Intussusception in a premature neonate: A rare and often misdiagnosed clinical entity

Intussusception is a very rare cause of intestinal obstruction in neonates. It is of extremely rare occurrence among premature neonates. We present a case of 11-day-old premature neonate who presented with abdominal distension, intolerance to feeds, vomiting, significant bilious aspirate and bleeding per rectum. The initial diagnosis of necrotizing enterocolitis (NEC) led to a delay in the diagnosis. On exploratory laparotomy, it turned out to be a case of ileo-colic intussusception with Meckel''s diverticulum as a lead point. This site of intussusception (ileo-colic) and presence of a lead point among premature neonate is of exceedingly rare occurrence and very few such cases have been reported.In this article, the published work about clinical features and management on intussusceptions in premature neonates has been reviewed. The authors intend to highlight the difficulty in distinguishing the NEC and intussusception. Subtle clinical and radiological features which can help in differentiating the two conditions have been emphasized. This can avoid the delay in diagnosis and management which can prove critical. High index of suspicion with timely intervention is the key for optimizing outcome. A diagnosis of intussusception should always be considered in any preterm infant with suspected NEC.     

Studies on the effects of Pluchea indica less root extract on gastroduodenal ulcer models in rats and guineapigs

The methanolic fraction of P. indica root extract was found to possess significant antiulcer activity in different experimental animal models. In preventive antiulcer tests, significant protective actions in acetylsalicylic acid, serotonin and indomethacin-induced gastric lesions were observed in experimental rats. The extract also afforded significant protection to chemically-induced duodenal lesion in guineapigs. Significant enhancement of healing process in acetic acid-induced chronic gastric lesions were also observed in the extract-treated animals.     

All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study.

AIMS: To investigate the association between estimated glomerular filtration rate (eGFR) and total and cardiovascular mortality in a population-based cohort of diabetic subjects. METHODS: A longitudinal study using a population-based district diabetes register comprising 3288 subjects in South Tees, UK. The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) study equation. Patients were stratified by baseline eGFR into five stages as per the National Kidney Foundation guidelines: Stage 1, eGFR > 90; Stage 2, eGFR 60-89; Stage 3, eGFR 30-59; Stage 4, eGFR 15-29; and Stage 5, eGFR < 15 ml/min per 1.73 m(2). Main outcome was all-cause and cardiovascular mortality between 1 January 1994 and 31 July 2004. RESULTS: At baseline, mean age (58.4 years) differed between groups. Persons with lower eGFR were older (P < 0.001). Thirty-six percent (n = 1193, males 56%) had died by 10 years (cardiovascular cause in 60%). Median follow-up was 10.5 years amounting to 28 342 person years. Stages 4 and 5 (eGFR 相似文献   

Heat stress of women doing manipulative work.

Six women were exposed to nine environmental conditions, ranging from 26.0 to 35.8 degrees C effective temperature (ET), in a climatic chamber. They were involved in manipulative work in a seated position for a duration of 3 hr. The O2 uptake, heart rate, deep body (Tc) and skin temperature (Tsk), sweat loss, and perception of thermal comfort were noted. The O2 uptake increased with the time of exposure at different heat levels. The work energy demand, which was 19% of VO2max at 26 degree C ET, increased to 35% of VO2max at 35.8 degrees C ET. However, the work output declined with the increase in ET. Thus, the elevated metabolic demands were the results of the thermal stimuli. The Tsk was greatly influenced by the environmental heat; the Tc changes were gradual. The highest mean Tsk attained was 37.3 degrees C at 33.8 degrees C ET when the gradient of Tc-Tsk was only 0.5 degrees C. The rate of change in mean Tsk for 31.6 to 33.8 degrees C ET was much faster compared to the range between 26.0 and 31.6 degrees C ET. From 32.1 degrees C ET onward the Tc and heart rates rose rapidly, while the sweating rate tended to fall, indicating some hindrance for evaporative cooling. Also, thermal sensations were noted as extremely hot for the conditions 32.1 to 35.8 degrees C ET with the increase in exposure duration.     

Early abdominal complications of intestinal surgery: the radiologist's role in management

Abdominal complications of intestinal surgery are an important cause of postoperative morbidity and mortality. We define early complications as those occurring within the first 30 days after surgery. The radiological contribution towards prompt and accurate diagnosis of common complications is discussed and the radiologist's role in non-operative management is outlined.     

