Health-Related Quality of Life after Fractures of the Distal Forearm in Children and Adolescents-Results from a Center in Switzerland in 432 Patients.

(1) Background: We aimed to evaluate the health-related quality of life (HRQoL) in children with fractures of the distal forearm and to assess if HRQoL was associated with fracture classification; (2) Methods: We followed up on 432 patients (185 girls, 247 boys) who sustained a fracture of the distal radius or forearm from 1/2007 to 6/2007, 1/2014 to 6/2014, and 11/2016 to 10/2017. Patients filled in the Quick-DASH (primary outcome) and the Peds-QL; (3) Results: The radius was fractured in 429 and the ulna in 175 cases. The most frequent injury of the radius was a buckle fracture (51%, mean age 8.5 years), followed by a complete metaphyseal fracture (22%, 9.5 years), Salter-Harris-2 fracture (14%, 11.4 years), greenstick fracture (10%, 9.3 years), Salter-Harris-1 fracture (1%, 12.6 years), and other rare injuries. The most common treatment was closed reduction and an above-elbow cast in 138 cases (32%), followed by a cast without reduction (30%), splint (28%), and K-wire fixation and cast (9%). Definite treatment was performed initially in 95.8%, a new cast or cast wedging was performed in 1.6%, and revision surgery was performed in 2.5%. There were no open reductions and no plate fixations. After a mean follow-up of 4.2 years, patients with buckle fractures had a mean Quick-DASH of 3.3 (scale of 0-100) (complete fracture: 1.5; greenstick: 1.5; SH-1: 0.9; SH-2: 4.1; others: 0.9). The mean function score of the PedsQL ranged from 93.0 for SH-2 fractures to 97.9 for complete fractures; (4) Conclusions: In this cohort of 432 children with fractures of the distal forearm, there was equally good mean mid- and long-term HRQoL when assessed by the Quick-DASH and the PedsQL. There was a trend for children with complete metaphyseal fractures reporting better HRQoL than patients with buckle fractures or patients with Salter-Harris II fractures, however, these differences were not statistically significant nor clinically relevant

Health-Related Quality of Life after Adolescent Fractures of the Femoral Shaft Stabilized by a Lateral Entry Femoral Nail.

(1) Background: In adolescents, fractures of the femoral shaft that are not suitable for elastic-stable-intramedullary-nailing (ESIN), are challenging. We aimed to evaluate the health-related quality of life (HRQoL) and complications in adolescents treated with intramedullary rodding using the adolescent lateral trochanteric entry femoral nail (ALFN), and to assess if HRQoL was associated with additional injuries. (2) Methods: We followed-up on 15 adolescents with a diaphyseal femoral fracture who were treated with an ALFN from 2004 to 2017. Patients were asked to fill in a questionnaire that includes the iHOT, Peds-QL, and the Pedi-IKDC. (3) Results: The ALFN was used as a primary method of fixation in 13 patients, and as a fixation for failed ESIN in two cases. All 15 fractures healed radiographically. One distal locking screw broke. After a mean follow-up of 2.8 years, the mean iHOT-12 was 14.0 (SD 15.4), PedsQL-function was 85.7 (SD 19.3), PedsQL-social-score was 86.2 (SD 12.5), and the mean Pedi-IKDC was 77.2 (SD 11.3). In patients where the femoral fracture was an isolated injury, the HRQoL-scores were consistently higher compared with patients who sustained additional injures. (4) Conclusions: Treating diaphyseal fractures in adolescents with an ALFN resulted in good radiographic outcomes in all our cases. HRQoL, as measured by the iHOT, PedsQL, and Pedi-IKDC, was good to excellent; but it was consistently inferior in patients with additional injuries. These results suggest that the ALFN is a good alternative when patients are not suitable for ESIN, and that the HRQoL of adolescents who were treated with an ALFN is mainly influenced by the presence of additional injures, and less by the fracture of the femur itself

True congenital cysts of the pancreas in the newborn and infant.

