Multiple cases with various types of pediatric malabsorption syndromes were evaluated. The clinical manifestations, laboratory findings, pathophysiology, and histopathological descriptions of each patient were analyzed in an effort to clear the pathogenesis of the malabsorption syndromes and the treatments were undertaken.

The cases studied, included one patient with cystic fibrosis, two with lactose intolerance with lactosuria (Durand type), one with primary intestinal lymphangiectasia, two with familial hypobetalipoproteinemia, one with Hartnup disease, one with congenital chroride diarrhea, one with acrodermatitis enteropathica, one with intestinal nodular lymphoid hyperplasia (NLH), five with intractable diarrhea of early infancy and four with glycogenosis type Ia. Each case description and outcome is described below: 1. A 15-year-old Japanese boy with cystic fibrosis presented with severe symptoms, including pancreatic insufficiency, bronchiectasis, pneumothorax and hemoptysis. His prognosis was poor.

Analysis of the CFTR genes of this patient revealed a homozygous large deletion from intron 16 to 17b. 2. In the sibling case of Durand type lactose intolerance, the subjects’disaccaridase activity of the small bowel, including lactase, were within normal limits. The results of per oral and per intraduodenal lactose tolerance tests confirmed lactosuria in both. These observations suggested, not only an abnormal gastric condition, but also duodenal and intestinal mucosal abnormal permeability of lactose. 3. In the case of primary intestinal lymphangiectasia, the subject had a lymphedematous right arm and hand, a grossly coarsened mucosal pattern of the upper gastrointestinal tract (identified via radiologic examination) and the presence of lymphangiectasia (confirmed via duodenal mucosal biopsy).

Source: Hosoyamada T / Department of Pediatrics Fukuoka Red Cross Hospital, Fukuoka, Japan.

By 2006, about 50 children had received cord blood transplants at Seattle Cancer Care Alliance. As this source of stem cells expands, the transplant donor pool expands as well, making stem cell transplants available to a greater number of patients. This can be especially important for ethnic minorities and those who have mixed ethnicity or unusual tissue types—in all these cases, it’s more difficult to find a suitably matched donor.

Stem cells for a hematopoietic cell transplant can come from three sources: bone marrow, peripheral blood (the blood that circulates around your body) or the blood that remains in the umbilical cord when a mother and newborn are separated. Most cord blood is discarded. But some is collected in banks so that people who need stem cell transplants can use it.

The stem cells from cord blood are more versatile than those from bone marrow or peripheral blood, simply because the infant donor’s immune system is immature. The stem cells are relatively “uneducated” compared to cells from an older child or an adult. So there’s less likelihood of an adverse interaction between the transplanted cells and the recipient’s cells. This means that in order to be useful, stem cells from cord blood do not have to match the recipient’s tissue as closely as bone marrow or peripheral blood stem cells do.

Other than the source of the stem cells, a cord blood transplant is very similar to a bone marrow or peripheral blood stem cell transplant. The main difference is that it sometimes takes longer for the transplanted cells to engraft—to establish themselves in the recipient’s body and begin producing blood cells. Longer time to engraftment means more time without adequate numbers of the white blood cells that guard against infection.

Source: Seattle Cancer Care Alliance

 

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Overweight is defined as a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) at the 85th to less than the 95th percentile for age. Obesity is defined as a BMI at or above the 95th percentile. Data are from the Centers for Disease Control and Prevention (CDC) 2008 Pediatric and Pregnancy Nutrition Surveillance Systems (program-based surveillance systems that monitor the nutritional status of low-income infants, children, and women in federally funded maternal and child health programs). Data are based on BMI percentiles for children 2 years of age or older from CDC growth charts from 2000. The Ohio data are from the Ohio Department of Health’s Women, Infants, and Children division; the prevalence according to the Ohio Department of Health’s Bureau of Child and Family Health Services is higher (33.1%).

Source: NEJM

JCI Accreditation in Europe: As one of the more developed regions in the world, Europe offers the overseas traveler or expatriate a large number of JCI accredited healthcare institutions. Ireland, Italy and Spain seem to have the largest number of healthcare institutions with JCI accreditation that probably reflect their ambitious efforts to promote medical tourism.

