SYMPTOMATIC MECKELS DIVERTICULUM IN THE NEWBORN: REVIEW OF THE LITERATURE

Meckels diverticulum accounts for 2 to 3% of gastrointestinal tract malformations in children. It is a distal remnant of the incompletely obliterated omphalo mesenteric duct that occurs at 4 weeks gestation, and is located approximately 40 to 60 cm from the last ileal loop. In the majority of cases, its presentation is asymptomatic and discovery is incidental. The symptomatic form represents 4% and is rare in children, including bleeding, occlusion, inflammation and intermittent umbilical oozing. The symptomatic form is exceptional in newborns. This work is a descriptive study of the literature regarding reported cases of newborns diagnosed with symptomatic Meckels diverticulum either as a picture of intestinal obstruction or by spontaneous perforation of the DM The objective of our study is to describe the cases of newborns operated in emergency for symptomatic Meckels diverticulum and to evaluate the surgical management.

Left parathyroid adenoma with features of brown tumor, incidental finding: a case report

Primary hyperparathyroidism (PHPT) occurs in a setting of excessive parathyroid hormone (PTH) secretion with an autonomous parathyroid gland which resulting in hypercalcemia. Cases of parathyroid adenoma are rare, PTH is a chief regulator of calcium homeostasis in the human body. PHPT could be caused by solitary adenomas, hyperplasia, multiple adenomas and carcinomas. A 35-year-old female who came in with complaints of left hip pain past 1 month which aggravated since 1 week, with previous medical history of hyperthyroidism. Laboratory and biochemical findings suggested features of PHPT. She underwent left parathyroid excision with subtotal thyroidectomy. Histopathology analysis revealed features of parathyroid adenoma with eosinophilic to clear cytoplasm, few foci with oxyphilic nodules. Patient showed significant fall in PTH levels after tumor excision and is being discharged 5th day after surgery. PHPT occurs at any age, but it is most commonly seen in people over the age of 50 years and postmenopausal women. The current presentation of PHPT shifts from the classical symptomatic form to the asymptomatic form. parathyroidectomy is still the treatment of choice for both symptomatic and asymptomatic forms. Parathyroid adenoma has an excellent prognosis with surgical treatment.

Funzione cardiopolmonare in bambini con pregressa infezione da Covid-19 lieve o asintomatica e ritorno all’attività sportiva

Aim - To evaluate the cardiopulmonary function in children returning to play sports after mild or asymptomatic SARS-CoV-2 infection. - Methods - This is a consecutive case series conducted at the Institute for Maternal and Child Health, Trieste, Italy. Paediatric patients who accessed the Institute for cardiologic and pneumological evaluation before the return to play competitive sports were recruited. According to the Italian Sports Medical Federation recommendations, echocardiogram, electrocardiogram, treadmill ECG test and pulmonary function tests were performed. - Results - 240 patients (aged 8-17 years old) were recruited. Among these, 233 children were considered for the final analysis. Out of 233, 147 (63.1%) had a mild symptomatic form of SARS-CoV-2 infection, while 86 (36.9%) were asymptomatic. The main referred symptoms were fever (n = 68, 46.3%), headache (n = 42, 28.6%), anosmia (n = 40, 27.2%), rhinitis (n = 34, 23.1%), ageusia (n = 32, 21.8%), cough (n = 22, 15%), asthenia (n = 21, 14.3%), arthralgia-myalgia (n = 20, 13.6%), sore throat (n = 14, 9.5%) and gastrointestinal symptoms (n = 9, 6.1%). No child presented evidence of cardiopulmonary function impairment after an average time of 76.1 days (SD 39.2) from SARS-CoV-2 swab positivity and a median of 68 days (IQ1 49, IQ3 98). - Conclusion - This study suggests that the diagnostic yield of cardiopulmonary tests before returning to play sports may be very low in the absence of specific symptoms.

Cardiovascular pathology in diff erent forms of primary hyperparathyroidism

Objective: To study the frequency and features of the clinical course of cardiovascular pathology in patients with diff erent clinical forms of primary hyperparathyroidism (PHPT). Materials and Methods: A retrospective analysis of case histories of 48 patients who received inpatient treatment for PHPT in the endocrinological or surgical departments of two large hospitals in Arkhangelsk from 2005 to 2015 was performed.Results: Among the revealed cases of PHPT, the symptomatic form of PHPT was the most common (88%). Th e analysis showed a high frequency of arterial hypertension (AH) (69%) with a more severe course in patients with a mixed form of PHPT. Th e level of parathyroid hormone (PTH) was higher in patients with AH compared with patients without hypertension and PHPT (p = 0.008). Left ventricular hypertrophy was detected in 60% of patients with a mixed form of PHPT. In a mild form, this complication was not observed. Th e relationship between the level of total blood calcium and PTH and the interventricular septum thickness was revealed by the results of echocardiography (p = 0.036 and p = 0.012). Th e inverse relationship between the duration of the QT interval and the level of ionized blood calcium was shown (p = 0.022).Conclusions: Changes in phosphorus-calcium metabolism provoked by PHPT aff ect the state of the cardiovascular system, which determines the need for increased attention of various specialists to this type of complications in PHPT, timely indication of treatment, and improvement of the quality of patient’s life.