Objectives: True congenital pancreatic cysts (CPC) are extremely rare, only 27 cysts were reported so far in children under 3 years of age. With several new cases reported here, conclusions for diagnostic work up and treatment can be drawn. Material and Methods: 4 cases with CPC are analyzed retrospectively and reviewed together with all previously published cases. Results: Girls were affected by CPC about twice as frequent as boys, cysts were localized more often in the tail than in the head or body of the pancreas. Unilocular cysts are seen more frequent than multilocular cysts. Diagnosis can be made by prenatal or postnatal ultrasound. Usually, total excision of the cyst(s) was performed and prognosis was good in otherwise healthy children. Conclusion: This rare diagnosis should be considered when cystic lesions appear in routine antenatal ultrasound. The benign nature of these cysts together with a certain risk for complications when left in place justifies for a planned surgical approach in the neonate aiming at total excision of the cyst with preservation of the pancreas. Ultrasound is sufficient for preoperative imaging. Keywords: Pancreatic cyst; Congenital; Prenatal diagnosis; Pediatri

Cytokines Activate JAK-STAT Signaling Pathway in MG-63 Cells on Titanium and Zirconia.

Although titanium has been traditionally used as the gold standard for dental implants, recent years have seen the widespread application of zirconia implants given their superiority with regards to reduced bacterial adhesion, inflammation and cellular-interaction in terms of bio-compatibility. The JAK-STAT signaling pathway plays an important role in bone remodeling and formation. The aim of the study was to investigate the activation of the JAK-STAT pathway through different cytokines in osteoblast-like cells (MG-63) on zirconia in comparison to titanium discs. IFN-γ induced the very strong activation of STAT1 protein, IFN-α activated both STAT1 and STAT3 molecules, IL-6 activated STAT3 and IL-4 induced the activation of STAT6 on both surfaces. The activation of STAT proteins was confirmed by western blot, immunofluorescence and flow cytometry using phospho-specific anti-STAT antibodies, which recognize only phosphorylated STAT proteins. The incubation of MG-63 cells with IFN-γ caused the upregulation of MHC class I and class II proteins when MG-63 cells were grown on zirconia and titanium discs. In sum, the present study shows that the JAK-STAT pathway is activated in MG-63 cells when they are incubated on titanium or zirconia surfaces

Paediatric thyroid surgery is safe - experiences at a tertiary surgical centre.

PRINCIPLES Thyroidectomy in children is rare and mostly performed because of thyroid neoplasms. The aim of this study based on prospective data acquisition was to evaluate whether thyroid surgery in children can be performed as safely as in adults when undertaken by a team of adult endocrine surgeons and paediatric surgeons. METHODS Between 2002 and 2012, 36 patients younger than 18 years underwent surgery for thyroid gland pathologies. All surgical procedures were performed by an experienced endocrine surgeon and a paediatric surgeon. Baseline demographic data, surgical procedure, duration of operation, length of hospital stay, and postoperative morbidity and mortality were analysed. RESULTS The median age of all patients was 13 years (range 2-17 years), with predominantly female gender (n = 30, 83%). The majority of operations were performed because of benign thyroid disease (n = 27, 75%) and only a minority because of malignancy or genetic abnormality with predisposition for malignant transformation (MEN) (n = 9, 25%). Total thyroidectomy was performed in the majority of the patients (n = 24, 67%). The median duration of the surgical procedure was 153 minutes (range 90-310 minutes). The median hospital stay was 5 days (3-1 days). One patient developed persistent hypoparathyroidism after neck dissection due to cancer. One persistent and two temporary recurrent nerve palsies occurred. CONCLUSION This study demonstrated that paediatric thyroidectomy is safe as performed by this team of endocrine and paediatric surgeons, with acceptable morbidity even when total thyroidectomy was performed in the case of benign disease

Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols

Forensic radiology is a new subspecialty that has arisen worldwide in the field of forensic medicine. Postmortem computed tomography (PMCT) and, to a lesser extent, PMCT angiography (PMCTA), are established imaging methods that have replaced dated conventional X-ray images in morgues. However, these methods have not been standardized for postmortem imaging. Therefore, this article outlines the main approach for a recommended standard protocol for postmortem cross-sectional imaging that focuses on unenhanced PMCT and PMCTA. This review should facilitate the implementation of a high-quality protocol that enables standardized reporting in morgues, associated hospitals or private practices that perform forensic scans to provide the same quality that clinical scans provide in court

Комплексные геофизические исследования с целью доразведки юго-западного фланга уранового месторождения Харасан (республика Казахстан)

Цель работ: Комплексные геофизические иследования с целью доразведки юго-заподного фланга уранового месторождения Харасан (республика Казахстан) Объект работ: Участок Байкенже месторождения Харасан, локализованный в горизонте верхнего мела на глубинах от 610 м до 690м. Методы решения задач: анализ и обобщение геолого-геофизических материалов. На территории «Харасан» для решения геологических задач применяется комплекс геофизических методов исследования скважин. При этом, гамма-каротаж, электрокаротаж, инклинометрия выполнялись во всех скважинах, независимо от их целей, задач и назначения. Дополнительные геофизические методы, такие как каротаж мгновенных нейтронов деления (КНД-М), кавернометрия, проводятся выборочно.Purpose of work: Integrated geophysical isledovanija for the purpose of further exploration of the south- west- side attack Kharassan uranium deposit (Republic of Kazakhstan ) Object of work: Planning Baykenzhe Kharassan deposits localized in the Upper Cretaceous horizon at a depth of 610 m to 690m . Methods for solving problems : analysis and synthesis of geological and geophysical data . On " Kharassan " territory for solving complex geological tasks used geophysical methods for wells .At the same time , gamma ray , electric logging , directional survey carried out in all wells , regardless of their objectives , tasks and appointments . Additional geophysical methods , such as logging prompt fission neutron ( CPV -M ) , caliper , conducted selectively

Das Triftprojekt : ein Überblick zu Projekt, Ökologie und Partizipation

Mit der Realisierung des Triftprojekts kann ein wesentlicher Beitrag zur erfolgreichen Umsetzung der schweizerischen Energiewende geleistet werden. Neben einer Erhöhung der Energieproduktion um 145 GWh/a kann künftig die Flexibilität der Stromproduktion erhöht und insbesondere ein Grossteil der Stromproduktion im Winter erfolgen. Allerdings sind mit dieser energiepolitischen Verbesserung sowohl gewässerökologische als auch terrestrische Beeinträchtigungen verbunden. Die umfangreichen und sehr detaillierten ökologischen Untersuchungen bildeten eine hervorragende Ausgangsbasis zur Beurteilung des Projekts und eine sachliche Diskussion. Im Rahmen eines gut strukturierten Begleitprozesses hatten alle relevanten Stakeholder die Möglichkeit, sich aktiv in die Diskussionen und Lösungsfindung einzubringen. Die Diskussionen im Begleitprozess verliefen sehr offen und lösungsorientiert. Mit zwei von allen Seiten anerkannten Bewertungsmethoden wurden die ökologischen Beeinträchtigungen und die Aufwertungsmassnahmen sowohl für aquatische als auch für terrestrische Lebensräume objektiv bilanziert. Nach rund drei Jahren Verhandlungen wurde schliesslich für alle relevanten ökologischen und technischen Aspekte eine Lösung gefunden und wurden die Konzessionsunterlagen im Herbst 2017 eingereicht

A note on the primordial abundance of stau NLSPs

In scenarios with a gravitino LSP, there exist strong BBN constraints on the abundance of a possible stau NLSP. We find that in settings with substantial left-right mixing of the stau mass eigenstates these constraints can be evaded even for very long-lived staus.Comment: 17 pages, 5 figures, discussion on vacuum stability adde