Prenatally detected gastroschisis presenting as jejunal atresia due to vanishing bowel

A case of gastroschisis complicated by vanishing bowel and presenting as jejunal atresia is reported that is uniquely different from previously reported cases. Following delivery, complete closure of the abdominal wall with a small fascial defect was observed. Complete healing of this fascial defect was observed at 1 month of age. Accepted: 5 January 1999     

Pathomorphology of uveitis caused by an echovirus

The monkey eyes infested by inoculation into the eye anterior chamber of the ECHO-19 virus from children with uveitis were studied morphologically. It was established electron microscopically that the inoculated virus is replicated in the capillary endothelium and stromal cells of the uveal tract. Crystal-like accumulation of virions and degenerative changes in the organelles are observed in these cells. Acute granulomatous alterative-exudative-hemorrhagic uveitis with the destruction of the iris, ciliary body and processes and secondary changes in the cornea and crystalline lens with the symptoms of keratitis and cataract develop in the anterior part of the eye as observed in the light microscope. The anterior and posterior goniosynechia develop. An acute inflammatory process is further transformed into a progressing autoimmune inflammation.     

Safety of pegylated interferon in patients with hepatitis C virus induced cirrhosis

OBJECTIVES: The authors described their experience with the therapy with pegylated interferon and its safety in patients with hepatitis C virus (HCV) induced liver cirrhosis treated at First Department of Medicine, Medical School, University of Pécs and at Tawam Hospital, Al Ain, United Arab Emirates. PATIENTS AND METHODS: Twenty four (12 male, 12 female, average: 55.66 +/- 7. 02 years) anti-HCV and/or HCV-RNA PCR positive cirrhotic patients were examined. Liver cirrhosis was diagnosed by abdominal ultrasound and/or histological examination of liver biopsy. RESULTS: Different genotypes of HCV were detected: genotype 1 in 7 cases, genotype 2 in 1 person, genotype 3 in 3 cases. Genotype 4 was detected in 10 patients, all of them were treated out of Hungary. Thirteen of 24 patients were not treated earlier, 6 persons were non-responders to previous interferon monotherapy, pegylated interferon was administered to 5 patients because of relapse. Biochemical parameters showed improvement in 16 cases (16/24, 66.66%), but did not in 5 patients. Until now, virological response was achieved in 13 patients (13/24, 54.16%), while three patients remained HCV-PCR positive. Temporary dose reduction was needed in 13/24 cases (54.16%). Withdrawal of therapy became necessary in only 2 patients due to severe neutropenia, thrombocytopenia and/or signs of decompensation. CONCLUSIONS: Pegylated interferon treatment is well tolerated by patients with compensated liver cirrhosis (Child-Pough stage A). Frequent side-effects (half of all cases) were usually mild or moderate requiring discontinuation only in 2 of 24 patients. The incidence of neutropenia and thrombocytopenia emphasizes the need of frequent blood cell count tests and patients follow up.     

Comparing neurootological complaints in patients at the end of their professional lives (51-60 years) with those during the first phase of retirement (61-70 years)

Geriatrics defines the branch of medicine that treats all problems peculiar to old age and the aging, including the clinical problems of senescence and senility. In the full chain of years of the human life, a special period is humans' last decade of professional life (i.e., 51-60 years) and their first decade of retirement (i.e., 61-70 years). For this study aimed at comparing neurootological complaints of persons in this period of their lives, we examined large samples of European neurootological patients: Group A consisted of 1,965 persons aged 51-60 years, and group B consisted of 1,032 persons aged 61-70 years. Of the 11 vertigo and nausea symptoms evaluated, group A demonstrated 2.68 signs and group B 2.49 signs per individual. Acoustic subjective symptoms of tinnitus were exhibited in 55.42% of group A patients, and hearing loss was present in 63.92% of these patients. In group B, 52.62% of patients exhibited tinnitus, and 68.31% of patients had hearing loss. Our experimental neurootometric investigations exhibited the following rates of abnormal test findings in group A: butterfly calorigrams, 71.86%; stepping craniocorpography, 72.01%; and pure-tone audiometry of bone conduction, 37.66% in the right and 47.07% in the left ear. Among group B patients, abnormal test findings were noted as follows: butterfly calorigrams, 69.86%; stepping craniocorpography, 74.03%; and pure-tone audiometry of bone conduction, 44.57% in the right and 55.43% in the left ear.     

Comparative trial of short-course ofloxacin for uncomplicated typhoid fever in Vietnamese children

An open, randomised comparison of 2 or 3 days of oral ofloxacin (10 mg/kg/day) for uncomplicated typhoid fever was conducted in 235 Vietnamese children. Multi-drug-resistant Salmonella typhi was isolated from 182/202 (90%) children and 5/166 (3%) tested isolates were nalidixic acid-resistant (Na(R)). Eighty-nine of 116 children randomised to 2 days and 107/119 randomised to 3 days were blood culture-positive and eligible for analysis. There were 12 (13.5%) failures in the 2-day group (six clinical failures, four blood culture-positive post treatment, two relapses) compared with eight (7.5%) failures in the 3-day group (four clinical failures, one blood culture-positive post treatment, three relapses) (OR 1.9, 95% CI 0.7-5.5,p = 0.17). There were no significant differences in the mean (95% confidence interval) fever clearance times (h) [92 (82-102) vs 101 (93-110), p = 0.18] or duration of hospitalisation (d) [7.6 (7.2-8.1) vs 8.0 (7.6-8.4), p = 0.19] between the two groups. There was one failure in the four eligible children infected with an Na(R) isolate of S. typhi. No adverse events were attributable to the ofloxacin. These results extend previous observations on the efficacy of short courses of ofloxacin for children with uncomplicated multi-drug-resistant typhoid fever.