Seunghye Lee, Sehyun Jung, Hyejin Jeon, Hani Jang, Hyun-Jung Kim, T. W. Lee, Eunjin Bae, D. J. Park, Se‐Ho Chang
{"title":"Spontaneous Remission of Minimal Change Disease in a Colon Cancer Patient: A Case Report","authors":"Seunghye Lee, Sehyun Jung, Hyejin Jeon, Hani Jang, Hyun-Jung Kim, T. W. Lee, Eunjin Bae, D. J. Park, Se‐Ho Chang","doi":"10.1159/000538279","DOIUrl":"https://doi.org/10.1159/000538279","url":null,"abstract":"Abstract Introduction Minimal change disease (MCD) is most often primary but may occur secondary to other systemic diseases such as malignancy. In secondary MCD, spontaneous remission of nephrotic syndrome after the treatment of related diseases without steroid therapy is rare. Case Presentation A 78-year-old man visited the outpatient clinic with foamy urine and generalized edema that had persisted for 2 months. The patient had nephrotic syndrome. Before a kidney biopsy, he underwent several tests to determine the secondary cause of the nephrotic syndrome. The serum CEA was slightly elevated, and colon cancer was detected in the sigmoid colon. MCD was diagnosed from a kidney biopsy. He immediately underwent surgery for colon cancer. Complete remission of the MCD was achieved within 2 weeks after surgery. Conclusion Here, we report a rare case of a patient with secondary MCD who successfully achieved spontaneous remission after colon cancer surgery.","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":" 22","pages":"62 - 66"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosemarie Nagy, T. Hemmelgarn, Stephen Deptola, Brianna Hemmann
{"title":"Evaluation of Initial Enoxaparin Dosing and Antifactor Xa Levels in Infants Admitted to the Neonatal Intensive Care Unit","authors":"Rosemarie Nagy, T. Hemmelgarn, Stephen Deptola, Brianna Hemmann","doi":"10.1159/000537797","DOIUrl":"https://doi.org/10.1159/000537797","url":null,"abstract":"Abstract Introduction Infants are at risk for thrombotic conditions due to multiple risk factors such as congenital heart defects and sepsis. According to the American College of Chest Physicians (ACCP) 2012 guidelines, enoxaparin may be given for thrombotic conditions at a dose of 1.5 mg/kg/dose every 12 h for patients less than 2 months of age and 1 mg/kg/dose every 12 h for those older than 2 months. Several studies have reported that infants typically require a higher initial dose of enoxaparin to reach therapeutic antifactor Xa levels than what is currently recommended. Methods This is a single-center retrospective case-control study of hospitalized infants less than 12 months of age who received treatment with enoxaparin while admitted to the neonatal intensive care unit (NICU) at a freestanding children’s hospital. The primary objective was the difference between the initial enoxaparin dose (mg/kg) compared to the enoxaparin dose in which the patient first achieved a therapeutic antifactor Xa level of 0.5–1.0 units/mL. Results A total of 56 infants were included in this study. The median enoxaparin dose at initiation was 1.5 mg/kg/dose, and the median enoxaparin dose at the first therapeutic antifactor Xa level was 1.9 mg/kg/dose (z = −12.7, p < 0.0001). There was no correlation between gestational age and weight with the enoxaparin dose required to reach a therapeutic antifactor Xa level. Conclusion Infants admitted to the NICU, specifically those less than 4 months of age, require higher initial enoxaparin dosing to reach therapeutic antifactor Xa levels than what is currently recommended.","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"9 3","pages":"54 - 61"},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140710577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Redefining Rare Disease Care in the Digital Age: Insights and Key Takeaways from a Digital Health Symposium Focused on Empowering Rare Disease Communities","authors":"Emily Lewis, Anuradha Dayal, Ron Li","doi":"10.1159/000536274","DOIUrl":"https://doi.org/10.1159/000536274","url":null,"abstract":"Abstract At the Stanford-UCB Rare Disease Digital Health Symposium held in Stanford, California, on September 8, 2023, researchers, clinicians, payers, thought leaders, and rare disease caregivers and advocates discussed the current state of care delivery and future perspectives of digitally-enabled care for