Aberrant origin of the right vertebral artery in a patient with truncus bicaroticus and aberrant right subclavian artery a possible baroreceptor nidus

Multiple aortic arch variations have been reported. Most of them are asymptomatic incidental findings, while others, like an aberrant right subclavian artery, can be symptomatic and require a surgical intervention. In this case report, we present the hemodynamic effects they might produce along with a short review of the literature. We, hereby, present the case of a patient with truncus bicaroticus, aberrant right subclavian artery and a right vertebral artery arising from the right common carotid artery. The patient was undergoing thymoma resection when she had two episodes of hypotension and bradycardia upon manipulation of the right vertebral artery origin. The presence of an ectopic baroreceptor is discussed

Vocal Symptoms and Acoustic Findings in Menopausal Women in Comparison to Pre-menopause Women with Body Mass Index as a Confounding Variable

OBJECTIVES: To compare the prevalence of phonatory symptoms in menopausal women compared to pre-menopause women with body mass index (BMI) as a confounding variable. METHODS: A total of 69 women, 34 menopausal and 35 pre-menopausal were invited to participate in this study. Demographic variables included age, smoking, and BMI. All subjects were asked about the presence hoarseness, loss of high or low frequencies, pitch breaks, throat clearing, dryness in the throat and vocal fatigue. Acoustic analysis was performed and the Voice Handicap Index (VHI)-10 was filled by all the subjects. RESULTS: There was a significantly higher prevalence of throat clearing and dryness in the menopausal group compared to the pre-menopause group with a P value of 0.035 and 0.032 respectively. When BMI was taken into account, there was no statistically significant difference in the prevalence of any of the phonatory symptoms in menopausal women with high BMI and pre-menopause. There was no statistically significant difference in the means of any of the acoustic parameters between the menopausal group and pre-menopausal group. There was no significant difference in the mean VHI-10 between the menopause group and the pre-menopause (P = 0.652). CONCLUSIONS: The results of this investigation substantiate the importance of fat as an alternative source of estrogen which can mask some of the phonatory symptoms.

Reeducation du syndrome de la traversee thoraco-brachiale. A propos de 60 malades

Sixty patients were treated by physical therapy for thoracic outlet syndrome [TOS] between 1995 and 1999. Females were predominant [76%] the average age was 34.5 years [I8 to 60]. Risk factors were hypermobility, cervical traumatism and profession. Neurological signs were predominant and positive provocation tests were found Adson [4S%], sonnette [62%], E.A.S.T. [51%]. Thoracic pain inaugurated the symptoms in 3 times pseudo-angina [2], dyspnea [1]. Radiological results were positive for cervical rib [8], apophysomegaly of C7 [25], clavicular traumatism [1]. Electromyogram was positive in 2 out of 3 patients, RMI in 2 of 4, and dynamic echo doppler in 3 of 4. After rehabilitation, immediate results were satisfactory in more than 70% of cases. After six months one patient had recurrence of symptoms, 66% were compliant with treatment, and 84% were satisfied. At one year the symptoms recurred in 2 patients, 15% were still compliant, and 81% were satisfied. Surgery was needed in 4 patients with cervical ribs

Triple plastie de comblement d'une thoracostomie de clagett

Clagett's thoracostomy is a widely used procedure in the initial treatment of postpneumonectomy empyema. We describe in this paper an original one step operation of thoracic filling after empyema sterilization. The triple plasty includes an apical thoracoplasty limited to the first 3 ribs, a pedicle flap of the latissimus dorsi transferred inside the thoracic cavity and an upper translation of the diaphragm to the 4th rib in order to reduce resiual pleural space. Three patients were operated and followed up clinically [for 20, 29 and 30 months], and radiologically with a MRI on the 12th months. Complete tissue healing and loss of all residual space was observed in all patients. We therefore recommend the use of this technique rather than thoracic wall coverage procedures