Current Approach to the Evaluation and Management of Hair-Thread Tourniquets.

Hair-thread tourniquet syndrome is a rare, painful condition that occurs when a strand of hair or thread becomes wrapped around toes, fingers, or other appendages. This causes focal edema, which eventually reduces arterial blood flow and can lead to ischemia and necrosis. A thorough physical examination and assessment of risk factors are important. Treatment involves depilatory agents or targeted incision at the bedside or in the operating room. Successfully treated cases can be discharged with local wound care. Parents should be advised on prevention strategies and ensure close follow-up for reexamination.

Variability of the pharyngeal phase of swallow in the cat.

OBJECTIVE: The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior. STUDY DESIGN: This is a prospective, preclinical, hypothesis driven, one group by three-task design. METHODS: We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal. RESULTS: Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter); a significant increase in parasternal (schluckatmung; swallow breath) activity; and increases in thyrohyoid (laryngeal elevator), thyroarytenoid (laryngeal adductor) and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow. CONCLUSIONS: The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.