Torsion and Inflammation of Meckel's Diverticulum: Rare Cause of Acute Abdominal Pain

Meckel's diverticulum is a remnant of the embryologic vitelline duct. It was named after its anatomical and embryological description, in the early 19th century, by Johann Meckel. It is known as a true diverticulum of the small bowel and is typically estimated to be present in 2% of the general population, with only a very small percentage being symptomatic. In this report, we present a 14-year-old boy with complaints of abdominal pain, fever, nausea, vomiting and diarrhea. During physical examination we observed peritoneal irritation and raised inflammatory markers. Surgical exploration revealed torsion and inflammation of a large Meckel's diverticulum with a gangrenous area. In order to ensure the removal of etopic tissue, if present, segmental bowel resection with primary anastomosis was performed. Histopathological analysis did not find ectopic tissue. The operative and postoperative courses were uneventful. Meckel's diverticulum is an important differential diagnosis in acute abdominal pain in children.info:eu-repo/semantics/publishedVersio

Chronic Gastric Volvulus

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Stump Appendicitis in Two Adolescent Boys: Rare Presentations and Alternative Approaches in Pediatrics

Stump appendicitis is a rare complication that results from reinflammation of the residual part of the appendix, after incomplete appendectomy. Factors that may contribute to inadequate identification of appendicular base are subserosal or retrocecal position, extensive inflammation or inadequate surgical exposure. The length of the appendiceal stump after ligation is likely a major predisposing factor. The presentation of stump appendicitis is similar to acute appendicitis, but this diagnosis is often dismissed because of the surgical history. Computed tomography and ultrasonography are the imaging modalities of choice. The usual recommended treatment for stump appendicitis is completion appendectomy. Stump appendicitis must be considered in the differential diagnosis of acute abdomen despite the patient’s appendectomy history. A delayed diagnosis may lead to an increase in morbidity. We present two cases of stump appendicitis in adolescents after laparoscopic appendectomies, one being a case of recurrent stump appendicitis. We report two alternative therapeutic approaches: interval appendectomy and non-operative management. We conclude that these alternative approaches may be suitable for some patients with stump appendicitis. A review of the pertinent literature was done.info:eu-repo/semantics/publishedVersio

Tubular Colorectal Duplication

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Determinação da Carga Alergénica (Ole e1) Presente no Ar Atmosférico na Região de Évora: Correlação com o conteúdo polínico de Olea

Introdução: Em Portugal, o pólen da oliveira (Olea europaea) constitui uma das fontes mais relevantes de aero-alergénios, sendo uma causa frequente de polinose na região Mediterrânica, onde o Ole e 1 é um alergeno major. Apesar de se julgar apenas associado aos grãos de pólen, desconhece-se a variabilidade inter-anual da carga alergénica do pólen e ainda existe alguma controvérsia sobre a forma como este aeroalergeno se distribui no ar atmosférico. Objectivo: Este trabalho teve como objectivos: i) determinar a fracção dos bioaerossóis mais rica em Ole e 1; ii) avaliar a correlação dos conteúdos diários de pólen e aeroalergeno no ar atmosférico; iii) avaliar variação anual da carga alergénica do pólen. Métodos: Os aeroalergenos foram captados utilizando um colector de impacto CHEMVOL equipado com dois filtros com capacidade para reter partículas de diferentes dimensões: PM>10µm e 10µm>PM>2,5µm. Após 24h os filtros foram retirados, a fracção proteica foi extraída e os alergenos quantificados por ELISA. Simultaneamente o pólen foi monitorizado pela tecnologia padrão utilizando um colector volumétrico Burkard 7-Day Recording Volumetric Spore Trap. Os colectores foram ambos colocados numa mesma plataforma a 17m de altura, e a ≈3-4m um do outro. Resultados: Entre 2009 e 2011, registou-se uma variação inter-anual quer do perfil quer da duração da época polínica (39, 47 e 45 dias, respectivamente). O conteúdo polínico total no ar atmosférico também foi variável no intervalo de 7240 a 12524 grãos/m3. Mais de 90% do alergeno foi encontrado na fracção de bioaerossóis de PM>10µm. O conteúdo em Ole e 1 foi directamente proporcional ao número de grãos de pólen no ar atmosférico, tendo-se encontrado uma correlação positiva entre os valores diários dos dois parâmetros. Comparando as épocas estudadas, os conteúdos totais de Ole e1 e de pólen não foram proporcionais, tendo-se observado que a carga alergénica por grão de pólen variou mais de 3x. Conclusões: Estes resultados sugerem que o Ole e 1 está preferencialmente associado aos grãos de pólen. Os conteúdos em pólen e Ole e 1 variaram inter-anualmente, tendo a carga alergénica dos grãos de pólen sido diferente. Este trabalho poderá assim contribuir para o desenvolvimento de um indicador que permita melhorar a previsão do risco de exposição a aeroalergenos. Agradecimentos: Este foi realizado no âmbito do projecto europeu HIALINE (Executive Agency for Health and Consumers, grant agreement No 2008 11 07)

