Doppler-guided hemorrhoidal artery ligation

BACKGROUND: In 1995, Morinaga reported a new technique for the treatment of hemorrhoids, hemorrhoidal artery ligation (HAL), which uses a specially designed proctoscope coupled with a Doppler transducer for identification and ligation of hemorrhoidal arteries. METHODS: Because the arteries carrying the blood inflow are ligated, internal pressure of the plexus hemorrhoidalis is decreased. RESULTS: We report the results of the first 308 patients (189 male and 119 female; median age 50.1 years) who have been treated at our department since 2002 and followed-up for a median period of 18 months. Eighty-nine patients had grade II, 192 patients had grade III, and 27 patients had grade IV hemorrhoids. The acute symptoms of hemorrhoids were treated immediately by performing HAL. CONCLUSIONS: Our study showed that HAL is painless, effective, and has a low rate of complications. It can be applied in an outpatient setting and is an good alternative to all other hemorrhoid treatment methods.     

25th Annual Meeting of the Surgical Working Group of Endocrine Surgery (CAEK) of the German Society of Visceral Surgery, 24–25 November 2006, Duisburg, Germany

Abstracts

25th Annual Meeting of the Surgical Working Group of Endocrine Surgery (CAEK) of the German Society of Visceral Surgery, 24–25 November 2006, Duisburg, Germany     

Stage pT0 bladder tumors after radical cystectomy: a review of our series

ObjectivesTo evaluate the data of progression and survival in 43 patients who underwent cystectomy with stage pT0 according to classification TNM-2002.Matherials and methodsbetween 1988 and 2003 in our center had realized 420 cystectomies, 43 patients (10.2%) had not tumor in the cystectomy specimen.ResultsIn these 43 cases the initial clinical stage (in the transuretral resection of bladder) was t1 in 10 cases (23,3 %), t2 in 31 cases (72%) and t3 in 2 cases. as far as the degree 24 patients presented g2 (55.8%) and 19 (44.2%) were g3.median time from the transuretral resection to the cistectomy was of 44 days at a median follow-up of 89.3 months. progressionfree survival in the 43 patients was of 180,6 months, but during the follow-up it appeared progression in 7 patients, with disease free survival at 36 months (3-126), since the date of the cistectomía.during the follow up, 5 patients died. when we analyzed the cancer-specific survival according to tumor stage, for the t2 with an average cancer-specific survival is of 180 months, decreasing to 35 months considerably for t3. similar it happens with the degree of differentiation, significantly diminishing as it advances the degree, with an average of cancer-specific survival for the g3 at 122.6 months. in the same way it happens with pathological positive lymph nodes in the radical cistectomy, with a cancer- specific survival of 188 months when it is n0 and of 54 months if the adenopathy was positive (n+).ConclusionIn our experiencie urothelial carcinoma pt0 present a prolonged free period of disease (medium of 180 months). the associated factors of risk to a smaller free period of disease are high degree of differentiation (g3, 116 months), the infiltration of deep layers in the transuretral resection(t3, 32 months) and the ganglionary affectation (pn+ 45 months).     

Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa

Please cite this paper as: Van Kerkhove et al. (2011) Epidemiologic and virologic assessment of the 2009 influenza A (H1N1) pandemic on selected temperate countries in the Southern Hemisphere: Argentina, Australia, Chile, New Zealand and South Africa. Influenza and Other Respiratory Viruses 5(6), e487–e498. Introduction and Setting Our analysis compares the most comprehensive epidemiologic and virologic surveillance data compiled to date for laboratory‐confirmed H1N1pdm patients between 1 April 2009 ‐ 31 January 2010 from five temperate countries in the Southern Hemisphere–Argentina, Australia, Chile, New Zealand, and South Africa. Objective We evaluate transmission dynamics, indicators of severity, and describe the co‐circulation of H1N1pdm with seasonal influenza viruses. Results In the five countries, H1N1pdm became the predominant influenza strain within weeks of initial detection. South Africa was unique, first experiencing a seasonal H3N2 wave, followed by a distinct H1N1pdm wave. Compared with the 2007 and 2008 influenza seasons, the peak of influenza‐like illness (ILI) activity in four of the five countries was 3‐6 times higher with peak ILI consultation rates ranging from 35/1,000 consultations/week in Australia to 275/100,000 population/week in New Zealand. Transmission was similar in all countries with the reproductive rate ranging from 1.2–1.6. The median age of patients in all countries increased with increasing severity of disease, 4–14% of all hospitalized cases required critical care, and 26–68% of fatal patients were reported to have ≥1 chronic medical condition. Compared with seasonal influenza, there was a notable downward shift in age among severe cases with the highest population‐based hospitalization rates among children <5 years old. National population‐based mortality rates ranged from 0.8–1.5/100,000. Conclusions The difficulty experienced in tracking the progress of the pandemic globally, estimating its severity early on, and comparing information across countries argues for improved routine surveillance and standardization of investigative approaches and data reporting methods.     

Consensus on the appropriate use of intrathecal baclofen (ITB) therapy in paediatric spasticity

Among features of motor disorders in children, spasticity is associated with considerable morbidity and problems in care, particularly in severely affected patients. Intrathecal baclofen (ITB) has been increasingly used as a relatively specific treatment modality for spasticity. To date, most of the evidence for its use in paediatric patients has come from retrospective and uncontrolled studies, although randomised, controlled trials of screening ITB and ITB therapy itself have recently been published. This consensus statement on the use of ITB in paediatric patients with spasticity was developed on the basis of currently available evidence, with the aim of providing information for clinicians, promoting an expert opinion and a consistent approach to the management of these patients and emphasising the need for further prospective, large-scale studies.     

SLC26A9-mediated chloride secretion prevents mucus obstruction in airway inflammation

Asthma is a chronic condition with unknown pathogenesis, and recent evidence suggests that enhanced airway epithelial chloride (Cl^–) secretion plays a role in the disease. However, the molecular mechanism underlying Cl^– secretion and its relevance in asthma pathophysiology remain unknown. To determine the role of the solute carrier family 26, member 9 (SLC26A9) Cl^– channel in asthma, we induced Th2-mediated inflammation via IL-13 treatment in wild-type and Slc26a9-deficient mice and compared the effects on airway ion transport, morphology, and mucus content. We found that IL-13 treatment increased Cl^– secretion in the airways of wild-type but not Slc26a9-deficient mice. While IL-13–induced mucus overproduction was similar in both strains, treated Slc26a9-deficient mice exhibited airway mucus obstruction, which did not occur in wild-type controls. In a study involving healthy children and asthmatics, a polymorphism in the 3′ UTR of SLC26A9 that reduced protein expression in vitro was associated with asthma. Our data demonstrate that the SLC26A9 Cl^– channel is activated in airway inflammation and suggest that SLC26A9-mediated Cl^– secretion is essential for preventing airway obstruction in allergic airway disease. These results indicate that SLC26A9 may serve as a therapeutic target for airway diseases associated with mucus plugging.