Isolated polyarteritis nodosa affecting the cecum

Summary We report the case of a 52-year-old white male who developed low back pain and 35-pound weight loss and whose barium enema revealed a constricting lesion of the cecum. After resection, polyarteritis was found to be the cause of the lesion. There was no other histological evidence for arteritis in this patient.The opinions expressed herein are those of the authors and not necessarily those of the Department of Defense, U.S. Air Force, or the Uniformed Services University of the Health Sciences.Figures are published with permission from the Armed Forces Institute of Pathology.     

Nonoperative management of delayed splenic rupture in an adult

Due to the evidence that a splenectomized patient is at increased risk for serious infection, nonoperative management of splenic injury, as well as operations designed to preserve functioning splenic tissue, have been recently reported. Most experience in nonoperative management has been in the pediatric and young-adult age groups. We report a case of delayed rupture of the spleen in a middle-aged patient who was successfully managed nonoperatively and was followed with ultrasonography to resolution.Supported in part by the Bureau of Medicine and Surgery Clinical Investigation Program.     

Muckle–Wells syndrome in an Indian family associated with NLRP3 mutation

Muckle — Wells syndrome (MWS) is a rare autosomal dominant disease that belongs to a group of hereditary periodic fever syndromes. It is part of the wider spectrum of the cryopyrin-associated periodic syndrome (CAPS) which has only rarely been described in non-Caucasian individuals. It is characterized by recurrent self-limiting episodes of fever, urticaria, arthralgia, myalgia and conjunctivitis from childhood. Progressive sensorineural hearing loss and amyloidosis are two late complications. MWS is caused by gain of function mutations in the NLRP3 gene, which encodes cryopyrin, a protein involved in regulating the production of proinflammatory cytokines. We report two patients with MWS in an Indian family associated with the p.D303N mutation in the NLRP3 gene. These findings promote awareness of these hereditary periodic fever syndromes as a cause for recurrent fevers from childhood in the Indian population.KEY WORDS: Hereditary periodic fever, D303N mutation, Indian family, Muckle—Wells syndrome, p.D303N mutation     

Comparison of cleansing methods in preparation for colonic surgery

Golytely, an oral gut lavage solution, was compared with a standard bowel cleansing preparation in patients undergoing elective colonic surgery. Sixty patients were randomly assigned to either a one-day preparation with Golytely and bisacodyl or a standard method using a three-day clear liquid diet, cathartics, and enemas. Colon cleansing was better with Golytely (100 percent optimal cleansing vs. 64 percent, P less than 0.05). Patients receiving Golytely had less weight loss and found this preparation more tolerable. Quantitative stool cultures before and after preparation and intraoperatively were not significantly different between the two preparations. In this surgical bowel preparation study, Golytely and Bisacodyl were found to be safe, rapid, and effective. The preparation was well tolerated by patients and has become our preferred method of colonic cleansing.     

Management of acute ankle ligament injuries

Ankle sprains are amongst the most common injuries presenting to emergency departments in the UK. They are not one single entity but a heterogeneous group of injuries with a wide spectrum of severity. Most injuries will involve the lateral ankle ligament complex but it is important to ensure injuries to the syndesmotic ligaments or the deltoid ligaments are not missed. Missed injuries or poor management can cause disabling consequences and may occur in as many as 40% of inadequately treated patients. This article focuses on the basic anatomy and biomechanics of the ankle joint, common mechanisms of injury, appropriate diagnostic techniques and the indications for non-operative and operative management.     

Mononuclear cell therapy reverts cuff-induced thrombosis in apolipoprotein E-deficient mice

Background

The effect of an herbal formulation LI85008F on weight loss in obese human subjects was evaluated in an 8-weeks randomized, double-blind, placebo-controlled study (Clinical Trial Registration no. ISRCTN37381706). Fifty obese subjects (Body mass index 30 to 40?kg/m2, 29.3% male; 70.7% female; ages 27?C50?years) were randomized into two groups; placebo (n?=?25) and LI85008F formulation (n?=?25). The participants received either 900?mg/day of LI85008F formulation in three divided doses or three identical placebo capsules and all of them remained on a calorie-controlled diet (2000 cal/day) and 30?min walking for 5?days a week during the entire duration of the study.

Results and discussion

At the end of the trial period, LI85008F supplemented group showed significant net reductions in body weight and Body Mass Index (BMI). The participants who received the herbal formulation, showed reduced fasting blood glucose, LDL, LDL/HDL ratio, and triglycerides. At the end of the study, LI85008F supplementation also provided 21.26% (p?=?0.012) increase in serum adiponectin level, compared with the placebo group. No major adverse events were reported by the participants in the study duration. In addition, Adipokine profiling study in 3T3-L1 adipocytes demonstrates that LI85008F modulates key regulatory factors of adipogenic differentiation and insulin sensitivity, such as Adiponectin, Pref-1, and resistin.

Conclusion

The herbal formulation LI85008F (Adipromin) is prepared from commonly used medicinal plants extracts, which provides useful and safe application for weight loss in obese humans. It also demonstrates potential promise in controlling healthy blood glucose level in obesity linked type 2 diabetes.