Liver abscess following ingestion of a foreign object

A 31 year old, previously healthy female presented to A&E on 24/07/2012 with a 2 day history of colicky epigastric pain and spiking fever; however on investigation no pathology was found except for an ovarian cyst of 4cm. It was concluded that it was unlikely that the cyst was causing pain and fever and the patient was discharged. She was given proton pump inhibitors for 2 weeks and pain improved, however on stopping therapy, the pain became much more severe, with radiation to the back. She presented to A&E again on 05/08/2012. A more detailed history elicited the fact that she had ingested half a toothpick by mistake 3 weeks previously. Imaging showed the formation of an abscess between the stomach and liver; which needed drainage.peer-reviewe

Discitis

Discitis is an inflammatory condition of the intervertebral disc or disc space. It is an uncommon condition which occurs mostly in young children or as a post-operative complication, such as following an epidural. It is extremely rare in the elderly as disc size and sponginess decreases with age and consequently the risk of infection decreases. In this case, discitis occurred spontaneously in an elderly patient and was complicated by a psoas abscess. The patient also suffers from acute renal failure, chronic heart failure, left sided pneumonia and shingles (Herpes Zoster) in dermatome S3. A trapped spinal nerve occurring at the intervertebral foramen is a common complication in fact, the subject did suffer from sciatica for the past 30 years.peer-reviewe

Depression from Childhood into Late Adolescence: Influence of Gender, Development, Genetic Susceptibility, and Peer Stress.

Depression is a debilitating mental illness with clear developmental patterns from childhood through late adolescence. Here, we present data from the Gene Environment Mood (GEM) study, which used an accelerated longitudinal cohort design with youth (N 665) starting in 3rd, 6th, and 9th grades, and a caretaker, who were recruited from the general community, and were then assessed repeatedly through semistructured diagnostic interviews every 6 months over 3 years (7 waves of data) to establish and then predict trajectories of depression from age 8 to 18. First, we demonstrated that overall prevalence rates of depression over time, by age, gender, and pubertal status, in the GEM study closely match those trajectories previously obtained in past developmental epidemiological research. Second, we tested whether a genetic vulnerability-stress model involving 5-HTTLPR and chronic peer stress was moderated by developmental factors. Results showed that older aged adolescents with SS/SL genotype, who experienced higher peer chronic stress over 3 years, were the most likely to be diagnosed with a depressive episode over time. Girls experiencing greater peer chronic stress were the most likely to develop depression. This study used repeated assessments of diagnostic interviewing in a moderately large sample of youth over 3 years to show that depression rates increase in middle to late adolescence, or postpubertally, and that the gender difference in depression emerges earlier in adolescence (age 12.5), or postpubertally. Additionally, genetically susceptible older adolescents who experience chronic peer stress were the most likely to become depressed over time