Meckel’s diverticulum in paediatric practice on Crete (Greece): A 10-year review

Background: Although Meckel’s diverticulum (MD) is the most prevalent congenital abnormality of the gastrointestinal tract, it has varied presentations and often becomes a diagnostic challenge. The purpose ofthis study was to review the diverse presentations of MD, record the epidemiologic features for Crete and review the detection techniques and the treatment options.Patients and Methods: This was a review of the records of all children who underwent surgery for MD in the department of Paediatric Surgery of the University Hospital of Crete (Greece) between January 1999 and January 2009. Result: A total of 45 patients (32 male and 13 female) aged 1 to 13 years (median 10 years) with a diagnosis of MD were retrospectively reviewed. The collected data were analysed, looking at age, gender, clinical features, investigations, histopathological findings and surgical interventions. In 25 patients, MD was an incidental finding at laparotomy because of  appendicitis. The remaining 20 patients were symptomatic and presented with various clinical features. Nine patients (19.9%) had clinical features of peritonitis; of these, three had perforated MD and six had Meckel’s diverticulitis at laparotomy. Four patients were diagnosed with intestinal obstruction. Seven patients (15.5%) presented with lower gastrointestinal bleeding. Ultrasound scans revealed intussusception in three patients, requiring open reduction. The remaining four patients with bleeding per rectum underwent a Meckel’s Tc99 scan that showed a positive tracer.Conclusion: All patients with MD underwent Meckel’s diverticulectomy with appendicectomy. MD has an incidence of approximately 1 to 2% in our population. It is necessary to maintain a high index of suspicion in the in the diagnosis of MD paediatric age group because it can be easily misdiagnosed

Symbiotic ecologies in next generation ambient intelligent environments

International audienceThis paper describes a novel approach to realize symbiotic ecologies within Next Generation Ambient Intelligent Environments (NGAIEs). The proposed approach comprises novel ontology and agent technologies allowing for adaptation on a variety of levels. The metaphor of symbiotic ecologies reflects a meaningful integration of relevant entities (i.e., services, devices, agents) and information within NGAIEs to accomplish a specific user’s task by relying on the symbiotic relationship of the user and his/her intelligent environment. We adopt a service-oriented architecture, combined with (a) intelligent agents that support adaptive task realization and enhanced human-machine interaction and (b) ontologies that provide knowledge representation, management of heterogeneity at user and device level, semantically rich resource discovery and adaptation using ontology alignment mechanisms. In this article, we analyse heterogeneity concerning user behaviour and adaptive user interaction modelling. Furthermore, we focus on heterogeneity regarding the representation of the states of entities and their availability over different networks. The paper will also report on the deployment of a system prototype in a real world setting which is the intelligent flat (iSpace) at the University of Essex