Chronic aorto-right ventricular fistula following penetrating cardiac injury: A case report

Aorto-cardiac fistula is a rare but potentially life-threatening condition. We herein report a rare case of chronic aorto-right ventricular fistula formation secondary to a stab penetrating injury to the heart and aorta occurred 15 years ago. The aorto-right ventricular fistula was not found until 15 years after the incident. The fistula had been repaired successfully to prevent further deterioration of cardiac function. Here, we report the clinical presentation, diagnosis and treatment strategies of the aorto-right ventricular fistula, and discuss the possible etiology of the development of the fistula after the penetrating injury.     

Overweight and television and computer habits in Swedish school‐age children and adolescents: A cross‐sectional study

The aim of this cross‐sectional study was to investigate the prevalence of overweight and obesity in children and adolescents (6–16 years), and relationships between being overweight and sleep, experiencing of fatigue, enjoyment of school, and time spent in watching television and in sitting at the computer. Trained school nurses measured the weight and height of 2891 children aged 6, 7, 10, 14, and 16, and distributed a questionnaire to them regarding television and computer habits, sleep, and enjoyment of school. Overweight, obesity included, was present in 16.1% of the study population. Relationships between lifestyle factors and overweight were studied using multivariate logistic regression analysis. Having a bedroom television and spending more than 2 h a day watching television were found to be associated with overweight (OR 1.26 and 1.55 respectively). No association was found between overweight and time spent at the computer, short sleep duration, enjoyment of school, tiredness at school, or difficulties in sleeping and waking up. It is recommended that the school health service discuss with pupils their media habits so as to promote their maintaining a healthy lifestyle.     

Endocrine‐Disrupting Chemicals and Reproductive Health

This review discusses the evidence linking industrial chemicals to a variety of health and reproductive outcomes. Industrial chemical production has increased over the past 30 to 40 years. Basic science, animal models, and epidemiologic data suggest that certain chemicals may act as endocrine disruptors (substances that interfere with normal hormonal action) and may play an etiologic role in a number of conditions whose incidence has also increased during this same period. These include low birth weight, gestational diabetes, obesity, certain cancers, certain birth defects, and neurodevelopmental disorders such as attention deficit disorder and autism. In addition, some environmental chemicals may have epigenetic effects, resulting in transgenerational health impacts. The epidemiologic and experimental evidence that links chemicals such as plasticizers (eg, phthalates and phenols), flame retardants, perfluorinated compounds, and pesticides with adverse reproductive health outcomes is reviewed. Women's health care providers are the liaison between scientific research and their patients; they should educate themselves on the significance of environmental toxins to health. They are ideally positioned, not only to counsel and reassure pregnant women, but also to suggest practicable changes in dietary and lifestyle habits to improve their health. Furthermore, women's health care providers should advocate for regulatory changes that protect women and their families from the health effects of environmental toxins.     

Aquagenic acrokeratoderma

Background Aquagenic acrokeratoderma (AA) is a rare condition with female predilection that occurs after brief water exposure and disappears minutes to an hour after drying. The pathogenesis remains unclear. Methods Four Chinese patients with AA were reported and analyzed. Results There were 2 males and 2 females (age range: 14‐33 years) who presented with a 2‐week to more than 10‐year history of small white papules coalescing into edematous plaques on the hands; lesions appeared within 5‐10 minutes of water exposure, began to regress in 3–20 minutes and disappeared within 5 minutes to one hour after drying. Warm water provoked the lesions more rapidly than cold water. Lesions of a female patient could be triggered by detergent. In another female patient, lesions also involved the feet and were associated with palmoplantar erythema and hyperhidrosis. Biopsy from the lesion of one patient after water exposure revealed hyperkeratosis, mild hypergranulosis, and dilatated eccrine ducts. Biopsy from the lesion of another patient after drying showed normal epidermis and dermis. Two patients were treated with topical formalin 3% in alcohol, and two with 3% potassium aluminium sulfate solution with partial relief without any adverse effects. Conclusion AA may occur in both males and females and may involve the feet. Warm water triggers the lesions more rapidly than cold. Topical formalin 3% in alcohol and 3% potassium aluminium sulfate solution may be optional therapy.