Bilateral lower motor neuron facial nerve palsy due to HIV seroconversion

A 34-year-old-woman presented with acute onset of headache and bilateral facial nerve paralysis. On examination bilateral lower motor neuron 7th cranial nerve palsy in keeping with bilateral Bell’s palsy was apparent. Investigations showed aseptic meningitis, with a low CD4 count of 352 cells/μl and an elevated viral load (5 300 counts/ml, log = 3.72), in keeping with acute HIV infection. Bell’s palsy is a known complication of seroconversion – 13 cases have been reported worldwide. To our knowledge this is the first reported case in South Africa

Ultrasound study of the asymptomatic shoulder in patients with a confirmed rotator cuff tear in the opposite shoulder

Objective. To document the incidence of asymptomatic rotator cuff tears in patients with a confirmed symptomatic tear in the opposite shoulder, and to identify ultrasound findings that may distinguish symptomatic from asymptomatic tears. Design. When patients are referred for an ultrasound examination for the confirmation of symptomatic rotator cuff tear the opposite shoulder is often used for comparison. However, patients often have a similar tear on the asymptomatic side. Fifty patients with a confirmed symptomatic rotator cuff tear and an asymptomatic shoulder on the opposite side were chosen for inclusion. The patients were examined using a Siemens Sonoline Elegra 7.5 MHz linear multi-frequency probe. The appearance of the rotator cuff, long head of the biceps and the subacromial-subdeltoid bursa (SASD bursa) were documented. The antero-posterior (AP) dimension of the supraspinatus muscle and fat between the trapezius and supraspinatus muscles were measured, which indicated if a tear was acute or chronic. The width and length of the rotator cuff tear were measured. Setting. Division of Sports Medicine, University of Pretoria. Results. Fifty-four per cent of the asymptomatic shoulders had tears. We found that the symptomatic tears were larger, appeared more chronic and had an associated biceps tendinopathy and glenohumeral joint effusion. Conclusion. As other authors have found, the high incidence of asymptomatic tears indicates that rotator cuff tears can be regarded as a natural correlate of aging and that bilateral tears are common. Initial treatment should be conservative, but larger tears may benefit from early surgery before becoming chronic and causing glenohumeral dysfunction. South African Journal of Sports Medicine Vol. 19 (1) 2007: pp. 23-2

Ultrasound study of the asymptomatic shoulder in patients with a confirmed rotator cuff tear in the opposite shoulder

Objective. To document the incidence of asymptomatic rotator cuff tears in patients with a confirmed symptomatic tear in the opposite shoulder, and to identify ultrasound findings that may distinguish symptomatic from asymptomatic tears. Design. When patients are referred for an ultrasound examination for the confirmation of symptomatic rotator cuff tear the opposite shoulder is often used for comparison. However, patients often have a similar tear on the asymptomatic side. Fifty patients with a confirmed symptomatic rotator cuff tear and an asymptomatic shoulder on the opposite side were chosen for inclusion. The patients were examined using a Siemens Sonoline Elegra 7.5 MHz linear multi-frequency probe. The appearance of the rotator cuff, long head of the biceps and the subacromial-subdeltoid bursa (SASD bursa) were documented. The antero-posterior (AP) dimension of the supraspinatus muscle and fat between the trapezius and supraspinatus muscles were measured, which indicated if a tear was acute or chronic. The width and length of the rotator cuff tear were measured. Setting. Division of Sports Medicine, University of Pretoria. Results. Fifty-four per cent of the asymptomatic shoulders had tears. We found that the symptomatic tears were larger, appeared more chronic and had an associated biceps tendinopathy and glenohumeral joint effusion. Conclusion. As other authors have found, the high incidence of asymptomatic tears indicates that rotator cuff tears can be regarded as a natural correlate of aging and that bilateral tears are common. Initial treatment should be conservative, but larger tears may benefit from early surgery before becoming chronic and causing glenohumeral dysfunction. South African Journal of Sports Medicine Vol. 19 (1) 2007: pp. 23-2

