Massive rectorhagia in a rural hospital in Kenya

A young female patient presented to our hospital for massive rectorrhagia associated with clinical signs of peritonitis. The provisional diagnosis was of sigmoid volvolus, but laparatomy demonstrated that the problem originated from Pelvic Inflammatory Disease (PID). Despite prompt and uncomplicated surgery the patient did not survive, probably because of septicaemia or pulmonary embolism

Smouldering onset of advanced mediastinal tumor in an adolescent boy: case report

An adolescent boy came at our observation with bilateral flaccid paralysis at both legs, cough, fecal and urinary incontinence. First symptoms started 6 months before, were initially mild and rather aspecific. There was incomplete information available from former diagnostic imaging and histologic assessment. We describe and discuss the subsequent diagnostic flow driving to the final diagnosis of spindle cell mediastinal carcinoma, its clinical management and outcome. Hopefully, sharing our lesson learnt may rise awareness around this rare tumor in adolescent population, in order to better anticipate diagnosis and improve its outcome

Neurofibromatosis type I: Case report

We present a case of neurofibromatosis type 1 (NF-1) discussing how cutaneous manifestations of disorders or  syndromes can be difficult to identify, especially when they are present since birth, present also in a  percentage of normal population, and especially when these are isolated findings, not accompanied by other  clinical relevant signs or symptoms. It is well known that NF-1 is a rather heterogeneous condition, with different degrees of expression and including cutaneous manifestations. Although there are some life  threatening complications clearly associated, for most patients the primary concern and main clinical impact remains the disfigurement caused by the presence and growth of cutaneous-dermal neurofibromas. These lesions can be underestimated especially in the impact on quality of life and sequelae that can cause if abnormally large and not removed. We present a clinical history spanning several years, before managing to properly diagnose our patient with neurofibromatosis type 1 and treat the relevant skin manifestation causing significant deformity and quality of life consequences

The challenges of a prostatectomy in rural Africa

Delayed complications of an established surgical procedure like transvescicalprostatectomy can occur in rural settings, where different factors can influence the outcome, beyond appropriate indication for surgery and technical skills of surgeons. Here we present a case that was per se surgically unremarkable, however a number of delayed omplications appeared in the post operative period, including infectious, neurologic, metabolic, hematologic ones, beyond purely post-surgery complications

A unique paediatric surgical case: case report

We present a surgical case of femoral hernia in an infant girl, aged three months. We consider this case of particular interest for two main reasons: the differential diagnosis of a groin mass in an infant, which included femoral hernia actually confirmed during open surgery performed in an emergency situation. The second interesting finding is that within the hernia sac we did not find the bowel nor the bladder, but with our surprise the uterus and a fallopian tube were contained in the hernia sac. Lastly, we comment on the importance to document similar cases by intra-operatory imaging. In our case the camera facility was not available in the theatre and we could not document this interesting case by imaging

Intestinal malrotation and Ladd’s bands in a young child

The case we present, is an interesting example of intestinal malrotation, which is a well known congenital condition, which tend to manifest early in life. In our case the age of our patient made the diagnosis potentially more challenging, as it was not the most typical age for duodenal stenosis due to Ladd’s bands, which is often mostly observed earlier in life. Stenosis of the duodenum is relatively rare, and may represent a surgical challenge, especially in setting with limited diagnostic and treatment facilities. We also discuss implication of language barriers to potentially delay timely diagnosis and optimal management

MicroRNA Signature in Human Normal and Tumoral Neural Stem Cells

MicroRNAs, also called miRNAs or simply miR‐, represent a unique class of non‐coding RNAs that have gained exponential interest during recent years because of their determinant involvement in regulating the expression of several genes. Despite the increasing number of mature miRNAs recognized in the human species, only a limited proportion is engaged in the ontogeny of the central nervous system (CNS). miRNAs also play a pivotal role during the transition of normal neural stem cells (NSCs) into tumor‐forming NSCs. More specifically, extensive studies have identified some shared miRNAs between NSCs and neural cancer stem cells (CSCs), namely miR‐7, ‐124, ‐125, ‐181 and miR‐9, ‐10, ‐130. In the context of NSCs, miRNAs are intercalated from embryonic stages throughout the differentiation pathway in order to achieve mature neuronal lineages. Within CSCs, under a different cellular context, miRNAs perform tumor suppressive or oncogenic functions that govern the homeostasis of brain tumors. This review will draw attention to the most characterizing studies dealing with miRNAs engaged in neurogenesis and in the tumoral neural stem cell context, offering the reader insight into the power of next generation miRNA‐targeted therapies against brain malignancies

Treatment of tibial pseudarthrosis secondary to snake bite in pediatric age: Chaaria mission hospital collaborative experience

In developing countries snake bites can cause necrosis and osteomyelitis, with consequent deformities, especially in children. Tibial segmental defects represent a therapeutic challenge, and are mainly due to congenital anomalies (agenesis or pseudoarthrosis), infections, post-traumatic fractures, and neoplastic lesions (6). A 13 years old girl was brought to our attention due to a severe deformity of left leg, secondary to previous osteomyelitis caused by a snake bite. The deformity was treated by osteotomy with peroneal excision and tibial synthesis with a DCP (Dynamic Compression Plate) which allowed to recover the right axis and joint rotation, allowing for a next step

Efecto de la lluvia en el momento de la cosecha (lavado) sobre características físicas, químicas y reológicas del grano de trigo Triticum aestivum L.

p.1-6Se simularon lluvias artificiales de magnitud creciente en un lote de trigo en condiciones de ser cosechado mecánicamente (humedad menor al 11,2 por ciento). Estas lluvias disminuyeron el Peso Hectolítrico y la densidad del grano, encontrándose una correlación curvilínea altamente significativa (r igual a -0,986 y r igual a -0,981, respectivamente) entre los dos parámetros y la magnitud de las lluvias. Se ideó una escala visual que se encontró estrechamente correlacionada con ambos (r igual a 0,88 y r igual a -0,83 en igual orden) posibilitando su uso como estimador rápido del lavado en experimentos en el futuro. Otros parámetros del grano no fueron afectados como tampoco lo fue la calidad industrial