An anatomical investigation of rare upper limb neuropathies due to the Struthers' ligament or arcade: a meta-analysis.

BACKGROUND: The Struthers' ligament (SL) is a fibrous band that originates fromthe supracondylar humeral process and inserts into the medial humeral epicondyle, potentially compressing both the median nerve and brachial artery. The controversial Struthers' arcade (SA) is a musculotendinous band found in the distal end of the arm that might compress the ulnar nerve. This study aimed to evaluate the pooled prevalence estimate of the SL and SA, and their anatomical features. MATERIALS AND METHODS: A meticulous search of major electronic medical databases was carried out regarding both structures. Applicable articles (and all relevant references) were analysed. Data from the eligible articles was extracted and evaluated. The quality and the potential risk of bias in the included studies were assessed using the AQUA tool. RESULTS: The arcade was reported in 13 studies (510 arms), whereas the ligament in 6 studies (513 arms). The overall pooled prevalence estimate of the ligament was 1.8%, and 52.6% for the arcade. Most frequently, the ulnar nerve was covered by a tendinous arcade (42.2%). In all cases, the ligament inserted into the medial humeral epicondyle, but had various origins. Only 1 study reported compression of the median nerve by the ligament, whilst another contradicted this view. CONCLUSIONS: Although the SL is rare, and the SA is a valid anatomical entity (though with a variable presentation), clinically meaningful neurovascular entrapments caused by these structures are infrequent. Nonetheless, a better understanding of each may be beneficial for the best patient outcomes.

Structural transformations of nitrogen adsorbed on graphite: Monte Carlo studies of spatial heterogeneity in multilayer system.

We present numerical Monte Carlo studies of nitrogen multilayers adsorbed on the basal plane of graphite. The analysis is focused on the system spatial heterogeneity and its influence on structures and phase transitions. The simulations have been carried out for surface coverage from monolayer to four layers, in canonical ensemble, in the temperature range from 5 to 100 K. An intricate phase situation is observed due to the competition between intermolecular and N(2)-graphite interactions. The commensurate monolayer is stabilized by the graphite corrugation. The multilayer commensurate structure is only metastable at low temperatures. Its stable structure is triangular, 1.08 times denser than the commensurate one stabilized by the N(2)-N(2) interactions. The multilayer structure is strongly spatially nonuniform, the individual layer structure changes from herringbone in the first layer to pinwheel arrangement in the fourth one. Two structural phase transitions, orientational order-disorder, and melting, are observed in each layer. Their mechanism and transition temperatures show strong variations depending on the position of the layer and the number of layers in the system.

[Characteristics of children with diagnosed pertussis]. / Charakterystyka dzieci z rozpoznanym zakazeniem paleczka krztusca.

In 1997 a significant increase in the incidence of pertussis in the Lódz voivodship was noticed--the incidence increased from 3.32 in 1996 to 26.34. The aim of this work was the analysis of the course of pertussis in the Lódz voivodeship. Epidemiological history was analysed of 331 children with diagnosed pertussis from the end of 1996 to February 1998. The diagnosis was made on the basis of clinical picture and passive haemagglutination reaction (PHR). The highest incidence occurred between September and November 1997 (196/331--59.2%). Children aged 7-15 years and toddlers constituted the most numerous groups (respectively: 60.7% and 24.5%). The majority of children with pertussis (83%) received four doses of DTP vaccine, according to the current vaccination schedule. Only 8.2% of children did not receive DTP vaccination or received only 1 or 2 doses. In the majority of properly vaccinated children (73.5%--202/275) the disease appeared mainly after 6-15 years from the last 4th dose of DTP vaccine. From the group of children with pertussis, 18.7% required hospitalisation--these were mainly neonates and children aged 2 and 3 years. The number of children who developed pertussis was highest in school age children after 6-15 years from the last dose of vaccine. The severity of the disease, evaluated on the basis of the percentage of hospitalisations, was highest in the youngest age groups. The laboratory methods used (PHR) are not sufficient for proper diagnosis of pertussis, and cannot provide epidemiological data to assess the incidence of the disease. Increasing number of pertussis cases requires a revision in the schedule of prophylactic vaccination.

Hepatitis B vaccination in preterm infants.

