Bulging anterior fontanelle: an unusual presenting sign of nutritional rickets

Aim: To report the first case series of infants with nutritional rickets who presented with bulging anterior fontanelleMethods: infants who were admitted to Alrass General Hospital, Qassim, Saudi Arabia, between October 2004 and October 2007, with bulging anterior fontanelle and later found to have nutritional rickets were reviewed. Diagnosis of rickets was based on typical biochemical and radiological findings with or without clinical signs of rickets and with a good response to treatment with vitamin D with or without calcium.Results: Nine cases of nutritional rickets who presented with bulging anterior fontanelle are reported. All were below 12 months of age and the majorities are boys. All patients are exclusively breast-fed. Five cases had hypocalcaemia and three of them presented with hypocalcaemic seizures.Five cases showed no clinical signs of rickets. Clinical, biochemical and radiological signs of rickets as well as the status of the anterior fontanelle reverted to normal within six weeks after treatment with vitamin D in all except one patient who took four months to respond.Conclusion: Nutritional rickets remains a problem in Saudi Arabia. A bulging anterior fontanelle is an important, but under- recognized presenting feature of nutritional rickets. Recognition of this association will alley anxiety when confronted with a case of rickets with a bulging anteriorfontanelle.Keywords: hypocalcaemic seizures, vitamin D, hypophosphataesia

Italian-American Religious Orders in the Development of Chicago Catholicism in the 19th and 20th Centuries

Mother Cabrini and the Sisters of the Sacred Heart Ellen Skerrett Fr. Augustine Morini and the Servites Conrad Borntrager, O.S.M. The Scalabrinians Dominic Candeloro, Ph.D

Kościół katolicki a zagłada Żydów: Perspektywy instytucjonalne

W artykule przedstawiono i zanalizowano oficjalne stanowiska Watykanu wobec Zagłady Żydów  - od oświadczenia  z 1998 r. pt. „Pamiętamy” aż do niedawnych wystąpień Benedykta XVI.  Autor wskazuje pewną dwuznaczność postaw Kościoła Katolickiego w kwestiach dotyczących antysemityzmu i Zagłady oraz niechęć wobec uznania roli katolików w Zagładzie. Omawia również sporną kwestię beatyfikacji Piusa XII

City-based action to reduce harmful alcohol use: Review of reviews

\ua9 2018 Anderson P et al.Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register, and Epub Ahead of Print databases. All reviews that address adults, without language or date restrictions resulting from combining the terms ("review" or "literature review" or "review literature" or "data pooling" or "comparative study" or "systematic review" or "meta-analysis" or "pooled analysis"), and "alcohol", and "intervention" and ("municipal" or "city" or "community"). Results: Five relevant reviews were identified. Studies in the reviews were all from high income countries and focussed on the acute consequences of drinking, usually with one target intervention, commonly bars, media, or drink-driving. No studies in the reviews reported the impact of comprehensive city-based action. One community cluster randomized controlled trial in Australia, published after the reviews, failed to find convincing evidence of an impact of community-based interventions in reducing adult harmful use of alcohol. Conclusions: To date, with one exception, the impact of adult-oriented comprehensive community and municipal action to reduce the harmful use of alcohol has not been studied. The one exception failed to find a convincing effect. We conclude with recommendations for closing this evidence gap

Hepatitis C virus infection and gene expression of hepatocellular carcinoma in Egyptian patients

Introduction: Gene expression profiling of hepatocellular carcinoma (HCC)is promising for refining the diagnosis and prognosis as well as identifyingpotential therapeutic targets.Aim of the Study: Our study aimed to study the gene expression in 40 HCC patients infected with hepatitis C virus (HCV) using RT-PCR technique on surgical liver sample. Gene expression changes in HCV-positive group were compared with gene expression in HCV-negative group. Four genes were included in this study, AFP gene, CD10 gene, HGF gene and GRB2 gene. The expression of the four genes were slightly higher in HCV positive group than in HCV negative group, however, the difference between the two groups wasnon-significant. HGF gene was expressed in only 20% of HCC patients andGRB2 gene was expressed in 95% of HCC patients. AFP gene and CD10 gene were expressed in all patients.Conclusion: AFP gene, CD10 gene and GRB2 gene play an important role as diagnostic markers of HCC.Key Words: Hepatocellular carcinoma, hepatitis C virus, AFP gene, CD10 gene, HGF gene and GRB2 gene

Coronary Artery Bypass Graft in a Young Adult, An Emerging Phenomenon: A Case Report

A 29-year-old, smoker, diabetic, hypertensive and hypercholesterolemic man was diagnosed of having severe coronary artery disease with a critical left main stem stenosis. On-pump coronary artery bypass graft surgery (CABG) was performed using conduits from the left internal mammary artery as well as the left radial artery and right saphenous vein which were both harvested endoscopically. He was discharged after a week of uneventful recovery. This case emphasizes on the best possible management of conduits selection, intraoperative myocardial protection and the risk factors modification in achieving a long term graft patency and avoiding premature cardiac related death

Direct image to subtype prediction for brain tumors using deep learning

BACKGROUND: Deep Learning (DL) can predict molecular alterations of solid tumors directly from routine histopathology slides. Since the 2021 update of the World Health Organization (WHO) diagnostic criteria, the classification of brain tumors integrates both histopathological and molecular information. We hypothesize that DL can predict molecular alterations as well as WHO subtyping of brain tumors from hematoxylin and eosin-stained histopathology slides. METHODS: We used weakly supervised DL and applied it to three large cohorts of brain tumor samples, comprising N = 2845 patients. RESULTS: We found that the key molecular alterations for subtyping, IDH and ATRX, as well as 1p19q codeletion, were predictable from histology with an area under the receiver operating characteristic curve (AUROC) of 0.95, 0.90, and 0.80 in the training cohort, respectively. These findings were upheld in external validation cohorts with AUROCs of 0.90, 0.79, and 0.87 for prediction of IDH, ATRX, and 1p19q codeletion, respectively. CONCLUSIONS: In the future, such DL-based implementations could ease diagnostic workflows, particularly for situations in which advanced molecular testing is not readily available