Orthodontic anomalies and malocclusions in Late Antique and Early Mediaeval period in Croatia

ObjectiveMalocclusions are relative infrequently analysed in bioarchaeological investigations and if investigated the samples are very small. This research provides analysis of orthodontic anomalies of even 1118 individuals from the Late Antique (LA) and Early Mediaeval (EM) period. Aims were to describe the prevalence of orthodontic anomalies in this historical period and to analyse which orthodontic anomalies are best suitable for bioarchaeological investigations.Methods1118 skulls were examined for anomalies of tooth number, tooth displacement (rotation, malposition, diastema and crowding) as well as for malocclusions.ResultsThe prevalence of hypodontia in the LA was 41.02% and 30.61% in the EM sample. Tooth displacement was noticed in 15.63% individuals from the LA and in 12.42% individuals from EM. About 26% of the LA sample and 7.19% of the EM sample were affected with tooth crowding and the difference was statistically significant.ConclusionOrthodontic anomalies affecting only one tooth or group of teeth are more suitable for examination in bioarchaeological investigations than orthodontic features requiring presence of both jaws and all or almost all teeth. Clinical investigation protocols and methodology should be adopted for bioarchaeological researches and international standards and recommendations should be established for this kind of investigation on skeletal remains.     

Frequency of portal and systemic bacteremia in acute appendicitis

BACKGROUND: Acute appendicitis is the most common condition requiring an emergency abdominal operation in childhood. In the present study, we analyzed the frequency of portal and systemic bacteremia in 42 patients with acute appendicitis and determined the microbial agents responsible for an acute appendicitis and for portal and systemic bacteremia. METHODS: Appendectomies were performed on 50 young patients (5-18 years of age), as well as clinical and bacteriological tests. Six independent samples from each patient isolated from the peripheral vein, superior mesenteric vein, appendix and peritoneum were obtained prior to surgery, during surgery and after surgery for biochemical, immunologic and bacteriologic examination. RESULTS: Pathohistology confirmed the diagnosis of appendicitis in 42 patients, while in the other eight patients there were no obvious pathologic findings, so they served as a control group. Of 50 patients with a clinical appearance of acute appendicitis, in 19 patients (38%) we detected portal bacteremia in the mesenteric vein, while in only three cases (6%) did we find systemic bacteremia detected from the peripheral vein. Furthermore, bacteriologic analysis revealed that Bacteroides spp. and Escherichia coli were the predominant species isolated. CONCLUSIONS: The results presented in this paper suggests that portal bacteremia did not influence peripheral blood reactions. Furthermore, in the present study we have found a positive correlation between the smear and bacteremia of the superior mesenteric vein, but not with the bacteremia of systemic blood.     

Management of blunt pancreatic trauma in children

Purpose  Blunt abdominal trauma is the major cause of abdominal injury in children. Because of the retroperitoneal location, insidious signs and symptoms and the lack of sensitivity with common imaging modalities often lead to difficulties in making an accurate diagnosis. The most common complication is the formation of a pancreatic fistula, pancreatitis and a pancreatic pseudocyst, which usually manifests within 3 or 4 weeks after injury. Methods  The case records of seven children (4 male, 3 female) treated for blunt pancreatic injury in the department of pediatric surgery, University Hospital, Split were reviewed. Results  The treatment modalities were selected according to the grade of the pancreatic injury, hemodynamic status and associated injuries. Because all of the patients were classified as grade I or II according to the American Association for the Surgery of Trauma (AAST) classification, a conservative treatment was selected for all seven patients. In four patients the conservative treatment resulted in the total regression of the clinical, biochemical and radiological signs within four weeks (AAST grade I). In the other three patients, pancreatic pseudocysts arose within 3 or 4 weeks after the injury (AAST grade II). Conclusions  The status of the main pancreatic duct and the location of the pancreatic injury constitute the basis of the AAST scoring system. This scale should be used as a guide to selecting a surgical or conservative strategy. Based on these data, two factors appear to be the most important determinants of the treatment strategy for children with pancreatic injury: the grade of the pancreatic injury, which is determined according to the status of the main pancreatic duct and the clinical status of the patient.     

Work related diseases and injuries on an oil rig

The analysis of diseases and injuries in the workers on an American oil rig, operating in the Mediterranean Sea, was done in the period of one year, from 1 May 1996 to 1 May 1997. In total, 518 medical examinations of sick and injuried workers were conducted. At the first place in morbidity, there were injuries and poisonings (26.7% of all registered cases). Then followed musculo-skeletal (17.5%), respiratory (14.2%), gastrointestinal diseases (12.1%), mental disorders (10.3%), nervous system (9.2%), skin (6.5%), urogenital (2.9%) and circulatory system diseases (0.6%). Out of all cases, the hand and finger injuries (48.3%) were most frequent, followed by injuries of the leg (13.4%), eye (11.3%), head and neck (10.1%), arm (7.9%), foot (6.7%) and trunk (2.3%). To reduce the incidence of diseases and injuries, special attention should be paid to the workers' basic medical education, to protective measures and providing first aid at the work site.     

