Pure leiomyoma of prostate presenting with rectal symptoms: a case report]

Pure leiomyoma of the prostate is a rare lesion. We report a case in a 68-year-old man who presented with rectal symptoms. Rectal examination showed a stony hard nodule with irregular surface near the apex of the prostate. Transrectal sonography showed a homogeneous well defined nodule measuring 3.5 cm in diameter in the left prostatic lobe protruding into the bladder. Magnetic resonance imaging (MRI) revealed an irregular shaped mass in the prostate with an isosignal to muscle in the T1 weighted images. Needle biopsy revealed pure leiomyoma histologically. Transurethral resection was performed and a nodule of white almost avascular tissue was resected in the apex proximal to vermontanum. After operation, the rectal symptoms improved.     

Knowledge,attitude and behaviour regarding dietary salt intake among medical students in Angola

High salt (sodium chloride) consumption is an important determinant of high blood pressure and cardiovascular risk. According to World Health Organisation (WHO) statistics, over 80% of cardiovascular disease (CVD) deaths take place in low-and middle-income countries, and elevated blood pressure levels were a major cause of these CVD deaths in those countries.1 Lifestyle factors such as unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol have been considered the most important behavioural risk factors for heart disease and stroke.2Among dietary factors, high salt intake has been the most strongly associated with raised blood pressure and increased risk of stroke and CVD.3 Therefore dietary sodium restriction has been recommended as a non-pharmacological approach to blood pressure lowering,4-6 and for the prevention and control of non-communicable diseases at the population level.7,8Cumulative evidence has shown that even a modest reduction in salt intake was associated with blood pressure lowering and therefore with a significant reduction in incidence of cardiovascular events.9-12 Furthermore, data from the most recent systematic review and meta-analyses has shown the benefit of lowering sodium intake in apparently healthy adults and children,13 and in both hypertensive and normotensive individuals, irrespective of gender and ethnic group.9Since hypertension is associated with CVD worldwide, a public health intervention to reduce high blood pressure must target the role of lifestyle, particularly reduced sodium intake.7 Therefore, several countries have initiated strategies to reduce dietary salt intake in the general population by a combination of various procedures such as public education, food labelling, and collaboration with the food industry to reduce the salt content of processed food.14Among sub-Saharan African countries, only Nigeria and South Africa have developed dietary guidelines regarding salt intake.15 Recently, the South African government implemented important specific legislation towards decreasing salt intake in the population by reducing sodium content of processed foods by industries.16 Therefore, the current public health recommendation is that countries should launch national initiatives to reduce the over-consumption of salt as part of non-communicable disease prevention and healthy nutrition policies for limiting salt intake to less than 5 g/day for the general population including children.7 Despite of this guideline, however, high sodium intake remains prevalent around the world, with average daily salt intake varying from 5 to 18 g/day per person.17Although processed foods have been found to be the principal source of excessive dietary salt intake,18 sources of dietary sodium vary largely worldwide and may be influenced by cultural context and dietary habits of the population.19 In sub-Saharan African countries experiencing demographic and epidemiological transition, the rapid rise in prevalence of CVD (chiefly hypertension) has been attributed to lifestyle change, including high dietary sodium intake.20,21 However, consistent data from studies on risk factors are lacking for the majority of these countries.With regard to Angola, available data from a cross-sectional study reported a high prevalence of multiple cardiovascular risk factors, such as hypertension, sedentary lifestyle, electrocardiographic left ventricular hypertrophy,22 and high rate of the metabolic syndrome23 in an apparently healthy middle-aged population of university public employees living in urban and peri-urban areas.Determining the level of sodium intake in the population is crucial to establish intervention strategies and policy on reduction of sodium intake. For medical students in particular, it is very important to assess their awareness regarding dietary salt intake, since they are the future providers of healthcare information for the counselling of people about the need to reduce salt consumption. The aim of this study was to determine salt intake and to assess the knowledge, attitude and behaviour regarding dietary salt among medical students.     

Augmentative and Alternative Communication (AAC) for adults with severe aphasia: where we stand and how we can go further

Purpose: To review literature specific to the use of AAC with adults who have severe aphasia. Method: The authors reviewed studies involving AAC interventions for adults with severe aphasia. Results: Published data support the use of aided and unaided AAC with adults with severe aphasia in controlled treatment contexts. Reported gains in communication typically have not generalized to everyday settings. Conclusions: The application of AAC with persons with severe aphasia must address factors potentially limiting treatment success outside of training environments.     

Health effect of long-term diet mercury contaminated tuna. Part II. Accumulation and retention of mercury and selenium in organs and clinical symptoms (author's transl)]

Health effects of long-term tuna diet in cats were examined. The cats were fed daily with three kinds of tuna, containing different concentrations of mercury and selenium. The following results were obtained. 1) A high correlation was noted between the amount of fish intake and the mercury level in hair and blood samples of cats. 2) Mercury levels in organs were elevated corresponding with the amount of tuna consumption, but the distribution of mercury in organs of cats exposed to mercury in tuna flake differed from that in tuna fresh meat. In the liver, the ratio of methyl mercury to the total mercury was very low with an average of 11.5% of the ratio. 3) With regard to selenium, there was no correlation between intake of selenium and selenium levels in the cerebrum, celebellum, and kidneys, exept in the liver (r=0.766). 4) None of the cats had definite methyl mercury poisoning, but some slight disturbances were noted in several cats.     

Arthroscopic surgery for synovial chondromatosis of the hip: a report of two cases

We have used arthroscopy in the treatment of synovial chondromatosis of the hip joint. Two patients complained of pain of the hip joint that was aggravated by weight bearing. On admission, range of motion of the affected hip joints was slightly restricted. At hip arthroscopy, osteochondral loose bodies were removed from the joint and partial synovectomy was performed. Histologic examination revealed synovial chondromatosis. Pain relief was obtained in both patients postoperatively.