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An unusual Monteggia equivalent type 1 lesion： Diaphyseal ulna and radius fractures with a posterior elbow dislocation in a child

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Chinese Journal of Traumatology 2018年第2期21卷 122-124页

作者： Lassaad Hassini Aymen Saidi Boujemaa Touati Aymen Ben Fradj Issam Aloui Abderrazek Abid department of Orthopaedic Surgery University Hospital 5000 Monastir Tunisia

In this report, we describe an extremely unusual Monteggia equivalent type 1 lesion in a 10-year-old boy following a fall from a height of I m. On the plain radiographs, our patient had a particular Monteggia equivalent type 1 injury associating a posterior elbow dislocation with diaphyseal radius and ulna fractures. The patient was treated by closed reduction technique. At six months of follow-up, the frac- tures were consolidated and the elbow was stable. To our knowledge, only 8 adult cases and one pae- diatric observation with similar lesions had been reported through medical literature. Therefore, the aim of our case report is to remind this rare entity and also to provide a comprehensive review of the literature related to this uncommon lesion.

关键词： Monteggia equivalent Children Forearm fracture Elbow dislocation

Abscess rate of patients with penetrating abdominal injury in Zaria

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Health 2013年第4期5卷 769-773页

作者： Jerry Godfrey Makama Ekundayo Stephen Garba department of Surgery Ahmadu Bello University Teaching Hospital Shika-Zaria Nigeria department of Surgery Ahmadu Bello University Teaching Hospital Shika-Zaria Nigeria

Background: Penetrating abdominal injury occurs when a foreign object pierces the skin. The morbidity and mortality associated with penetrating abdominal trauma is related to the intra-abdominal complications. This study is, therefore, intended to determine the abscess rate resulting from penetrating abdominal trauma in Ahmadu Bello University Teaching Hospital Zaria. Method: A 6-year (January 2006-December 2011) retrospective study of penetrating abdominal trauma emphasizing on the rate of development of intra-abdominal abscess. Information was obtained from patients’ case notes, operating room log books and surgical audit data. Information extracted included cases of penetrating abdominal trauma, intra-operative findings and cases of intra-abdominal abscesses. Results: A total of 39 cases of penetrating abdominal trauma were treated within this period of six years. 3 (7.7%) were treated in 2006, 6 (15.4%) in 2007, 3 (7.7%) in 2008 and 11 (28.2%) in 2009, 8 (20.5%) in 2010, 9 (23.1%) in 2011. 26 (66.7%) were adult while 13 (33.3%) were paediatric cases. The male were 37 (94.9%) and the female were 2 (5.1%), with a sex ratio of 18.5:1 (male to female). The age range was 5 -60 years (39.92 mean). The commonest cause of injury was road traffic accident. At exploration, 13 (33.3%) had organ injury only, 17 (43.6%) suffer from both organ injury and intra-peritoneal emorrhage, 9 (23.1%) had retroperitoneal haemorrhage only. The intra-abdominal abscess rate of penetrating abdominal injury in Zaria was found to be 2.6%. Conclusion: Contamination from either foreign object or organ injury is found to increase the risk of post-operative intra-abdominal abscess. In this center, the abscess rate of penetrating abdominal trauma is comparatively low.

关键词： Abscess Penetrating Abdominal Injury Rate

A Derived Exposure Chart for Computed Radiography in a Negroid Population

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Health 2016年第10期8卷 953-958页

作者： Thomas Adejoh Odira C. Ewuzie Joshua K. Ogbonna Stanley O. Nwefuru Nnamdi C. Onuegbu Radiology department Nnamdi Azikiwe University Teaching Hospital Nnewi Nigeria

