Assessing parasitic infestation of vegetables in selected markets in Metro Manila,Philippines

ObjectiveTo assess the parasitic infestation of vegetables in selected markets in Metro Manila, Philippines.MethodsA total of 80 vegetables were purchased from public and private markets in Munoz, Quezon City, and Alabang, Muntinlupa City. Vegetables were washed, and the washings were collected and examined for parasitic organisms.ResultsIn all vegetables examined, 36 of 80 (45.0%) were infested with parasitic organisms. Vegetables obtained from Muntinlupa City showed that 17 of 40 (42.5%) have parasitic infestation as compared with those obtained from Quezon City with 19 of 40 (47.5%). Significant differences on the parasitic organisms existed between the public and private markets and between the two locations (P<0.05).ConclusionsFindings indicate that vegetables can be potential source of parasitic infection. There is a need to be vigilant in ensuring that foodstuffs sold in our market systems are safe and fit for consumption.     

Assessment of hyperemia in acute appendicitis: Comparison between power Doppler and color Doppler sonography

The purpose of our study was to compare power Doppler sonography (US) and conventional color Doppler US in the diagnosis of acute appendicitis by revealing local signs of hyperemia. One hundred consecutive patients (46 males and 54 females, ages 7–61 years; mean, 24.7 years) with clinically suspected acute appendicitis were prospectively examined with power Doppler US and conventional color Doppler US. Of 38 patients who subsequently underwent surgery, appendicitis was proven in 34. The remaining 62 patients who were not submitted to surgery had no clinical evidence of appendicitis over a 2- to 6-month follow-up. At gray-scale US, the appendix was visualized in 30 (88.2%) of the 34 cases with pathologically proven acute appendicitis. Power Doppler US depicted a moderate to marked hypervascularity of the appendiceal wall and surrounding mesoappendix in 28 (93.3%) of these 30 patients. At conventional color Doppler US, flow signal within the appendiceal wall and surrounding mesoappendix was shown in only 21 (70%) of 30 cases (P<0.05). No false-positive diagnosis was made at either power or color Doppler US among the 62 patients without appendicitis. Power Doppler US is more sensitive than conventional color Doppler imaging for revealing signs of local hyperemia in acute appendicitis.     

Trochlear nerve palsy after repeated percutaneous balloon compression for recurrent trigeminal neuralgia: case report and pathogenic considerations

OBJECTIVE AND IMPORTANCE: Repeated percutaneous balloon compression for the treatment of idiopathic trigeminal neuralgia is infrequent. When a second procedure is performed, the outcome is unknown. A patient developed an isolated trochlear nerve palsy after undergoing percutaneous trigeminal ganglion balloon compression for a second time. The mechanism of diplopia and the complications associated with this technique were studied. CLINICAL PRESENTATION: The patient was a 67-year-old woman with a history of medically refractory idiopathic trigeminal neuralgia involving all three divisions of the right trigeminal nerve. INTERVENTION: Percutaneous balloon compression was performed. Despite initial total relief from pain without complications, the patient again displayed manifestations of trigeminal neuralgia 3 months after the procedure. The pain disappeared after she underwent a second balloon compression procedure, but she developed an isolated trochlear nerve palsy, which spontaneously resolved in 2 months. CONCLUSION: Isolated trochlear nerve palsy is a rare and reversible complication after percutaneous balloon compression for trigeminal neuralgia. This case illustrates that the mechanism of injury to the fourth nerve is the result of an erroneous technique: excessive penetration of the Fogarty catheter in Meckel's cave beyond the porus trigemini and compression of the cisternal segment of the trochlear nerve when the inflated balloon is pushed against the tentorium.     

