A pin in appendix within Amyand's hernia in a six-years-old boy: case report and review of literature

<p>Abstract</p> <p>Introduction</p> <p>Presence of vermiform appendix (non-inflamed or inflamed) in inguinal hernia is called Amyand's hernia in honor to surgeon C. Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. This presentation of foreign body Amyand's hernia appendicitis is very rare, and here we present such a case.</p> <p>Case presentation</p> <p>A 6-year-old boy, white Kosovar ethnicity, presented with right groin pain, swelling and redness. Two days before admission the patient was injured by football during a children game in the right lower abdomen and the next day he complained of pain in the right inguinal area.</p> <p>On admission patient had a painful non-reducible mass in the right inguinal region and cellulitis. Plain abdominal x-ray showed no fluid-air levels, but a metallic foreign body (pin) under right superior pubic ramus was apparent. With preoperative diagnosis of suspect incarcerated inguinal hernia with cellulitis the patient was operated on under general anaesthesia in December 2, 2006. Intraoperatively we found the inflamed vermiform appendix perforated by a pin in the hernial sac. Appendectomy and herniotomy were performed. The wound was primary closed, without any post-operative complications and follow up for the patient is three years long.</p> <p>Conclusion</p> <p>Foreign body (pin) Amyand's hernia appendicitis seems to be extremely rare, maybe once in a century (Amyand 1735, Hall 1886, and our case in 2006). In patients with clinical signs of incarcerated inguinal hernia, with locally inflammatory signs, but without signs of intestinal obstruction Amyand's hernia appendicitis in differential diagnosis must be considered. In our case, it is possible that the injury during the football game might have induced perforation of the vermiform appendix with the foreign body in it.</p

Measuring fast electron spectra and laser absorption in relativistic laser-solid interactions using differential bremsstrahlung photon detectors

A photon detector suitable for the measurement of bremsstrahlung spectra generated in relativistically-intense laser-solid interactions is described. The Monte Carlo techniques used to back-out the fast electron spectrum and laser energy absorbed into fast electrons are detailed. A relativistically-intense laser-solid experiment using frequency doubled laser light is used to demonstrate the effective operation of the detector. The experimental data was interpreted using the 3-spatial-dimension Monte Carlo code MCNPX (Pelowitz 2008), and the fast electron temperature found to be 125 keV

Analyticity, Crossing Symmetry and the Limits of Chiral Perturbation Theory

The chiral Lagrangian for Goldstone boson scattering is a power series expansion in numbers of derivatives. Each successive term is suppressed by powers of a scale, $\Lambda_\chi$, which must be less than of order $4\pi f/\sqrt{N}$ where $f$ is the Goldstone boson decay constant and $N$ is the number of flavors. The chiral expansion therefore breaks down at or below $4 \pi f/\sqrt{N}$. We argue that the breakdown of the chiral expansion is associated with the appearance of physical states other than Goldstone bosons. Because of crossing symmetry, some ``isospin'' channels will deviate from their low energy behavior well before they approach the scale at which their low energy amplitudes would violate unitarity. We argue that the estimates of ``oblique'' corrections from technicolor obtained by scaling from QCD are untrustworthy.Comment: harvmac, 18 pages (3 figures), HUTP-92/A025, BUHEP-92-18, new version fixes a TeX problem in little mod

S-wave Meson-Meson Scattering from Unitarized U(3) Chiral Lagrangians

An investigation of the s-wave channels in meson-meson scattering is performed within a U(3) chiral unitary approach. Our calculations are based on a chiral effective Lagrangian which includes the eta' as an explicit degree of freedom and incorporates important features of the underlying QCD Lagrangian such as the axial U(1) anomaly. We employ a coupled channel Bethe-Salpeter equation to generate poles from composed states of two pseudoscalar mesons. Our results are compared with experimental phase shifts up to 1.5 GeV and effects of the eta' within this scheme are discussed.Comment: 18 pages, 6 figure

Another look at ππ\pi\pi scattering in the scalar channel

We set up a general framework to describe $\pi\pi$ scattering below 1 GeV based on chiral low-energy expansion with possible spin-0 and 1 resonances. Partial wave amplitudes are obtained with the $N/D$ method, which satisfy unitarity, analyticity and approximate crossing symmetry. Comparison with the phase shift data in the J=0 channel favors a scalar resonance near the $\rho$ mass.Comment: 17 pages, 5 figures, REVTe

Existence of the σ\sigma-meson below 1 GeV and f0(1500)f_0(1500) glueball

On the basis of a simultaneous description of the isoscalar s-wave channel of the $\pi\pi$ scattering (from the threshold up to 1.9 GeV) and of the $\pi\pi\to K\bar{K}$ process (from the threshold to $\sim$ 1.4 GeV) in the model-independent approach, a confirmation of the $\sigma$-meson at $\sim$ 665 MeV and an indication for the glueball nature of the $f_0(1500)$ state are obtained. It is shown that the large $\pi\pi$-background, usually obtained, combines, in reality, the influence of the left-hand branch-point and the contribution of a very wide resonance at $\sim$ 665 MeV. The coupling constants of the observed states with the $\pi\pi$ and $K\bar{K}$ systems and lengths of the $\pi\pi$ and $K\bar{K}$ scattering are obtained.Comment: 13 pages, 3 figures, LaTex; submitted to Physics Letters