rare disease patient populations. Digital health aims to improve healthcare delivery through novel ways of providing access to more precise diagnosis, monitoring of disease progression, treatment, prognosis, and care management for rare disease patients. The meeting focused on highlighting challenges and unmet needs, data infrastructure and analytics, the need for targeted and effective personalized therapies, and the importance of digital care transformation. The meeting also covered the social and ethical impact of access to digitally delivered, patient-centered care, as well as views on implementation and patient autonomy and empowerment.","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"2006 13","pages":"38 - 44"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Value of Flemish Version of the Triage Risk Screening Tool in Predicting Unfavorable Outcomes after Elective Cancer Surgery: A Propensity Score-Matched Retrospective Cohort Study.","authors":"Shugo Yajima, Yasukazu Nakanishi, Ryo Andy Ogasawara, Naoki Imasato, Kohei Hirose, Sao Katsumura, Madoka Kataoka, Hitoshi Masuda","doi":"10.1159/000538247","DOIUrl":"https://doi.org/10.1159/000538247","url":null,"abstract":"<p><strong>Introduction: </strong>The Flemish version of the Triage Risk Screening Tool (fTRST), derived from the Triage Risk Screening Tool for assessing risk of readmission to the emergency department, is increasingly used as a simple screening tool in oncology. This study aimed to evaluate the utility of the fTRST in the context of elective surgical treatment for urologic cancer patients.</p><p><strong>Methods: </strong>We included 886 patients who underwent major urologic cancer surgery at our institution between 2020 and 2022 and underwent preoperative screening, including fTRST. We set the fTRST cutoff at 2 and used propensity score matching and multivariate regression analysis to assess how fTRST affected two postoperative outcomes: ambulation failure and delirium.</p><p><strong>Results: </strong>Of the 886 patients, 693 (78%) had an fTRST score <2, and 193 (22%) had an fTRST score ≥2 (high likelihood of frailty). After matching the groups by propensity scores, we compared the outcomes of 131 patients in each group. We found that the group with fTRST ≥2 had significantly higher rates of ambulation failure (15 vs. 11%, <i>p</i> = 0.03) and delirium (16 vs. 11%, <i>p</i> = 0.008) than the group with fTRST <2. Multivariate logistic regression analysis showed that fTRST score ≥2 was an independent risk factor for postoperative ambulation failure (odds ratio [OR] = 4.05, <i>p</i> = 0.02), along with age ≥75 years (OR = 6.62, <i>p</i> = 0.02), preoperative benzodiazepine medications (OR = 5.12, <i>p</i> = 0.01), and receiving radical cystectomy (OR = 9.30, <i>p</i> = 0.02). Similarly, for delirium, fTRST score ≥2 was an independent risk factor (OR = 2.88, <i>p</i> = 0.03), along with preoperative benzodiazepine medications (OR = 4.38, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The fTRST might be a screening tool with great potential for identifying patients at high risk for unfavorable postoperative outcomes in elective urologic cancer surgery.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"9 1","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biomedicine hubPub Date : 2024-01-29eCollection Date: 2024-01-01DOI: 10.1159/000535596
Ana Lucia Seminario, Ashley E Karczewski, Whasun Chung, Yan Wang, Dalton Wamalwa, Sarah Benki-Nugent, Grace John-Stewart, Jennifer A Slyker, Arthur Kemoli
{"title":"Salivary Cathelicidin (LL-37) in Children and Adolescents Living with HIV.","authors":"Ana Lucia Seminario, Ashley E Karczewski, Whasun Chung, Yan Wang, Dalton Wamalwa, Sarah Benki-Nugent, Grace John-Stewart, Jennifer A Slyker, Arthur Kemoli","doi":"10.1159/000535596","DOIUrl":"10.1159/000535596","url":null,"abstract":"<p><strong>Introduction: </strong>Human cathelicidin LL-37 is a salivary antimicrobial peptide (AMP) with broad-spectrum activity against oral diseases, but few studies have assessed its role in children and adolescents living with HIV (CALHIV). We assessed salivary LL-37 levels and correlates in a long-term cohort of Kenyan CALHIV followed since antiretroviral therapy (ART) initiation.