Europe has well over 60 JCI accredited hospitals alone. This is no doubt an underestimation of the number of quality hospitals in the region since most countries have alternative mechanisms for insuring quality healthcare services. Generally speaking, the international quality of healthcare is very good in the Western European countries.

Source: Gary Spirit | November 20, 2011

 

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Using prostate supplements is an absolute necessity if you want to achieve optimal health. Prostate massage used together with the right kind of supplements plus well balanced diet, provide all the right arsenal for you to be a good fighter against your prostate woes.

This is why:

Our body is only as strong as we make it. It is up to us to supply it with all the proper nutrients it needs to function well on a daily basis and to fight the disease. We either get these nutrients in the food we consume or artificially in a form of a pill.

Back in the day, the quality of food was better – food had less pesticides and chemicals, diet was versatile and natural. There wasn’t pre packaged snacks options sold in vending machines and fast food drive throughs. If you wanted to snack you would eat fruits or veggies in their raw form. Now the food industry is mostly concerned with profits and not at all with your health. That is why it is up to you to not only avoid bad processed and junk foods but to enrich your diet with supplements that contain vital minerals and nutrients.

In case with you prostate gland, it only functions or heals well if you provide these nutrients. If you don’t provide them, they won’t just appear out of nowhere, and most likely will not be found in the food you consume. Your immune and lymphatic system, which is responsible for fighting disease and cleansing your system is usually one of the first to dysfunction. In males especially the most fragile system is the reproductive system (especially the prostate gland). That is why prostate related problems are as common as colds.

Source: Prostate Health Center

Les infections urinaires sont les infections bactériennes les plus fréquentes quelque soit l’âge. Entre 20 et 50 ans, les infections sont 50 fois plus fréquentes chez la femme, mais après 50 ans l’incidence chez l’homme augmente nettement du fait de l’augmentation des maladies prostatiques, et le ratio est donc seulement de 3/1 chez les sujets âgés. La fréquence des infections est inférieure à 5 % dans la population féminine et inférieure à 0,1 % chez les hommes.

La fréquence augmente progressivement avec l’âge. Les récidives infectieuses sont fréquentes chez la femme. 20% des femmes ayant une infection urinaire vont avoir un nouvel épisode et 30% de celles-ci encore un autre épisode. Dans le dernier groupe, 80% vont avoir ensuite des récidives. Chez l’enfant, l’infection urinaire est rare, et doit faire d’abord évoquer une malformation de la voie urinaire.

L’urine normale est stérile, c’est à dire qu’elle ne contient à l’état normal ni microbe, ni virus ni champignon. Cependant, les infections urinaires sont les plus fréquentes de toutes les infections bactériennes car l’urine n’a en fait aucune propriété pour résister aux microbes, et peut donc être un excellent milieu de culture. 

Source: UroPage.com

The current vaccination programme protects against only some of the bacterial types involved. A Chilean study, reported in The Lancet medical journal, found more evidence the new vaccine works against the B form of the disease. This causes about 2,000 cases in the UK each year, mostly in the under-fives.

The meningitis vaccine programme here is thought to have saved many hundreds of lives over the past decade. However, meningitis B has been an elusive target for vaccine developers, as it is a group of thousands of subtly-different strains of bacteria, making it difficult to find a single jab that could cover them all.

So while four other major strains are included in the vaccine, the danger from meningitis B remains. The infection, which causes inflammation of membranes surrounding the spinal cord and brain, still causes more than 100 deaths a year, with many more children suffering serious and potentially disabling illness.

Scientists produced the “4CMenB” vaccine by analysing the genetic structure of thousands of B strains, looking for shared features which could be targeted. There have already been encouraging results when given to toddlers, and the latest study, carried out by University of Chile scientists, looked at its effectiveness when given to 11 to 17-year-olds.

Source: BBC

La distribution aux organes effecteurs (les muscles) des programmes moteurs centraux, s’effectue par les voies du Système nerveux périphérique. Ce sont :

1) – Les racines spinales (ou rachidiennes) Situées entièrement dans le canal vertébral (ou canal rachidien), elles sont de longueur croissante, du renflement cervical de la moelle au renflement lombo – sacré, en raison de leur obliquité progressive. A ce niveau, elles sont exposées à plusieurs pathologies spécifiques : arrachements traumatiques radiculo – médullaires (avulsions), compressions tumorales intra- rachidiennes bénignes (lipome, névrome) ou malignes, hernies discales compressives au niveau des lordoses (cervicale ou lombo – sacrée) etc…

2) – Les nerfs spinaux (ou n. rachidiens) sortent des foramen intervertébraux. Ils sont exposés aux mêmes types de pathologie.

