Assessment of single and combined effects of bisphenol-A and its analogue bisphenol-S on biochemical and histopathological responses of sea cucumber Holothuria poli

Bisphenols (BPs) are among emerging pollutants that have been frequently detected in different compartments of marine ecosystems and elicited great concern due to their potential toxicity to marine organisms. This work aimed to investigate the toxicity of bisphenol A (BPA) and bisphenol S (BPS) on oxidative stress markers, neurotoxicity and histopathological alterations in sea cucumbers (Holothuria poli). The results showed that exposure to 200 μg/L of BPA and BPS produced oxidative stress, neurotoxicity in the digestive tract and respiratory tree, and several types of histopathological lesions in tissues of the respiratory tree of the sea cucumber, posing a health hazard to this aquatic organism. In addition, BPA has greater effects than BPS on the generation of oxidative stress marked by the inductions of catalase (CAT), glutathione S-transferase (GST) and malondialdehyde (MDA) levels and neurotoxicity shown by the decrease in acetylcholinesterase activity (AChE). The respiratory tree of sea cucumbers might be an appropriate tissue for assessing CAT, MDA and AChE activity levels, which are reliable biomarkers that may be useful in marine biomonitoring studies. Evaluation of histopathological lesions of the respiratory tree suggests that BPA and BPS and their mixture cause various tissue alterations that may be associated with oxidative stress damage and neurotoxicity. In conclusion, this study showed that oxidative stress (CAT and MDA) and neurotoxicity (AChE) markers, as well as respiratory tree lesions, are sensitive biomarkers for the assessment of BPA and BPS toxicity in sea cucumbers.

AB1249 IMPACT OF OVERWEIGHT AND OBESITY ON HIP INVOLVEMENT IN JUVENILE IDIOPATHIC ARTHRITIS

Background

The prevalence of obesity among children is on the rise, becoming a worldwide epidemic. The overweight is also associated with mechanical stress in the weight-bearing joint especially in the hip joint. Previous studies showed that increased Body mass index was a predicting factor of a poor outcomes [1].

Objectives

In this regard, we proposed to evaluate the effect of obesity on hip involvement in JIA patients.

Methods

We conducted a cross-sectional study including children with JIA according to the International League of Associations for Rheumatology (ILAR)). Transcribed data included age, sex and the characteristics of the disease (subtype of JIA, disease duration). Data on hip involvement was also collected. Weight and height of each patient was recorded. The body mass index (BMI) was calculated (Kg/m2). We compared these parameters between two groups: G1: presence of coxitis and G2: absence of coxitis.

Results

The study included 62 patients with a male perdominance: sex ratio was 2.3. The mean age of onset of the disease was 11.4 years [3-16].The frequency of each JIA subset was at follows: polyarticular with rheumatoid factor (n=2), polyarticular without rheumatoid factor (n=4), systemic (n= 1), enthesitis-related arthritis (n=44), oligoarthritis (n=8), psoriatic arthritis (n=3). Hip involvement was reported in 71 % of cases and was bilateral in 81% of patients. The mean weight (Kg) and height (meter) was similar between the two groups (57.4 in G1 vs 53.6 in G2, p=0.486) and (1.61 in G1 vs 1.58 in G2, p=0.483) respectively. The prevalence of overweight patients was higher in G1 than G2 without reaching a statistically significant correlation (23% vs 12.5%, p=0.518). Similarly, there was no statistically significant correlation between the body mass index (Kg/m2) and coxitis (22.2 vs 21, p=0.45). Moreover, a higher BMI was not associated with a limited range of motion as well as hip replacement (p=0.7, p=0.1 respectively).

Conclusion

Our study showed that BMI did not impact hip involvement in juvenile idiopathic arthritis patients. As obesity confers an additional health risk, addressing this co-morbidity should be a health priority in these patients.

References

[1]Makay B, Gücenmez ÖA, Ünsal E. Inactive Disease in Enthesitis-related Arthritis: Association of Increased Body Mass Index. J Rheumatol. 2016;43(5):937-43.

