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Africa
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The history
Published in Caroline J Rodgers, Richard Harrington, Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Caroline J Rodgers, Richard Harrington
Pronator teres syndrome is possible also but it is much rarer.10 This is compression of the median nerve between the two heads of the pronator teres. The clinical picture is of pain, numbness or paraesthesia in the anterior forearm as well as the hand, whereas these symptoms are localised to the hand (the palmar lateral three and a half digits) in CTS.11
Upper limb
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Pronator teres - arising proximally from the common flexor origin, the muscle crosses the forearm obliquely to be attached distally halfway down the lateral side of the radius. It has a small deep head from the coronoid process of ulna, and the median nerve, by which it is innervated, passes distally between the two heads.
The Antebrachium
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Pronator Quadratus. The pronator quadratus arises on the distal fourth of the ulna (flexor surface) and passes directly transversely to insert upon the adjacent face of the radius. Its function is to pronate the forearm, with the assistance of the pronator teres.
Licking the lungs, biting the brain: malignant MCA infarct in a patient with COVID 19 infection
Published in British Journal of Neurosurgery, 2021
Rimita De, Anupam Maity, Chandramouli Bhattacharya, Sayan Das, Prasad Krishnan
While the major manifestations of the novel coronavirus disease 2019 (COVID 19) are pulmonary, ischemic strokes have also been reported though these are mostly in the nature of case reports.1 Unlike in our case where there was infarction in the MCA territory, the largest series of 6 patients reported by Beyrouti et al.2 has a preponderance of posterior circulation strokes. Coagulopathy with arterial and venous thrombosis causing stroke has been reported in patients with COVID-19.2 Mao et al.3 in a series of 214 patients with COVID 19 from Wuhan, China reported a 5.7% incidence of cerebrovascular disease among patients with severe disease and a 0.8% incidence of the same in patients with non severe disease. In a systematic review of available literature Voili et al.4 found the data to be ‘suggestive of low-grade intravascular clotting activation’ in severely affected cases. This is supported by elevation of D-dimer in these cases and is associated with poorer survival. They also report a trend towards prolongation of PT, APTT and thrombocytopenia in patients with more severe disease. Antiphospholipid antibodies have also been speculated to be responsible in causation of these strokes.2
COVID-19 vaccines and thrombosis with thrombocytopenia syndrome
Published in Expert Review of Vaccines, 2021
Chih-Cheng Lai, Wen-Chien Ko, Chih-Jung Chen, Po-Yen Chen, Yhu-Chering Huang, Ping-Ing Lee, Po-Ren Hsueh
The emergence of SARS-CoV-2 has caused a pandemic and has urged the rapid development of COVID-19 vaccines. Although many clinical trials have demonstrated the effectiveness and safety of COVID-19 vaccines, a new adverse event, TTS, has been reported rarely in recipients of these vaccines. The exact epidemiological characteristics and possible pathogenesis of this disease remain unclear. Most cases of TTS developed in women within 2 weeks of the first dose of vaccine, restrictively on the receipt of the ChAdOx1 nCoV-19 and Ad26.COV2.S COVID-19 vaccines. Clinicians should be aware of this complication and its symptoms, including severe headache, blurred vision, seizure, severe and persistent abdominal pain, painful swelling of the lower leg, and chest pain or dyspnea, and they should perform associated laboratory tests (D-dimer, PT, aPTT, and Clauss fibrinogen) and imaging examinations according to the symptoms for early diagnosis. Although a marked elevation of D-dimer levels is highly suggestive of TTS, the PF4 antibody assay remains a confirmatory test (Table 2) [50,55]. Non-heparin anticoagulants and immunoglobulins may be useful in the treatment of TTS (Table 2) [50,55]. However, further studies are required to better understand this rare clinical entity.
Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion
Published in Physiotherapy Theory and Practice, 2021
Gyeong-Tae Gwak, Ui-Jae Hwang, Sung-Hoon Jung, Jun-Hee Kim, Moon-Hwan Kim, Oh-Yun Kwon
LSR is often caused by a short or stiff pronator teres (Neumann, 2010; Sahrmann, 2011). The stiff pronator teres may compress the median nerve and cause pronator syndrome (Mackinnon and Novak, 1994). Because the pronator teres can act as an elbow flexor, forearm supination might be more difficult in an elbow-extended than in an elbow-flexed position in patients with LSR. Many studies have considered MIFST in healthy subjects (Gordon et al., 2004; Kerschbaum, Maziak, Böhm, and Scheibel, 2017; Kramer et al., 1994; O’Sullivan and Gallwey, 2002). However, little research has been performed comparing MIFST according to elbow position in subjects with and without LSR. Therefore, the purpose of this study was to compare MIFST in subjects with and without LSR in two elbow positions, 90° elbow flexion and full elbow extension.