The impact of low erythrocyte density in human blood on the fitness and energetic reserves of the African malaria vector Anopheles gambiae

Background Anaemia is a common health problem in the developing world. This condition is characterized by a reduction in erythrocyte density, primarily from malnutrition and/or infectious diseases such as malaria. As red blood cells are the primary source of protein for haematophagous mosquitoes, any reduction could impede the ability of mosquito vectors to transmit malaria by influencing their fitness or that of the parasites they transmit. The aim of this study was to determine the impact of differences in the density of red blood cells in human blood on malaria vector (Anopheles gambiae sensu stricto) fitness. The hypotheses tested are that mosquito vector energetic reserves and fitness are negatively influenced by reductions in the red cell density of host human blood meals commensurate with those expected from severe anaemia. Methods Mosquitoes (An. gambiae s.s.) were offered blood meals of different packed cell volume(PCV) of human blood consistent with those arising from severe anaemia (15%) and normalPCV (50%). Associations between mosquito energetic reserves (lipid, glucose and glycogen)and fitness measures (reproduction and survival) and blood meal PCV were investigated. Results The amount of protein that malaria vectors acquired from blood feeding (indexed by haematin excretion) was significantly reduced at low blood PCV. However, mosquitoes feeding on blood of low PCV had the same oviposition rates as those feeding on blood of normal PCV, and showed an increase in egg production of around 15%. The long-term survival of An. gambiae s.s was reduced after feeding on low PCV blood, but PCV had no significant impact on the proportion of mosquitoes surviving through the minimal period required to develop and transmit malaria parasites (estimated as 14 days post-blood feeding). The impact of blood PCV on the energetic reserves of mosquitoes was relatively minor. Conclusions These results suggest that feeding on human hosts whose PCV has been depleted due to severe anaemia does not significantly reduce the fitness or transmission potential of malaria vectors, and indicates that mosquitoes may be able exploit resources for reproduction more efficiently from blood of low rather than normal PCV

Randomized, Double-Blind, Placebo-Controlled Phase III Study of Tasquinimod in Men With Metastatic Castration-Resistant Prostate Cancer

PURPOSE: Tasquinimod, a novel oral therapy targeting the tumor microenvironment, significantly improved progression-free survival (PFS) in a randomized, placebo-controlled phase II trial in men with metastatic castration-resistant prostate cancer (mCRPC). This phase III study was conducted to confirm the phase II results and to detect an overall survival (OS) benefit. PATIENTS AND METHODS: Men with chemotherapy-naïve mCRPC and evidence of bone metastases were assigned (2:1) to receive tasquinimod once per day or placebo until progression or toxicity. The primary end point was radiographic PFS (rPFS; time from random assignment to radiologic progression or death) per Prostate Cancer Working Group 2 criteria and RECIST 1.1. The study had 99.9% power to detect an rPFS hazard ratio (HR) of 0.6 with a two-sided alpha error of .05 and 80% power to detect a target HR of 0.8 for OS, the key secondary end point. RESULTS: In all, 1,245 patients were randomly assigned to either tasquinimod (n = 832) or placebo (n = 413) between March 2011 and December 2012 at 241 sites in 37 countries. Baseline characteristics were balanced between groups: median age, 71 years; Karnofsky performance status ≥ 90%, 77.3%; and visceral metastases, 21.1%. Estimated median rPFS by central review was 7.0 months (95% CI, 5.8 to 8.2 months) with tasquinimod and 4.4 months (95% CI, 3.5 to 5.5 months) with placebo (HR, 0.64; 95% CI, 0.54 to 0.75; P < .001). Median OS was 21.3 months (95% CI, 19.5 to 23.0 months) with tasquinimod and 24.0 months (95% CI, 21.4 to 26.9 months) with placebo (HR, 1.10; 95% CI, 0.94 to 1.28; P = .25). Grade ≥ 3 adverse events were more frequent with tasquinimod (42.8% v 33.6%), the most common being anemia, fatigue, and cancer pain. CONCLUSION: In chemotherapy-naïve men with mCRPC, tasquinimod significantly improved rPFS compared with placebo. However, no OS benefit was observed

An unusual location of retroperitoneal epidermoid cyst in a child: case report and a review of the literature

We report the case of a 4-year-old girl presenting with the retroperitoneal epidermoid cyst. The lesion presented as an intra-abdominal cyst on physical examination and was followed up with more specific investigations by ultrasound and computed tomographic scanning. The final diagnosis was obtained only after laparotomy where the cystic mass was completely excised and pathological examination was done. The patient is well at 3-year follow-up. epidermoid cyst of the reteroperitoneal space, although rare, should be considered in the differential diagnosis of incidentally discovered intra-abdominal cysts during investigation of irrelevant illnesses or during routine abdominal ultrasound scan