Idiopathic Myenteric Ganglionitis Underlying Acute ‘Dramatic’ Intestinal Pseudoobstruction: Report of an Exceptional Case

Inflammation of the myenteric plexus of the gastrointestinal tract is a very rare pathological condition, with few reports in the medical literature. This pathological condition causes atonic gut motor dysfunction and is principally secondary to other diseases, being reported nearly solely as a paraneoplastic phenomenon in neuroendocrine lung tumors, including small cell carcinomas or neuroblastomas. In addition it can also be associated with disorders of the central nervous system, although it has rarely been described in Chagas disease. It has been named ‘idiopathic myenteric ganglionitis’ because no apparent causes can be demonstrated. We report the clinicopathologic findings of an exceptional case of a young woman affected by severe chronic constipation suddenly changing into acute intestinal pseudoobstruction with dramatic evolution. Relationships between ganglionitis, idiopathic constipation and acute intestinal pseudoobstruction as well as therapeutic implications are discussed

Comparison between ozone monitoring data and modelling data, in Italy, from the perspective of health indicator assessments

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Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures

Procedure for prolapsing hemorrhoids (PPH) and stapled transanal rectal resection for obstructed defecation (STARR) carry low postoperative pain, but may be followed by unusual and severe postoperative complications. This review deals with the pathogenesis, prevention and treatment of adverse events that may occasionally be life threatening. PPH and STARR carry the expected morbidity following anorectal surgery, such as bleeding, strictures and fecal incontinence. Complications that are particular to these stapled procedures are rectovaginal fistula, chronic proctalgia, total rectal obliteration, rectal wall hematoma and perforation with pelvic sepsis often requiring a diverting stoma. A higher complication rate and worse results are expected after PPH for fourth-degree piles. Enterocele and anismus are contraindications to PPH and STARR and both operations should be used with caution in patients with weak sphincters. In conclusion, complications after PPH and STARR are not infrequent and may be difficult to manage. However, if performed in selected cases by skilled specialists aware of the risks and associated diseases, some complications may be prevented

LO STESSO E L'ALTRO

il libro tratta delle trasformazioni identitarie in adolescenza secondo un'ottica psicoanalitic

Child undernutrition in Sudan: the social and economic impact and future perspectives

The nutrition situation in Sudan is one of the worst in North East Africa and it is characterised by persistently high levels of acute and chronic malnutrition that have increased over the last two dec-ades. The underlying causes of malnutrition are multi-sectoral and are mainly due to inequalities, inadequate food practices and limited access to health care services. Based on the report The Eco-nomic and Social Impacts of Child Undernutrition in Sudan, this paper assesses the impact that malnutrition has on health, education and productivity in Sudan. The country is estimated to have lost an equivalent of about 11,6 Billion SDG in 2014, which represented 2.6% of the GDP. Produc-tivity related losses contributed the largest costs at 1.53% of GDP followed by Health and Educa-tion sectors at 1.03% and 0.03% respectively. In 2020 the outbreak of the COVID-19 pandemic further exposed the fragility of Sudan’s health, social and economic system. It is mandatory that all stakeholders address child nutrition as a main concern and stunting is incorporated in the centre of the development agenda. In particular, the national development frameworks should be updated to ensure the reduction of the stunting prevalence and to put in place a comprehensive multi-sectoral nutrition policy, strategy and plan of action