Anatomo-radiological study of the middle colic artery in children from 0 to 1 year

The authors tried to establish the most frequent origin and distribution patterns of the middle colic artery. The search consisted of fifty cases and it was possible to distinguish five fundamental types of vascular origin and two basic types of distribution. The use of the radiological method for the anatomical study of small vascular structures proved us the great importance comparing it with the traditional dissecation.     

Valve Repair in Children with Congenital Mitral Lesions: Late Clinical Results

Mitral valve repair may be performed without ring support with advantages related to results and complications. The objective of this study was to analyze the long-term clinical results following surgical repair and reconstruction without the use of rings in cases of congenital mitral lesions in children less than 12 years of age. Twenty-one patients who had undergone surgery during the period from 1975 to 1998 were evaluated. The mean age was 4.6 +/- 3.4 years. Females represented 47.6% of the total. Mitral regurgitation was present in 57.1% (12 patients), stenosis in 28.6% (6 patients), and the mixed lesion group represented 14.3% (3 patients). Perfusion time was 43.1 +/- 9.5 minutes and ischemic time 29.4 +/- 10.5 minutes. Follow-up time was 41.5 +/- 53.6 months for the regurgitation group, 46.3 +/- 32.0 months for the stenosis group, and 39.41 +/- 37.51 months for the mixed lesion group. Echocardiographical follow-up time was 37.17 +/- 39.51 months for the regurgitation group, 42.61 +/- 30.59 months for the stenosis group, and 39.41 +/- 37.51 months for the mixed lesion group. Operative mortality was 9.5% (two cases). There were no late deaths. In the regurgitation group, 10 patients (83.3%) were asymptomatic (p = 0.004). In the echocardiographical follow-up, most of the patients had minimal regurgitation. In the clinical follow-up of the stenosis group all patients were in functional class I (NYHA). The mean transvalvular gradient measured by echocardiography was from 8 to 12 mmHg with a mean gradient of 10.7 mmHg. In the mixed lesion group there was one reoperation at postoperative month 43. There were no cases of endocarditis or thromboembolism. Mitral valve repair in congenital lesions is associated with good late results. The majority of cases in the regurgitation group remain asymptomatic and do not require reoperation. Rings or annular support are not necessary in such cases. Satisfactory repair is more difficult to achieve in cases of mitral stenosis due to valvular abnormalities and the seriousness of the associated lesions.     

Short stature with pigmentation

Four hypomelic children of abnormally short stature had slight intellectual defect, melanotic skin, and some facial features in common. 3 were followed to the age of 23-26 years, and they remained small and pigmented.     

我国道路交通事故伤概况

以公安部交通管理局公布的数据为基础，报告我国近４０多年来，道路交通事故及其所致的伤亡不断上升，分别增加了约３０倍至５０余倍；万车死亡率有明显下降趋势，由１９５１年的１３７．６４人降至１９９３年的２７．２７人，但仍远高于发达国家（＜５人），１０万人死亡率有增高的趋势，由１９５１年的０．１５人增至１９９３年的５．２９人，但低于发达国家（＞７．７人），这显然与我国人均汽车拥有量较少有关。通过分析道路交通     

The Impact of Gabapentin Administration on Brain GABA and Glutamate Concentrations: A 7T 1H-MRS Study

Gamma-aminobutyric acid (GABA) and glutamate are implicated in numerous neuropsychiatric and substance abuse conditions, but their spectral overlap with other resonances makes them a challenge to quantify in humans. Gabapentin, marketed for the treatment of seizures and neuropathic pain, has been shown to increase in vivo GABA concentration in the brain of both rodents and humans. Gabapentin effects on glutamate are not known. We conducted a gabapentin (900 mg) challenge in healthy human subjects to confirm and explore its effects on GABA and glutamate concentrations, respectively, and to test the ability of single voxel localized proton magnetic resonance spectroscopy (¹H-MRS) to reliably measure GABA and glutamate in the visual cortex at the ultra-high magnetic field of 7 Tesla. Reproducibility of GABA and glutamate measurements was determined in a comparison group without drug twice within day and 2 weeks apart. Although GABA concentration changes were small both within day (average 5.6%) and between day (average 4.8%), gabapentin administration was associated with an average increase in GABA concentration of 55.7% (6.9–91.0%). Importantly, drug-induced change in GABA levels was inversely correlated to the individual''s baseline GABA level (R²=0.72). Mean glutamate concentrations did not change significantly with or without drug administration. In conclusion, localized ¹H-MRS at 7 Tesla can be successfully applied to the measurement of GABA concentration and is sensitive to acute drug-induced changes in cortical GABA. Whether baseline GABA concentrations predict clinical efficacy of gabapentin is an area worthy of exploration.     

Knowledge and practices in breastfeeding promotion by Family Health teams in Montes Claros, Brazil

The Family Health Strategy has been implemented in Brazil with the aim of reorganizing the health care system with an emphasis on promotion and prevention. Thus, encouragement for breastfeeding is one of the most important activities by family health care teams. The objective of this study was to assess knowledge and practices by family health care teams in relation to breastfeeding. In addition to a questionnaire on health professionals' characteristics, a specific knowledge test on breastfeeding was conducted with 41 physicians and nurses and another test on the same subject was given to 152 community health workers. Scores were above 80% on the advantages of breastfeeding in all the teams, but knowledge on practical issues concerning technique and management of the main problems encountered in breastfeeding was not uniform among the health professions. Nurses scored better than physicians, and community health workers had the lowest scores. Practical activities to promote breastfeeding were not developed uniformly among health care professionals. There is a need for systematic and ongoing training in breastfeeding management in the family health teams.