Rectal Lipoma in a 4-Year-Old Boy Presenting with Anal Prolapse.

Colonic lipomas, even though rare, are the most common intramural tumor and the second-most common benign tumor of the colon after adenomatous polyps. We present the case of a 4-year-old boy with a large rectal lipoma causing anal prolapse, bleeding, and constipation, to discuss differential diagnostic problems and the proper management. A 4-year-old boy presented with symptoms of anal prolapse and constipation.

Dietary and nutraceutical approach to type 2 diabetes.

Nutritional medical treatment is the first step to achieve adequate glycemic control and prevent diabetic complications. Lifestyle changes include moderate weight loss (7%) and regular physical activity (150 min/week). The appropriate diet composition is < 30% total fat, < 10% saturated fats, > 15 g/1000 kcal fiber, half soluble, 45-60% of carbohydrates with amoderate intake of sugar (50 g/day) and protein intake of 15-20% of the total calories a day.

Increased inflammatory response in patients with dilated cardiomyopathy is associated with dyslipidemia: Effects of statin therapy.

Dilated cardiomyopathy (DCM) is associated with increased inflammatory response reflected among other markers in high-sensitivity C-reactive protein (hsCRP) and soluble interleukin-2 receptor (sIL-2R) levels. We examined prospectively 60 consecutive patients with DCM. Of them, 30 were dyslipidemic (group I) and 30 normolipidemic (group II).

Abscess formation of a spherical-shape duplication in the splenic flexure of the colon: case report and review of the literature.

Gastrointestinal tract duplications are rare congenital malformations that may occur anywhere in the alimentary tract from the mouth to the anus, and vary greatly in presentation, size, location, and especially in symptoms. We present a case of an infected spherical colonic duplication, in a 20-day-old baby, located at the splenic flexure of the colon. The prominent symptom was acute abdomen, accompanied by bilious vomiting, intestinal obstruction, and high fever.

Management of abdomen hydatidosis after rupture of a hydatid splenic cyst: a case report.

We present a case of multiple hydatidosis in an 8-year-old boy that resulted from a ruptured hydatid cyst of the spleen and spread into the peritoneal cavity. We also present a new approach for managing these difficult and high-risk cases.

A case of spontaneous rupture of the bladder.

Rupture of the bladder in the neonatal period followed by urinary ascites is rare and usually the result of umbilical artery catheterization. Patients may present with abdominal distension, oliguria or anuria, and signs of renal insufficiency. We present a case of urinary ascites in a premature neonate due to a spontaneous rupture of the bladder, and we discuss the pathogenesis, diagnosis and management of this case.

Pyloric duplication: ultrasound appearance.

This paper reports a case of pyloric duplication, an extremely rare abnormality usually discovered during infancy. Clinical findings involved mainly symptoms of obstruction and radiological evaluation included abdominal US, plain radiography and CT imaging. Pyloric duplication was diagnosed by US and confirmed by CT scans and surgery.

Axial torsion and gangrene of a giant Meckel's diverticulum.

A variety of complications are related to a Meckel's diverticulum, including hemorrhage, intestinal obstruction and inflammation. Axial torsion and gangrene of Meckel's diverticulum is the rarest of the complications that have been reported, with this being particularly true in case of children. We report a case of axial torsion and gangrene of a giant Meckel's diverticulum in a 6 year old child.

Suprapubic catheter knotting: an unusual complication.

We describe a case of true knotting of a suprapubic catheter in a 25-month-old boy who underwent surgery for urethrocutaneous fistula as a complication of a distal penile hypospadias repair. This unusual complication was probably attributable to an excessive length of catheter being inserted into the bladder, thereby allowing it to bend onto itself.

Duodenal duplication. Is ultrasound appearance enough to confirm the diagnosis?

A case of duodenal duplication is reported. It is a rare anomaly and is commonly discovered during infancy. Symptoms of partial obstruction dominate the clinical picture.

Multifocal hydatid disease in a child.

One of the most serious helminth infections in humans with widespread occurrence is hydatid disease. Although the majority of the cases are referred in adults, many of them have to do with children. The hydatid cysts can occur in any organ of the human body and in rare cases in a combination of different sites.

Familial clustering of autoimmune diseases in patients with dilated cardiomyopathy.

In this study, we examined the hypothesis that dilated cardiomyopathy (DCM) shares genetic risk factors with other diseases of presumed autoimmune etiology, and, therefore, the same multiple genes in combination with environmental factors lead to numerous different autoimmune diseases. In accordance with this hypothesis, we showed an increased prevalence of autoimmune diseases in first-degree relatives of patients with DCM. Also, T-cell activation, as reflected in high levels of the soluble interleukin-2 receptor, appears to identify patients with DCM with a clustering of autoimmune diseases.

