The type III aortic dissection. Diagnosis, outcome, contribution of the endovascular therapies to their management--a case report

The dissection of the descending aorta is a serious affection regarding to its mortality and its complications. It becomes chronic after the 14th day following the first signs of dissection. The authors report the case of a 55 years old patient who has presented a type III dissection diagnosed at the chronic period. The persistance of the pain has indicated the implantation of a stent at the intimal tear. This new endovascular treatement of the aorta diseases is a promising and less invasive alternative to the surgical treatement. It may reduce the morbidity and the mortality of this pathology but it needs an accurate and performant imaging techniques.     

A neuroprotective peptide antagonizes fetal alcohol exposure-compromised brain growth

We evaluated a 9-amino-acid peptide, SALLRSIPA (SAL), an agonist of activity-dependent neurotrophic factor (ADNF), for its protective properties against fetal alcohol-related brain growth retardation, using an established liquid diet model of alcohol-related neurodevelopmental disorder (ARND) in C57BL/6 mice. Alcohol exposure during neurulation reduced body weight, head size, and specifically brain weight and volume. Major gross brain deficits include underdevelopment of brain areas, cortical thinning, ventricle enlargement, and restricted midline neural tissue growth leading to openings at the roof/floor plate. SALLRSIPA (SAL) treatment increased fetal body weight and restored brain weight, brain volume, and regional brain size. Furthermore, SAL restored cortical thickness, reduced the size and frequency of neural tube openings, and attenuated ventricular enlargement. The ability of SAL to antagonize alcohol-retarded brain growth and development of forebrain and midline neural tube at midgestation suggests its potential use as an antagonist against fetal alcohol-rendered microencephaly early in development.     

Effects of epilepsy surgery on quality of life: a controlled study in a Middle Eastern population

The purpose of this study was to investigate which areas of quality of life (QOL) change after epilepsy surgery and generate QOL data specific to the Lebanese population. The QOL of 20 consecutive patients 1 year after surgery was compared (using the ESI-55 scale) with that of 20 matched patients who underwent the same presurgical evaluation, but no surgery. Overall QOL improved in both groups, but was greater in the surgery group (85% seizure free as compared to 0% in nonsurgery group). Significant differences were noted within the "well-being" domain including health perception (5/9 items), energy-fatigue (2/4), and emotional well-being (2/5). Differences were less common in the "functioning" domain including physical (1/10 items), social (1/2), and cognitive (0/5) functioning scales, and in the role limitation domain (1/17 items). Our patients experienced, 1 year after epilepsy surgery, improvements similar to those reported in Western populations after a similar period: they had marked improvements in overall QOL, health perception, well-being, and cognitive functioning areas. They had less remarkable improvements in social functioning and role limitation areas.     

Congressus Mundi Dermatologiae Paris 1889-Paris 2002

Twenty International congresses for dermatology and sexually transmitted diseases were held between 1889 and 2002. The number of attendees and the subjects discussed during such congresses progressively increased in number and quality. The continuous progress and development in the knowledge presented year after year was a natural reflection of development in science, culture, and social standard of the countries that hosted these congresses. In this paper, we highlight the achievements of the great universal figures in dermatology who contributed to its progress, and the important milestones of scientific development that will remain as history and references for the future generation.     

Management of intractable constipation with antegrade enemas in neurologically intact children

OBJECTIVES: To assess the benefit of antegrade enemas in children with severe constipation who were referred to a tertiary care center. METHODS: From 1997 to 1999, 12 children (9 male, aged 8.7 +/- 4.4 years) underwent cecostomy placement. All children were neurologically normal and had been extensively examined to rule out organic causes of constipation. Follow-up included a questionnaire to interview caregivers 13.1 +/- 8.5 months after cecostomy placement. RESULTS: For all children, antegrade enemas led to improvement in the number of bowel movements / week (7.1 versus 1.4, P < 0.005), number of soiling accidents / week (1.0 versus 4.7, P < 0.01), abdominal pain score (0.9 versus 2.9, P < 0.005), emotional health score (3.6 versus 1.9, P < 0.005), overall health score (3.6 versus 1.7, P < 0.005), number of medications used for constipation (0.8 versus 4.0, P < 0.005), number of missed school days / month (1.5 versus 7.5, P < 0.02), and number of physician office visits / year (9.2 versus 24.0, P < 0.05). Irrigation solutions used for the antegrade enemas included polyethylene glycol (67%), saline and glycerin solution (25%), and phosphate enema (8%), administered everyday in seven children and every other day in five children. Adverse events included skin breakdown and granulation tissue in one patient, leakage of irrigation solution in one patient, and dislodging of the tube in two patients. Five patients discontinued the use of antegrade enemas within a mean of 14.6 +/- 9.1 months after beginning treatment. CONCLUSION: Antegrade enemas through a cecostomy are a safe and satisfactory option for children who are neurologically intact and who have severe constipation that does not respond to medical treatment.     

Congenital sick sinus syndrome in a healthy heart: case report

Isolated congenital sick sinusal syndrome on non harmed heart is a rare affection. Its association with an atrio-ventricular block is exceptional. The authors report a case of a 19 year-old patient, with an early history of bradycardia, hospitalised for effort intolerance. His electrocardiogram reveals a high degree sino-atrial block replaced by a junctional rhythm at 30/mn. During Treadmill test, the sinusal acceleration is satisfactory and an effort atrio-ventricular block was present. He later had a definitive stimulation under DDDR. This report shows that the sinusal node, in the same way as the atrio-ventricular node may be injured by congenital dysimmunitary process. The coexistence of these two conductive troubles worsen the prognosis and should lead more often to the practice of definitive stimulation by the only mode DDDR.