Deposition of tin oxide, iridium and iridium oxide films by metal-organic chemical vapor deposition for electrochemical wastewater treatment

In this research, the specific electrodes were prepared by metal-organic chemical vapor deposition (MOCVD) in a hot-wall CVD reactor with the presence of O2 under reduced pressure. The Ir protective layer was deposited by using (Methylcyclopentadienyl) (1,5-cyclooctadiene) iridium (I), (MeCp)Ir(COD), as precursor. Tetraethyltin (TET) was used as precursor for the deposition of SnO2 active layer. The optimum condition for Ir film deposition was at 300 °C, 125 of O2/(MeCp)Ir(COD) molar ratio and 12 Torr of total pressure. While that of SnO2 active layer was at 380 °C, 1200 of O2/TET molar ratio and 15 Torr of total pressure. The prepared SnO2/Ir/Ti electrodes were tested for anodic oxidation of organic pollutant in a simple three-electrode electrochemical reactor using oxalic acid as model solution. The electrochemical experiments indicate that more than 80% of organic pollutant was removed after 2.1 Ah/L of charge has been applied. The kinetic investigation gives a two-step process for organic pollutant degradation, the kinetic was zero-order and first-order with respect to TOC of model solution for high and low TOC concentrations, respectively

Endoscopic Balloon Dilatation for Treatment of Primary Obstructive Megaureter: Experience of a Center

Introduction: Congenital obstructive megaureter may be treated with endoscopic balloon dilatation, particularly in children under one year of age. We report our experience over a six year period. Methods: All patients with diagnosis of primary obstructive megaureter treated with endoscopic balloon dilatation from 2009 to 2014 (6 years) were included. The diagnosis of primary obstructive megaureter was based on dilatation of the distal ureter greater than 7 mm, obstructive curve on MAG-3 diuretic renogram and absence of vesicoureteral reflux. After diagnosis, conservative management was maintained with antibiotic prophylaxis in all patients. The indications for surgery were a combination of clinical, ultrasonographic and renographic findings. Under general anesthesia and after retrograde ureteropielography, high pressure balloon dilation of the ureterovesical junction was performed under direct and fluoroscopic vision until the disappearance of the narrowed ring. A double-J catheter was positioned. Follow-up was performed with ultrasonography and diuretic renogram. The success of the intervention was defined by improvement of hydroureteronephrosis (at least 2 grades). Results: A total of nine patients underwent this procedure on a single ureter, two girls and seven boys, with a mean age of 7.6 months (range 1-14) at the intervention. Five were left sided and four were right sided. All patients had prenatal diagnosis of hydroureteronephrosis. No patients were lost to follow-up (average 46.7 months). They all had hydroureteronephrosis greater than grade 3 and preoperative MAG-3 diuretic renogram was obstructive in all cases. Mean differential function of the affected kidney was 46.2% (range 40-53%). The main indication for surgical treatment was progressive hydroureteronephrosis. All patients were treated endoscopically with no intraoperative complications. Ultrasound showed improvement of the hydroureteronephrosis in six patients (66.7%). Three patients were reimplanted (33.3%). The mean differential renal function after the procedure was 47.4% (range 41-53%). At the latest follow-up assessment, all patients remained asymptomatic. Conclusion: Endoscopic balloon dilatation is a useful option in the management of primary obstructive megaureter requiring surgical intervention and may be considered first line treatment in small children.info:eu-repo/semantics/publishedVersio

Efeito do óxido de grafeno em Lactuca sativa sob influência de substâncias húmicas.