UNLABELLED: Preterm infants, especially those with very low birth weight, are at risk of hepatitis B virus infection. They often require invasive diagnostic methods in their first weeks of life, intensive treatment and long-term hospitalisation. Therefore, hepatitis B vaccination is particularly justified in these patients. Our aim was to determine the reaction of preterm children to hepatitis B vaccination. The study comprised 64 preterm children whose birth weight ranged from 700 g to 2460 g (mean 1776.6 g +/- 480.4 g) and whose gestational age was between 25 and 36 weeks. A 10 microg dose of the recombinant vaccine Engerix-B (SmithKline Beecham) was given at intervals of 0, 1, 2 and 12 months. In 49.2% of the children vaccination was administered on the 1st day of life, and in the remaining cases between the 2nd and 119th days post delivery. One month after vaccination completion the levels of anti-hepatitis B surface antigen (HBs) antibodies were evaluated. In 98.4% of the vaccinated preterm infants the level of antibodies was > 10 mIU/ml. Mean level of anti-HBs antibodies in the group of children with birth weight < or = 2000 g was 2431.4 mIU/ml, while in those with birth weight >2000 g it was 4803.9 mIU/ml. In children with a birth weight < or = 1000 g, the mean level of anti-HBs antibodies was significantly lower than in those with birth weight >2000 g. The level of anti-HBs antibodies in children who started vaccination > 1 st day of life was significantly lower in preterm children with a birth weight < or = 2000 g than in those with a birth weight >2000 g. Although vaccination was started on the 1st day of his life, one child with birth weight of 2300 g developed a hepatitis B virus infection. One child did not respond to vaccination (anti-HBs < 10 mIU/ml) and in three cases the response was very poor (11 100 mIU/ml). These patients were given a supplementary booster double dose of Engerix B (20 microg). After 1 month the level of anti-HBs antibodies was evaluated again and high values of 657 mIU/ml to 14520 mIU/ml were observed. In the group of children with a birth weight < or = 1000 g the response to vaccination was weaker as compared to children with a birth weight >2000 g (P < 0.05). In systematic mass vaccination programmes, monitoring of antibody levels is not recommended unless the patient is at risk. However, in extremely preterm infants (< 1000 g at birth), especially after very serious infections, monitoring the level of anti-HBs antibodies after complete immunisation should be considered. In preterm infants who show very low postvaccination levels of anti-HBs antibodies, stimulation with an additional double booster dose of vaccine gives positive results. CONCLUSION: The majority of preterm infants (98.4%) responded well to hepatitis B vaccination given at intervals of 0, 1, 2 and 12 months and developed a protective level of antibodies. The level of anti-hepatitis B surface antigen antibodies in children with a birth weight >2000 g was higher than in those with a birth weight < or = 1000 g.

[Does vaccination protect a child of an HBs Ag carrier mother against HBV infection?]. / Czy szczepienie stanowi ochrone dziecka matki nosicielki HBs Ag przed zakazeniem HBV?

The aim of the study was to determine the degree of protection provided to the children born from HBs antigen carrying mothers, by vaccination administered according to the 0-1-2-12 scheme (Engerix B, SmithKline Beecham) as well as the level of HBs antibodies after a booster dose given 5 years later. The examination was conducted in 52 children. The level of HBs antibodies as well as the remaining serological markers of HBV infection were assessed at the age of 6. Four to six months after booster dose administration the level of HBs antibodies was assesed again. The markers of HBV infection were determined with the IMx-AUSAB test (Abbott Laboratories). After 5 years from the vaccination, 3 (5.8%) children were found infected with HBV; the performed assessment of their immune system did not reveal any significant compromise. Values of anti-HBs < 10 mlU/ml were found in 4 (8.2%) of 49 infection-free children and low levels (11-100 mlU/ml) in other 4 (8.2%) children, moderate (101-1000 mlU/ml) in 29 (55.8%), and very high (> 1000 mlU/ml) in 9 (17.3%). Four to six weeks after a booster dose, only one child did not respond to the vaccination. High levels of anti-HBs antibodies were obtained in the rest of the children. In our opinion there is a justified need to administer a booster dose 5 years after completing the vaccination in the risk group children.

[Evaluation of physical activity in obese individuals]. / Hodnocení pohybové aktivity obézních.

