radiograph is abnormal and requires further evaluation.     

Drug-induced lung injury

Lung injury is an increasing cause of morbidity and mortality in patients treated with cytotoxic and noncytotoxic drugs. Prompt diagnosis is important because early drug-induced lung injury will often regress with the cessation of therapy. Diagnosis requires a high index of suspicion because infection, radiation pneumonitis, and recurrence of the underlying disease can manifest clinically and radiologically in a similar manner. Because the lungs have only a limited number of histopathologic responses to injury, including pulmonary edema/diffuse alveolar damage, NSIP, BOOP, EP, and pulmonary hemorrhage, knowledge of these manifestations and the corresponding radiologic manifestations can often be useful in suggesting a diagnosis of drug-induced lung injury. An understanding of the drugs most commonly associated with lung injury can also facilitate diagnosis.     

Lung cancer and positron emission tomography with fluorodeoxyglucose

Over the past years, positron emission tomography (PET) with fluoro-2-deoxy-D-glucose (FDG) has emerged as an important imaging modality. In the thorax, FDG-PET has been shown to differentiate benign from malignant pulmonary lesions and stage lung cancer. Preliminary studies have shown its usefulness in assessing tumor recurrence, and assisting in radiotherapy planning. FDG-PET is often more accurate than conventional imaging studies, and has been proven to be cost-effective in evaluating lung cancer patients. This review will discuss the current applications of FDG-PET as compared with conventional imaging in diagnosing, staging, and following patients with lung cancer.     

Anaesthesia and the diabetic patient

Since it is estimated that 1 out of every 2 diabetic patients will require surgery at some point in his lifetime, it is imperative that the anaesthetist should understand the disease process as well as the anaesthetic problems associated with it. This article emphasizes the medical, surgical and anaesthetic aspects of the treatment of patients with diabetes mellitus.