Atypical brain MRI findings in a patient with treatment responsive anti-IgLON5 disease.

Anti-IgLON5 disease is a rare autoimmune neurological condition which was relatively recently described in the literature. This syndrome encompasses a range of clinical manifestations with most cases showing unremarkable findings on brain magnetic resonance imaging (MRI). Here, we report a case of a 61-year-old female patient with unique brain MRI features that, to the best of our knowledge, has not been reported in the literature before. Following treatment including immunotherapy, the patient experienced significant improvement clinically accompanied by radiological improvement on the follow-up imaging.

Hypertrophic olivary degeneration associated with bilateral vocal cord adductor dystonia.

BACKGROUND: Hypertrophic olivary degeneration (HOD) is a rare condition caused by lesions within the dentato-rubro-olivary pathway, resulting in ocular nystagmus and palatal myoclonus (oculopalatal tremor) but not usually dystonia. Dystonia is an uncommon association, and we present the first reported association of hypertrophic olivary degeneration with bilateral vocal cord dystonia. CASE PRESENTATION: A 33 year old male presented initially with acute hydrocephalus on the background of previous ventriculoperitoneal (VP) shunting for previously treated medulloblastoma. After revision of the VP shunt, the patient developed progressive hiccups and stridor leading to respiratory failure requiring intubation. Ocular pendular nystagmus and palatal myoclonus at 3 Hz was observed. Flexible nasendoscopy (FNE) demonstrated bilateral tonic adduction of the vocal folds with 3 Hz coarse supraglottic, pharyngeal and palatal rhythmic myoclonus. MRI imaging demonstrated T2 hyperintensity within the bilateral inferior olivary nuclei consistent with stage 3 radiological HOD. CONCLUSIONS: Dystonia is a rarely reported phenomenon in HOD but is not unexpected with the inferior olivary nucleus implicated in dystonic disorders. We report the association of HOD with bilateral vocal cord adductor dystonia, a potentially life threatening condition.

Attitudes and practices associated with pubic hair grooming behaviours: A cross-sectional study.

BACKGROUND: Female pubic hair grooming (PHG) habits have changed in the last 20 years. Most studies present findings around female PHG attitudes, practices, and behaviours, lacking data on male attitudes and practices. AIMS: We explored the attitudes and practices of PHG from male and female perspectives. MATERIALS AND METHODS: A cross-sectional convenience survey was conducted online with 1560 male and female young adult participants aged 18 to 25 years. The study was conducted over two time periods (2014 and 2021). The survey explored attitudes, practices, and behaviours around PHG. Descriptive statistics included frequencies and proportions for categorical variables and the median for continuous variables. Males and females were compared using the χ2 test or Fisher's exact test for categorical variables. We used logistic regression to explore independent factors of PHG. RESULTS: Seventy-two percent (n = 471/728) of females and 64.7% (n = 257/728) of males were likely to engage in PHG. Participants were more likely to groom their pubic hair for reasons associated with religion (adjusted odds ratio (aOR): 9.01, 95% CI: 2.87-28.2), comfort when wearing clothing (aOR: 3.85, 95% CI: 1.52-9.71), a neater and cleaner genital appearance (aOR: 3.90, 95% CI: 1.62-9.41) and before attending a healthcare consultation (aOR: 4.79, 95% CI: 2.27-10.09). Moreover, twice as many females compared with male groomers reported watching pornography (69.7% vs 30.3%). CONCLUSION: Several factors can influence PHG. Our findings demonstrate that the reasons participants engage in PHG practices are for hygiene, aesthetics, comfort, and sexual satisfaction.

The ergonomics of laparoscopic surgery: a quantitative study of the time and motion of laparoscopic surgeons in live surgical environments.

BACKGROUND: Laparoscopic surgery presents multiple ergonomic difficulties for the surgeon, requiring awkward body postures and prolonged static muscle loading that increases risk of musculoskeletal strain and injury. This prospective study quantitatively measures the biomechanical movements of surgeons during laparoscopic procedures to determine at-risk movements from prolonged static muscle loading and repetitive motions that may lead to injury. METHODS: A total of 150 video recordings of 18 surgeons, standing at the patient's left, were captured from three fixed camera positions during live gynecological laparoscopic surgery. Postoperative processing quantified surgeon movements at the neck, shoulders and elbows using computer software to measure extreme joint angles and time spent within defined joint angle ranges. RESULTS: Surgeons spent a median of 98 % (range 77-100 %) of surgical time with their neck rotated at 21° (range 0°-52°). The non-dominant arm was subjected to more extreme positions for significantly longer periods of time compared to the dominant, with shoulder flexion at 45°-90° for 35 vs. 0 % (p < 0.001) and elbow flexion at >120° for 31 vs. 0 % (p < 0.001) of total surgical time. Procedures involving power morcellation required significantly greater number of instrument insertion/removals-119 (range 56-182) compared with 12 (range 2-122) when morcellation was not used (p < 0.001). Shorter surgeons maintained significantly greater degrees of neck rotation when viewing the monitor (p < 0.003) and surgeons with shorter arm lengths spent longer in extreme positions with their non-dominant shoulder at >90° (p = 0.04) and elbow at >120° (p < 0.001) compared with taller surgeons. No significant correlations were found between BMI or surgical experience and more extreme joint positions. CONCLUSIONS: Four primary areas have been identified where surgeons are consistently demonstrating movements that increase their risk of harm: (1) extended periods of neck rotation; (2) asymmetrical loading between the dominant and non-dominant shoulders; (3) power morcellation and frequent insertions/removals of laparoscopic instruments resulting in repetitions of the most extreme shoulder positions and (4) a negative correlation between height and percentage time spent in more extreme positions.