The Impact of Kinesiology Taping on a Greek Foot with a Hammertoe—A Case Report

Background and Objectives: Hammertoe, one of the most common toe deformities, causes pain due to overloading of the periarticular tissues and skin lesions. Additionally, it results in problems with footwear choice, an unattractive foot appearance and a deterioration in quality of life. The most common treatment for rigid and advanced deformities is surgery, and these procedures are widely described in literature. If the changes in the interphalangeal and metatarsophalangeal joints are flexible (that mean they undergo correction without causing pain) or surgery is not possible, conservative treatment should be considered. No research, however, has been found detailing this treatment method. Conservative treatment includes the Kinesiology Taping (KT) method, which involves applying taping to correct deformities. This report describes the effect of KT treatment in a female patient with hammertoes. Materials and Methods: Anthropometric foot measurements (3D scanner) and foot loadings (baropodometric platform) are presented before KT applying, immediately after tapes application and after tapes removal following one month of use. Results: After using KT application parameters such as: foot length, maximum foot load, load under the area of the metatarsals II-III changed. Conclusion: Kinesiology Taping seems to be a symptomatic form of treatment of the effects of lesser toes deformity, therefore it is a good alternative for patients who do not want or cannot undergo surgery.

Primary hyperparathyroidism misdiagnosed as metastatic disease, with trans-oral endoscopic surgical management

Primary hyperparathyroidism is not so uncommon a disease. In high-income countries, with the introduction of routine biochemical testing in 1980s, it is diagnosed early, and the majority are seen as asymptomatic disease. However, in India, a severe symptomatic form is still seen, and many times patients are undiagnosed, thus continuing to suffer debilitating disease. Here, we report such a patient who was being treated as having bony metastases from an unknown primary source, when in fact he had osteitis fibrosa cystica due to primary hyperparathyroidism and was cured after surgery.

Immediate results of treatment of patients with myocardial bridges of the coronary arteries

The objective was to evaluate the immediate results of treatment of patients with symptomatic form of myocardial bridges of the coronary arteries.Methods and materials. In the course of a retrospective study, the results of treatment of 70 patients who had underwent drug treatment and 52 patients who had underwent surgical treatment were analyzed. All the subjects had high functional angina pectoris.Results. Pharmacological therapy showed significant positive dynamics in 18 (25.7 %) patients. Analysis of the intraoperative and early postoperative periods in patients who underwent supracoronary myotomy allows us to conclude that surgical treatment of patients with myocardial bridges of the coronary arteries shows satisfactory results.Conclusion. Drug therapy may be effective in some patients with myocardial bridges of the coronary arteries. In case of ineffectiveness of pharmacological treatment, the possibility of performing surgery in the amount of supracoronary myotomy should be considered.

Current view on Blastocystis species: clinical forms, diagnosis and treatment

The symptomatic form of Blastocystis spp. infection not only with mild diarrhea or dysentery-like syndrome, but also with the development of severe ulcerative necrotic lesions of the intestine. Meanwhile, the pathogenicity of these microorganisms should not be exaggerated, due to majority asymptomatic cases or infection transmission with minor impaired bowel function.

Spatial variability of SARS-CoV-2 infection in the Silesian voivodeship, Poland

INTRODUCTION. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and related to infection COVID-19 (coronavirus disease 2019) remain a new and global challenge for public health. Due to the location, specifics of employment, and the high density of population in the Silesia voivodeship it is appropriate to study the available epidemiological data in a region with a potentially higher risk of infection. MATERIALS AND METHODS. In the descriptive model of the study, data on the number of infected, hospitalized, and dead people due to SARS-CoV-2 infection were analyzed. The source of information was daily reports conducted by the Provincial Sanitary and Epidemiological Station in Katowice, in the period from March 5 to August 18, 2020. RESULTS. Results of antigenic molecular tests for SARS-CoV-2 infection in the Silesian voivodeship indicate that in the first half of 2020, the infection rate was approximately 5% and the symptomatic form of the disease was approximately 20%. CONCLUSIONS. The analysis of the frequency of infection and mortality in the poviats reveals a large variation in the occurrence of both phenomena, but the explanation of this difference is not possible due to the descriptive nature of the analysis and the secondary form of epidemiological data.