</p><p><strong>Methods: </strong>Saliva was collected from 76 CALHIV who were recruited from two ongoing pediatric HIV studies in Nairobi, Kenya. Oral examinations documenting oral manifestations of HIV, dental caries, and gingivitis were completed. Additional variables included age, sex, HIV treatment (initial ART regimen) and disease parameters, caregivers' demographics, and oral pathologies were conducted. Data were statistically analyzed using the independent <i>T</i> test on the log-transformed LL-37.</p><p><strong>Results: </strong>At the oral exam visit, the mean age of participants was 13.3 years (±SD = 3.4), and the median CD4 count was 954 cells/mm<sup>3</sup>. Mean salivary cathelicidin values of the cohort were 23.7 ± 21.1 ng/mL. Children with permanent dentition at time of oral examination, and children who initiated ART at ≥2 years old had higher mean LL-37 concentrations compared to those with mixed dentition and those who initiated ART <2 years old (<i>p</i> = 0.0042, 0.0373, respectively). LL-37 levels were not found to differ by initial type of ART regimen, CD4 count, or oral disease.</p><p><strong>Conclusion: </strong>Further research and longitudinal studies are necessary to evaluate and improve the innate immunity of CALHIV in Kenya.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"9 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biomedicine hubPub Date : 2024-01-23eCollection Date: 2024-01-01DOI: 10.1159/000535507
Lora Wahab, Christian G Cornelissen, Wolfram Windisch, Michael Dreher
{"title":"GLI-12 Reference Values versus Fixed 0.7 Ratio for the Detection of Airflow Obstruction in the Presence of Lung Hyperinflation.","authors":"Lora Wahab, Christian G Cornelissen, Wolfram Windisch, Michael Dreher","doi":"10.1159/000535507","DOIUrl":"10.1159/000535507","url":null,"abstract":"<p><strong>Introduction: </strong>Airflow obstruction (AO) is evidenced by reduced forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) with the threshold for diagnosis often being set at <0.7. However, currently the ATS/ERS standards for interpretation of lung function tests recommend the lower limit of normal (LLN), calculated by reference equations of the Global Lung Initiative from 2012 (GLI-12), as a threshold for AO diagnosis. The present study aims to investigate phenotypes, with focus on hyperinflation, which influence AO prevalence defined by FEV1/FVC < LLN when compared to the fixed 0.7 threshold.</p><p><strong>Methods: </strong>Data from 3,875 lung function tests (56.4% men, aged 18-95) including 3,824 body plethysmography recordings performed from July 2021 to June 2022 were analysed. The difference between both classifiers was quantified, before and after stratification by sex, age, and hyperinflation.</p><p><strong>Results: </strong>AO diagnosis was significantly less frequent with the LLN threshold (18.2%) compared to the fixed threshold (28.0%) (<i>p</i> < 0.001) with discordance rate of 10.5%. In the presence of mild or moderate hyperinflation, there was substantial agreement (Cohen's kappa: 0.616, 0.718) between the classifiers compared to near perfect agreement in the presence of severe hyperinflation (Cohen's kappa: 0.896). In addition, subgroup analysis after stratification for sex, age, and hyperinflation showed significant differences between both classifiers.</p><p><strong>Conclusion: </strong>The importance of using the LLN threshold instead of the fixed 0.7 threshold for the diagnosis of AO is highlighted. When using the fixed threshold AO, misdiagnosis was more common in the presence of mild to moderate hyperinflation.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"9 1","pages":"16-24"},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Monji-Azad, D. Männle, Jürgen Hesser, Jan Pohlmann, N. Rotter, Annette Affolter, Cleo-Aron Weis, Sonja Ludwig, Claudia Scherl
