Panhypopituitarism : a rare cause of neonatal cholestatic jaundice

Although not uncommon, neonatal cholestatic jaundice is usually caused by congenital anatomical defects of the biliary tree or intrinsic liver pathology. We describe a case of persistent cholestatic jaundice in a six week old female infant caused by panhypopituitarism. To our knowledge this is the first report of hypopituitarism presenting with cholestatic jaundice in Malta. Prolonged obstructive jaundice in the neonatal period should be urgently investigated until a cause is found.peer-reviewe

Malignant disease in childhood : the price of cure : late physical and socioeconomic effects of treatment

The aim of cancer therapy in childhood is to achieve a lasting cure without physical and psychosocial harm and, preferably, at a low financial cost. Although cure is possible in many types of childhood cancer, this is often accompanied by complications as a consequence of intensive therapy. These late effects primarily affect fertility, the cardio-respiratory and endocrinological systems. Psychosocial adverse effects may have serious implications on the marriage and employment prospects of those patients surviving into adulthood. Furthermore, the risk of treatment-induced, secondary malignancies may increase as survival improves. With current intensive chemotherapy and radiotherapy, the attainment of cure rates in (EXC)ess of 60-70% is, inevitably, associated with significant morbidity. Indeed, recent developments in cancer therapy have focused on ways of reducing this morbidity, whilst still maintaining the overall improvement in survival.peer-reviewe

Discerning God’s will

The expression “discerning God’s will” has been quite a household word in spiritual and religious circles and, particularly so, since the Second Vatican Council. This is not because the Council issued any particular document about discernment. Its teaching, however, as deeply rooted in Revelation, Tradition and Scripture found particularly strong inspiration in Pope John XXIII’s charismatic call to the whole Church to “read the signs of the times.”2 The Council Fathers, taking to heart these prophetic words of the Lord, worked hard to discern what the Spirit of God was calling the Church to. The Vatican Council Constitutions and Decrees, being the benchmark against which to judge the reform of Catholic pastoral practice, are still urgently calling the Christian Community to shake off much dust gathered over the years and to strenuously commit to live and witness the vitality, freshness and joy of the Gospel.peer-reviewe

Simultaneous measurement of multiple parameters of a subwavelength structure based on the weak value formalism

A mathematical extension of the weak value formalism to the simultaneous measurement of multiple parameters is presented in the context of an optical focused vector beam scatterometry experiment. In this example, preselection and postselection are achieved via spatially-varying polarization control, which can be tailored to optimize the sensitivity to parameter variations. Initial experiments for the two-parameter case demonstrate that this method can be used to measure physical parameters with resolutions at least 1000 times smaller than the wavelength of illumination

The relationship between infecting organisms and underlying structural anomalies in children with urinary tract infections

Introduction: Urinary tract infections (UTIs) are a common cause of morbidity in childhood with potential for renal scarring and reflux nephropathy which can lead to hypertension and end-stage renal failure. Aim: The aim of this study was to investigate the relationship between the infecting organism and any underlying anomalies of the urinary tract which may predispose to the development of infections and which may alter the management of children with UTIs. Methods and results: A total of 72 cases of UTI were recorded retrospectively (in- and outpatients), with ages ranging from 3 days to 48 months (mean 9.5, median 5 months). Fifty seven (79%) of patients had their first reported urinary tract infection under the age of 1 year.. Fifty eight (80.6%) were E. coli infections. These presented at an older age than non-E. coli infections. Investigations were abnormal in 31 (43%) cases. The mean age for first infection in patients with abnormal investigations was 7.7 months (median 2 months), younger than those with no renal tract abnormalities. Organisms other than E. coli were rarely found when no significant abnormalities were detected with investigation by US and MCUG and this was a statistically significant difference (p<0.001). Renal scarring was identified in 10 (13.9%) patients. Discussion: This study confirms that non-E. coli UTI is associated with underlying renal pathology and that early infections with any organism are more likely to be associated with underlying abnormalities. We also outline an algorithm based on the recent NICE 2007 guidelines which will be adopted by the Paediatric Department, Mater Dei Hospital for the investigation of UTI.peer-reviewe

Age-related relationships among peripheral B lymphocyte subpopulations

An immunological data-driven model is proposed, for age related changes in the network of relationships among cell quantities of eight peripheral B lymphocyte subpopulations, that is, cells exhibiting all combinations of three specific receptor clusters (CD27, CD23, CD5). The model is based on immunological data (quantities of cells exhibiting CD19, characterizing B lymphocytes) from about six thousands patients, having an age ranging between one day and ninety-five years, by means of a suitably combination of data analysis methods, such as piecewise linear regression models. With relaxed values for statistically significant models (coefficient p-values bounded by 0.05), we found a network holding for all ages, that likely represents the general assessment of adaptive immune system for healthy human beings. When statistical validation comes to be more restrictive, we found that some of these interactions are lost with aging, as widely observed in medical literature. Namely, interesting (inverse or directed) proportions are highlighted among mutual quantities of a partition of peripheral B lymphocytes