Intussusception as a Cause of Bowel Obstruction in Adults from a Resource Limited Area,Cameroon

Background

Intussusception refers to the telescoping of a proximal segment of bowel into a distal segment. It is a rare cause of intestinal obstruction in adulthood.

Case Details

We report two cases of adult intussusception in a post-operative period following Caesarean Section (with no lead point) and Appendicectomy (due to colonic adenocarcinoma) respectively.

Conclusion

Though rare in adulthood, intussusception should be considered as a differential diagnosis to bowel obstruction in adults even in the post-operative period.     

Fruit and vegetable consumption,ethnicity and risk of fatal ischemic heart disease

Objective: Mortality rates from ischemic heart disease vary among ethnic groups. Dietary intake of fruits and vegetables has been associated with a lower risk of ischemic heart disease, but ethnic-specific data are limited. Design: Prospective cohort study. Setting: Hawaii and Los Angeles County, between 1993 and 1996. Participants: These analyses included 164,617 adults age 45 to 75, representing five ethnic groups who were enrolled in the Multiethnic Cohort Study. Dietary data were collected at baseline using a validated food frequency questionnaire and fatal ischemic heart disease cases were identified up to December 31, 2001. Associations between fruit and vegetable consumption and fatal ischemic heart disease were examined using multivariate Cox proportional hazard models. Results: The associations between fruit and vegetable intake and fatal ischemic heart disease were similar among the five ethnic groups. When data for the ethnic groups were combined, higher vegetable intake was associated with a protective effect against ischemic heart disease in men with all intake levels above 3.4 servings per day (over 6.6 servings per day: hazard ratio, 0.73; 95% confidence interval, 0.58–0.92). Inconsistent results were observed for women, where the protective association was observed only at mid-level vegetable intake levels, but not among women with the highest level of vegetable intake. There was no evidence of an association for fruit intake. Conclusions: Associations between fruit and vegetable intake and fatal IHD do not appear to vary among ethnic groups. Additional research is needed to clarify associations for fruit versus vegetable intake and impact on cardiovascular outcomes.     

Non-steroidal anti-inflammatory drugs and amyotrophic lateral sclerosis: Results from five prospective cohort studies

Animal and pathological studies suggest that inflammation may contribute to amyotrophic lateral sclerosis (ALS) pathology and that non-steroidal anti-inflammatory drugs (NSAIDs) might be protective. However, there are no prospective data on the relation between NSAID use and ALS risk in humans. The relation between NSAID use and ALS risk was explored in five large prospective cohort studies (the Nurses' Health Study, the Health Professionals Follow-up Study, the Cancer Prevention Study II Nutrition Cohort, the Multiethnic Cohort Study, and the National Institutes of Health - AARP Diet and Health Study). Detailed NSAID information was sought from 780,000 participants, 708 of whom developed ALS during follow-up. Cox proportional hazards models were used within each cohort and cohort-specific estimates were pooled with random effects models. Results showed that neither non-aspirin NSAID use, nor aspirin use was associated with ALS risk overall. The multivariable, pooled relative risk was 0.96 (95% CI 0.76-1.22) among non-aspirin NSAID users compared with non-users. Duration of NSAID use in years and frequency of NSAID use were not associated with ALS risk overall. In conclusion, the results do not support an overall effect of NSAIDs on ALS risk, but because NSAIDs have heterogeneous effects, a role of individual compounds cannot be excluded.     

Body mass index and mortality in an ethnically diverse population: the Multiethnic Cohort Study

Body mass index (BMI) has been strongly related to overall mortality, but the consistency of this association across diverse ethnic groups and the effects of early adult BMI versus BMI in later adulthood have not been adequately studied. A prospective analysis was performed using data from 183,211 adults aged 45-75 who enrolled the population-based Multiethnic Cohort Study by completing a questionnaire that included self-reported weight and height information in 1993-1996. Participants were African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites living in Hawaii and California. During an average 12.5?years of follow-up, 35,664 deaths were identified. To control for confounding caused by conditions that lead to weight loss and mortality, we excluded participants with a history of cancer or heart disease, who ever smoked, and who died within the first 3?years of follow-up. An increased risk of mortality was observed in participants with a BMI?≥?27.5 in both men and women compared with the reference category of BMI 23.0-24.9; a BMI?≥?35.0 carried a greater risk of mortality in men than in women. Although the findings were generally similar across ethnic groups, the association of higher BMI with mortality in Latino men appeared to be weaker than in the other groups. A BMI of 25.0-34.9 at age 21 showed a stronger positive association, with no further increase in risk for a BMI?≥?35.0, than did BMI in later adulthood. These results indicate that the association of BMI with mortality is generally consistent across sex and ethnic groups, with some variation in the strength of the effect. Most notably, the effect of overweight in young adulthood appears to be much stronger than that of overweight in later adulthood on mortality in later life. This emphasizes the importance of weight management in childhood and adolescence.     

