Paediatric mandibular fractures: report of a case

Abstract – The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14‐year‐old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.     

Urinary cystatin C as a specific marker of tubular dysfunction.

BACKGROUND: Cystatin C (CST3), a strong inhibitor of cysteine proteinases, is freely filtered by the kidney glomerulus and is reabsorbed by the tubules, where it is almost totally catabolized, with the remainder then eliminated in urine. In tubular diseases, it seems sensible to postulate that CST3 degradation would be reduced and consequently an increase in its urinary elimination would be observed. METHODS: We report here the development of an automatic quantitative assay to measure CST3 concentrations in urine using a Behring N-Latex Cystatin C kit on a BNII laser nephelometer. We tested its clinical relevance on several kidney disease patients. RESULTS: This assay is sensitive (limit of detection 0.008 mg/L) and precise (within- and between-day CVs < 4%). Reference values for freshly collected urine samples range from 0.03 to 0.18 mg/L. Mean urine CST3 concentrations obtained from 52 patients with kidney tubular disease (4.31 +/- 3.85 mg/L) were significantly higher than those for 60 controls (0.096 +/- 0.044 mg/L; p < 0.0001) and 47 glomerular disease patients (0.106 +/- 0.133 mg/L; p < 0.0001). CONCLUSION: Increased urinary CST3 concentrations allow the accurate detection of tubular dysfunction among pure and mixed nephropathies. Because of its ability to be processed on automated clinical chemistry analyzers, this assay could easily be used as an adjunct to the standard panel used to screen kidney pathologies, even in emergency situations.     

Bile Gastritis Following Laparoscopic Single Anastomosis Gastric Bypass: Pilot Study to Assess Significance of Bilirubin Level in Gastric Aspirate

Introduction

Laparoscopic single anastomosis gastric bypass (SAGB) is increasingly performed for morbidly obese patients.

Aim of Work

This pilot study aims primarily at evaluating the incidence of bile gastritis after SAGB. The occurrence of reflux oesophagitis and reflux symptoms were also assessed.

Patients and Methods

This study included 20 patients having no reflux symptoms. All patients underwent a SAGB as a primary bariatric procedure by a single surgeon. Patients included consented to have an upper GI endoscopy done at 6 months postoperatively. Gastric aspirate was sent for bilirubin level assessment. Gastric and esophageal biopsies were submitted for histopathology and campylobacter-like organism (CLO) test.

Results

In our study, the rate of bile gastritis was 30%. In 18 patients, the level of bilirubin in gastric aspirate seems to be related to the degree of mucosal inflammation. The remaining two patients had microscopic moderate to severe gastritis with normal aspirate bilirubin level. Two patients with bilirubin level in aspirate more than 20 mg/dl had severe oesophagitis, gastritis with erosions, and metaplasia. Relationship between bilirubin level and histopathological findings of gastric biopsy examination was statistically significant with a P value of 0.001.

Conclusion

The incidence of bile gastritis in this cohort is higher than reported in the literature, and this may be worrying. The correlation between endoscopic findings and patients’ symptoms is poor. Bilirubin level and pH in aspirate might be useful tools to confirm alkaline reflux. Its level might help to choose candidates for revision surgery after SAGB. This needs further validation with larger sample size.

     

