Geotomus granulosus, a peculiar sehirine-like new species of the subfamily Cydninae (Hemiptera: Heteroptera: Cydnidae) from Burundi

Geotomus granulosus sp. n. is described from Burundi, and is the third burrower bug species recorded hitherto from this country. This burrower bug resembles species of two Sehirinae genera, i.e. Ochetostethus Fieber, 1860 and Ochetostethomorpha Schumacher, 1913, in its dorsal body habitus. However, all its crucial diagnostic characters (the body chaetotaxy, the shape of evaporatoria and the peritreme, the meso- and metathoracic wings venation, and the shape of spermatheca) demonstrate it represents the genus Geotomus Mulsant et Rey, 1866 (subfamily Cydninae, tribe Geotomini sensu lato).

Ultrasonographic Visualization of the Ovaries to Detect Ovarian Cancer According to Age, Menopausal Status and Body Type

Because the effects of age, menopausal status, weight and body mass index (BMI) on ovarian detectability by transvaginal ultrasound (TVS) have not been established, we determined their contributions to TVS visualization of the ovaries. A total of 29,877 women that had both ovaries visualized on their first exam were followed over 202,639 prospective TVS exams. All images were reviewed by a physician. While visualization of both ovaries decreased with age, one or both ovaries could be visualized in two of every three women over 80 years of age. Around 93% of pre-menopausal women and ~69% of post-menopausal women had both ovaries visualized. Both ovaries were visualized in ~72% of women weighing over 300 lbs. and in ~70% of women with a BMI over 40. Conclusions: Age had the greatest influence on the visualization of the ovaries. The ovaries can be visualized well past the menopause. Body habitus was not limiting to TVS ovarian imaging, and TVS should be considered capable of imaging one or both ovaries in two of every three women over 80 years of age. Thus, older and obese patients remain good candidates for TVS exams.

Abstract 10861: Determining the Importance of Gender, Race, and Body Shape for Cardiopulmonary Resuscitation Education Using Manikins

Introduction: Cardiopulmonary resuscitation (CPR) education plays a critical role in reducing cardiovascular deaths. Thus, it is crucial that trainees engage in practice simulations that accurately replicate a cardiovascular emergency. Recent work has shown that certain demographic groups such as Black Americans and women are less likely to receive efficient CPR, and technique may vary on individuals who have an increased body mass index or who are pregnant. Poor representation of these groups in the manikins used for CPR simulation may play a substantial role in these inequities. Hypothesis: There is a deficiency in the diversity of race, gender, and body habitus of manikins used for CPR training in North and South America. Methods: Institutions, businesses, and non-governmental organizations which administer CPR certification in North and South America were identified for survey distribution through a collaboration with the Inter-American Society of Cardiology. A survey was administered using the online platform Qualtrics (Provo, USA) consisting of 18 questions about manikin supply, usage, and diversity. Results and Conclusions: A total of 52 survey responses were received from North America (n=20; 854 total manikins) and South America (n=32; 1,169 total manikins). Of the total manikins (n=2,023), 318 (16%) were non-white, 114 (6%) were female, 20 (1%) represented a non-lean body habitus, and 18 (1%) were pregnant. The importance of diverse manikin representation in simulation training is underscored by literature detailing deficiencies in CPR initiation and associated outcomes in individuals who are not lean white males. Yet, the majority of manikins used in North and South America still disproportionally represent this population. It is pertinent that manikins used for CPR training reflect all populations at risk for major adverse cardiovascular events.

Premature spinal fusion after insertion of magnetically controlled growing rods for treatment of early-onset scoliosis: illustrative case

BACKGROUND Magnetically controlled growing rod (MCGR) systems have gained attention for their use in the treatment of early-onset scoliosis. Although traditional growing rods require frequent operations to lengthen the construct, MCGR allows for fewer open procedures and more frequent distractions by externally controlling rod elongation. Despite its appealing advantages, MCGR is not without limitations. OBSERVATIONS The authors describe a case of premature spinal autofusion before growing rod removal and termination of rod distraction. LESSONS This case highlights the limitations of MCGR systems, including length of use, body habitus restrictions, and risk of autofusion.

Efficacy of serratus anterior plane block in pain control in traumatic posterior rib fractures: A case series

Blunt trauma patients commonly present with multiple rib fractures, which increases overall morbidity and mortality due to pulmonary complications. Effective chest wall analgesia may be challenging due to positioning difficulty, body habitus, anticoagulation issues with neuraxial interventions, etc. Serratus anterior plane block has been shown to be beneficial in anterior and lateral rib fractures in recent studies. We propose the efficacy of this block in posterior rib fractures as well, through this small case series of blunt trauma patients with posterior rib fractures, reporting significant pain relief after the block.

