[Proximal tibial fractures sustained during alpine skiing - incidence and risk factors]. / Proximale Tibiafrakturen im Skisport - Inzidenz und Risikofaktoren.

BACKGROUND: Prior to introduction of carving skis, complex fractures of the proximal tibia were rarely seen. Recently these fractures are being seen more frequently in connection with alpine skiing. The aim of this study was to find out the incidence of proximal tibia fractures in alpine skiing and to identify possible risk factors. METHODS: All patients with proximal tibia fractures related to alpine skiing in a large German ski resort were included. Fracture type, patient and skiing related factors were recorded. Incidence of fractures was determined by using the number of all registered skiers. Multinomial logistic regression analysis was used to calculate the odds ratios for risk factors. RESULTS: Between 2007 and 2010 a total of 188 patients was treated for proximal tibia fractures caused by alpine skiing. Forty-three patients had a type-A injury, 96 patients a type-B injury, and 49 patients a type-C injury. The incidence of injury increased continuously, starting from 2.7 and climbing to 7.0 per 105 skiing days. The risk factors compared to patients with type-A fractures, type-C fracture occurred in older (OR 0.93; 0.89 - 0.97) and heavier (OR 0.86; 0.74 - 0.99) individuals and were more likely on icy snow conditions (OR 0.22; 0.05 - 0.96), higher speed (OR 0.29; 0.09 - 0.97) and skiing skill (OR 0.35; 0.13 - 0.95). These was also seen in artificial and icy snow conditions (OR 0.25; 0.07 - 0.87) when compared to type-B fractures. CONCLUSION: The incidence of proximal tibia fractures related to skiing has increased over the past four years. Risk factors such as age, BMI, snow conditions, speed, and the skill of the skiers, were identified as causes contributing to complex fractures.

Antimicrobial, cytotoxic and antioxidant activity of selected basidiomycetes from Yemen.

Dichloromethane, methanol and aqueous extracts of 23 selected Basidiomycetes species fruiting bodies collected in Yemen were screened in vitro for their antibacterial activities against three Gram-positive bacteria (Staphyloccocus aureus, Bacillus subtilis, Micrococcus flavus), two Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) and against one yeast fungus (Candida maltosa), as well as for their cytotoxic and antioxidant activity. The highest antibacterial activity was shown by extracts from Agaricus sp. (Type 1), Coriolopsis caperata, Ganoderma colossus, Ganoderma resinaceum, Phellorinia herculea and Tulostoma obesum. Strong antioxidative effects employing the DPPH assay were exhibited by methanol extracts from Ganoderma resinaceum, Inonotus ochroporus, Phellinus rimosus and Phellorinia herculea. The results provide evidence that some of the studied fungi might be potential sources for new biologically active agents.

Deletions with inversions: report of a mutation and review of the literature.

Herein we report a 10.9 kb deletion and a 95 bp inversion in a patient with severe hemophilia B (factor IXHB209). With the addition of factor IXHB209, three of six characterized deletions in the factor IX gene are now known to include inversions. A high frequency of combined deletions and inversions has not previously been described in a human gene.

Malignancy-induced lactic acidosis.

Lactic acidosis, a rare and usually fatal complication of malignancy, is defined as a clinical condition in which the pH is less than or equal to 7.35 and the serum lactate level greater than or equal to 5 mEq/L. We have described the clinical aspects of four cases of lactic acidosis associated with malignancy, and have reviewed all reported cases of lactic acidosis in malignancy meeting the criteria. Rapid recognition of the condition and prompt institution of chemotherapy led to reversal of lactic acidosis in three of our four patients, but long-term survival is related to the responsiveness of the underlying tumor.