Background: Computed radiography has a wider exposure latitude when compared with film-screen imaging system. Consequently, the risk of dose creep is high. A conscientious effort is there-fore, needed by the radiographer to keep exposure as low as reasonably achievable. Objective: To derive a computed radiography exposure chart for a negroid population using AGFA photostimulable phosphor plates and a GE static X-ray machine. Materials and Method: A static X-ray machine, a digitizer, and photostimulable phosphor plates were used for the X-ray examination. Chest examinations were done at a Focus-Film-Distance (FFD) of 150 - 180 cm while all other examinations were conducted at 90 - 100 cm FFD. The range of exposure factors (kVp, mA and mAs) used by radiog-raphers in the centre was noted and the 90th percentile calculated. Over a three-month period, the patients were examined with the 90th percentile of tube potential (kVp) while keeping other factors constant. The kVp was gradually decreased and halted if radiologists and radiographers uncon-nected with the work expressed misgivings about the quality of the image. A similar procedure was adopted for the tube current (mA). The threshold adopted as low as reasonably achievable was the factor preceding the point of observation by other personnel. Metrics for central tendency from the statistical packages for social sciences, version 17.0 was used to analyze the data. Results: 335 subjects of both gender aged 0 - 92 years were examined by the researchers. adult exposure factors used by the radiographers (and those derived by the researchers) had a range of 45 - 130 kVp (62 - 94 kVp), 63 - 320 mA (100 - 250 mA) and 4.0 - 25.0 mAs (5.0 - 20.0 mAs) respectively. Pediatric chest (and researchers-derived) factors were 50 - 75 kVp (52 - 65 kVp), 50 - 250 mA (100 - 220 mA) and 3.20 - 10.0 mAs (3.2 - 6.5 mAs) respectively. Conclusion: Upper threshold of adult (and paediatric) exposure factors in computed radiography with comparab

关键词： Computed Radiography Exposure Radiographer kVp Tube Current X-Ray

Nutritional therapy for active Crohn’s disease

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World Journal of Gastroenterology 2008年第27期14卷 4420-4423页

作者： Paul A Smith Specialist Registrar in Gastroenterology North Manchester General Hospital Gastroenterology Department Delaunays Road Crumpsall Manchester

Nutritional therapy for active Crohn’s disease (CD) is an underutilised form of treatment in adult patients, though its use is common in the paediatric population. There is evidence that nutritional therapy can effectively induce remission of CD in adult patients. Enteral nutrition therapy is safe and generally well tolerated. Meta-analysis data suggest that corticosteroids are superior to nutritional treatment for induction of remission in active CD. However, the potential side effects of such pharmacotherapy must be taken into consideration. This review examines the evidence for the efficacy of elemental and polymeric diets, and the use of total parenteral nutrition in active CD.

关键词： Crohn's disease Nutrition Dietary Treatment Steroids

Crohn’s and colitis in children and adolescents

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World Journal of Gastroenterology 2012年第41期18卷 5862-5869页

作者： Andrew S Day Oren Ledder Steven T Leach Daniel A Lemberg department of Gastroenterology Sydney Children's HospitalRandwickSydneyNSW 2031Australia School of Women's and Children's Health University of New South WalesSydneyNSW 2031Australia department of paediatrics University of Otago ChristchurchChristchurch 8140New Zealand

Crohn＇s disease and ulcerative colitis can be grouped as the inflammatory bowel diseases （IBD）. These conditions have become increasingly common in recent years, including in children and young people. Although much is known about aspects of the pathogenesis of these diseases, the precise aetiology is not yet understood, and there remains no cure. Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life, including in infancy. Pain, diarrhoea and weight loss are typical symptoms of paediatric Crohn＇s disease whereas bloody diarrhoea is more typical of colitis in children. However, atypical symptoms may occur in both conditions： these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythma nodosum. Growth and nutrition are commonly compromised at diagnosis in both Crohn＇s disease and colitis. Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis, the- reby avoiding the consequences of diagnostic delay. Patterns of disease including location and progression of IBD in childhood differ substantially from adult- onset disease. Various treatment options are available for children and adolescents with IBD. Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn＇s disease. Medical and surgical therapies need to considered within the context of a growing and developing child. The overall management of these chronic conditions in children should include multi-disciplinary expertise, with focus upon maintaining control of gut inflammation, optimising nutrition, growth and quality of life, whilst preventing disease or treatment-related complications.