{"title":"Point Cloud Registration for Measuring Shape Dependence of Soft Tissue Deformation by Digital Twins in Head and Neck Surgery","authors":"Sara Monji-Azad, D. Männle, Jürgen Hesser, Jan Pohlmann, N. Rotter, Annette Affolter, Cleo-Aron Weis, Sonja Ludwig, Claudia Scherl","doi":"10.1159/000535421","DOIUrl":"https://doi.org/10.1159/000535421","url":null,"abstract":"Introduction: A 2½ D point cloud registration method was developed to generate digital twins of different tissue shapes and resection cavities by applying a machine learning (ML) approach. This demonstrates the feasibility of quantifying soft tissue shifts. Methods: An ML model was trained using simulated surface scan data obtained from tumor resections in a pig head cadaver model. It hereby uses 438 2½ D scans of the tissue surface. Tissue shift was induced by a temperature change from 7.91 ± 4.1°C to 36.37 ± 1.28°C. Results: Digital twins were generated from various branched and compact resection cavities (RCs) and cut tissues (CT). A temperature increase induced a tissue shift with a significant volume increase of 6 mL and 2 mL in branched and compact RCs, respectively (p = 0.0443; 0.0157). The volumes of branched and compact CT were decreased by 3 and 4 mL (p < 0.001). In the warm state, RC and CT no longer fit together because of the significant tissue deformation. Although not significant, the compact RC showed a greater tissue deformation of 1 μL than the branched RC with 0.5 μL induced by the temperature change (p = 0.7874). The branched and compact CT forms responded almost equally to changes in temperature (p = 0.1461). Conclusions: The simulation experiment of induced soft tissue deformation using digital twins based on 2½ D point cloud models proved that our method helps to quantify shape-dependent tissue shifts.","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"41 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139442358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biomedicine hubPub Date : 2024-01-03eCollection Date: 2024-01-01DOI: 10.1159/000535096
Purbasha Mishra, Pankaj Kumar Mohanty, Tapas Kumar Som, Tanushree Sahoo, Usha Devi, Nerbadyswari Deep Bag
{"title":"Comparison of Ultrasound-Guided Umbilical Venous Catheter Insertion with Blind Method: A Randomized Controlled Trial.","authors":"Purbasha Mishra, Pankaj Kumar Mohanty, Tapas Kumar Som, Tanushree Sahoo, Usha Devi, Nerbadyswari Deep Bag","doi":"10.1159/000535096","DOIUrl":"10.1159/000535096","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasonography (USG) can be used in neonates to manipulate and place the umbilical catheter in the correct position. Although chest radiograph (CXR) is the gold standard, a noninvasive method like USG without radiation exposure may be an alternative bedside armamentarium to the clinician. The purpose of the study was to evaluate whether USG-guided umbilical venous catheter (UVC) insertion is superior to the conventional method for the successful insertion of UVC.</p><p><strong>Method: </strong>The neonates born between 25 and 42 weeks of gestation requiring parenteral fluids and admission to neonatal intensive care unit (NICU) between September 2020 and November 2022 were randomized in two weight-based strata: ≤1,200 and >1,200 g. USG-guided UVC insertion was done in the intervention group and blind UVC insertion was done in the control group.</p><p><strong>Results: </strong>Out of 112 enrolled neonates, 58 were in the USG-guided group and 54 in the blind group. There was no significant difference in the failure rate between the intervention and control groups (20% versus 29% [RR: 0.69, 95% CI: 0.36-1.33]). The sensitivity and specificity of USG in locating tip position were 97 and 46.8%, respectively. The mean procedure time in USG and blind groups was 8.9 and 8.3 min, respectively (<i>p</i> value 0.56).</p><p><strong>Conclusion: </strong>USG does not reduce the failure rates during the insertion of umbilical catheters. However, being a safe, noninvasive procedure, it can be considered a rescue modality to CXR in NICUs equipped with portable USG for guiding UVC insertion.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"9 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10764083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Research Progress on the Etiology and Treatment of Premature Ovarian Insufficiency.","authors":"Yuxian Wang, Jianqiu Jiang, Jiali Zhang, Peiyin Fan, Jian Xu","doi":"10.1159/000535508","DOIUrl":"10.1159/000535508","url":null,"abstract":"<p><strong>Background: </strong>Menopause in women marks the knot of reproductive life, and menopause is defined as the last menstrual period in a woman, but this is caused by the failure of the ovarian reserve. The average age of natural menopause in the general population of women has remained around 50-52 years. Premature ovarian insufficiency (POI) is a debilitating clinical syndrome that manifests as a decline in ovarian function in women under 40. This condition is a prominent cause of female infertility.