The North Equatorial Current and rapid intensification of super typhoons.

Super Typhoon Mangkhut, which traversed the North Equatorial Current (NEC; 8-17 °N) in the western North Pacific in 2018, was the most intense Category-5 tropical cyclone (TC) with the longest duration in history-3.5 days. Here we show that the combination of two factors-high ocean heat content (OHC) and increased stratification - makes the NEC region the most favored area for a rapid intensification (RI) of super typhoons, instead of the Eddy Rich Zone (17-25 °N), which was considered the most relevant for RI occurrence. The high OHC results from a northward deepening thermocline in geostrophic balance with the westward-flowing NEC. The stratification is derived from precipitation associated with the Inter-Tropical Convergence Zone in the summer peak typhoon season. These factors, which are increasingly significant over the past four decades, impede the TC-induced sea surface cooling, thus enhancing RI of TCs and simultaneously maintaining super typhoons over the NEC region.

Tarsal tunnel surgery secondary to a tarsal ganglion: be prepared before performing this complicated operation.

Tarsal tunnel surgery complicated with ganglia or any other type of cystic mass can be a very challenging operation. Preoperative planning before any tarsal tunnel surgery involving a soft-tissue mass is imperative. Plans to reconstruct the posterior tibial nerve and/or artery should be in place. The authors will present a case study that involved tarsal tunnel syndrome with an associated ganglion in the tarsal canal. They will review what microsurgical techniques and equipment should be on hand prior to performing this complicated surgical procedure.

A retrospective study of radiofrequency thermal lesioning for the treatment of neuritis of the medial calcaneal nerve and its terminal branches in chronic heel pain.

UNLABELLED: We undertook a retrospective analysis of 75 consecutive patients with recalcitrant plantar heel pain caused by calcaneal neuritis, all who were treated with radiofrequency thermal lesioning (RTL). The median age of the cohort was 55 (range 24 to 83) years, 25 (33.3%) of the patients were male, 50 (66.7%) of the patients were female, and 15 (20%) of the patients were treated for bilateral heel pain caused by medial calcaneal neuritis. The median preoperative VAS score was 9 (range 2 to 10), whereas the median long-term postoperative VAS score was 1 (range 0 to 8), and this difference was highly statistically significant (P < .0001). Five (6.7%) of the patients experienced recurrent heel pain, over a median follow-up duration of 18 (range 12 to 36) months. Overall, 93.3% of the patients experienced satisfactory pain relief with radiofrequency lesioning for the treatment of recalcitrant plantar heel pain caused by medial calcaneal neuritis. LEVEL OF CLINICAL EVIDENCE: 2.

Capillary hemangioma of the foot.

Capillary hemangiomas are benign, vascular lesions of skin and mucous membranes that often occur in infancy and childhood. Capillary hemangiomas are most commonly found in the head and neck region. Capillary hemangiomas that occur in adults and on the lower extremities are uncommon. A clinical case involving surgical treatment of the lesion on an adult foot is presented.