Large aneurysmal bone cyst of iliac bone in a female child: a case report

<p>Abstract</p> <p>Background</p> <p>Symptomatic aneurysmal bone cysts in pediatric age group with an expansile lesion in ilium is a rare occurrence.</p> <p>Case</p> <p>An 11-year-old female presented with a swelling over her right iliac region and numbness along the medial aspect of thigh. Clinicoradiological diagnosis was aneurysmal bone cyst confirmed on fine needle aspiration cytology. Excision curettage (wide margin excision of the soft tissue tumor and intralesional curettage in the region of acetabulum) of the tumor was performed in view of proximity to acetabular roof and endangered hip stability.</p> <p>Result</p> <p>At follow up of 18 months, the child has full painless range of movements in the hip joint with no recurrence.</p> <p>Conclusions</p> <p>Pelvic aneurysmal bone cysts are distinctly rare in pediatric age. The lesion was associated with an atypical symptom of numbness along the femoral nerve distribution. Hip stability and range of movements were major concern in this patient. Although many treatment options are described, surgical excision still remains the mainstay. In our case, we performed excision curettage, with good outcome.</p

Comparison of the posture of school children carrying backpacks versus pulling them on trolleys

Objective: To investigate whether there is a difference in the posture of schoolchildren walking with a backpack versus pulling a trolley. Design: Comparative, controlled, pilot trial. Setting: “Grundschule Fallersleben” – primary school in Germany. Subjects: Thirty-four school children between 6 and 8 years of age. Methods: Initially, neutral posture was measured in a standing position. All children were then asked to walk a predetermined route without intervention for approximately seven minutes. This was followed by walking the same route with either a backpack (n = 19) or trolley (n = 15). Deviations from neutral of the thoracic and lumbar spine (flexion, extension, lateral flexion and rotation) from the final 30 seconds of the imaging sequences were taken and analysed. Results: Compared to unburdened walking, walking with a backpack led to a statistically significant (p ≤ 0.05) increase in thoracic extension (3.91°, 95% CI = 3.35 to 4.46) and right lumbar lateral flexion (2.29°, 95% CI = -3.41 to -1.18), and a statistically significant decrease of lumbar flexion (2.2°, 95% CI = 0.34 to 4.06). In contrast, walking with a trolley increased extension (1.4°, 95% CI = 0.72 to 2.08), right lateral flexion (1.24°, 95% CI = -1.91 to -0.57) and right rotation (3.09°, 95% CI = -3.85 to -2.32) of the thoracic spine, and a statistically significant increase in left rotation (3.57°, 95% CI = 2.58 to 4.55) of the lumbar spine. Comparing the backpack and trolley groups showed to a statistically significant (p ≤ 0.05) increase in thoracic extension and right lumbar lateral flexion in the backpack group. Posture during trolley pulling was characterized by a statistically significant (p ≤ 0.05) increase in right thoracic and left lumbar rotation. Conclusion: Participants adopted asymmetric postures during walking with a backpack and pulling a trolley. However, the trolley group was characterised by spinal rotation which possibly adds an extra source of stress. This suggests that school children should use backpacks rather than trolleys when the weight is within recommended limits

A randomised controlled trial of laser scanning and casting for the construction of ankle foot orthoses

Study Design: Randomised controlled trial with blinding of orthotists and patients to the construction technique used. Background: Three-dimensional laser scanning has been used for patient measurement for cranial helmets and spinal braces. Ankle foot orthoses are commonly prescribed for children with orthopaedic conditions. This trial sought to compare ankle foot orthoses produced by laser scanning or traditional plaster casting. Objectives: Assessment of the effectiveness and efficiency of using laser scanning to produce AFOs. Methods: A randomised double blind trial comparing fabrication of AFOs from casts or laser scans. Results: The time spent in the rectification and moulding of scanned AFOs was around 50% less than for cast AFOs. A non-significant increase of 9 days was seen in the time to delivery to the patient for LSCAD/CAM. There was a higher incidence of problems with the scan-based AFOs at delivery of the device, but no difference in how long the AFOs lasted. Costs associated with laser scanning were not significantly different from traditional methods of AFO manufacture. Conclusions: Compared with conventional casting techniques laser scan based AFO manufacture neither significantly improved the quality of the final product nor delivered a useful saving in time

The role of grazers in early-life stages of Cystoseira sensu lato can be crucial in the restoration of marine forests