Vitamin E and coronary heart disease in Tunisians

BACKGROUND: Vitamin E (VE) is thought to be effective in preventing atherosclerosis. However, to date no consistent relationship has been identified between VE and coronary heart disease (CHD). This study was designed to assess the degree of association between VE and CHD in a sample of the Tunisian population. METHODS: Sixty-two angiographically confirmed coronary atherosclerotic patients and 65 age- and sex-matched controls were included. VE was measured in plasma and in the LDL fraction by HPLC. Cholesterol, triglycerides, and phospholipids were measured by enzymatic methods. RESULTS: A trend toward a meaningful decrease of plasma VE was observed in affected patients compared with controls (P: = 0.06). VE concentrations standardized for cholesterol and lipid concentrations were significantly lower (P: <0.02) in coronary patients than in controls (4.35 +/- 1.03 vs 4.82 +/- 1.23 mmol/mol for cholesterol-adjusted VE and 2.35 +/- 0.56 vs 2.66 +/- 0.65 mmol/mol for lipid-adjusted VE, respectively). In the LDL fraction, only cholesterol-standardized VE was significantly lower in cases than controls (3.84 +/- 1.13 vs 4.41 +/- 1.16 mmol/mol). This association between VE and CHD remained unchanged independent of age, sex, smoking habit, hypertension, and diabetes. In CHD patients, lower lipid-adjusted VE was associated with enhanced LDL susceptibility to oxidation but without alteration of the serum fatty acid profile. CONCLUSIONS: These results support the hypothesis that VE plays a role in preventing atherosclerosis.     

Effects of the 11+ and Harmoknee Warm-up Programs on Physical Performance Measures in Professional Soccer Players

The purpose of this study was to examine the effects of the 11+ and HarmoKnee warm-up programs on performance measures in professional soccer players. Thirty-six male professional soccer players (age: 18.9 ± 1.4 years) were divided into 3 groups, the 11+, HarmoKnee and control group (n = 12 per group). The experimental groups performed the programs 3 times per week for 2 months (24 sessions), whereas the control group only performed their regular soccer training. The performance tests carried out were: 10m speed tests with and without a ball, 20m single sprint, vertical jump, Wall-Volley and Illinois agility tests. The 11+ group demonstrated significant increases from pre-to-post time points in the vertical jump (3.7%), Wall- Volley (5.4%) and Illinois agility tests (1.7%), while the HarmoKnee group showed a significant increase in Wall-Volley test, with a 5.2% increase. The repeated measures analysis revealed differences between the groups (large effect size) in the 11+ and HarmoKnee groups, compared to the control group, in 10m speed tests with and without a ball, 20m single sprint and Illinois agility tests (p < 0.05). Thus 8-weeks performing the 11+ warm-up program can enhance jump height, agility and soccer skill while the HarmoKnee program generally only improves soccer skill in young professional male soccer players.

Key Points

• The 11+ improves performance by means of Illinois agility, vertical jump and Wall-Volley tests whereas HarmoKnee improves Wall-Volley test. Incorporating 11+ as a part of the warm-up program by the young teams would be beneficial in agility, leg power and soccer skill respectively.
• Further modification of both programs may be required to fully realize the players'' speed performance potential.
• Data from this research can be helpful for soccer trainers in choosing programs to enhance performances in young male professional soccer players.

Key words: Performance, vertical jump, Illinois agility test, sprint, Wall-Volley test     

ABO blood group in Kuwaitis: detailed allele frequency distribution and identification of novel alleles

BACKGROUND: The ABO blood group is clinically the most important blood group system and can now be genotyped easily by DNA-based methods without family studies. STUDY DESIGN AND METHODS: Samples (n = 166) from a Kuwaiti population were phenotyped by standard serologic techniques for the ABO blood group and genotyped for the ABO locus by an established multiplex polymerase chain reaction protocol followed by single-strand conformation polymorphism (SSCP) analysis. Nonstandard SSCP patterns were investigated by DNA sequencing of exons 6 and 7 and, if necessary intron 6. RESULTS: Standard SSCP patterns identified six classical alleles in this population: A101 (0.1115), A102 (0.0181), A201 (0.0301), B101 (0.1627), O101 (0.3103), and O201 (0.2500). One A, 1 B, and 8 O variant alleles were identified (total frequency, 0.1175). All variant alleles were each present in one or two chromosomes (< or =0.0060) in our samples except O109 (0.0813). Three of these 10 variant alleles were novel alleles defined by newly identified single-nucleotide polymorphisms in exon 7 (527G>A, 687C>T, and 1116G>A). One new base substitution result in amino acid change. CONCLUSIONS: This is the first study reporting the detailed distribution of ABO alleles and genotypes in Kuwaitis. Sixteen alleles were identified, including 3 novel alleles.