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Purpose: Persistent symptomatic inferior oblique (IO) muscle overaction (IOOA) after IO muscle weakening surgery is a common problem. We describe the results of reexploration and myectomy of the IO muscle using a standard inferotemporal approach to treat this clinical entity. Methods: A retrospective noncomparative consecutive series of patients referred for treatment of persistent IOOA. The following preoperative and postoperative measurements were recorded in each case: (1) the ductions and versions of the overacting IO muscle and its antagonist superior oblique (SO) muscle; and (2) alternate prism cover test, using loose prisms at 6 m, in primary position and right- and leftgaze. The preoperative and longer term postoperative findings were compared. Results: Eight patients were identified. Three had previously undergone a standard IO myectomy, and five had undergone a standard IO muscle recession. The median period of postoperative follow-up was 12 months (range, 7 months to 2 years). The IOOA was eliminated in three patients and a reduction of IOOA of at least 1 unit was achieved in all patients. Seven patients showed improvement of their SO muscle underaction on versions, postoperatively. All patients achieved a marked improvement in their alignment across the three standard horizontal positions of gaze. The mean vertical deviations pre- and postoperatively was 23Δ versus 7Δ in contralateral gaze, 17Δ versus 4Δ in primary gaze, and 7Δ versus 1Δ in ipsilateral gaze. Conclusions: Reexploration and myectomy of the IO muscle near to the temporal border of the inferior rectus muscle is a reliable and effective way of treating persistent IOOA. [Copyright &y& Elsevier]

Rapid and accurate field diagnostic tools can be used to support clinical diagnosis during outbreaks of exotic livestock diseases. This study evaluated a mobile PCR amplification platform that performs RNA extraction, real-time reverse-transcription PCR (rRT-PCR) and interpretation of results without operator intervention. Initial studies showed that there was equivalence between the detection limit generated by RNA extracted using the mobile platform and an automated laboratory-based system. In subsequent studies, two validated laboratory-based foot-and-mouth disease virus (FMDV)-specific rRT-PCRs were transferred onto the mobile platform and all assay steps (RT incubation and PCR amplification) were performed with non-lyophilised reagents using an optimised protocol of less than 60 rain. The limit of detection of the rRT-PCR on the mobile PCR platform was equivalent to an automated laboratory-based assay used for routine diagnosis of FMDV and there was concordance between these methods for results generated using samples in a reference laboratory proficiency panel. Future studies will be directed at the development and validation of commercially-viable consumables using lyophilised PCR reagents for FMDV and the evaluation of this technology in FMD endemic countries using field samples. [ABSTRACT FROM AUTHOR]