浙江省4个地区60岁以上老人生活满意度的调查

目的:了解浙江省农村老年人生活满意度的现状及其有关影响因素。方法:于2005-07/10随机抽取浙江省乐清市北白象镇、白石镇、大荆镇,建德市的莲花镇及杭州下沙区和余杭区内能回答调查问卷的各项内容,同意参与该项调查的60岁以上老年人430名为调查对象。应用WHO推荐的生活满意度指数A量表,一般状况调查表,最满意和最不满意的事情调查表进行入户问卷调查。生活满意度指数A量表,包括20个项目,其中12个条目反映正性情感,8个条目反映负性情感。每项最高分为2分,总分最高分为40分。评分越高,生活质量越佳。一般状况调查表包括姓名、年龄、性别、职业、文化程度、婚姻、健康状况、医疗费用来源、住址和联系电话。结果:共发放问卷430份,收回有效问卷389份。①389名老年人生活满意度评分为25.8±7.2,与正常值(12.4±4.4)比较,差异有显著性意义(P<0.05)。②经多个独立样本的非参数检验,老年人的生活满意度评分性别差异无显著性(P>0.05),而在年龄、婚姻、文化程度、健康状况、职业、医疗费用来源和所在地区维度差异有显著性(P≤0.05)。③313人对“最满意和最不满意的事情”项目进行了回答,老年人最满意的事是“生活条件改善”和“家庭关系和睦”,有195人,占62.3%,最不满意的事主要是“家庭不和睦”(17.4%)、“社会发展不佳”(14.8%)、“身体状况差”(14.2%)、“生活条件差”(10.3%)。结论:浙江省农村老年人生活满意度较高,年龄、婚姻、文化程度、健康状况、职业、医疗费用来源、地区差异对老年人生活满意度有重要影响。     

Comparison of autosurge versus surge protocols for discontinuous-flow centrifugation plateletapheresis

Autosurge is a new, highly automated protocol for collecting platelets by centrifugation plateletapheresis. It was developed to allow optimal cell collections with less operator effort than was required with the earlier, standard Surge protocol. The authors compared the cellular content of 201 platelet concentrates prepared by Surge with that of 120 concentrates prepared by Autosurge by the same group of operators, using the same cell separator. Platelet yields were similar (p = 0.775) for both protocols (mean X 10(-11) were 3.54 and 3.57 for Surge and Autosurge, respectively) and when subdivided according to preapheresis donor blood platelet counts, hematocrits, and leukocyte counts. Although platelet yields were comparable in concentrates prepared by either protocol, high donor hematocrit had less adverse effect on platelet yield when the Autosurge protocol was used. The composition of concentrates differed between protocols in that leukocytes contamination was significantly less (p less than 0.001) in units collected by Autosurge (3.4 X 10(8)) than in those collected by Surge (5.8 X 10(8)). Operator involvement can be less intense with Autosurge because the protocol includes automatic adjustment of cell separator settings for optimal plateletapheresis. The results of the direct comparison study were confirmed by data from 509 additional plateletapheresis procedures performed during routine blood center operation. Autosurge should replace Surge because the former easily produces platelet concentrates that contain fewer leukocytes without compromising platelet yields.     

Mammographic density and breast cancer risk: the multiethnic cohort study

In a nested case-control study (2001-2004), the authors investigated the association between mammographic density and breast cancer risk among women of Caucasian, Japanese, and Native Hawaiian ancestry in the Hawaii component of the Multiethnic Cohort Study. The authors retrieved several prediagnostic mammograms for breast cancer cases and for controls frequency-matched to cases by age and ethnicity. A reader who was blinded to case status and year of mammogram performed computer-assisted density assessment. Suitable mammographic readings were obtained for 607 cases and 667 controls. The authors used unconditional logistic regression to estimate odds ratios and 95% confidence intervals while adjusting for confounders. Mean percent density and mean dense area were significantly greater for cases than for controls: 39.6% vs. 29.7% and 37.3 cm2 vs. 28.4 cm2, respectively. For the earliest mammogram taken, the overall odds ratio for a 10% increase in breast density was 1.22 (95% confidence interval: 1.14, 1.30), and the overall odds ratio for a 10-cm2 increase in dense area was 1.17 (95% confidence interval: 1.11, 1.24). The similar sizes of the areas under the receiver operating characteristic curve (0.66) confirmed that percent density and dense area predicted breast cancer equally well. Because the risk estimates appeared higher for Caucasians and Native Hawaiians than for Japanese women, ethnicity-specific models may be necessary to predict risk from breast density in different ethnic groups.     

结肠冗长症手术治疗及自拟爽府汤预防复发的疗效观察

目的探讨结肠冗长症手术治疗方法以及自拟爽府汤在其术后的应用效果。方法将我院结肠冗长症患者40例随机分为观察组和对照组,对照组给予常规外科手术治疗,在此基础上观察组术后联合自拟爽府汤联合西药治疗,随访评估两者远期治疗效果。结果术后6个月观察组总有效率为100%,对照组为100%,两组比较差异无统计学意义（P〉0.05）。术后随访2年,观察组总有效率仍为100%,复发率为0%;对照组总有效率为68.42%,复发率为31.58%;两组比较差异具有统计学意义（P〈0.05）。结论单纯外科治疗结肠冗长症远期复发率高,联合自拟爽府汤可有效降低复发率。