Conservation status and threats for African reptiles

The assimilation of information on taxonomy, distribution, basic ecology and conservation status of Africa's reptiles lags far behind that for most other continents. Many regions of mainland Africa are rarely surveyed, resulting in severe knowledge gaps that currently limit effective conservation of African reptiles. Here, we provide a précis on the knowledge gaps and conservation status of mainland African reptiles, and quantify the main threats based on IUCN Red List of Threatened Species assessments using publicly available distribution data. Our results show that these data are insufficient to confidently identify areas of high biodiversity, with large gaps in knowledge in the Horn of Africa, central Africa and West Africa. There is a strong overall taxonomic bias in extinction risk with 45% of families more threatened than expected by chance. Furthermore, Amphisbaenidae, Chameleonidae, Gerrhosauridae, Testudinidae, Viperidae all have a high percentage of their constituent species at risk. Overall, land transformation for agriculture, particularly subsistence farming, constitutes the primary threat to African reptiles, and our derived Threat Index based on socio-economic traits of African countries show that risk is high in Burundi, Ethiopia, Liberia, Malawi, Rwanda and Sierra Leone. These findings highlight important challenges facing the conservation of African reptiles, and we suggest that conservation priorities in mainland Africa be focussed on areas where the potential for overall loss of biodiversity is high, particularly in regions where knowledge is inadequate

Determinants in early life for asthma development

A reliable screening test in newborns for the subsequent development of bronchial asthma (BA) has not been found yet. This is mainly due to the complexity of BA, being made up by different types and underlying mechanisms. In different studies, a number of risk factors for BA have been identified. These include a positive family history of BA, passive smoking (also during pregnancy), prematurity (including pulmonary infections, RDS and BPD), early viral respiratory infections (such as RSV-bronchiolitis), male gender, early lung function abnormalities and atopic constitution. The major risk factor for persistent BA is an underlying allergic constitution. Therefore, early symptoms and markers of allergy (i.e. The Allergic March) and a positive family history for allergy should be considered as important risk factors for the development of BA

Locally applied Simvastatin improves fracture healing in mice

<p>Abstract</p> <p>Background</p> <p>HMG-CoA reductase inhibitors, statins, are widely prescribed to lower cholesterol. High doses of orally administered simvastatin has previously been shown to improve fracture healing in a mouse femur fracture model. In this study, simvastatin was administered either subcutaneously or directly to the fracture area, with the goal of stimulating fracture repair at acceptable doses.</p> <p>Methods</p> <p>Femur fractures were produced in 70 mature male Balb-C mice and stabilized with marrow-nailing. Three experiments were performed. Firstly, 20 mice received subcutaneous injections of either simvastatin (20 mg) or vehicle. Secondly, 30 mice were divided into three groups of 10 mice receiving continuous subcutaneous delivery of the vehicle substance, the vehicle with 5 mg or with 10 mg of simvastatin per kg bodyweight per day. Finally, in 20 mice, a silicone tube was led from an osmotic mini-pump to the fracture area. In this way, 10 mice received an approximate local dose of simvastatin of 0.1 mg per kg per day for the duration of the experiment and 10 mice received the vehicle compound. All treatments lasted until the end of the experiment. Bilateral femurs were harvested 14 days post-operative. Biomechanical tests were performed by way of three-point bending. Data was analysed with ANOVA, Scheffé's post-hoc test and Student's unpaired t-test.</p> <p>Results</p> <p>With daily simvastatin injections, no effects could be demonstrated for any of the parameters examined. Continuous systemic delivery resulted in a 160% larger force at failure. Continuous local delivery of simvastatin resulted in a 170% larger force at failure as well as a twofold larger energy uptake.</p> <p>Conclusion</p> <p>This study found a dramatic positive effect on biomechanical parameters of fracture healing by simvastatin treatment directly applied to the fracture area.</p

Salivating for Knowledge: Potential Pharmacological Agents in Tick Saliva

Joppe Hovius and colleagues review anticoagulant and immunosuppressive proteins present in tick saliva, and discuss how immunologically targeting such molecules could prevent transmission of tick-borne pathogens