Snake bite induced cellulitis leading to infected open dislocation of the first metacarpophalangeal joint – A rare complication

Non-traumatic open dislocation of the first metacarpophalangeal joint is a rare phenomenon. We present a rare such occurrence secondary to snake bite induced cellulitis. A 22-year-old girl presented with pain and instability of her right thumb two months. She had snake bite two months back following which she developed cellulitis which gradually became infected. She presented with raw area over her dorsal aspect of the thumb with active infection. Radiographs revealed metacarpophalangeal joint dislocation. She underwent debridement, stabilisation and soft tissue coverage. At final follow up, she was pain free and the wound healed completely.     

Balance and Strength—Estimating the Maximum Prey‐Lifting Potential of the Large Predatory Dinosaur Carcharodontosaurus saharicus

Motivated by the work of palaeo‐art “Double Death (2011),” a biomechanical analysis using three‐dimensional digital models was conducted to assess the potential of a pair of the large, Late Cretaceous theropod dinosaur Carcharodontosaurus saharicus to successfully lift a medium‐sized sauropod and not lose balance. Limaysaurus tessonei from the Late Cretaceous of South America was chosen as the sauropod as it is more completely known, but closely related to the rebbachisaurid sauropods found in the same deposits with C. saharicus. The body models incorporate the details of the low‐density regions associated with lungs, systems of air sacs, and pneumatized axial skeletal regions. These details, along with the surface meshes of the models, were used to estimate the body masses and centers of mass of the two animals. It was found that a 6 t C. saharicus could successfully lift a mass of 2.5 t and not lose balance as the combined center of mass of the body and the load in the jaws would still be over the feet. However, the neck muscles were found to only be capable of producing enough force to hold up the head with an added mass of 424 kg held at the midpoint of the maxillary tooth row. The jaw adductor muscles were more powerful, and could have held a load of 512 kg. The more limiting neck constraint leads to the conclusion that two, adult C. saharicus could successfully lift a L. tessonei with a maximum body mass of 850 kg and a body length of 8.3 m. Anat Rec, 298:1367–1375, 2015. © 2015 Wiley Periodicals, Inc.     

前牙、双尖牙唇（颊）侧面开髓位置的临床研究

目的：了解前牙、双尖牙唇（颊）侧面开髓位置的临床应用的效果.方法：对264例前牙、双尖牙因楔形缺损或唇（颊）龋病并发牙髓炎、尖周炎的患者分为两组,试验组采用唇（颊）侧面位置进行开髓;对照组用传统方式（即舌或牙合面）开髓方法.结果：试验组,抗剪切力大,牙体不易劈折,成功率97.05％,对照组成功率30.40％ （P＜0.05）.结论：前牙、双尖牙唇（颊）侧面开髓位置只是一种针对前牙、双尖牙唇、颊面牙颈部深龋或楔形缺损引起牙髓及根尖感染、需要根管治疗的改进一种新开髓位置的方法,但不适应上颌第一双尖牙.     

Molar bite force and its correlation with signs of temporomandibular dysfunction in mixed and permanent dentition

The aim of the study was to evaluate molar bite force (BF) magnitude and its correlation to the signs of temporomandibular dysfunction (TMD), gender, weight, height and age in 101 students ranging in age from 6 to 18 years (32 boys/21 girls with mixed dentition and 23 boys/25 girls with permanent dentition). TMD clinical signs were evaluated using the Craniomandibular Index (CMI), and two subscales, the Dysfunction Index (DI) and the Palpation Index (PI). BF was determined with a pressurized tube connected to a sensor (MPX5700-Motorola SPS). anova, Tukey's test, and Pearson's and Spearman's coefficients were evaluated. BF was higher in the permanent dentition (P < 0.05). There was no difference in BF between genders within the groups, but boys with permanent dentition had higher values than children with mixed dentition (P < 0.05). The girls with permanent dentition presented negative correlation in BF with PI and CMI (P < 0.05). BF was positively correlated with weight, height and age in the permanent dentition group (P < 0.05). It was concluded that BF increased from mixed to permanent dentition, with an assumed enhancing influence of body variables and ageing. The TMD signs in older girls were correlated to decreasing BF, suggesting an influence of muscle tenderness preventing subjects from exerting maximum BF.     

State-related electroencephalographic deviances in attention deficit hyperactivity disorder

This study investigated the stability and state-related characteristics of electroencephalographic (EEG) deviances in attention-deficit/hyperactivity disorder (ADHD). Three minutes resting EEG with eyes closed and eyes open were compared between 21 children with ADHD and 29 typically developing children. Across resting conditions, children with ADHD exhibited divergent topographic distribution for theta, alpha and beta power compared to typically developing children. In addition, less alpha and theta suppression to eye opening was found in children with ADHD, but only in those without comorbid ODD/CD. Findings of the present study refer to a consistent divergence in topographic distribution in ADHD across resting state conditions, yet demonstrate that state-related factors and comorbidity may also contribute to resting EEG deviances in ADHD. The state-related findings are in accord with several theoretical accounts emphasizing the role of contextual and state factors defining deficits in ADHD.     

Current treatment of Crimean–Congo hemorrhagic fever in children

Crimean–Congo hemorrhagic fever (CCHF) is a fatal viral hemorrhagic fever and is usually transmitted to humans by tick bite, or exposure to infected blood or tissues of infected livestock or humans. Although children can be infected with the CCHF virus, infection is unusual in the younger age group. Early diagnosis and treatment of CCHF infection is critical to the survival of patients and the control of the disease. In this article, we underline current therapeutic approaches to CCHF infection in children.     

咀嚼肌肌腱-腱膜增生症的研究进展

咀嚼肌肌腱-腱膜增生症(MMTAH)是一种咀嚼肌肌腱及腱膜慢性进行性增生所导致的疾病,可有张口受限、方面型等表现,通常从青春期开始,进展缓慢,患者少有不适主诉,一般难以发现.自2000年被日本学者报道以来,其他国家也陆续有研究者针对该疾病发表报告及研究.临床上一般采用手术的方法进行治疗,疗效较好.本文将从其命名、诊断、...     

机械通气及大黄在抢救毒蛇咬伤致呼吸衰竭的应用

目的探讨毒蛇咬伤致急性呼吸衰竭治疗措施。方法选择毒蛇咬伤致呼吸衰竭患者46例,治疗方法：①机械通气治疗：患者出现呼吸困难或者呼吸浅慢时,及时气管插管行机械通气。上机模式为辅助／控制通气或同步间歇指令通气,注意观察患者胸廓起伏情况及肺部体征,动态监测脉搏血氧饱和度、X线胸片及血气分析,并视病情变化调整通气参数,使其逐渐达到脱机标准;②生大黄20g＋清水250ml水煎15min,管饲,qd,连用3～5d;③常规治疗：伤口切开排毒及药物局部封闭,及早足量应用抗蛇毒血清等。结果患者住院时间6～20天,平均（13．4±5．2）d。通气时间〈48h者28例（60．9％）,48～72h者12例（26．1％）,〉72h者6例（13．0％）。治愈44例（95．7％）,死亡2例（4．3％）。死亡者均是就诊时合并多器官功能障碍者。结论机械通气联合大黄、抗蛇毒血清等集柬治疗是抢救毒蛇咬伤致呼吸衰竭有效的方法。