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Highlights • The CMAPshin measurement is a convenient and safe method with good intra-observer reliability. • The right-left difference in the CMAPshin amplitude/area is likely pathological where a difference is more then 25%. • This method can be used to estimate the axonal loss in lesions involving these muscles., Objective The normal limits of symmetry for the compound muscle action potential of the shin muscles (CMAPshin) have not been determined yet. The goal of this study is to provide extensive data on the limits of symmetry and the reliability of CMAPshin. Methods The study was conducted in normal healthy males and females. All subjects underwent CMAPshin measurements bilaterally. The median percent differences of right/left amplitude/area, with range of these measurements, were calculated. In addition, the intra- and interobserver reliability was examined in a separate population. Results The study group consisted of 58 healthy individuals. The median percent right/left difference for amplitude and area were respectively 7.2% (range 0–23.6%) and 5.4% (range 0.7–25.6%). Right/left difference of the amplitude/area of the CMAPshin greater than 24%/26% respectively can be considered as pathological. The Pearson correlation coefficients (r) for the intra-observer reliability amplitude/area are 0.905/0.882 and for the inter-observer reliability are 0.968/0.981. Conclusions The results confirm symmetry and good intra- and interobserver reliability in CMAPshin measurements. Significance CMAPshin can be used in practice to estimate axonal loss in case of a foot drop. Data studies examining symmetry of CMAPshin can facilitate in the clinical interpretation of these nerve conduction studies.

Carpal tunnel syndrome (CTS), compression of the median nerve lying deep under the flexor retinaculum, is the most common entrapment neuropathy of the upper limb. After a failure of conservative treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs) and splinting, interventional techniques are required. Hydrodissection is an injection technique that separates the nerve from the surrounding tissue. Although this technique is gaining ground in modern medicine, the state-of-the-art literature is lacking a clear protocol or approach for hydrodissection for CTS. In this article, we describe a safe, minimally invasive, effective, and easy-to-use ultrasound-guided hydrodissection technique for CTS.

A case report is presented that gives new insight into a very rare cause of athletic pubalgia. Up till now, no case has been published in literature about the relevance of an arcuate pubic ligament (APL) injury in athletic pubalgia. The APL or inferior pubic ligament is a thick triangular arch of ligamentous fibers connecting the 2 pubic bones below. The main function of the APL is to stabilize the symphysis pubis. The rupture of this ligament can lead to groin pain due to lack of stabilization of the symphysis pubis. Despite the importance of the anatomical and clinical function of the APL, very limited research is available about injuries of this ligament. This report describes a case of a traumatic left APL rupture, confirmed by magnetic resonance imaging, causing longstanding left groin pain in an amateur athlete.

We report a case of a 54-year-old man with an angioleiomyoma originating from the right nasal floor. Nasal vascular leiomyomas are extremely rare tumours. A review of the literature revealed a limited number of cases of vascular leiomyoma in the nasal cavity. Clinically, they are characterised by nasal obstruction, epistaxis or pain as the primary symptom. Up to our knowledge, this is the first case in which a 3D CT scan was performed preoperatively. 3D CT scan reconstructions can show the delineation of the tumour very accurately helping to establish the therapeutic plan for removal. The definite diagnosis can only be confirmed by histopathology. Histopathologically, a vascular leiomyoma demonstrates proliferation of smooth muscle cells intermingled with dilated venous vessels.

International audience; Seed circulation among farmers, which is embedded in composite social networks, is a key process in the dynamics of seed systems that shape crop diversity. We analyzed the daily circulation of biological objects, i.e., cultivated plants (31 species, 284 landraces), within a community of first-generation migrants (16 households, 30 persons) living on the island of Vanua Lava in the South Pacific archipelago nation of Vanuatu. By combining participant observation, ethnobiological inventories, and social network analysis, we investigated how farmer social status and plant biocultural value affect plant circulation. Plant biocultural value was estimated by referring to their local classification according to uses, cultivation practices, growing environments, and biological properties. An aggregate plant circulation network (577 events) and three subnetworks (i.e., for starchy, side dish, or snack food categories) sharing the same 30 nodes were analyzed using exponential random graph models. Evidence that farmer social status influences the patterns of plant circulation was found through the distribution of structural parameters of the network, including: dyadic reciprocity; in-degree, out-degree, and their correlation; triadic cycling; and transitivity. At the scale of the aggregate network, direct or indirect reciprocity was not observed. Instead, a high out-degree (i.e., being a more frequent giver) and a negative correlation between in-degree and out-degree both confer prestige and reinforce hierarchy. These results suggest that some of the social dynamics of the Melanesian-type Big Man political system may persist, even though the system itself no longer exists in traditional form. Moreover, based on our comparative analysis of the three subnetworks, farmer social status appears to influence greatly the circulation of plants with high biocultural value while having little influence on plants with low biocultural value. Farmer social status and plant biocultural value (following their local classification) are important factors for understanding the social rules shaping seed circulation.