All articles

Tongue-tied: Management in Pierre Robin Sequence

Nikita Rajaraman Rajaraman, Elvino Barreto

An 18-month-old male with Pierre Robin Sequence (PRS) presented to A&E with airway obstruction and hypoxia due to retroglossoptosis. The patient was resuscitated immediately and intubated. Gold standard treatment was surgical management by mandibular distraction osteogenesis. However, as the patient was unable to afford the surgery, a simpler and cheaper surgical technique had to be employed. The procedure involved pulling the base of the tongue anteriorly and tying to the hyoid bone. This maintained airway patency and patient was extubated. Mother was given feeding and positioning advice for the child. It is expected that the mandibular growth will eventually catch up with the tongue growth.

Autistic Spectrum Disorders and Diet: the Present and the Future

Irene Mateos Rodriguez

The frequent presence of gastrointestinal problems in Autistic Spectrum Disorder (ASD) has led to attempts to understand how gastrointestinal disturbances relate to behaviour, and how modifying diets may help to modify behaviour. This review paper aims to summarise the rationale for managing symptoms of ASD through diet, the current status of research on diet and ASD, and the future of employing this approach to manage ASD.

The contribution of psychology to our present understanding of schizophrenia

Marta Isibor

Schizophrenia can be described in two ways. One perspective is a life-long devastating brain disease whereas the alternative is a distress resulting from difficult experiences which can be often successfully managed. The difference in the mere definition is not banal as it illuminates deeper discrepancies in current approaches to mental health.

Potential applications of three-dimensional bioprinting in Regenerative Medicine

Dominic Kwan

It can be argued that the concept of bioengineering began when Alexis Carrel and Charles Lindbergh published “The Culture of Organs” in 1938, which described the equipment and methods that made the in vitro maintenance of organs possible. The final chapter of the book mentions an ‘ultimate goal’ of increasing the speed of wound healing. From its conception in the 1980s to the present day, scientists and medical researchers alike have been investigating the exciting prospects that three-dimensional printing offers to the field of medicine. Over the course of three decades, advances in this technology have led to several famous milestones, in the process spawning the term ‘bioprinting’. In contemporary medicine, bioprinting is beginning to play a role in regenerative medicine and clinical research by providing scientists with the ability to build tissue-engineered scaffolds, prosthetic limbs, and even functioning kidneys. One of the earliest cases of bioprinting made international headlines in 1999 when the world’s first 3D printed collagen scaffold was used for bladder augmentation in dogs. Then, in 2009, researchers at Organovo Inc., a 3D bioprinting company in the United States, created the world’s first bioprinted blood vessels for hepatic tissue by printing tri-layered analogues formed of human fibroblasts (to represent the adventitia), smooth muscle cells (to represent the media), and vascular endothelial cells (to represent the intima).

Rapidly deteriorating mobility in a young man: Case description and possible differential diagnoses

V Srirangam

A 32 year old gentleman, presenting initially with a ‘dragging’ foot, rapidly progressed to become paraplegic within a year. Here, a case summary is presented initially, followed by the differential diagnosis for the clinical presentation. Investigations primarily showed combined central and peripheral demyelination which could have been secondary to the anti-CRMP5 antibodies found in his serum. Such antibodies are highly associated with malignancy and, as a consequence, our patient was extensively investigated for an occult neoplasm (which was not found). While the central and peripheral demyelination may have been secondary to an antibody-mediated paraneoplastic syndrome, other differentials such as autoimmune combined demyelination must also be considered.