A Better Standard-Uptake-Value Body Habitus Normalizer for Fluorodeoxyglucose in Humans

Purpose To devise a new body-habitus normalizer to be used in the calculation of a standardized uptake value (SUV) that is specific to the PET tracer 18F-FDG. Methods After exclusions for type and extent of cancer and timing of the scan, a cohort of 481 patients was selected for analysis of 18F-FDG uptake into “normal” tissues (presumed to be unaffected by their disease). Among these, 65 patients had only brain concentrations measured and the remaining 416 were randomly divided into an 86-patient test set and a 330-patient training set. Within the test set, normal liver, spleen and blood measures were made. In the training set, only normal liver concentrations were measured. Using data from the training set, a simple polynomial function of height and weight was selected (following a subjective procedure) to predict each patient’s mean liver percent injected dose per milliliter. This function, when used to normalize measured %ID/ml concentrations, defines a new SUV metric (SUVfdg) which we compared to SUV metrics normalized by body weight (SUVbw), lean-body mass (SUVlbm) and body surface-area (SUVbsa) in a five-fold cross-validation. SUVfdg was also tested on the independent holdout sets utilizing the measurements of normal liver, blood, spleen and brain. Results For patients of all sizes including pediatric patients, the normal range of liver 18F-FDG uptake concentration at 60 minutes post injection in units of SUVfdg is 1.0 ± 0.16. Liver, blood and spleen SUVfdg in all comparisons had lower coefficients of variation (CoV) compared to SUVbw SUVlbm and SUVbsa. Blood had a mean SUVfdg value of 0.8 ± 0.11 and showed no correlation with age, height or weight. Brain SUVfdg measures were significantly higher (P < 0.01) in pediatric patients (4.7 ± 0.9) compared to adults (3.1 ± 0.6). Conclusion A new SUV metric, SUVfdg, is proposed. It is hoped that SUVfdg will prove to be better at classifying tumor lesions and other tissues compared to SUV metrics in current use and may be useful in predicting patient specific radiation dose. Other tracers may benefit from similarly tracer-specific body habitus normalizers.

Making every contact count: recognising obesity in paediatric and young adult cardiology

Introduction: With increased survival, children with CHD are reaching adulthood, however, obesity amongst this cohort is an emerging problem. Making every contact count encourages clinicians to utilise contact to elicit behaviour change. The aim of this work was to identify whether the body habitus of children classified as obese was addressed during a clinical review. Methods: A retrospective observational cohort study was completed using a cardiology outpatient dataset from 2010 to 2019. Inclusion criteria are all children with a body mass index z score classified as obese (≥ 2 z scores). Individual electronic patient records were reviewed to identify long-term anthropometric measures including (i) recognition of body habitus, (ii) prescription of physical activity or dietary intervention, and (iii) referral to a weight management programme or dietitian. Results: From the cohort of 95 patients, 285 “obese clinical encounters” were identified, at the time of a cardiology clinic attendance. Of those, obesity was acknowledged in 25 clinic letters (8.65%), but only 8 used the correct terms “obese” or “obesity” (2.77%). Action to tackle obesity was recorded in 9.3% of cases with a direct referral to a dietitian being made on 3 occasions (1.04%). Conclusions: Body habitus is not being routinely addressed by cardiologists caring for paediatric and young adult cardiac patients. This study has recognised an alarmingly high incidence of missed opportunities to make every contact count, to manage those with obesity and associated risk factors.

Novel Hemizygous Missense Variant of Spermine Synthase (SMS) Gene Causes Snyder-Robinson Syndrome in a Four-Year-Old Boy

Snyder-Robinson syndrome (SRS) is an extremely rare X-linked intellectual disability syndrome (MRXSSR; MIM #309583). The main clinical features of SRS include psychomotor delay, hypotonia, and asthenic-type body habitus – reduced body weight and bone abnormalities (osteoporosis, fractures, kyphoscoliosis). We report a case of SRS with a hemizygous missense variant in the <i>SMS</i> gene,c.334C&#x3e;G (p.Pro112Ala), in a 4-year-old boy, who initially developed hypotonia, delayed motor skills, and subsequently epilepsy. This variant in <i>SMS</i> was found to be de novo. To the best of our knowledge, this novel <i>SMS</i> gene variant has never been previously reported in disease-related variation databases, such as ClinVar or HGMD.