关键词： Children Adolescents Crohn's disease Ulcerative colitis Inflammatory bowel diseases

Diet therapy for inflammatory bowel diseases: The established and the new

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World Journal of Gastroenterology 2016年第7期22卷 2179-2194页

作者： Franziska Durchschein Wolfgang Petritsch Heinz F Hammer department of Internal Medicine Division of Gastroenterology and Hepatology Medical University of Graz

Although patients with inflammatory bowel diseases(IBD) have a strong interest in dietary modifications as part of their therapeutic management, dietary advice plays only a minor part in published guidelines. The scientific literature shows that dietary factors might influence the risk of developing IBD, that dysbiosis induced by nutrition contributes to the pathogenesis of IBD, and that diet may serve as a symptomatic treatment for irritable bowel syndrome-like symptoms in IBD. The role of nutrition in IBD is underscored by the effect of various dietary therapies. In paediatric patients with Crohn's disease(CD) enteral nutrition(EN) reaches remission rates similar to steroids. In adult patients, however, EN is inferior to corticosteroids. EN is not effective in ulcerative colitis(UC). Total parenteral nutrition in IBD is not superior to steroids or EN. The use of specific probiotics in patients with IBD can be recommended only in special clinical situations. There is no evidence for efficacy of probiotics in CD. By contrast, studies in UC have shown a beneficial effect in selected patients. For patients with pouchitis, antibiotic treatment followed by probiotics, like VSL#3 or Lactobacillus GG, is effective. When probiotics are used, the risk of bacterial translocation and subsequent bacteremia has to be considered. More understanding of the normal intestinal microflora, and better characterization of probiotic strains at the phenotypic and genomic levels is needed as well as clarification of the mechanisms of action in different clinical settings. A FODMAP reduced diet may improve symptoms in IBD.

关键词： enteral nutrition parenteral nutrition probiotics fermentable oligo-, di-, and monosaccharidesand polyols Crohn's disease ulcerative colitis

Ileocolic Intussusception Prolapsing from the Rectum in von Recklinghausen's Disease

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Surgical Science 2012年第8期3卷 421-423页

作者： Marlén Alvite Canosa Leticia Alonso Fernández Lucía Dorado Castro Rocío González López Ana álvarez Gutiérrez Inmaculada Monjero Ares José Conde Vales Félix Arija Val General surgery department of Hospital Universitario Lucus Augusti Lugo Spain

Intussusception is a paediatric condition that rarely presents in adults. We report an exceptional case of ileocolic intussusception prolapsing from the rectum in an adult with Von Recklinghausen′s disease. A 31-year-old man with von Recklinghausen′s disease presented to emergency department with a history of severe abdominal pain, vomits and rectal bleeding. Abdominal computed tomography showed intestinal obstruction probably due to a sigmoidorectal intussusception. Ileum, appendix, cecum and ascending colon were found to be intussuscepting through transverse, descending and sigmoid colon and prolapsing from the rectum during an emergent laparotomy. A right hemicolectomy was performed. An anatomical pathology examination revealed a neurofibroma of the appendix as lead point for intussusception. Intussusception in adults requires early surgical resection regardless of the nature of the initial case. Neurofibroma of the appendix is very rare;although it is benign, prompt resection is recommended because of a high risk of appendicitis and malignant transformation.

关键词： adult Intussusceptions Neurofibromatosis Von Recklinghausen′s Disease Appendiceal Neurofibroma

Retinoblastoma: Socio-Demographic, Clinical and Therapeutic Aspects in the Hemato-Oncology Unit of the department of Pediatrics of Donka National Hospital, Guinea

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Open Journal of Pediatrics 2020年第3期10卷 561-569页

作者： Aïssata Barry Mamadou M. Diop Mamadou A. Doukoure Emmanuel Camara Saliou B. Diallo Narcisse V. Gateu Tadjom Fatoumata Barry Hasmiou Dia Boubacar Togo Mamadou P. Diallo department of Pediatrics National Hospital Donka Conakry Guinea department of Pediatrics Ignace Deen Hospital Conakry Guinea departmentof Pediatrics Gabriel Toure Hospital Bamako Mali Medical and Health Counseling Center Conakry Guinea

Introduction: Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. Methods: This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. Results: Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). Conclusion: In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.

关键词： Retinoblastoma Leukocoria Chemotherapy Enucleation

Genetic ＆ Epigenetic alterations in Gliomas with special reference to age related differences:Indian experience

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Genetic ＆ Epigenetic alterations in Gliomas with special re...