La diagnosi e la gestione del prolasso rettale

2020 ◽  
Vol 39 (7) ◽  
pp. 453-457
Author(s):  
Silvia Ventresca ◽  
Micol Bacchini ◽  
Giulia Graziani ◽  
Federico Marchetti
Keyword(s):  
Cystic Fibrosis ◽  
Natural History ◽  
Spina Bifida ◽  
Rectal Prolapse ◽  
Newborn Screening ◽  
Complete Resolution ◽  
Toilet Training ◽  
Rare Occurrence ◽  
The Family ◽  
History Of

Rectal prolapse is an overall rare occurrence in children in the first 4 years of age. It typically tends to relapse. In the majority of cases it is not possible to highlight a single cause that determines prolapse, even if it is more frequent in children who suffer from constipation. In about 1 in 10 cases there is an underlying predisposing anatomical-neurological condition (in particular neurological: myelomenigocele, spina bifida occulta). A predisposing cause that must always be considered and excluded is cystic fibrosis, even in the age of newborn screening. Rectal prolapse management is conservative in most cases. Behavioural measures (correct toilet training, good hydration, diet rich in fibres) and the use of the macrogol laxative are fundamental. The prolapse that does not resolve spontaneously must be reduced manually by instructing the family on the technique to be used. In 90% of cases the natural history of rectal prolapse is favourable, with complete resolution within the first 4 years of age. After this age, it occurs more rarely. Surgery is rarely indicated. The current techniques that have a large consensus are sclerotherapy and laparoscopic rectopexy. The paper reports the management of recurrent rectal prolapse in a 3-year-old boy.

Embryopathogenetic surgicoanatomical classification of dysraphism and surgical outcome of spinal lipoma: a nationwide multicenter cooperative study in Japan

2009 ◽  
Vol 3 (5) ◽  
pp. 412-419 ◽  
Author(s):  
Shizuo Oi ◽  
Sadahiro Nomura ◽  
Masato Nagasaka ◽  
Hajime Arai ◽  
Reizo Shirane ◽  
...  
Keyword(s):  
Natural History ◽  
Spina Bifida ◽  
Complete Resolution ◽  
Cooperative Study ◽  
Foot Deformity ◽  
Spinal Lipoma ◽  
Scale Scores ◽  
History Of ◽  
The Mean

Object The natural history of asymptomatic spinal lipoma in infancy remains unclear, and the indication for the prophylactic untethering operation is still debatable. To address this question, a multicenter cooperative study for the treatment of spinal lipoma was performed by the 7 most active institutions in neurosurgical care for spina bifida in Japan between 2001 and 2005. Methods Patients were classified using the embryopathogenetic surgicoanatomical classification. Their neurosurgical postoperative course was analyzed using the Spina Bifida Neurological Scale. Among 261 patients, 159 were asymptomatic and 102 were symptomatic. Results Of the 136 patients for whom prophylactic surgeries were performed, 135 remained asymptomatic and only 1 (0.4%) of the 261 patients presented with mild sensory disturbance. Mild foot deformity was identified in 1 (4.3%) of 23 conservatively observed patients. Of 100 symptomatic patients, deterioration after surgery was seen in 6%, and improvement in 44%. Complete resolution of symptoms was seen in only 14.2%. Filar types for patients > 3 years old improved in Spina Bifida Neurological Scale scores from 12.3 to 14.0. The mean age of symptomatic patients with lipomyelomeningocele was the youngest of all (1.3 years), which indicates lipomyelomeningocele may deteriorate in early infancy. Improvements from surgery were seen for all types of lipoma except the caudal type, presenting at an older mean age (15 years). Conclusions A low rate of postsurgical worsening indicates that surgeries for asymptomatic and symptomatic lipomas are safe. Surgeries done after the onset of symptoms seldom cure the patients. These two results support early untethering for any kind of lipoma; however, further study of the natural history is required.

scholarly journals Natural history of glucose tolerance, beta-cell function and peripheral insulin sensitivity in cystic fibrosis patients with fasting euglycemia

2003 ◽  
Vol 149 (1) ◽  
pp. 53-59 ◽  
Author(s):  
F Lombardo ◽  
F De Luca ◽  
M Rosano ◽  
C Sferlazzas ◽  
C Lucanto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Insulin Sensitivity ◽  
Natural History ◽  
Glucose Tolerance ◽  
Pancreatic Beta Cells ◽  
Cell Function ◽  
Glucose Levels ◽  
Peripheral Insulin Resistance ◽  
History Of ◽  
Over Time