Disclosure of Interests

None declared

Application of the Paracentrotus lividus sea-urchin embryo-larval bioassay to the marine pollution biomonitoring program in the Tunisian coast

The pollution of the marine environment by treated and untreated effluents has increased due to human activities. Monitoring the marine ecosystem is nowadays a global concern. In this work, we evaluated the effect of contaminated and uncontaminated seawater, from different Tunisian coastal areas, on the fertilization, gastrulation, and embryo-larval development events of sea urchins (Paracentrotus lividus). The station of Salakta (SA) is considered as a control station, while the stations of Hamdoun Wadi (HW), Port of Monastir (PM), Karaia Monastir (KM), Teboulba (TE), and Khniss Lagoon (KL) are considered to be contaminated stations. The analysis of seawater physicochemical characteristics showed that levels of the total suspended matter (TSM), chemical oxygen demand (COD), biochemical oxygen demand (BOD), total organic carbon (TOC), and nitrate (NO^3-) were lower in the seawater of the reference site Salakta (SA) when compared to those of the contaminated seawater sites. In addition, a very strong variation in the levels of trace metals in seawaters sampled in the studied sites was noted. In fact, the highest concentrations of Pb and Cu were observed in Hamdoun Wadi (HW), port of Monastir (PM), and Karaia Monastir (KM), while the highest concentration of Zn was noted in the Teboulba lagoon (TE) and Khniss (LK). Alterations in physicochemical characteristics as well as elevated trace metal levels in the studied seawater samples were correlated with reduced fertility rate, gastrulation rate, and the frequency of normal sea urchin larvae. The total absence of normal sea urchin pluteus larvae in the sea waters of heavily polluted sites proves the great sensitivity of the larval frequency to mixed pollution. This work recommends the utility of urchin fertilization and gastrulation rates and normal pluteus larval frequencies as useful bioassays to monitor the exposure of marine ecosystems to mixed pollution.

[Acute hematogenous osteomyelitis of the obturator rim in seven children]

PURPOSE OF THE STUDY

Acute osteomyelitis of the rim of the obturator foramen is rarely reported. The clinical presentation is atypical, making diagnosis a difficult task. We report a series of seven cases of osteomyelitis of the obturator rim which illustrate the different features of this localization.

MATERIAL AND METHODS

The series included seven boys with osteomyelitis involving the obturator foramen. We reviewed the clinical history, the diagnostic approach and management. Complications and anatomic outcome were noted at mean three years follow-up (range one to 10 years).

RESULTS

Mean age was 9.5 years (five to 12 years). Bilateral involvement was noted in one boy. Mean time from symptom onset to consultation was five days and mean time from consultation to hospitalization was eight days. No specific clinical presentation could be identified. Fever was not a constant feature. Mean body temperature was 38.6 degrees C and was not greater than 38.5 degrees C in four children. Symptoms were limited to hip pain in five cases and abdominopelvic pain was noted in two. Physical examination failed to trigger exquisite ischial or pubic pain in two patients. The osteomyelitis involved the ischiopubic ramus in four cases, the ischium in two with one bilateral case, and the pubis in one. Certain diagnosis was established as follows: MRI findings plus isolation of the pathogenic agent (n=4) ; the plain x-ray showed a defect in the ischiopubic ramus, MRI showed signs favoring osteomyelitis of the ischiopubic ramus and surgery evacuated a purulent collection (n=1) ; strong uptake of the obturator rim on scintigraphy (n=2). Medical treatment was given in all cases and surgery was performed in six patients. Outcome was noted at three years follow-up, range one to 10 years. All patients recovered normal function. There were no complications.

DISCUSSION

Hematogenous osteomyelitis of the pelvis is exceptional (2-11 % of cases of osteomyelitis). Localization in the obturator rim is rare. We discuss the specific diagnostic and therapeutic features of this localization. Despite the controversy concerning the treatment of pelvic osteomyelitis and in particular cases involving the obturator rim, prognosis is generally good. No complications have been described in the literature specifically associated with osteomyelitis of the obturator rim.

[Acute hematogenous osteomyelitis of the neck of the femur in children: 28 cases]

PURPOSE OF THE STUDY

Osteomyelitis of the neck of the femur is uncommon, often with a misleading clinical presentation. We report a series of 28 cases of osteomyelitis of the femoral neck to illustrate the particular clinical and imaging findings related to this localization.

MATERIAL AND METHODS

This was a series of 28 children treated in our unit from 1990 through 2004: 17 boys and 11 girls, mean age eight years (range one month to 14 years). We analyzed the data in this series using a standard checklist, which noted the diagnostic and therapeutic measures. Results were analyzed by studying the complications, anatomic and functional outcome at mean follow-up of 3.5 years.

