Feeding pattern of children under two years of age in Riyadh, Saudi Arabia

Mothers or other close relatives of children who were in hospital in Riyadh, were asked about their feeding practices. Sixty-four per cent of mothers of newborn babies had attended antenatal clinics, but only 10% had received any instructions on feeding. Of the hospitalized children only 27% were receiving breast milk alone by one month of age. However, of the 28% of mothers who had some education, 84% were breast feeding at three months of age. In Riyadh 36 brands of artificial milk feeds are available, and by three months of age, the average baby had been on six varieties of milk. Less than 14% of mothers intending to bottle feed could read the instructions, and of those who believed they knew how, only 18% made up the formula correctly. Educational opportunities need to be exploited and easy availability of artificial milk curbed.     

An automated data algorithm to distinguish screening and diagnostic colorectal cancer endoscopy exams

Despite questions about accuracy, automated data are used increasingly for research and quality measurement. The goal of this study was to develop an automated data algorithm designed to distinguish screening and diagnostic endoscopy (sigmoidoscopy and colonoscopy) exams. We assessed the algorithm's ability to correctly classify the exams using paper medical records as the "gold standard." The algorithm used diagnostic codes to identify the indication of the endoscopies. The algorithm's ability to classify the indication varied by endoscopy exam. The sensitivities for identifying diagnostic sigmoidoscopy and colonoscopy were 48.1% and 23.8%, respectively. The algorithm missed most of the diagnostic endoscopies. Conversely, the sensitivities for identifying screening sigmoidoscopy and colonoscopy were high (87.9% and 84.4%, respectively) but were associated with low specificities. Our findings suggest that studies relying solely on automated data overestimate screening rates if indication is not considered. The automated algorithm presented here needs further improvements to better differentiate screening from diagnostic exams.     

Congenital macrodactyly: a clinical study

Congenital macrodactyly is a rare congenital malformation characterised by progressive enlargement of all mesenchymal elements of a digit. The present study is an attempt to draw the attention towards the similarities and differences between macrodactyly of the hand and foot. Radiographical, operative findings and histopathological examination of five cases are included in the present study. Emphasis was given to know the possible basic lesion. Radiographic findings, which differentiate this entity from other forms of local gigantism, were also analysed. The most characteristic finding noted was excessive overgrowth of fibro-fatty tissue with unusually large fatty lobules, apparently fixed by a mesh of dense fibrous tissue. Hypertrophy and tortuosity of the digital nerve, a striking feature in macrodactyly of the hand, was notably absent in cases affecting the foot. None of the patients had any other associated congenital anomalies. Neither the patients nor any of their family members had any stigmata of neurofibromatosis. Chromosomal study was normal in all of them. We conclude that in macrodactyly of the foot, excessive proliferation and accumulation of adipose tissue was the basic lesion, whereas involvement of the nerve might be the fundamental lesion in gigantism of the hand. Furthermore, whatever be the basic lesion, the final pathway must be either the local deficiency of a growth inhibiting factor or local expression of a basic intrinsic factor, leading to excessive growth of all elements of the digit.     

Spinal pelvic reconstruction after total sacrectomy for en bloc resection of a giant sacral chordoma. Technical note

Although radical resection prolongs the disease-free survival period, surgical management of primary sacral tumors is challenging because of their location and often large size. Moreover, in cases of lesions for which a radical resection necessitates total sacrectomy, reconstruction is required. The authors have previously described a modified Galveston technique in which a liaison between the spine and pelvis is achieved using lumbar pedicle screws and Galveston rods embedded into the ilia; additionally, a transiliac bar reestablishes the pelvic ring. Although this reconstruction technique achieves stabilization, several biomechanical limitations exist. In the present report the authors present the case of a patient who underwent spinal pelvic reconstruction after a total sacrectomy was performed to remove a giant sacral chordoma. They describe a novel spinal pelvic reconstruction technique that addresses some of the biomechanical limitations.     

Giant aneurysm of the saphenous vein graft presenting as a mediastinal mass: a case report

We report a patient who presented initially with a diagnosis of a mediastinal mass. During the cardiac catheterization, the patient was diagnosed with a saphenous vein graft aneurysm. We proceeded with a catheter-based intervention resulting in occlusion of the aneurysm. Repeat angiogram after three months showed complete occlusion of the vein graft supplying the aneurysm. We believe that in selected patients with saphenous vein graft aneurysm a catheter-based procedure is feasible and successful.     

Vestibular gaze stabilization: different behavioral strategies for arboreal and terrestrial avians

In birds, it is thought that head movements play a major role in the reflexive stabilization of gaze and vision. In this study, we investigated the contributions of the eye and head to gaze stabilization during rotations under both head-fixed [vestibuloocular (VOR)] and head-free conditions in two avian species: pigeons and quails. These two species differ both in ocular anatomy (the pigeon has 2 distinct foveal regions), as well as in behavioral repertoires. Pigeons are arboreal, fly extended distances, and can navigate. Quails are primarily engrossed in terrestrial niches and fly only short distances. Unlike the head-fixed VOR gains that were under-compensatory for both species, gaze gains under head-free conditions were completely compensatory at high frequencies. This compensation was achieved primarily with head movements in pigeons, but with combined head and eye-in-head contributions in the quail. In contrast, eye-in-head motion, which was significantly reduced for head-free compared with head-fixed conditions, contributed very little to overall gaze stability in pigeons. These results suggest that disparity between the stabilization strategies employed by these two birds may be attributed to differences in species-specific behavior and anatomy.     

Bone marrow cells from normal and ovariectomized rats respond differently to basic fibroblast growth factor and bone morphogenetic protein 2 treatment in vitro

The protein growth factors basic fibroblast growth factor (bFGF) and bone morphogenetic protein 2 (BMP-2) are being actively pursued for bone tissue engineering. Although both proteins are capable of stimulating osteogenic activity of bone marrow cells (BMCs), no studies have addressed the effect of estrogen deficiency on the growth factor responsiveness of BMCs. This study investigated the osteogenic response of BMCs from normal and ovariectomized (OVX) rats to bFGF and BMP- 2. In the absence of growth factors, a higher number of total colony-forming units (t-CFU) and alkaline phosphatase-expressing CFU (ALP-CFU) were obtained with BMCs derived from OVX rats. The percentage of ALP-CFU, however, was not significantly different between BMCs from the two groups of rats. Whereas BMP-2 did not influence the t-CFU and percentage of ALP-CFU, bFGF decreased t-CFU in BMCs derived from OVX rats and reduced the percentage of ALP-CFU in BMCs from both types of rats. Consistent with the higher t-CFU, the number of mineralized colonies (min-CFU) was also higher for BMCs derived from OVX rats. The number of min-CFU was not influenced by BMP-2 treatment, but was reduced with bFGF treatment. Comparison of the growth factor effects on a per-cell (DNA) basis confirmed the expected stimulatory effect of BMP-2 on ALP activity and mineralization in BMCs from normal rats, but these two parameters were not unequivocally stimulated in BMCs from OVX rats. We conclude that BMCs derived from normal and OVX rats exhibited significant differences in their osteogenic response to bFGF and BMP-2 treatment.