Is proliferative colonic disease presentation changing?

AIM: To compare the site, age and gender of cases of colorectal cancer (CRC) and polyps in a single referral center in Rome, Italy, during two periods.METHODS: CRC data were collected from surgery/pathology registers, and polyp data from colonoscopy reports. Patients who met the criteria for familial adenomatous polyposis, hereditary non-polyposis colorectal cancer syndrome or inflammatory bowel disease were excluded from the study. Overlap of patients between the two groups (cancers and polyps) was carefully avoided. The χ² statistical test and a regression analysis were performed.RESULTS: Data from a total of 768 patients (352 and 416 patients, respectively, in periods A and B) who underwent surgery for cancer were collected. During the same time periods, a total of 1693 polyps were analyzed from 978 patients with complete colonoscopies (428 polyps from 273 patients during period A and 1265 polyps from 705 patients during period B). A proximal shift in cancer occurred during the latter years for both sexes, but particularly in males. Proximal cancer increased > 3-fold in period B compared to period A in males [odds ratio (OR) 3.31, 95%CI: 2.00-5.47; P < 0.0001). A similar proximal shift was observed for polyps, particularly in males (OR 1.87, 95%CI: 1.23-2.87; P < 0.0038), but also in females (OR 1.62, 95%CI: 0.96-2.73; P < 0.07).CONCLUSION: The prevalence of proximal proliferative colonic lesions seems to have increased over the last decade, particularly in males.     

Ein seltenes genitales Ulkus

We report the case of a young girl who presented with acute severe pain from a genital ulceration. The diagnosis of ulcus vulvae acutum or Lipschütz??s acute ulcer of the vulva, a self-healing, acute genital ulceration of unknown origin but characteristic clinical picture was established. The patient recovered fully with symptomatic treatment, mainly appropriate analgetics within 14 days. A review of the scarce literature is discussed and the importance of non-invasive diagnostic procedures is stressed.     

A curious lobe

A case of azygos lobe is presented. An azygos lobe is an accessory lobe of the lung that may occasionally be confused with a pathological process such as a bulla, lung abscess or neoplasm. Its pathogenesis is discussed, as are the characteristic x-ray features that enable an accurate diagnosis.     

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??With the increasing prevalence of childhood overweight/obesity in the worldwide??obesity-related glomerulopathy??ORG?? has become a growing concern among pediatricians. Clinical and pathologic characteristics ofORG are proteinuria??glomerulomegaly??progressive glomerulosclerosis and renal function decline. If not intervened in time??the disease may slowly progress??some of which end in end-stage renal disease. Here we review the recent advances in the pathogenesis and clinical features of ORG??as well as diagnosis and differential diagnosis and potential therapeutic targets.     

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??With the rapid development of pediatric critical care medicine in recent years??the mortality of children in intensive care unit??ICU?? has decreased significantly. A large proportion of surviving patients still have physical dysfunctions several years after discharge. The functional status and quality of life of these patients begin to become focus problems??and pediatric critical care rehabilitation??a new interdisciplinary field??has attracted people’s attention. Rehabilitation evaluation runs throughout the medical activities of pediatric critical care rehabilitation. Because the related work began late with weak foundation in our country??ithasn’t been done in many hospitals yet. Therefore??it is urgent to realize the importance of rehabilitation evaluation and to improve the pediatric critical care rehabilitation and rehabilitation evaluation.