RESULTS

Time from symptom onset to consultation was five days on average with a delay of 4.5 days from consultation to hospitalization. Intense pain was noted for eight patients (28%) and total functional incapacity of the limb was noted for 15 (53%). Hip stiffness was observed in 11 patients (39%). The diagnosis of osteomyelitis of the femoral neck was established on the basis of imaging (MRI or scintigraphy) in three patients with bacteriological proof in two, of operative findings which confirmed the neck localization in 19, and on changes in the X-ray image of the neck in six. A positive bacteriology was noted in 71%. The germ was isolated from blood cultures and local samples obtained by arthrotomy in five patients (same germ), only in blood cultures for four, and only in local samples in 11. Met-S Staphylococcus aureus was isolated in 18 patients, Met-R S. aureus in one and a Streptococcus in one. All patients were given medical treatment and 25 underwent surgery. There were five thromboembolic complications and five patients who developed femoral pandiaphysitis. Results were analyzed at mean 3.5 years (range four months to 14 years). Complete hip motion was recovered in 78%. There were four cases of hip stiffness and two cases of ankylosis. Partial cephalic necrosis was noted in two hips and total necrosis of the head and neck in two.

DISCUSSION

Little data is available in the literature on isolated osteomyelitis of the femoral neck. Based on the pathogenic mechanisms known for osteomyelitis, an isolated localization in the neck of the femur, with no other site in the hip joint, is quite possible in an early stage of infection. We discuss the specific clinical and imaging features of this localization. Analysis of our findings show that the prognosis of femoral neck osteomyelitis is directly related to time to management. Outcome is poorer when treatment is started late. Prognosis is poor if pandiaphysitis develops.

Fracture de l’ulna et luxation congénitale bilatérale de la tête radiale

We report a case of bilateral congenital dislocation of the radial head discovered at the time of a fracture of the ulna. The dislocation was missed initially and when considered as part of the Monteggia fracture, raised a problem concerning the therapeutic approach. The purpose of this report is the emphasize the importance of careful physical examination before undertaking treatment of any lesion.

[Supracondylar femoral extension osteotomy for knee flexion contracture correction in poliomyelitic conditions]

PURPOSE OF THE STUDY

Knee flexion contracture due to quadriceps paralysis is a major handicap in poliomyelitis patients. The patient has to stabilize the knee with the ipsilateral hand to achieve weight bearing and the deformed knee precludes use of orthopedic devices. Extension can be achieved with supracondylar femoral osteotomy if the knee flexion contracture is less than 30 degrees. We assessed functional and anatomic outcome.

MATERIAL AND METHODS

We reviewed the files of 87 patients who had undergone 93 supracondylar femoral osteotomies for knee flexion contracture (6 bilateral cases); mean age was 18 years and mean flexion was 25 degrees. The surgical correction was achieved by diaphyseal metaphyseal impaction with resection of an anterior wedge and preservation of the posterior component of the articulation. If some gluteus maximus activity was retained and the tibiotarsal joint was in a slightly equine position, weight bearing in a stable locked position became an automatic postural event even in case of total paralysis of the quadriceps. Osteotomy was not possible if the contracture flexion was greater than 30 degrees due to excessive tension on the vaculonervous bundles. The procedure was equally impossible in children under 12 years of age due to the risk of recurrence subsequent to migration and callus remodeling with bone growth.

RESULTS

Complete extension of the knee was achieved peroperatively in all cases. The most serious complications were three cases of septic arthritis that led to an irreducible stiff knee. In addition, we had two cases of transient paralysis of the common fibular nerve that recovered spontaneously. Bone fusion was achieved in all cases within 30 days. Recurrent flexion contracture was observed in 5 cases and required a revision using the same procedure in 3 or them. Postoperatively, the amplitude gained in knee extension corresponded to the amplitude lost for flexion. Sixty-three patients were able to walk independently without manual stabilization and a knee extension orthesis could be installed for 19 others. Three patients were still unable to walk despite the correction of the knee flexion contracture due to failure of poorly accepted orthopedic devices.

DISCUSSION

Several conservative methods (physiotherapy, manipulations, successive corrective casts) and surgical procedures (release of posterior soft tissues, Ilizarov technique) have been proposed for the correction of paralytic knee flexion contracture. Supracondylar femoral osteotomy for extension can be useful after the end of growth if the flexion contracture remains below 30 degrees. The procedure is simple and morbidity is relatively low compared with the regularly successful results. When the flexion contracture exceeds 30 degrees, the supracondylar osteotomy cannot be employed due to the risk of stretching the vasculonervous bundles and due to the instability and disorganization of the lower femur. Progressive correction can be proposed for these patients: regular monitoring of the neurological and vascular situation is required. Functional improvement is considerable after correction of knee flexion contracture. The patients can walk more easily, no longer need to stabilize their knee with their hand, and can benefit from orthopedic devises due to the more favorable biomechanical conditions.