Influence of Stress Ratio on the Elevated-Temperature Fatigue of a Silicon Carbide Fiber-Reinforced Silicon Nitride Composite

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65470/1/j.1151-2916.1991.tb07152.x.pd

Hirschsprung\u2019s Disease

Hirschsprung\u2019s disease (HD) or \u201ccongenital megacolon\u201d is a congenital developmental disorder characterized by the absence of ganglion cells in the distal intestine with variable proximal extension. HD affects approximately 1 / 5,000 live births and is more common in males (M: F = 4: 1). According to the proximal extension is possible to indentify different forms of HD: ultrashort, short segment or classical form, long segment and total colonic aganglia. Most children with HD (50-90%) are diagnosed in the neonatal period. Typically the infant with HD is born at term and present with failure to pass meconium.When there is a clinical suspicion of HD, diagnostic investigations to be performed include: radiologic evaluation (plain radiographs, barium enema), anorectal manometry, rectal full-thickness biopsy or serum-muscle and / or rectal biopsy by suction (Rectal Suction biopsy - RSB).There are numerous surgical techniques described for the treatment of HD. The most commonly performed, and therefore considered \u201cthe major pull-through procedures\u201d, are: Swenson rectosigmoidectomy, Duhamel retrorectal transanal pull-through, Rehbein pull-through with anterior colorectal anastomosis, Soave rectosigmoidectomy with aseptic endorectal colon pull-through.Early postoperative complication is represented by colo-anal anastomosis dehiscence (3.2%) which, if not massive, is solvable conservatively. Late postoperative complications are HAEC and colo-anal anastomosis stenosis.On rare occasions the child may require a RedoPT procedure. Indication for RedoPT in the recent review was most commonly for a retained aganglionosis/transition zone pathology (RA/TZP; 71% overall ). Other indications included stricture/obstructing Duhamel pouch (19%), excessively tight cuff (8%), twisted-PT (4%). Operative approach can vary widely and is heavily dependent on type of complication, underlying pathology, previous surgical history as well as surgeon preference as to the type of repair. Complications are quite similar after redo-PT compared to primary PT in experienced hands but stooling outcomes are significantly worse compared to those after a primaryPT. Importantly, continence is still retained in the majority of children

Effects of a dietary and environmental prevention programme on the incidence of allergic symptoms in high atopic risk infants: Three years follow-up

A prospective case-control study is presented to assess an allergy prevention programme in children up to 36 months of age. Infants born at three maternity hospitals were followed from birth: 279 infants with high atopic risk (intervention group) were compared with 80 infants with similar atopic risk but no intervention (non-intervention group). The intervention programme included dietary measures (exclusive and prolonged milk feeding diet followed by a hypoantigenic weaning diet) and environmental measures (avoidance of parental smoking in the presence of the babies, day care >2 years of life). Mothers in this group who had insufficient breast milk were randomly assigned to one of two coded formulas: either a hydrolysed milk formula (Nidina HA, Nestle) or a conventional adapted formula (Nan, Nestle). Other environmental measures remained the same as for the breastfeeding mothers. The non-intervention group were either breastfed or received the usual Italian milk feeding and weaning diet, without environmental advice. The main outcome measures were anthropometric measurements and allergic disease manifestations. Normal anthropometric data were observed both in the intervention group and in the nonintervention group. The incidence of allergic manifestations was much lower in the intervention group than in the nonintervention group at I year (11.5 versus 54.4%, respectively) and at 2 years (14.9 versus 65.6%) and 3 years (20.6 versus 74.1%). Atopic dermatitis and recurrent wheezing were found in both the intervention group and the non- intervention group from birth up to the second year of life, while urticaria and gastrointestinal disorders were only present in the nonintervention group in the first year of life. Conjunctivitis and rhinitis were present after the second year in both the intervention group and the non-intervention group. Relapse of the same allergic symptom was less in the intervention group (13.0%) than in the non-intervention group (36.9%). In comparison to the non- intervention group, there were fewer intervention group cases with two or more different allergic symptoms (8.7 versus 32.6%), and they were more likely to avoid steroid treatment (0 versus 10.8%) and hospital admission (0 versus 6.5%). Babies in the non-intervention group fed with adapted formula were more likely to develop allergies than breastfed babies in the same group. In the intervention group the breastfed infants had the lowest incidence of allergic symptoms, followed by the infants fed the hydrolysed formula (ns). Infants in the intervention group fed the adapted formula had significantly more allergies than the breastfed and hydrolysed milk fed infants, although less than their counterparts in the non-intervention group. Of the affected subjects in the intervention group, 80.4% were RAST and/or Prick positive to food or inhalant allergens. Total serum IgE values detected at birth in the intervention group were not predictive, but at 1 and 2 years of age, IgE values more than 2 SD above the mean in asymptomatic babies were found to predictive for later allergy. In breastfed babies the total IgE level at 1 and 2 years of age was lower than in the other two feeding groups. Of the various factors tested in the non-intervention group, the following were the most important in the pathogenesis of allergic symptoms: (i) formula implementation begun in the first week of life; (ii) early weaning (< 4 months); (iii) feeding beef (< 6 months); (iv) early introduction of cow's milk (< 6 months); and (v) parental smoking in the presence of the babies and early day care admission (< 2 years of life). All the preventive measures used in this study (exclusive breastfeeding and/or hydrolysed milk feeding, delayed and selective introduction of solid foods, and environmental advice) were effective at the third year of follow-up, greatly reducing allergic manifestations in high atopic risk babies in comparison with those not receiving these interventions