OBJECTIVE: The loss of pancreatic beta-cells is thought to be one of the principal causes of diabetes mellitus (DM) in cystic fibrosis (CF), but the role of peripheral insulin resistance (IR) in the pathogenesis of DM in CF remains unclear. The aim of this study was to evaluate whether eventual changes of glucose tolerance (GT) over time were associated with modifications of insulin secretion or sensitivity. METHODS: Plasma glucose and insulin responses to an oral GT test (OGTT) were investigated and reinvestigated 13 Years later in 14 CF patients with initial and persistent fasting euglycemia and no history of insulin treatment. Insulin sensitivity (IS) at both tests was assessed on the basis of insulin and glucose levels both in the fasting state and during OGTTs. RESULTS: From the 1st to the 2nd OGTT: (a) the prevalence of DM responses significantly increased; (b) the areas beneath the respective glucose and insulin curves significantly increased and decreased respectively; (c) IR and IS indices decreased and increased respectively, even in the patients who developed DM; (d) pulmonary function significantly worsened in the entire series, especially in the patients who developed DM. CONCLUSIONS: (i) the natural history of glyco-metabolic status in CF is characterized by deteriorating GT over time; (ii) insulinopenia plays a prominent role in the pathogenesis of GT worsening; (iii) IR does not play any significant part in the pathogenesis of DM development; (iv) deterioration of lung function tests is more severe in the subjects who develop DM over time.

THE FAMILY HISTORY OF SPINA BIFIDA CYSTICA

PEDIATRICS ◽  
1965 ◽  
Vol 35 (4) ◽  
pp. 589-595
Author(s):  
John Lorber
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Spina Bifida ◽  
Index Case ◽  
Progressive Increase ◽  
Point Of View ◽  
The Family ◽  
History Of ◽  
The Central Nervous System ◽  
Spina Bifida Cystica

1. The family histories of 722 infants who were born with spina bifida cystica were studied. 2. The index cases were referred for surgical treatment and were not selected in any way from the genetic point of view. 3. Intensive inquiries were made to obtain a complete family pedigree, including a prospective follow-up of siblings born after the index case. 4. Of 1,256 siblings 85 or 6.8% had gross malformation of the central nervous system: spina bifida cystica in 54, anencephaly in 22, and uncomplicated hydrocephalus in 9. 5. Of 306 children born after the index case 25 (8%) or 1 in 12 were affected. 6. There was a progressive increase in multiple cases in the family with increasing family size. In sibships of five or more, multiple cases occurred in 24.1%. 7. In 118 families cases of gross malformation of the central nervous system were known to have occurred among members of the family other than siblings. Cases occurred in three generations. 8. It is possible that spina bifida cystica might be a recessively inherited condition.

scholarly journals Most of Staphylococcus aureus and Pseudomonas aeruginosa co-infecting isolates coexist, a condition that may impact clinical outcomes in Cystic Fibrosis patients

2020 ◽  
Author(s):  
Paul Briaud ◽  
Sylvère Bastien ◽  
Laura Camus ◽  
Marie Boyadjian ◽  
Philippe Reix ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Multivariate Analysis ◽  
Natural History ◽  
Clinical Outcomes ◽  
Bacterial Colonization ◽  
Childhood And Adolescence ◽  
History Of

AbstractStaphylococcus aureus (SA) is the major colonizer of the lung of cystic fibrosis (CF) patient during childhood and adolescence. As patient aged, the prevalence of SA decreases and Pseudomonas aeruginosa (PA) becomes the major pathogen infecting adult lungs. Nonetheless, SA remains significant and patients harbouring both SA and PA are frequently found in worldwide cohort. Impact of coinfection remains controversial. Furthermore, co-infecting isolates may compete or coexist. The aim of this study was to analyse if co-infection and coexistence of SA and PA could lead to worse clinical outcomes. The clinical and bacteriological data of 212 Lyon CF patients were collected retrospectively, and patients were ranked into three groups, SA only (n=112), PA only (n=48) or SA plus PA (n=52). In addition, SA and PA isolates from co-infecting patients were tested in vitro to define their interaction profile. Sixty five percent (n=34) of SA/PA pairs coexist. Using univariate and multivariate analysis, we confirm that SA patients have a clinical condition less severe than others, and PA induce a poor outcome independently of the presence of SA. FEV1 is lower in patients infected by competition strain pairs than in those infected by coexisting strain pairs compared to SA mono-infection. Coexistence between SA and PA may be an important step in the natural history of lung bacterial colonization within CF patients.

