Partial rupture of the quadriceps muscle in a child

<p>Abstract</p> <p>Background</p> <p>The quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture.</p> <p>Case Presentation</p> <p>A 4-year-old girl admitted to our clinic with left knee pain and limitation in knee movements. Her father reported that she felt pain while jumping on sofa. There was no direct trauma to thigh or knee. We located a palpable soft tissue swelling at distal anterolateral side of thigh. The history revealed that 10 days ago the patient was treated for upper tract respiratory infection with intramuscular Clindamycin for 7 days. When we consulted the patient with her previous doctor and nurse, we learnt that multiple daily injections might be injected to same side of left thigh. MRI showed a partial tear of vastus lateralis muscle matching with the injection sites. The patient treated with long leg half-casting for three weeks. Clinical examination and knee flexion had good results with conservative treatment.</p> <p>Conclusions</p> <p>Multiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.</p

Microstructure, mechanical properties and cracking behaviour in a gamma'-precipitation strengthened nickel-base superalloy fabricated by electron beam melting

The influences of EBM processing and post-processing on microstructure, mechanical properties and cracking behaviour in a γ′ precipitation-strengthened nickel-base superalloy DZ125 are critically assessed. Results show that a solution treating and ageing (STA) is required to obtain γ′ precipitates with a cuboidal shape. The columnar grain width was found to gradually increase from the bottom to the top of the as-EBM sample having a total build height of 80 mm, whereas there was little gradient in γ′ size. The presence of EBM induced intergranular cracks can be closed by hot isostatic pressing (HIP), however reappearance of intergranular cracks with a much wider crack opening width was observed after STA treatment. EBM induced cracks are classified as liquid-state cracking, as the classic dendritic morphology were found on the cracked surfaces. The post-processing induced cracks can be attributed to the effect of γ′ dissolution and re-precipitation of fine γ′ during the cooling stage of solution treatment. The results suggest that HIP is not an effective approach in healing liquid-state cracks in EBM fabricated γ′ precipitation-strengthened superalloys

VACTERL Association: A New Case with Biotinidase Deficiency and Annular Pancreas

VACTERL (V - Vertebral anomalies, A - Anal atresia, C - Cardiovascular anomalies, T - Tracheoesophageal fistula, E - Esophageal atresia, R - Renal (Kidney) and/or radial anomalies, L - Limb defects) association includes vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal dysplasia, and limb anomalies. Less frequent defects seen with VACTERL association are prenatal and postnatal growth deficiency, laryngeal stenosis, ear anomaly, large fontanels, defect of lower limb, rib anomaly, tethered cord, and defects of external genitalia. We report a case of VACTERL association who had concomitant biotinidase deficiency and annular pancreas, which has not been previously reported

Juvenile Alexander Disease: a Case Report

Alexander disease is a rare autosomal recessive disorder that is characterized by degeneration of the white matter in the central nervous system. Alexander disease is a leukodystrophy that is usually observed in early childhood but rarely in adults. It is characterized by megalencephaly, demyelinization and multiple Rosenthal fibers. Specific magnetic resonance imaging (MRI) findings and genetic investigations are necessary to diagnose the disorder. Signs of leukodystrophy were found in the bilateral white matter on a brain MRI of our four-year-old patient. He had megalencephaly since birth. We use this case to discuss Alexander disease

Effects of the COVID‐19 lockdown on sleep duration in children and adolescents: A survey across different continents

Background A parent survey was conducted to assess the sleep habits of children residing in various countries before and during the SARS‐CoV‐2 pandemic. It was hypothesized that lockdown would be associated with increased sleep duration. Methods Outcomes were changes in bedtime, wake time, and sleep duration in the pandemic compared to before. Logistic regression was applied to evaluate the effects of age and covariates on outcomes. Results A total of 845 questionnaires completed from May 1 to June 10, 2020 were analyzed (45.8% female; age 3–17 years). During the pandemic, 23.1% of preschoolers, 46.2% of school‐age children, and 89.8% of adolescents were going to bed after 10 p.m. on weekdays compared to 7.1%, 9.4%, and 57.1% respectively before the pandemic, with these proportions being higher on weekends. Likewise, 42.5% of preschoolers, 61.3% of school‐age children, and 81.2% of adolescents were waking after 8 a.m. on weekdays (11.6%, 4.9%, and 10.3%, before) with these proportions being greater on weekends. Sleep duration did not change in 43% of participants on weekdays and in 46.2% on weekends. The 14–17 years group had fourfold increased odds for longer sleep duration on weekdays (p &lt; .01), and children aged 6–13 years had twofold increased odds for longer sleep duration on weekends relative to the 3–5 years age group (p = .01). Conclusions Although lockdown was associated with later bedtime and wake time, this shift did not alter sleep duration in more than 40% of children. Yet, compared to preschoolers, high school‐aged children were more likely to sleep more on weekdays and primary school children on weekends

Effects of the COVID‐19 lockdown on sleep duration in children and adolescents: A survey across different continents

Background A parent survey was conducted to assess the sleep habits of children residing in various countries before and during the SARS‐CoV‐2 pandemic. It was hypothesized that lockdown would be associated with increased sleep duration. Methods Outcomes were changes in bedtime, wake time, and sleep duration in the pandemic compared to before. Logistic regression was applied to evaluate the effects of age and covariates on outcomes. Results A total of 845 questionnaires completed from May 1 to June 10, 2020 were analyzed (45.8% female; age 3–17 years). During the pandemic, 23.1% of preschoolers, 46.2% of school‐age children, and 89.8% of adolescents were going to bed after 10 p.m. on weekdays compared to 7.1%, 9.4%, and 57.1% respectively before the pandemic, with these proportions being higher on weekends. Likewise, 42.5% of preschoolers, 61.3% of school‐age children, and 81.2% of adolescents were waking after 8 a.m. on weekdays (11.6%, 4.9%, and 10.3%, before) with these proportions being greater on weekends. Sleep duration did not change in 43% of participants on weekdays and in 46.2% on weekends. The 14–17 years group had fourfold increased odds for longer sleep duration on weekdays (p &lt; .01), and children aged 6–13 years had twofold increased odds for longer sleep duration on weekends relative to the 3–5 years age group (p = .01). Conclusions Although lockdown was associated with later bedtime and wake time, this shift did not alter sleep duration in more than 40% of children. Yet, compared to preschoolers, high school‐aged children were more likely to sleep more on weekdays and primary school children on weekends