3) – Les plexus : En raison de leurs intrications et subdivisions anatomiques (troncs primaires, secondaires, faisceaux), ils constituent des tableaux cliniques complexes, traumatiques ou compressifs. Les troncs nerveux périphériques (Nerfs médian, radial, fémoral, etc…) sont, pour eux-mêmes et à des degrés divers, le siège de pathologies traumatiques, infectieuses, dégénératives, aboutissant aux tableaux cliniques classiques des paralysies périphériques.

Source: Dr. Bertrand Boutillier – Pr. Gérard Outrequin

Superior mesenteric artery syndrome is obstruction of the third portion of the duodenum by compression between the abdominal aorta and superior mesenteric artery. Pediatric orthopedists are familiar with this entity, as the association between superior mesenteric artery syndrome and spinal fusion or body casting has been well established. However, patients with spinal deformities usually experience superior mesenteric artery syndrome after orthopedic intervention, with rates after corrective spinal surgery reported between 0.5% and 2.4%.

Figure 1: Upper GI study demonstrating proximal duodenal dilation and occlusion of the third portion of the duodenum. Note the absence of contrast in the fourth portion of the duodenum.

Symptoms of superior mesenteric artery syndrome typically include nausea, bilious emesis, abdominal pain, early satiety, and anorexia. Initial treatment focuses on gastric decompression and maintaining euvolemia and electrolyte balance. The patient should receive enteral nutrition via nasojejunal tube or parenteral nutrition to allow for weight gain and subsequent resolution of the obstruction.

The superior mesenteric artery takes off from the duodenum at an angle of 45° to 60° in normal individuals. The third portion of the duodenum is suspended between these vessels by the ligament of Treitz. Any variation in this relationship that decreases the arteriomesenteric angle may induce obstruction. Specifically, lumbar hyperextension or hyperlordosis can traction the mesentery and vessels. Only 2 cases of superior mesenteric artery syndrome in patients with sagittal plane spinal deformity have been described in the literature. In patients with concomitant superior mesenteric artery syndrome and spinal deformity, correction of the deformity may help alleviate the obstruction and result in faster recovery. The contribution of spinal column deformity to the arteriomesenteric angle should not be overlooked.

Source:

Drs Marecek and Sarwark are from the Department of Orthopedic Surgery, Northwestern University, and Drs Barsness and Sarwark are from The Children’s Memorial Hospital, Chicago, Illinois. Drs Marecek, Barsness, and Sarwark have no relevant financial relationships to disclose.

Correspondence should be addressed to: Geoffrey S. Marecek, MD, Department of Orthopedic Surgery, Northwestern University, 676 N Saint Clair St, Ste 1350, Chicago, IL 60611

On ne parle pas ici d’un bâtonnet de menthe poivrée qui perd son goût trop rapidement mais de problèmes avec l’essence même de votre sourire: les tissus de couleur corail qui retiennent vos dents. Nous parlons, bien sûr, de vos gencives. Protégez-les ou vous perdrez vos dents.

Le problème de gencive le plus courant est le saignement. C’est un signe d’inflammation, ce que les dentistes appellent gingivite. La gingivite est une maladie précurseur d’un trouble plus grave : la périodontite. Une fois que la gencive est parvenue à ce stade, vous pouvez perdre vos dents.

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La gingivite est causée par une accumulation de plaque qui se forme autour des dents et des gencives. La plaque est un sédiment de salive et d’aliments plein de bactéries. Toute personne qui va régulièrement chez son dentiste sait qu’elle souffrira des effets de l’accumulation de plaque si elle ne se brosse pas ni se passe la soie dentaire chaque jours. Cependant, d’autres facteurs interviennent dans les problèmes de gencive.