Whole muscle contractile parameters and thickness loss during 35-day bed rest

Extended exposure to microgravity leads to significant musculoskeletal adaptations. Contractile parameters of four skeletal muscles (biceps brachii-BB, vastus medialis-VM, biceps femoris-BF and gastrocnemius medialis-GM) were measured in ten healthy males (aged 22.3 +/- 2.2 years) during 35 days of horizontal bed rest by a mechanomyography-based method termed 'tensiomyography' (TMG). Two contractile parameters: contraction time (Tc) and maximal displacement (Dm) were individually measured from electrically evoked maximal single twitch TMG response of all four muscles before and after bed rest. Significant changes in Tc were found after bed rest, as shown by an increase in GM muscle Tc by 18% (p < 0.01). Dm values significantly increased (p < 0.01) after bed rest, by 24, 26 and 30% in the VM, BF and GM muscles, respectively. In the GM, the change in Dm significantly correlated with the decrease in muscle thickness (r = -0.70, p < 0.01). In conclusion, bed rest induced changes in both Dm and Tc of the TMG signal; changes in Dm being inversely related to those of muscle thickness. Amongst the investigated muscles, most affected, in terms of atrophy and mechanical alterations, were those of the lower limbs. The observed increase in Dm may be attributed to a decrease in muscle, as well as tendon stiffness, causing larger muscle fibre and non-contractile tissue oscillations following contraction.     

Modified Marcy repair for indirect inguinal hernia in children: a 24-year single-center experience of 6826 pediatric patients

Purpose

To evaluate the management and outcomes of modified Marcy repair for inguinal hernia in a large series of children.

Methods

We analyzed the case records of 6826 pediatric patients who underwent surgery for inguinal hernia between January, 1991 and January, 2015 at Split University Hospital in Croatia. The following parameters were examined: sex, age, location of the hernia, intraoperative or postoperative complications, recurrence, and surgical method.

Results

The 6826 patients included 4751 boys and 2075 girls operated on for inguinal hernia. The mean age was 3.5 years, and mean followup was 14 years. Right-side predominance was noted with 59.50 % right hernia repairs, 33.72 % left hernia repairs, and 6.78 % bilateral hernia repairs. There were 6410 (93.90 %) elective procedures and 416 (6.10 %) emergency procedures for incarceration. The mean duration of surgery was 26 min (14–90 min), and the mean hospital stay was 1 day. Marcy repair was the most commonly performed operation (95.76 %), whereas Ferguson’s technique was performed in only 3.98 % of the children. The overall recurrence rate was 0.43 %, with a recurrence rate of 0.36 % for Marcy repair and 1.83 % for Ferguson repair (p = 0.0003).

Conclusion

Modified Marcy hernia repair is a safe and effective procedure for inguinal hernia in children with excellent outcomes and a low incidence of recurrence.

     

Hyperhomocysteinemia and the role of B vitamins in cancer

BACKGROUND: Patients suffering from malignancies have increased complications due to corresponding cardiovascular diseases and risk factor for the development of venous thromboembolism. Epidemiological studies have shown that increased homocysteine plasma concentration (hyperhomocysteinemia) is related to a higher risk of coronary heart disease, stroke, peripheral vascular disease and malignancies. Homocysteine (tHcy) is an intermediate sulfur-containing amino acid produced from methionine during processing of dietary proteins. The plasma homocysteine levels are strongly influenced by diet, as well as by genetic factors. Folic acid, vitamins B6 and B12 are dietary components which influence the plasma homocysteine levels the most. Several studies have found that high blood levels of B vitamins are related to the integrity and function of DNA, and, are at least related to lower concentration of homocysteine. Folate depletion has been found to change DNA methylation and DNA synthesis in both animal and human studies. Because of this critical role of folate, most studies including homocysteine have focused on these two actions. CONCLUSIONS: Hyperhomocysteinemia proves to be the most common condition highly associated with both venous and arterial thrombosis in many cancer patients, while the associated pathophysiology has not been precisely established yet. Therefore, of current interest is the possible role of folate metabolism developing into a cancer initiating hyperhomocysteinemia. This review will discuss this possibility.     

Wi-Fi Technology and Human Health Impact: A Brief Review of Current Knowledge

An enormous increase in the application of wireless communication in recent decades has intensified research into consequent increase in human exposure to electromagnetic (EM) radiofrequency (RF) radiation fields and potential health effects, especially in school children and teenagers, and this paper gives a snap overview of current findings and recommendations of international expert bodies, with the emphasis on exposure from Wi-Fi technology indoor devices. Our analysis includes over 100 in vitro, animal, epidemiological, and exposure assessment studies (of which 37 in vivo and 30 covering Wi-Fi technologies). Only a small portion of published research papers refers to the “real” health impact of Wi-Fi technologies on children, because they are simply not available. Results from animal studies are rarely fully transferable to humans. As highly controlled laboratory exposure experiments do not reflect real physical interaction between RF radiation fields with biological tissue, dosimetry methods, protocols, and instrumentation need constant improvement. Several studies repeatedly confirmed thermal effect of RF field interaction with human tissue, but non-thermal effects remain dubious and unconfirmed.Key words: exposure to RF fields, e-school, radiofrequency, SAR     

Expression and prognostic value of the Ki-67 in Wilms’ tumor: experience with 48 cases

Purpose  

Ki-67, tumor proliferation marker, is an important prognostic factor in a variety of cancers. In the present study, we investigated the expression and the prognostic value of Ki-67 in nephroblastoma.     

Injuries from Antitank mines in Southern Croatia

OBJECTIVE: Antitank mines inflict devastating injuries that are usually fatal. The objective of this retrospective study was to analyze antitank mine casualties in South Croatia during the period from 1991 to 1995. METHODS: Mechanism, degree of injury according to Abbreviated Injury Scale and Injury Severity Score, as well as surgical treatment were analyzed. FINDINGS: Of 464 mine victims, 42 (9.0%) patients sustained antitank mine injuries, and 12 of these were fatal (29%). Abbreviated Injury Scale of the antitank mine injuries was 5.3 +/- 10.6. Military personnel were injured in 29 cases, and civilians were injured in 13 cases. CONCLUSION: Although injuries from antitank mines were ravaging, and frequently fatal, a significant number of patients survived.