Wound Management of a Pediatric Spina Bifida Patient Secondary to a Canine-Inflicted Fifth-Digit Amputation: A Case Report

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Brittany A. Lovett ◽  
Cristóbal S. Berry-Cabán ◽  
Deanna E. Duran ◽  
Sharon P. McKiernan
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Spina Bifida ◽  
Human Infection ◽  
Further Education ◽  
Wound Management ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
The Family ◽  
History Of

We present a case of a pediatric patient with a history of spina bifida who presented to the emergency department of a large Army medical treatment facility with a partially amputated right fifth digit she sustained while sleeping with the family canine. There are several reports in the popular press that suggest that an animal, particularly a dog, can detect human infection, and it is hypothesized that the toe chewing was triggered by a wound infection. This case provides an opportunity to provide further education in caring for foot wounds in patients with spina bifida.

Encopresis, soiling, constipation: What's to be done?

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 348-349
Author(s):  
Joseph F. Fitzgerald
Keyword(s):  
Fecal Incontinence ◽  
Natural History ◽  
Bowel Movement ◽  
Negative Impact ◽  
The Family ◽  
History Of ◽  
Frequent Problem

Though a frequent problem with a tremendous negative impact on the family as well as the child, fecal incontinence has received little attention in the pediatric literature. Levine's study of the natural history of children with encopresis in this issue of Pediatrics is, therefore, a welcome contribution. Encopresis is defined as incontinence of feces not due to organic defect or illness. Mercer preferred to define encopresis as the voluntary or involuntary passage of an ordinary bowel movement into the clothing, and soiling as the constant involuntary seepage of feces associated with impaction. He reported that the former was rare in his experience.

Wedge-tailed Eagle

2005 ◽  
Author(s):  
Penny Olsen
Keyword(s):  
Natural History ◽  
Final Section ◽  
Comprehensive Overview ◽  
The Family ◽  
The World ◽  
Chick Development ◽  
History Of ◽  
Rock Paintings ◽  
Large Predators

Australia’s Wedge-tailed Eagle belongs to the family of eagles, which together span the world. Eagles are powerful predators, with exceptional powers of flight and sight. They may kill to survive, but they also sleep, play, enjoy a bath, make tender parents, and form lasting relationships. This book gives a comprehensive overview of Australia’s largest true eagle and one of the country’s few large predators and scavengers. First appearing in Aboriginal rock-paintings more than 5000 years ago, the Wedge-tailed Eagle was little more than a curiosity to the early European settlers. The book traces the subsequent changes in perception—from its branding as a vicious sheep killer to an iconic species worthy of conservation—and covers distribution, habitat, hunting, relationships, reproduction and chick development. A final section deals with threats to the existence of this magnificent bird. Winner of the 2006 Whitley Award for Best Natural History of an Iconic Species.

NATURAL HISTORY OF SPINA BIFIDA

The Lancet ◽  
1969 ◽  
Vol 294 (7613) ◽  
pp. 213
Author(s):  
StephenP. Mark
Keyword(s):  
Natural History ◽  
Spina Bifida ◽  
History Of

Discovery and natural history of the mussel leech Batracobdella kasmiana (Oka, 1910) (Hirudinida: Glossiphoniidae) in Russia

Zootaxa ◽  
2017 ◽  
Vol 4319 (2) ◽  
pp. 386 ◽  
Author(s):  
IVAN N. BOLOTOV ◽  
ILYA V. VIKHREV ◽  
OLGA V. AKSENOVA ◽  
YULIA V. BESPALAYA ◽  
MIKHAIL Y. GOFAROV ◽  
...  
Keyword(s):  
Natural History ◽  
Freshwater Mussels ◽  
Mantle Cavity ◽  
Parasitic Species ◽  
Ecological Preferences ◽  
The Family ◽  
History Of ◽  
Eastern Half

The mussel leech Batracobdella kasmiana (Oka, 1910) (Hirudinida: Glossiphoniidae) inhabits the mantle cavity of large freshwater mussels (Sawyer 1986; Lai & Chen 2010). This specific lifestyle is unusual in leeches although a few additional parasitic species from mussels have been reported (Grizzle & Brunner 2009). The known localities of B. kasmiana are situated in Japan (Honshu), continental China and Taiwan (Oka 1910, 1917; Gee 1919; Yang 1996; Yamauchi et al. 2008; Lai & Chen 2010). The majority of records were reported from continental China, in which this species is widely distributed across the eastern half of the country from Yunnan to Beijing (Yang 1996). It has never been mentioned as a member of the Russian fauna (Lukin 1976). A few naiad species in the family Unionidae are known hosts of B. kasmiana, including Sinanodonta spp., Cristaria plicata (Leach, 1815), and Nodularia douglasiae (Griffith and Pidgeon, 1833) (Oka 1917; Yang 1996; Yamauchi et al. 2008). The biology and ecological preferences of this leech species are poorly known (Yang 1996; Yamauchi et al. 2008; Lai & Chen 2010). 

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