Prenatal diagnosis of neuronal ceroid-lipofuscinoses

We report on the successful prenatal diagnosis of the late infantile "Jansky-Bielschowsky" variant of the neuronal ceroid-lipofuscinoses (NCL). The fetus was studied at 16 weeks of gestation because of an affected sib. Uncultured amniotic fluid cells were studied by conventional electron microscopic techniques. About one-third of a subpopulation of dark, elongated cells contained one or more deposits of curvilinear cytosomes bound by a single unit membrane. These findings were considered typical of the late infantile variant of NCL. After delivery at term, a skin punch biopsy and a buffy coat preparation from the baby were examined and found to have similar characteristic inclusions, which confirmed our prenatal diagnosis.     

Calbindin immunoreactivity in the developing and adult human cerebellum

Calbindin (CALB), a calcium-binding protein, is known to be expressed in the embryonic nervous system. In this study, we have examined its distribution in the cerebellum of human fetuses (11–25 weeks of gestation) and adult by immunohistochemistry. At the gestational age of 11–12 weeks, CALB immunoreactivity was present in granule and Purkinje cells throughout the cerebellum. By 16–21 weeks of gestation, immunoreactive Purkinje cells were well-differentiated in the vermis and flocculus, and their axons ran towards the deep cerebellar nuclei area, while the axon collaterals were seen to be distributed into adjacent folia. At the gestational period of 24–25 weeks, most Purkinje cells of the flocculus and vermis were arranged in one to two rows, while those of the hemispheres were still undifferentiated. A few Golgi cells of the vermis showed immunoreactivity. The neurons of the deep nuclei were immunonegative right from the gestational age of 11 weeks although a fine stippled staining of fibers was present throughout the body of all nuclei. The fibers lying close to the hilum of the dentate nucleus were strongly CALB-positive. The vestibulocerebellar fibers, being traced at the level of lower pons and upper medulla oblongata were stained as early as 11 weeks of gestation, whereas the olivocerebellar fibers were stained from 16 weeks onward. In the adult cerebellum, Purkinje cells were moderately immunopositive while granule cells were faintly stained; no other cells, including those of the deep nuclei were stained. In the medulla oblongata, the inferior olivary nucleus and olivocerebellar fibers were strongly CALB-positive. Our results indicate that CALB is expressed in early migratory Purkinje cells, and their maturation occurs in a vermal-to-hemisphere gradient. It is likely that CALB plays a significant role in the regulation of Ca²⁺-dependent activities in the developing cerebellum.     

Ultrastructural localization of lectin receptors on cerebral endothelium

Summary Oligosaccharide residues on the endothelial luminal plasma membrane of rat cerebral cortical vessels were localized using biotinylated lectins. In addition, the effect of pretreatment of brain slices with neuraminidase prior to the binding of cationized ferritin (CF) and certain lectins was studied.Conjugates of biotinylated lectins and avidin-d horseradish peroxidase reaction product were evenly distributed on the endothelium of arterioles, capillaries, and venules. Lectin binding sites were observed on the plasma membrane of pinocytotic vesicles open onto the vascular lumen and at the luminal end of the interendothelial space only. The following sugar residues were localized: -d-mannosyl, -d-glucosyl, -N-acetylglucosaminyl, sialyl,d-galactosyl, -l-fucosyl, and -N-acetyl-d-galactosaminyl.Following pretreatment of brain slices with neuraminidase -d-gal-(1–3)-d-galN-acetyl groups were demonstrated on endothelium. In this respect, cerebral endothelium differs from noncerebral endothelium which is reported to have peanut agglutinin binding sites without neuraminidase pretreatment.Anionic groups on cerebral endothelium were demonstrated at the same locations as the lectin binding sites. Following neuraminidase pretreatment there was reduction, but not absence, of CF binding supporting the observation that surface charge is not wholly due to sialyl groups.The role of monosaccharide residues in states of altered cerebrovascular permeability remains to be determined.Supported by Ontario Heart Foundation grant no. 2-6     

Anti-inflammatory activity of Indian black tea (Sikkim variety).

In this study, the anti-inflammatory (in reference to the cardinal signs of inflammation) and other related pharmacological activities of the hot water extract of black tea (Camellia sinensis, Sikkim variety) were evaluated along with certain standard drugs. The extract showed significant inhibitory activity against carrageenin, histamine, serotonin and prostaglandin-induced pedal inflammation. The extract inhibited exudative inflammation. The tea extract also inhibited cotton pellet-induced granuloma formation and adjuvant-induced polyarthritis. Black tea extract showed significant inhibition against glucose oxidase-mediated inflammation. The present observations establish the efficacy of this particular variety of black tea, both in the exudative and proliferative forms and as well in the chronic phase of inflammation.