Subcapsular hepatic haematoma of the right lobe following endoscopic retrograde cholangiopancreatography: Case report and literature review

Sub capsular hepatic haematoma is a rare complication after endoscopic retrograde cholangiopancreatography(ERCP). Exact pathological mechanism is still unclear and few reports are nowadays available in literature. We report the case of a 58-year-old woman with recurrent episodes of upper abdominal pain, nausea and vomiting. On the basis of laboratory exams, abdomen ultrasound and magnetic resonance imaging she was diagnosed with a common bile duct stone. Endoscopic biliary sphincterotomy was performed. On the following day the patient complaint severe abdominal pain with rebound and hemodynamic instability. A computed tomography scan reveal a 14 cm × 6 cm × 19 cm subcapsular hepatic haematoma on the right lobe that was successfully managed via percutaneous embolization. Sub capsular liver haematoma is a rare life threatening complication after ERCP that should be managed according to patients' haemodynamic and clinic.     

Piranhas (Serrasalmus spp.) as markers of mercury bioaccumulation in Amazonian ecosystems

Mercury (Hg) concentration in fish depends on feeding strategies and age/size within the species as well as on water parameters related to acidity and Hg speciation. We chose two species of piranhas (Serrasalmus aff. eigenmanni and Serrasalmus rhombeus) to test their suitability as markers of Hg bioaccumulation. The results of Hg concentrations in piranhas of the Rio Negro, with no history of gold-mining activity, are similar to other Amazonian rivers with intensive gold mining. An increase in water Hg associated with low pH favored higher mean Hg concentrations in the two species. S. rhombeus in this habitat showed a consistently higher Hg concentration than S. eigenmanni. This result was attributed to fish size because of differences in correlation coefficient between S. rhombeus (r = 0.4443; P < 0.0001) and S. eigenmanni (r = 0.1520; P = 0.0135). Matching for fish weight resulted in comparable ranges of Hg concentrations between the two species.     

Zinc and vitamin A in liver of foetuses and infants

The association of zinc and vitamin A levels was studied in liver of foetuses and infants which were stillborn or died of various causes between the age of 26 weeks of gestation up to 16 weeks post-partum. No correlation between zinc and vitamin A was observed (r = 0.07). Although smaller infants had more hepatic vitamin A than larger infants no significant difference was observed between these groups for liver zinc values.     

The nociceptive flexion reflex as a tool for exploring pain control systems in headache and other pain syndromes

The authors review the neural pathways mediating nociceptive flexion reflexes, the method for analyzing these reflexes in human beings, and available data on their modulation by supraspinal, opioid as well as serotonergic systems. They present results of studies of the biceps femoris flexion reflex (RIII) in pain syndromes and various types of headache. Nociceptive flexor reflexes appear to be interesting for studying the pathophysiology of head pain mechanisms and possibly for evaluating analgesic treatment.     

Contact dermatitis to quinoline, corticosteroids and antibiotics after short time treatment of delayed wound healing following malignant melanoma excision in a young woman

BACKGROUND: We describe a 20-year old woman with retarded healing after a melanoma excision. After short time application of several creams containing antiseptic, antibiotic and anti-inflammatory ingredients she developed a severe contact dermatitis. Patch testing revealed sensitizations against corticosteroids, an antibiotic and quinoline. CONCLUSION: In our case multiple relevant contact sensitizations appeared within a short period of two months after excision of a malignant tumour.