Psoas muscular abscess in children

Symptoms of psoas muscular abscess in children are nonspecific and differential diagnosis is made among diseases included in childreńs acute hip pain syndrome, imaging tests being necessary for diagnostic confirmation. During the first semester of 1995, 48,550 children were examined in Pronto Socorro do Instituto da Crian?a do Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo, four of them diagnosed as having psoas muscular abscess (2 females and 2 males, ages varying from 1 to 12 years). All of them had nonspecific clinical features and diagnosis was confirmed by abdominal ultrasound and/or computerized tomography. Staphylococcus aureus was isolated as the etiologic agent in 3 children, findings similar to the ones in literature.     

Low-dose (5 mg/kg) desferrioxamine treatment in acutely aluminium-intoxicated haemodialysis patients using two drug administration schedules

BACKGROUND: According to the recommendations proposed at The Consensus Conferenceon Diagnosis and Treatment of Aluminium Overload in End-StageRenal Failure Patients, Paris, 1992 low-dose desferrioxamine(DFO) treatment was applied for the first time in 41 acutelyaluminium-intoxicated patients. METHODS AND RESULTS: DFO-related neurological/ophthalmological side-effects wereobserved in nine of 11 patients with a post-DFO serum aluminiumlevel >300 µg/litre and in two patients of 30 belowthis level after a single administration of a 5-mg/kg dose ofthe chelator in the conventional way (i.e. the last hour ofa dialysis session). They were no longer observed after introducingan alternative DFO administration schedule (i.e. administrationof the chelator 5 h prior to the start of a haemodialysis session;group I: n=14). A significant decrease in the serum aluminiumlevels as well as in the post-DFO serum aluminium increment(sAl) was observed during the first 6 months' course of low-doseDFO treatment in group I as well as group II (which consistedof patients receiving DFO in the conventional way; n=27). Low-doseDFO treatment was accompanied by a significant increase in themean ±SD serum iPTH levels (group I: 174±245 upto 286±285 ng/litre; group II: 206±272 up to 409±424ng/litre; P<0.005) and the mean corpuscular volume (groupI: 80±6.4 up to 85±3.7 fL, P<0.005; group II:76±5.0 up to 87±4.3 fL, P<0.0001). Serum ferritinlevels significantly decreased in both groups. No further side-effectswere observed during the DFO course. Patients in which DFO treatmentcould be stopped (i.e. subjects in which both serum aluminiumand sAl were below 50 µg/litre at two successive occasions)before the end of the 6-months' treatment course had a significantlygreate residual diuresis (700±682 ml/min vs 84±109ml/24 h). Also, residual diuresis was found to protect againstaluminium intoxication as reflected by the values noted in groupI versus those in group II. CONCLUSIONS: The 5-mg/kg DFO treatment provides a safe and adequate therapyfor aluminium overload. In severely aluminium-intoxicated patientspresenting post-DFO serum aluminium levels above 300 µg/litreDFO should be given once weekly 5 h prior to high-extractiondialysis ensuring (i) maximal chelation of aluminium (ii) limitedexposure to circulating aluminoxamine levels, and (iii) adequateremoval of the latter compound. Finally, the necessity for abetter communication between the local water distribution companiesand the dialysis centres is a major lesson that can be drawnfrom this dramatic intoxication.     

An assessment of fructose-1,6-bisphosphate as an antimicrobial and anti-inflammatory agent in sepsis.

Tissue lesion mechanisms provoked by sepsis include the infectious process, inflammation, and cellular energy deficit. We chose to test fructose-1,6-bisphosphate (FBP) because of its possible anti-inflammatory and antimicrobial actions. Wistar rats were used and divided into three experimental groups: a control group (n=10), in which a capsule was introduced into the peritoneum of the animals; a septic group (n=10), in which a capsule containing non-sterile fecal matter was introduced together with Escherichia coli (1.5 x 10(9)CFU); and a septic group treated with FBP 500 mg/kg (n=10). The blood cell tests revealed that levels of leukocytes increased significantly in the septic group when compared to both the septic group treated with FBP and the control group. The blood cultures were 100% positive in both the septic group and the septic group treated with bisphosphorylated sugar. The antibiogram only revealed an inhibitory halo in the case of the antibiotic ampicillin, there was no such indication for FBP. The anti-inflammatory power of FBP remained at 60% for 5 h in the rats that received the carrageenan injection. What is more, the sugar reduced the levels of ionic calcium in relation to the control group. This data proves the validity of using FBP in the treatment of sepsis, possibly due to its anti-inflammatory rather than antimicrobial action.     

Revisiting colorectal cancer animal model – An improved metastatic model for distal rectosigmoid colon carcinoma

Colorectal cancer (CRC) is the second most frequent and fatal cancer in Western countries. Understanding its biology with different incidence along the colon and rectum, genetic profile and how these factors contribute to local/distant progression, has been hampered by the lack of a suitable CRC model.We report a reproducible model, using human CRC cell lines (CL) (WiDr, LS1034, C2BBe1) injected (1?×?10⁷ cells/animal) in RNU rats (n?=?55) which underwent cecostomy and descending colostomy with mucosal-cutaneous fistula of the sigmoid colon. CL were characterized by immunohistochemistry: CK20, CDX2, P53, vimentin, Ki67, CD44, CD133, E-cadherin, β-catenin and CEA; cancer stem cells-immune system interaction was studied and tumor progression was assessed with nuclear medicine imaging (^99mTc-MIBI).Animals developed locally invasive tumors and with WiDr neural invasion was registered. Cancer stem cells were detected in WiDr (CD44 positive). All the cell lines stimulated the immune system, being WiDr the most aggressive. Imaging studies demonstrated tumor uptake.With this CRC model we can study the microenvironment role and tumor-stroma interactions. All CL developed primary disease, but only the WiDR established neural invasion which may represent a metastatic pathway. This model can help unveiling the underlying metastatic mechanisms, and ultimately test better therapeutic approaches for CRC.     

Primary infertility associated with schitosoma mansoni: a case report from the Jos plateau,north central Nigeria

Testicular schistosomiasis caused by Schistosoma mansoni is very rare and more so when associated with primary infertility. A 40 years old man from the Jos Plateau, North Central Nigeria presented with primary infertility after ten years of marriage. Sperm count revealed oligospermia and he also complained of inability to sustain erection. Testicular biopsy revealed several ova of Schistosoma mansoni in the connective tissue of the testes. Cases of infertility in endemic areas especially when there is no supply of potable water should raise suspicion of schistosomiasis among other pathologies and possible hormonal disturbances when the testes are involved.