• Crowley Gissel postete ein Update vor 12 Monaten

    Idiopathic spontaneous intraperitoneal hemorrhage (ISIH) is a rare but potentially fatal entity. The majority of the reported cases of ISIH due to middle colic artery rupture are associated with pseudoaneurysm. Our case is unique in that no pathology could be identified. To our knowledge, this is the third case report in the literature of a spontaneous middle colic artery rupture with no underlying pathology.

    In our report, we present the case of a 27-years old male presenting with a hemoperitoneum due to ruptured middle colic artery with no evidence of pseudoaneurysm or any other pathology. The patient’s hemodynamic status deteriorated abruptly requiring a damage control exploratory laparotomy for evacuation of the hemoperitoneum, ligation of the middle colic artery and transverse colectomy. The post-operative course was uneventful afterwards and the patient was discharged a week after presentation with full recovery.

    Patients with ISIH might exhibit the „double rupture“ phenomenon, compromising their hemodynamic stability and necessitating urgent surgical interventions. CTA can be of paramount importance to guide such interventions if the patient’s clinical status permits. Angiographic embolization is an acceptable alternative approach in specific situations.

    ISIH should be on the differential diagnosis of any young patient presenting to the ED with an acute abdomen, regardless of the identifiable risk factors.

    ISIH should be on the differential diagnosis of any young patient presenting to the ED with an acute abdomen, regardless of the identifiable risk factors.

    Crohn’s disease (CD) is an inflammatory bowel disease that typically affects the distal part of the gastrointestinal tract (GI) such as the terminal ileum and colon. However, it can affect the upper GI tract, potentially resulting in complications such as strictures, but discussion of the management of such effects is limited in the surgical literature.

    A 39 year old male was referred to our department with stricturing upper GI disease 20 years after CD diagnosis. He had a history of intermittent abdominal pain, nausea, frequent vomiting and weight loss. Imaging demonstrated a long stricture in the duodenum with proximal dilatation. There was no evidence of acute inflammatory Crohn’s disease. A Roux-en-Y bypass was performed to successfully relieve the obstructive symptoms.

    Proximal obstructive gastrointestinal manifestations of CD are a rare entity and require a full diagnostic workup and treatment in a specialist centre. A variety of systemic treatments, endoscopic procedures and surgical techniques are addressed in this paper.

    Evidence for the optimal treatment of obstructive upper gastrointestinal CD is limited, but careful consideration of the extent of the disease, thorough preoperative planning and weighing up the benefits and risks can lead to a positive outcome for these patients.

    Evidence for the optimal treatment of obstructive upper gastrointestinal CD is limited, but careful consideration of the extent of the disease, thorough preoperative planning and weighing up the benefits and risks can lead to a positive outcome for these patients.

    Tuberculous cerebellar abscess is a rare form of extra-pulmonary tuberculosis. The outcome is often favorable with well-managed treatment; however, they can continue to develop. We share in this article our experience on the management of this rare pathologie.

    A 10-year-old boy with a medical history of tuberculous meningitis after 3 months of tuberculosis treatment. He presented to the hospital with acute obstructive hydrocephalus due to a large tuberculous cerebellar abscess. A puncture of the abscess was initially performed, followed by placement of a ventriculoperiotoneal shunt, which resulted in some clinical improvement. However, the child subsequently presented with neurological deterioration due to the massive enlargement of the tuberculous abscess despite adequate antituberculosis chemotherapy. The initiation of corticosteroid therapy associated with a readjustment of the dose of anti-tuberculosis drugs and a repeated puncture ultimately led to clinical improvement.

    Tuberculous brain abscess is an extra-pulmonary location of tuberculosis rarely seen in immunocompetent children. The treatment consists of surgery associated with antituberculosis chemotherapy and rigorous clinico-radiological monitoring. Recurrence is possible despite well-conducted treatment. Additional corticosteroid therapy is necessary with readjustment of the anti-tuberculosis treatment for an effective cure.

    Rarely, the tuberculous abscess of the cerebellum continues to evolve despite proper treatment. This pattern does not necessarily mean treatment failure. Close clinical and imaging monitoring is crucial in the management of these cases.

    Rarely, the tuberculous abscess of the cerebellum continues to evolve despite proper treatment. This pattern does not necessarily mean treatment failure. Close clinical and imaging monitoring is crucial in the management of these cases.

    This study investigated the effects of marine phytoplankton supplementation (Oceanix®, Tetraselmis chuii) on 1) maximal isometric strength and immune function in healthy humans following a oneweek high-intensity resistance-training program and 2) the proinflammatory cytokine response to exercise in a rat model.

    In the human trial, 22 healthy male and female participants were randomly divided into marine phytoplankton and placebo groups. Following baseline testing, participants underwent a 14-day supplement loading phase before completing five consecutive days of intense resistance training. In the rat model, rats were randomly divided into four groups (n=7 per condition) (i) control, (ii) exercise, (iii) exercise + marine phytoplankton (2.55 mg/kg/day), or (iv) exercise + marine phytoplankton (5.1 mg/kg/day). Rats in the exercising groups performed treadmill exercise 5 days per week for 6 weeks.

    In the human model, marine phytoplankton prevented significant declines in the isometric peak rate of force development compared to placebo. Additionally, salivary immunoglobulin A concentration was significantly lower following the resistance training protocol in the placebo group but not in the marine phytoplankton group. Marine phytoplankton in exercising rats decreased intramuscular levels and serum concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) and intramuscular concentrations of malondialdehyde.

    Marine phytoplankton prevented decrements in indices of functional exercise recovery and immune function. VU0463271 price Mechanistically, these outcomes could be prompted by modulating the oxidative stress and proinflammatory cytokine response to exercise.

    Marine phytoplankton prevented decrements in indices of functional exercise recovery and immune function. Mechanistically, these outcomes could be prompted by modulating the oxidative stress and proinflammatory cytokine response to exercise.

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