« Ce symptôme est plutôt sexiste. Les femmes sont beaucoup plus susceptibles de souffrir d’une gingivite que les hommes, déclare JoAnne Allen, D.D.S., dentiste en pratique privée à Albuquerque. Durant leurs règles, les gencives des femmes sont plus enflées et plus sensibles, souligne-t-elle. Et leurs gencives saignent plus facilement. Cette sensibilitté ne prédispose pas les femmes aux maladies des gencives, mais la situation pourrait s’aggraver si d’autres facteurs comme une mauvaise hygiène dentaire étaient présents. »

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Le Dr Allen souligne aussi que presque toutes les femmes qui deviennent enceintes souffrent d’une gingivite temporaire accompagnée d’enflure et de saignements qui s’aggrave à mesure que la grossesse arrive à terme.

Source: WebDoctuer

Avec environ 40 000 nouveaux cas estimés à partir des années 2000, le cancer de prostate par sa fréquence se situe maintenant au 2ème rang de l’ensemble des cancers et au 1er rang pour l’homme, chez qui il représente 25 % de l’ensemble des nouveaux cas. Un homme sur six risque d’avoir un diagnostic de cancer de prostate au cours de sa vie. C’est un enjeu de santé publique. Son incidence est en augmentation constante de 9 % en moyenne par an en France.

Le dépistage par le dosage de PSA explique en partie cette augmentation. Sa mortalité a commencé à diminuer sur la période récente du fait de sa prise en charge par la prostatectomie totale à un stade curable. La chirurgie du cancer de la prostate (prostatectomie totale = ablation totale de la prostate et des vésicules séminales) pouvait se faire jusqu’à une période récente par deux techniques chirurgicales : la chirurgie conventionnelle et la coelioscopie.

A partir des années 2000, la chirurgie robotique s’est progressivement installée. Les progrès technologiques sont tels que la chirurgie assistée par robot et notamment la prostatectomie totale est maintenant largement diffusée aux Etats-Unis et en augmentation constante. Ainsi, aux USA, 120 000 prostatectomies totales sont réalisées chaque année et l’incidence rapidement ascendante de la prostatectomie robotique fait qu’au cours de l’année 2008, il est prévu qu’environ 60 % de ces interventions soient réalisées sous robotique.

Il est également prévu qu’à terme de 5 ans, si les courbes de progression restent à l’identique, la part de la prostatectomie radicale non robotique deviendra extrêmement marginale.

Source: Centre d’Urologie et d’Andrologie de Paris

What Are Recent Advances in Knee Replacement Surgery? Minimally invasive surgery (MIS) has revolutionized knee replacement surgery as well as many fields of medicine. Its key characteristic is that it uses specialized techniques and instrumentation to enable the surgeon to perform major surgery without a large incision. MIS knee joint replacement requires a much smaller incision, three to five inches, versus the standard approach and incision, which is typically eight to twelve inches.

The smaller, less invasive approaches result in less tissue trauma by allowing the surgeon to work between the fibers of the quadriceps muscles instead of requiring an incision through the tendon. It may lead to less pain, decreased recovery time and better motion due to less scar tissue formation. Currently this less invasive procedure is performed by only a small percentage of orthopaedic surgeons in North America. Because this type of surgery is still relatively new, research has been initiated to determine how the immediate and long-term results will compare to traditional surgery.

Source: WebMD

The bone structure of the knee joint is formed by the femur, the tibia, and the patella. The ACL is one of the four main ligaments within the knee that connect the femur to the tibia.

 

• (Left) Arthroscopic picture of the normal ACL.
• (Right) Arthroscopic picture of torn ACL [yellow star].

The knee is essentially a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) ligaments. The ACL runs diagonally in the middle of the knee, preventing the tibia from sliding out in front of the femur, as well as providing rotational stability to the knee.

The weight-bearing surface of the knee is covered by a layer of articular cartilage. On either side of the joint, between the cartilage surfaces of the femur and tibia, are the medial meniscus and lateral meniscus. The menisci act as shock absorbers and work with the cartilage to reduce the stresses between the tibia and the femur.

Source:

Eating before liver biopsy — You should have nothing to eat or drink for six hours before the procedure. You may be allowed to have a light breakfast only, such as black tea or coffee and toast. Some doctors recommend eating a small amount of fat (such as butter or margarine) with breakfast, which will empty the gallbladder and potentially decrease the risk of gallbladder injury during the biopsy.

LIVER BIOPSY PROCEDURE — Most liver biopsies are done in a hospital. Upon arrival for the biopsy (usually in the early morning), a doctor or nurse will review your medical history, including medications and allergies. You may have an IV line placed into a vein so that fluid and medicine can be given if needed.