Grazing is one of the most important biological factors controlling the abundance of early-life stages of fucoids and one of the major issues when restoring marine forests. Benthic macroinvertebrates (e.g., sea urchins) and fish shape and regulate benthic macroalgal communities from polar to tropical regions and can be responsible for regime shifts leading to the predominance of turfs and/or barren grounds. However, other herbivores (i.e., mesograzers) could also significantly participate in the grazing, especially on early-life stages, hampering the persistence and capacity of Cystoseira sensu lato populations to recover after major disturbances and being a cause of failure of restoration actions. We performed experiments in the field and in mesocosm in order to investigate the herbivory pressure and the effects of different grazers on recruits of Cystoseira compressa. The results highlight that non-strict herbivorous invertebrates, such as Clibanarius erythropus, Cerithium vulgatum, and Idotea balthica, graze on recruits of Cystoseira s.l. spp., with I. balthica showing the highest consumption rate. We concluded that biotic factors such as herbivory, which affect key life stages, can be crucial for the conservation of Cystoseira s.l. forests and need to be better understood and considered on a case-by-case basis when planning restoration actions

HIV-1-infected patients from the French National Observatory experiencing virological failure while receiving enfuvirtide

Objectives We studied gp41 mutations associated with failing enfuvirtide salvage therapy. Methods This multicentre study involved patients with HIV-1 plasma viral load (pVL) > 5000 copies/mL after at least 3 months of uninterrupted enfuvirtide therapy and with plasma samples available at inclusion (T0), at initial enfuvirtide failure (T1) and at last follow-up visit during continued failing enfuvirtide therapy (T2). The HR-1 and HR-2 domains of the gp41 gene were sequenced at T0, T1 and T2. Results Ninety-nine patients were enrolled. At baseline, the median pVL and CD4 cell count were 5.1 log copies/mL and 72 cells/mm3, respectively. Based on the ANRS Resistance Group algorithm, the proportion of patients harbouring viruses with enfuvirtide resistance mutations increased significantly between T0 and T1. In the HR-1 domain, the V38A/M, Q40H, N42T, N43D and L45M mutations wereselected (P < 0.02). In the HR-2 domain, no mutations were significantly selected during the follow-up. None of the mutations was associated with a CD4 cell count increment. Conclusions Mutations selected during failing enfuvirtide salvage therapy are mainly located in the HR-1 domain of the gp41 gene, between codons 38 and 45. No mutations were associated with an increase in the CD4 cell coun

Vital capacity evolution in patients treated with the CMCR brace: statistical analysis of 90 scoliotic patients treated with the CMCR brace

<p>Summary</p> <p>Objective</p> <p>To study the evolution of pulmonary capacity during orthopaedic treatment of scoliosis with the CMCR brace.</p> <p>Background</p> <p>Investigating the impact of moderate scoliosis on respiratory capacity and its evolution during CMCR brace treatment with mobile pads.</p> <p>Context</p> <p>Several studies demonstrate the impact of scoliosis on respiratory capacity but few of them focus on the impact of bracing treatment. We studied the evolution of the pulmonary capacity of a cohort of 90 scoliotic patients.</p> <p>Methods</p> <p>This retrospective study included 90 scoliotic patients treated since 1999 with a brace with mobile pads called CMCR (n = 90; mean age: 13 years; 10-16). These patients were diagnosed with an idiopathic scoliosis (mean angulation 20.6°). All patients underwent a radiographic and respiratory evaluation at the beginning, the middle and the end of treatment.</p> <p>Results</p> <p><it>Mean age at treatment start was </it>13. Before treatment, our patients did not have a normal pulmonary capacity: Forced Vital Capacity (FVC) was only 75% of the theoretical value. All curvature types (thoracic, thoraco-lumbar and combined scoliosis) involved this reduced pulmonary capacity, with moderate-angulated scoliosis having a negative impact. At the beginning of brace treatment, the loss of real vital capacity with brace (0.3 litres) was 10% lower than without brace.</p> <p>At CMCR removal, the FVC had increased by 0.4 litre (21% +/- 4.2% compared to the initial value). The theoretical value had increased by 3%. This positive evolution was most important in girls at a low Risser stage (0,1,2), and before 11 years of age.</p> <p>Conclusion</p> <p>These results supported our approach of orthesis conception for adolescent idiopathic scoliosis which uses braces with mobile pads to preserve thorax and spine mobility.</p