</p><p><strong>Summary: </strong>POI is a debilitating condition that not only wreaks havoc on patients' physical and mental well-being but also imposes substantial mental, psychological, and economic burdens, particularly on women. In addition to diminished fertility, individuals afflicted with POI face an elevated risk of developing debilitating conditions such as osteoporosis and cardiovascular disease. The etiologies of POI are highly heterogeneous, and it can be caused by spontaneous genetic defects or induced by autoimmune diseases, infections, and iatrogenic or environmental factors. Alarmingly, idiopathic POI, a subtype characterized by an unknown etiology, accounts for more than half of all POI cases. Currently, clinical interventions for POI primarily consist of hormone replacement therapy. Fertility preservation methods are cryopreservation of embryos, oocytes, and ovarian tissue. Immunological interventions, gene editing techniques, and stem cell-based therapies are being explored to unravel the diverse etiologies and underlying mechanisms of POI, thereby enabling the identification of optimal therapeutic interventions. These innovative approaches offer unprecedented opportunities to advance the field of reproductive medicine.</p><p><strong>Key messages: </strong>The main aim of this paper was to offer a succinct summary of the latest research breakthroughs concerning the elucidation of the mechanisms governing the origin and management of POI.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"8 1","pages":"97-107"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138816139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biomedicine hubPub Date : 2023-10-31eCollection Date: 2023-01-01DOI: 10.1159/000533628
Santa Heede, William Astle, Emi Sanders, Irina Kovalevskaya, Sandra Valeina, Uwe Griebenow
{"title":"Preliminary Results of New Modification of Vertical Muscle Transposition to Enhance Abducting Force in Sixth Nerve Palsy.","authors":"Santa Heede, William Astle, Emi Sanders, Irina Kovalevskaya, Sandra Valeina, Uwe Griebenow","doi":"10.1159/000533628","DOIUrl":"10.1159/000533628","url":null,"abstract":"<p><strong>Introduction: </strong>Since 1907, multiple transposition procedures have been established for the treatment of abducens paralysis. The purpose of the study was to determine where the transposed muscle should be reattached in order to increase the tangential force necessary to improve abduction.</p><p><strong>Methods: </strong>Retrospective case review of 12 consecutive patients with abducens paralysis who underwent transposition procedures between 2016 and 2019 was conducted. Vertical rectus muscles are transposed to the insertion of lateral rectus muscle; the temporal parts are joined and sutured to the sclera on top of the lateral rectus muscle in the middle of the insertion. The nasal parts are sutured to the sclera following the spiral of Tillaux. The muscle junction suture is placed 8 mm from the insertion, with the temporal parts of the vertical muscles bellies joined and sutured to the lateral rectus muscle. A full-tendon transposition was performed on 11 patients, a half-tendon transposition procedure on 1 patient. The minimum follow-up was 3 months.</p><p><strong>Results: </strong>The mean preoperative deviation was ET of 37° (range: ET 24° to ET 51°). The mean preoperative abduction limitation was 5 mm from midline (range: 7 to 1 mm). The postoperative mean deviation was ET of 2° (range: 0° to ET 5°). The postoperative mean abduction improvement was 5 mm past midline (range: 2-6 mm). There were no complications or signs of anterior segment ischemia.</p><p><strong>Conclusion: </strong>To achieve the maximal abductive force from the transposed muscles, we suggest that the vertical muscles be reattached as close as possible to the middle of the lateral rectus insertion.</p>","PeriodicalId":101351,"journal":{"name":"Biomedicine hub","volume":"8 1","pages":"88-96"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71430805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}