Incidence and treatment of adhesive bowel obstruction after gastroschisis closure

Background: Children with gastroschisis, especially when it is complicated by atresia or perforation, often suffer from severe long-term sequelae such as short-bowel syndrome and chronic dysmotility. These children are also susceptible to adhesive bowel obstruction later in life, which can alter their nutritional intake and may require repeated visits to the hospital. However, few long-term studies have attempted to determine the rate of occurrence of intestinal occlusion after gastroschisis. In this study we measured the incidence and management ofadhesive bowel obstruction in children with gastroschisis at one academic pediatric hospital.Methods: A retrospective chart review was carried out on patients with gastroschisis born between January 2000 and December 2007. A total of 74 patients who underwent closure of their gastroschisis during this period were identified.Results: Twelve of these 74 (16%) patients were readmitted to the hospital with at least one episode of adhesive bowel obstruction. Three of the 12 patients had gastroschisis complicated by atresia. Eight patients underwent immediate primary closure of their defect on the first day of life. Silos were installed on the remaining four (36%) and were kept in place for an average of 6.25 (range: 4–9) days. Five of the 12 children resolved their obstruction with nasogastric tube decompression alone. The remaining seven (58%) required lysis of adhesions after failure of decompression. The seven children who underwent surgical lysis of adhesions did not have additional episodes of occlusion after laparotomy.Conclusion: In this study, 16% of the patients born with gastroschisis within a 7-year period presented with a adhesive obstruction. Occurrence of obstruction was unrelated to the method of closure or the severity of the defect. Although conservative management with nasogastric tube decompression may be effective initially, over half of patients with occlusion will need eventual surgery for lysis of adhesions.Keywords: bowel obstruction, gastroschisis, lysis of adhesion

Tough Times

Lokale Praxis und globale Informations- und Kommunikationstechnik (IT) gehen immer dann eine sichtbare Verbindung ein, wenn IT eingesetzt wird, um Echtzeit-Informationen an einen anderen Ort zu übertragen, so wie dies z.B. durch Mobiltelefone/ MMS, ferngesteuerte Sensoren oder Live-Webcams geschieht. Diese Arbeit beschreibt eine Feldstudie zu IT-unterstützter Wartungsarbeit innerhalb der Infrastruktur eines Energieversorgers. Die Studie möchte insbesondere die Relationen zwischen lokalen Praxen und der Gestaltung einer IT-Infrastruktur als "Location Based System" hervorheben, die nicht auf den ersten Blick sichtbar sind. Besonders richten wir den Blick sowohl auf "das Globale" als auch auf "das Lokale" von Strom- und IT-Infrastruktur. Wir orientieren uns am Infrastruktur-Konzept von Star & Ruhleder (1996) für eine Beschreibung und Analyse zweier unterschiedlicher Wartungsteams vor dem Hintergrund sozio-räumlicher sowie sozio-technischer Aspekte der Energieversorgungsinfrastruktur, der Informations- und Kommunikations-Infrastruktur und der jeweilig resultierenden Arbeitspraxis und diskutieren Konsequenzen für eine infrastrukturorientierte Technikgestaltung

Neither essence nor accident: Situated knowledge and its importance for the community broker

The paper describes the design of the Community Broker as a case study for the development of a tool attempting to support individual web-search strategies by using the community-based nature of a great deal of information exchange and learning. Community experiences affect the understanding, validation and organization of individual knowledge. Communities affecting the representation of knowledge frame the every-day decisions individuals have to take in spite of incomplete, insecure knowledge and the vagueness of communicating in natural languages. As for the often distributed, fragmented and heterogeneous nature of knowledge and related problems of information search in the internet - some of which are described in the paper - technical tools can support information search, when the influence of community-based identities upon knowledge representation and -identification is used as a source of additional information instead of being ignored

Depth of Encoding Through Observed Gestures in Foreign Language Word Learning

Word learning is basic to foreign language acquisition, however time consuming and not always successful. Empirical studies have shown that traditional (visual) word learning can be enhanced by gestures. The gesture benefit has been attributed to depth of encoding. Gestures can lead to depth of encoding because they trigger semantic processing and sensorimotor enrichment of the novel word. However, the neural underpinning of depth of encoding is still unclear. Here, we combined an fMRI and a behavioral study to investigate word encoding online. In the scanner, participants encoded 30 novel words of an artificial language created for experimental purposes and their translation into the subjects\u2019 native language. Participants encoded the words three times: visually, audiovisually, and by additionally observing semantically related gestures performed by an actress. Hemodynamic activity during word encoding revealed the recruitment of cortical areas involved in stimulus processing. In this study, depth of encoding can be spelt out in terms of sensorimotor brain networks that grow larger the more sensory modalities are linked to the novel word. Word retention outside the scanner documented a positive effect of gestures in a free recall test in the short term

An overview of the latest metabolomics studies on atopic eczema with new directions for study

Atopic eczema (AE) is an inflammatory skin disorder affecting approximately 20% of children worldwide and early onset can lead to asthma and allergies. Currently, the mechanisms of the disease are not fully understood. Metabolomics, the analysis of small molecules in the skin produced by the host and microbes, opens a window to observe the mechanisms of the disease which then may lead to new drug targets for AE treatment. Here, we review the latest advances in AE metabolomics, highlighting both the lipid and non-lipid molecules, along with reviewing the metabolites currently known to reside in the skin