Resumo: Diversas áreas revelam o grafeno como um nanomaterial promissor em várias aplicações, tais como transporte de fármacos, remoção de poluentes de água e ar (metais, orgânicos e microrganismos). Nas áreas de agricultura e meio ambiente, seu uso é promissor na remoção de pesticidas de águas contaminadas por esses insumos agrícolas. É esperado que materiais a base de grafeno estejam presentes nas estações de tratamento de efluentes em quantidades consideráveis, o que pode comprometer a qualidade do lodo agrícola usado como biofertilizante. A semente de alface Lactuta Sativa (L. sativa) é um organismo bioindicador de contaminação de áreas úmidas de transição entre o compartimento aquático e o compartimento solo. No presente trabalho avaliou-se o efeito do óxido de grafeno na germinação e taxa de crescimento das raízes de L. sativa, sob diferentes concentrações do nanomaterial e de influência do ácido húmico neste efeito. Esta última substância pode afetar a biodisponibilidade do nanomaterial. Como resultado observou-se que mesmo na maior concentração testada, 100 mg L-1, não houve alteração significativa (P>0,05) da germinação e do crescimento de Lactuca sativa. A presença do material húmico, na concentração de 20 mg L-1, não contribuiu para manifestar efeito adverso do material-teste. Abstract: Several areas show graphene as a promising nanomaterial in various applications such as transportation of drugs, removal of water and air pollutants (metals, organics and microorganisms). In the areas of agriculture and environment, it is promising use in removing water contaminated by pesticides. It is expected that graphene based materials are present in the wastewater treatment plants in considerable quantities, which can compromise the quality of agricultural sludge used as bio-fertilizer. Lettuce (L. sativa) seed is a bioindicator organism used to evaluate the contamination of the transition area between the water compartment and the ground. In the present study we evaluated the effect of graphene oxide on the germination and growth rate of L. sativa roots under different nanomaterial concentrations and the influence of humic acid in this effect. This latter substance can affect the bioavailability of the nanomaterial. As a result, even the highest concentration tested (100 mg L -1 ) did not produced significant change (P> 0.05) on the germination and growth of L. sativa. The presence of the humic material at the concentration of 20 mg L -1 did not contributed to manifest adverse effect of the test-material

A simplified curcumin targets the membrane of Bacillus subtilis

Abstract Curcumin is the main constituent of turmeric, a seasoning popularized around the world with Indian cuisine. Among the benefits attributed to curcumin are anti‐inflammatory, antimicrobial, antitumoral, and chemopreventive effects. Besides, curcumin inhibits the growth of the gram‐positive bacterium Bacillus subtilis. The anti‐B. subtilis action happens by interference with the division protein FtsZ, an ancestral tubulin widespread in Bacteria. FtsZ forms protofilaments in a GTP‐dependent manner, with the concomitant recruitment of essential factors to operate cell division. By stimulating the GTPase activity of FtsZ, curcumin destabilizes its function. Recently, curcumin was shown to promote membrane permeabilization in B. subtilis. Here, we used molecular simplification to dissect the functionalities of curcumin. A simplified form, in which a monocarbonyl group substituted the β‐diketone moiety, showed antibacterial action against gram‐positive and gram‐negative bacteria of clinical interest. The simplified curcumin also disrupted the divisional septum of B. subtilis; however, subsequent biochemical analysis did not support a direct action on FtsZ. Our results suggest that the simplified curcumin exerted its function mainly through membrane permeabilization, with disruption of the membrane potential necessary for FtsZ intra‐cellular localization. Finally, we show here experimental evidence for the requirement of the β‐diketone group of curcumin for its interaction with FtsZ

Vascular Trauma in Children-Review from a Major Paediatric Center

BACKGROUND: Traumatic noniatrogenic vascular injuries in children are rare and rarely discussed in literature. Pediatric vascular injuries pose a set of challenges mainly because of continued growth and development in a child or adolescent. The purpose of the study is to characterize management strategies and outcomes in these cases. METHODS: This is a single-center retrospective review of patients less than age 18 years (pediatric age) with acute, noniatrogenic traumatic vascular injuries between January 2009 and December 2015. Patient's demographics, injury characteristics, surgical management, complications, and follow-up were analyzed. RESULTS: From 2009 to 2015, 3277 children with traumatic injuries were treated, of which 21 (0.6%) had 23 significant vascular injuries: 17 arterial and 6 venous injuries. The majority were males (n = 16), and the median age was 14 years (range 1 to 16 years). Penetrating injuries were the predominant mechanism (n = 21), mainly by glass (n = 13). At presentation, 4 patients were hemodynamically unstable, 3 of them in hypovolemic shock. All patients were managed operatively. Operations for arterial injuries included 5 primary arterial repairs, 4 repairs using vein grafts and 8 ligations. The following adjunct procedures were necessary: one 4-compartment leg fasciotomy due to associated soft tissue trauma, 8 tendon repairs, and 11 nerve repairs. Operations for venous injuries included 4 ligations and 2 primary repairs. There were no intraoperative or postoperative deaths, major complications, or limb loss. The median length of stay in the hospital was 6 days (range: 2-23 days). The median time of follow-up was 52 months (range: 20-94 months). Ten patients did not have any sequelae, and 11 patients reported impaired mobility and/or decreased sensation, which was transitory in most cases and related to associated neurological or muscle tendon injuries. All reconstructions remained patent over the course of follow-up. No limb asymmetry was observed. CONCLUSIONS: Noniatrogenic pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt and extremities are more frequently affected. Overall complications come from associated injuries to tendons and nerves.info:eu-repo/semantics/publishedVersio