BACKGROUND: Dynamic exercise is the optimal form of spending leisure time and forms the contents of the majority of children's games. It is a risk to restrict (or enforce) physical activity in particular on young children. This pertains also to obese children where the regulation of the ratio energy input: energy output is one of the therapeutic components. METHODS AND RESULTS: The authors investigated physical activity during spontaneous activity in a group of 36 obese subjects, 20 non-obese controls and 41 comparable subjects aged 8-16 years (with the exception of a group of 13-14-years-olds the obese children were taller than the control group). Assessment by concealed camera. Children had a varied selection of gymnastic apparatuses and other activities. Concurrently the heart rate was recorded (by a Sport-Tester Pollar, evaluated by Sony equipment). Everything was rated as active movement with the exception of the standing, sitting or recumbent position. The examiners did not interfere with the physical activity. The assembled values confirm the basic need of activity in relation to age and the important role of elevated body weight. The latter was the reason why, while less time was spent for exercise (chronometer), the heart rate of obese subjects did not differ significantly from that of the control group during spontaneous physical activity and during a 3-minute run. CONCLUSIONS: Controlled physical activity must always respect the total burdening with excessive body weight as well as the physical action of overweight. Physical activity of young subjects with a higher body weight is in relation to needs of exercise of the given age group and to their total body weight.

Chemiluminescence of peripheral blood leukocytes and activity of an inflammatory process in juvenile chronic arthritis (JCA).

The oxidative metabolites have been implicated in the aetiology and pathology of rheumatoid arthritis. In our work we endeavoured to deal with polymorphonuclear leukocytes (PMNLs) ability to generate oxygen free radicals (OFRs). PMNLs metabolic activity was assessed by the means of chemiluminescence (CL) method. We observed significantly higher PMNLs metabolic activity in children suffering from JCA in comparison to the healthy group. Greater activity of the rheumatoid process was accompanied by an increased PMNLs activity. The results constitute another piece of evidence confirming the role of PMNLs in the pathogenesis of JCA.

[Use of mid-arm and head circumference to estimate gestational age and nutritional status of newborns]. / Zastosowanie wskaznika ramienno-glowowego dla oceny wieku ciazowego i stanu odzywienia noworodka.

1110 neonates, from 30 to 42 of estimated gestational age (EGA) were measured on the 1st day of life to estimate upper mid-arm circumference (MAC) and head circumference (HC). Individual MAC/HC ratio was calculated. MAC/HC ratio was used to estimate gestational age and nutritional status of the newborns. We proved that MAC/HC ratio increased linearly between 30 and 38 week of pregnancy and it stabilized between 38-42 week. We compared MAC/HC ratio with birth weight, skin fold score, and ponderal index. We concluded that this ratio may be very useful to estimate gestational age and to include the neonates to "the group of risk".

[Evaluation of the respiratory system function in girls from the Textile Technical College in Lódz (II)]. / Ocena czynnosci ukladu oddechowego dziewczat z Technikum Wlókienniczego w Lodzi (Czesc II).

The work in textile industry is a risk factor of the development of chronic non-specific diseases of the respiratory tract. Thus the vocational selection for the posts in this industry should particularly take into account the health status of the applying youths. The subjects of the study were 35 girls from Textile Technical College and 42 girls from Grammar School (control group). The girls were examined three times in the succeeding school years. Anthropometric and spirometric examinations were performed. No significant differences between the values of ventilation parameters in both the groups were observed, which indicates that the selection of pupils admitted to the Technical College was proper. During the period of professional training no adverse effects of the industrial environment on the respiratory function could be found either.

[Evaluation of somatic development, physical fitness and motor skills of girls from the Textile Technical College in Lódz (I)]. / Ocena rozwoju somatycznego, wydolnosci fizycznej i sprawnosci motorycznej dziewczat z technikum wlókienniczego w Lodzi.

Thirty-five girls from a technical college (TC) and forty-five from a grammar school (GS) (a control group) were included in a long-term examination. Somatic traits have been investigated for 4 years, while aerobic capacity and motor efficiency have been studied for 3 years. The preliminary selection was noticed in girls--candidates to technical college and grammar school. These two groups of girls differed in respect of social factors and somatic predisposition. At the beginning of the examination the girls from the technical college revealed a considerably lower motor efficiency as compared to those from the GS. After 3 or 4 years of learning traits of the body length were still weaker in the girls from the technical college. However, they had a more massive skeleton, stronger trunk muscles and stronger hands. In addition, these girls were characterized by a remarkable improvement of general physical efficiency, particularly endurance, speed and nimbleness. In the final stage of the study in all girls from both TC and GS aged 18 lower aerobic capacity in comparison with data from the previous year was found, which could results from inefficient physical activity during the educational process. This fact may be especially unfavourable for the girls from TC as far as their future profession is concerned.