Eruption of the central incisor,the intermaxillary suture,and maxillary growth in patients with a single median maxillary central incisor

The occurrence of a single median maxillary central incisor (SMMCI) is a very rare condition and might be a sign of a more severe midline defect, which could be a mild degree of holoprosencephaly. Absence of the internasal and partial absence of the intermaxillary suture has been observed in a fetus with holoprosencephaly. The purpose of this study was to evaluate the intermaxillary suture, the eruption pattern of the single central incisor in the SMMCI condition, and the growth of the maxilla in a group of patients with SMMCI. A similar study was not found in the scientific literature. The material included orthopantomographs, dental radiographs, and lateral cephalometric radiographs from 11 patients with an SMMCI. The orthopantomographs and dental radiographs showed that the intermaxillary suture was abnormal anterior to the incisive foramen; however, the SMMCI erupted within the expected time interval. Superimposition on stable structures on lateral cephalometric radiographs from two untreated patients, in which growth analysis was possible, showed that the horizontal and vertical growth of the maxilla was normal. Due to the sutural midline defect it is suggested that a transversal growth analysis is included in all treatment planning of SMMCI patients.     

Hypertriglyceridemia is associated with insulin levels in adult cystic fibrosis patients

BackgroundRecent studies have identified hypertriglyceridemic cystic fibrosis patients (CF-TG). However, whether hypertriglyceridemia is associated with an altered metabolic profile remains unknown.ObjectiveTo characterize CF-TG and determine whether triglycerides (TG) levels are associated with metabolic alterations.Methods210 adult CF subjects from the Montreal Cystic Fibrosis Cohort without known diabetes were included in the analysis. All subjects underwent an OGTT to assess glucose tolerance, insulin secretion (insulin AUC) and insulin sensitivity (Stumvoll index). Fasting lipid profiles, pulmonary function (%FEV₁) and BMI were determined. Hypertriglyceridemia (TG > 1.7 mmol/L) was observed in 20 CF patients. These subjects were matched for age, sex and glucose tolerance category with 20 CF patients (CF-normal-TG) and 20 healthy controls that had TG levels below 1.7 mmol/L. Pearson correlations were performed in the complete study sample (n = 210) to examine the associations between TG levels and other parameters.ResultsThe prevalence of hypertriglyceridemia was 9.5%. Compared to CF-normal-TG, CF-TG subjects displayed significantly higher %FEV_1, insulin AUC (AUC_0–120, AUC_0–30, AUC_30–120), cholesterol levels and a higher ratio of total cholesterol to HDL-cholesterol. Pearson analysis demonstrated that TG levels were associated with BMI, %FEV₁, fasting insulin, insulin AUC_0–120 and AUC_30–120, Stumvoll index, cholesterol levels and the ratio of total cholesterol to HDL-cholesterol. All these correlations remained significant after correction for BMI except %FEV₁.ConclusionTG levels are associated with a mild alteration of the metabolic profile. Whether these changes will increase the long-term risk of CF patients in developing cardiometabolic complications remains to be investigated.     

Missed isolated volar dislocation of the scaphoid

A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postoperatively the functional result was good. A radiograph showed no sign of avascular necrosis.     

Microbial contamination of embryo cultures in an ART laboratory: sources and management

BACKGROUND: Although rare, microbial contamination of culture dishes occasionally occurs in our IVF/ICSI programme. Despite stringent culture conditions and the use of medium containing penicillin and streptomycin, an increasing number of infections was observed once they were routinely recorded. In this study, 95 cases of contaminated culture dishes were examined, in an attempt to identify possible causes. METHODS: Relevant data of the IVF/ICSI treatment cycles and the micro-organisms isolated from the infected culture dishes were evaluated retrospectively. RESULTS: Infections were observed only in IVF culture dishes and never after applying intra-cytoplasmic sperm injection. Identification of the contaminating micro-organisms showed that infections were mainly caused by Escherichia coli (n = 56; 58.9%) and Candida species (n = 24; 25.3%). Of the E. coli strains isolated, 41 (73.2%) appeared to be resistant to both antibiotics used in the culture medium and 13 (23.2%) appeared to resist either penicillin or streptomycin. Of all bacterial strains isolated, the resistances were 61.4% to both and 30% to one of the antibiotics used. CONCLUSIONS: Applying the ICSI procedure prevents colonization of the culture dishes by micro-organisms. Infections in IVF culture dishes are mainly caused by bacterial strains insensitive to the antibiotics used or due to yeast colonization by Candida species which frequently reside in the vagina.