You may be given medicines to minimize discomfort and anxiety. Because your cooperation is needed during a liver biopsy, you will not be put to sleep. The biopsy itself only takes a few seconds as the biopsy needle is passed quickly in and out of the liver. A small bandage will be applied to the biopsy site; stitches are not needed.

LIVER BIOPSY COMPLICATIONS — A liver biopsy is a very safe procedure when performed by an experienced doctor. The most common problems include mild pain and a minor decrease in blood pressure. More serious complications, such as bleeding, infection, and injury to nearby organs, are very rare.

Source:

• Sanjiv Chopra, MD 
• Section Editor
• Marshall M Kaplan, MD
• Deputy Editor
• Anne C Travis, MD, MSc, FACG

Courtesy of Youtube

People sometimes have a hard time understanding the difference between depression and normal sadness. Dr. Eredlyi discusses the different kinds of depression, and how to recognize them.Watch More Health Videos at Health Guru: http://www.healthguru.com/?YT

Dr. Michael Stifelman, who heads up the Robotic Surgery Center’s program for urinary tract reconstruction, has one of the largest number of robot-assisted urinary tract reconstruction surgeries to his credit in the world. He lectures and demonstrates his surgical techniques nationally and internationally, and has published extensively in this area. The following table shows the results of the most recent 156 robotic reconstructive procedures that he’s performed.

 

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Note: Proicedures performed: May 2004 – November 2009

Source: NYU Langone Medical Center

The effect of acupuncture for postoperative pain control remains controversial. We therefore studied the effects of electrical auricular acupuncture (AA) on postoperative opioid consumption in a randomized, patient-blinded clinical trial.

40 female patients undergoing laparoscopy were included. Anaesthetized patients were randomly assigned to receive AA (shen men, thalamus and one segmental organ-specific point) or electrodes and electrical stimulation for 72 hours. Postoperatively patients received 1 g paracetamol every 6 hours and additional piritramide on demand. A blinded observer obtained the doses of piritramide and the visual analogue pain scores (VAS) at 0, 2, 24, 48, and 72 hours

Postoperative pain treatment is a major issue in management of surgical patients. Goal of the treatment is a maximal effect with minimal side effects. There are various treatment options, including conventional pharmacological and complementary approaches. Acupuncture is a system with an empirical basis, which has been used in the treatment for centuries. The mechanisms can be partly explained in terms of endogenous pain inhibitory systems. Its use for pain relief has been supported by clinical trials and this has facilitated its use in pain clinics in most countries.

 

Needle acupuncture and other forms of sensory stimulation produce similar physiological changes in humans and mammals, e.g. rhythmic discharges in nerve fibres, and the release of endogenous opioids. Besides acupuncture points located on “meridians” all over the body acupuncture points are also described on the ear. The stimulation of acupuncture points can be achieved by pressure, a mechanical action of needling, or electrical point stimulation.

In chronic pain treatment acupuncture has been found to be more effective than other non-pharmacological therapies. Furthermore, continuous electrical stimulation of auricular acupuncture points improves the treatment of chronic cervical pain patients. Finally, acupuncture represents not only a therapeutically beneficial, but also a cost-effective treatment option. Auricular acupuncture is also known to be effective in treatment of acute postoperative pain.

The aim of our study is to investigate in a randomized, prospective, double – blind, and controlled design whether continuous electrical stimulation of auricular acupuncture points results in reduction of postoperative pain.

Source: Andrea Holzer, MD, Medical University of Vienna

The type and timing of surgical repair depends on the child’s condition and the type and severity of heart defects.

In general, symptoms that indicate that surgery is needed are:

• difficulty breathing because the lungs are wet, congested, or fluid-filled (congestive heart failure)
• problems with heart rate or rhythm (arrhythmias)
• excessive work load on heart that interferes with breathing, feeding, or sleeping

An incision may be made through the breastbone (sternum) and between the lungs (mediastinum) while the child is deep asleep and pain-free (under general anesthesia). For some heart defect repairs, the incision is made on the side of the chest, between the ribs (thoracotomy) instead of through the breastbone. Heart-lung bypass may be needed. Tubes are used to re-route the blood through a special pump that adds oxygen to the blood and keeps it warm and moving through the rest of the body while the repair is being done.

Source: Medline Plus