Laparoscopic approach in complicated diverticular disease

AIM: To analyze the results of laparoscopic colectomy in complicated diverticular disease.METHODS: This was a retrospective cohort study conducted at an academic teaching hospital. Data were collected from a database established earlier, which comprise of all patients who underwent laparoscopic colectomy for diverticular disease between 2000 and 2013. The series was divided into two groups that were compared: Patients with complicated disease(abscess, perforation, fistula, or stenosis)(G1) and patients undergoing surgery for recurrent diverticulitis(G2). Recurrent diverticulitis was defined as two or more episodes of diverticulitis regardless of patient age. Data regarding patient demographics, comorbidities, prior abdominal operations, history of acute diverticulitis, classification of acute diverticulitis at index admission and intra and postoperative variables were extracted. Univariate analysis was performed in both groups.RESULTS: Two hundred and sixty patients were included: 28%(72 patients) belonged to G1 and 72%(188 patients) to G2. The mean age was 57(27-89) years. The average number of episodes of diverticulitis before surgery was 2.1(r 0-10); 43 patients had no previous inflammatory pathology. There were significant differences between the two groups with respect to conversion rate and hospital stay(G1 18% vs G2 3.2%, P = 0.001; G1: 4.7 d vs G2 3.3 d, P < 0.001). The anastomotic dehiscence rate was 2.3%, with no statistical difference between the groups(G1 2.7% vs G2 2.1%, P = 0.5). There were no differences in demographic data(body mass index, American Society of Anesthesiology and previous abdominal surgery), operative time and intraoperative and postoperative complications between the groups. The mortality rate was 0.38%(1 patient), represented by a death secondary to septic shock in G2.CONCLUSION: The results support that the laparoscopic approach in any kind of complicated diverticular disease can be performed with low morbidity and acceptable conversion rates when compared with patients undergoing laparoscopic surgery for recurrent diverticulitis.     

Bizarre parosteal osteochondromatous proliferation (Nora’s lesion): report of two cases

Abstract We describe two cases of bizarre parosteal ostechondromatous proliferation (BPOP), commonly known as Nora’s lesion from the author who first described it, arising from the hands of two middle-aged patients. We emphasize the rarity of this lesion and the difficulty in diagnosis, since the histological pattern may mimic that of a malignant sarcoma.     

Longitudinal evaluation of mycophenolic acid pharmacokinetics in pediatric kidney transplant recipients. The role of post-transplant clinical and therapeutic variables

Abstract:  This longitudinal study assessed the influence of post-transplant clinical and therapeutic variables in 50 kidney transplant recipients aged 2–19 yr receiving a triple immunosuppressive regimen consisting of cyclosporine microemulsion (CsA), steroids and MMF (300–400 mg/m² body surface area twice daily), the full pharmacokinetic profile (10 points) of which was investigated on post-transplant days 6, 30, 180 and 360. Total plasma MPA was measured by Enzyme Multiplied Immunoassay Technique. CsA therapeutic drug monitoring (TDM) was performed via C2 blood monitoring, while MPA TDM via C0. MPA Cmax, tmax, AUC0-12 and AUC0-4 pharmacokinetic profile changed significantly during the first post-transplant year. C0 was a poor predictor of the total MPA exposure [as measured by the area under the concentration-time curve AUC)], while a truncated AUC was a good surrogate of the 12-h profile (r = 0.91; p < 0.001) Graft function and cyclosporine therapy influenced MPA pharmacokinetics, as shown by the univariate and multivariate analyses. We conclude that because after transplantation MPA exposure varied over time, a strict TDM is advisable in the pediatric population.     

Profilaxis antibiótica en la biopsia transrectal de próstata

IntroductionTransrectal ultrasound-guided needle biopsy of the prostate is a safe technique, but it is not complication-free, and its most serious complications are genitourinary infections (GUI) and the conditions they cause. The purpose of antibiotic prophylaxis is to reduce this GUI incidence rate. However, no established guidelines exist and there are significant differences among centres where this procedure is performed. The objective of the present report is to review antibiotic prophylaxis protocols described in the literature.Material and methodsWe reviewed indexed articles published in English or Spanish and accessible through literature databases.ResultsFive articles comparing antibiotic prophylaxis with a placebo observe lower bacteriuria and infectious complications percentage rates in the group receiving prophylaxis. In most cases, E. coli is the microorganism responsible for infection. Oral quinolones are the most commonly prescribed prophylactic antibiotics. Three studies of oral vs. parenteral prophylaxis found no differences between the two groups. Three other articles comparing short term and single-dose prophylaxis found no differences between the two groups.ConclusionsAdministering prophylactic antibiotics is more advantageous than not doing so. The moment for beginning prophylaxis depends on the antibiotic's bioavailability and how it is administered. The chosen antibiotic will preferably be administered orally as a single dose or short term course, according to the sensitivities of prevalent microorganisms. More studies are needed to determine what role pre-biopsy enemas play in reducing infectious complications.