The spectrum of primary cutaneous elastolytic granulomas and their distinction from granuloma annulare: a clinicopathological analysis.

Aims: Actinic granuloma (AG) and annular elastolytic giant cell granuloma (AEGCG) are terms commonly applied to cutaneous lesions characterized by elastolysis, elastophagocytosis and a multinucleated cell infiltrate. The aim of this study was to clarify the relationship of these lesions to granuloma annulare (GA) which they resemble clinically.

Methods And Results: The clinicopathological data of 20 patients whose biopsies showed the histology of elastolytic granuloma as well as those of previously published cases with identical tissue changes were analysed to assess differences between AG, AEGCG and GA.

Eruptive large melanocytic nevus in a patient with hereditary epidermolysis bullosa simplex.

Hereditary epidermolysis bullosa (HEB) is a group of genetically determined mechanobullous disorders characterized by blister formation following minor trauma. Unusual melanocytic lesions may be a rare feature of all major categories of HEB. We report a large melanocytic nevus, clinically simulating malignant melanoma, which developed at a site of healing blisters in an 8-year-old male with recessive generalized epidermolysis bullosa simplex (EBS).

Spontaneous pneumomediastinum: is a chest X-ray sufficient?

Spontaneous pneumomediastinum (SPM) is an uncommon disease defined as a non-traumatic presence of free air in the mediastinum, without underlying disease. We present a 13-year- old boy who was previously in a perfect health, who was presented with subcutaneous cervical emphysema, dysphagia, chest and neck pain. The chest roentgenogram revealed the presence of subcutaneous emphysema without any other abnormal findings.

Prognostic significance of soluble interleukin-2 receptor levels in patients with dilated cardiomyopathy.

Background: Activation of T lymphocytes is thought to mediate myocardial dysfunction in dilated cardiomyopathy (CMP), probably through cytotoxic cytokines, but its value as a prognostic factor has not been evaluated.

Methods: For 2 years we prospectively followed 76 patients (65 males, 11 females, age 49 +/- 7 years) with CMP and New York Heart Association(NYHA) Class II-III heart failure; left ventricular (LV) function was assessed echocardiographically. Thirty-three patients (28 males, five females, age 52 +/- 6 years) with ischaemic heart disease (IHD) and similar NYHA and LV function characteristics were used as controls.

Urological symptoms of acute appendicitis in childhood and early adolescence.

We present 15 cases of acute appendicitis in ten boys and five girls (age 3-15 years) with cardinal symptomatology coming from the urogenital tract, who were treated in our departments. All the patients presented with right renal colic, dysuria, frequency and urinary retention. The symptoms were attributed to an ongoing appendix inflammatory process in close proximity to the right distal ureter and urinary bladder.

Lichen planus in children: a possible complication of hepatitis B vaccines.

Lichen planus (LP) has been reported as a complication of hepatitis B vaccination in both adults and children. According to published observations, an autoimmune reaction may be triggered by the viral S epitope. In children, LP is uncommon and, because of its atypical clinical presentation, definitive diagnosis may require biopsy.

Seborrhoeic keratosis or occult malignant neoplasm of the skin?

Background: Seborrhoeic keratosis is generally considered to be a benign lesion of the skin.

Observation: We present the case of a 68-year-old male who presented with clinically typical seborrhoeic keratosis that later histological examination showed partially covered an occult basal cell carcinoma.

Objective: To have an indication of what percentage of clinically apparent seborrhoeic keratoses may be associated with some form of histologically proven skin malignancy.

Hyperprolactinaemia in patients with heart failure: clinical and immunogenetic correlations.

Background: Prolactin represents a stimulatory link between the neuroendocrine and immune systems, but its involvement in the neurohumoral adaptations to heart failure (HF) has not been explored.

Methods: We prospectively studied 55 patients (45 males, 10 females, age 48 +/- 7 years) with NYHA Class II/III HF due either to dilated cardiomyopathy (CMP) (n = 33) or ischemic heart disease (IHD) (n = 22). Serum prolactin levels were determined by radioimmunoassay, soluble interleukin-2 receptor (sIL-2R) levels by enzyme-linked immunoassay and HLA-DQ genotyping with PCR.

Hyperthyroidism is associated with preserved preconditioning capacity but intensified and accelerated ischaemic contracture in rat heart.

Background: The present study was undertaken to define the effects of thyroxine administration on ischaemic preconditioning (PC) and the ischaemic contracture.

Methods: Hyperthyroidism was induced by administration of L-thyroxine in rats (THYR) while normal animals served as controls (NORMa). Isolated rat hearts were perfused in a Langendorff preparation.

Late onset focal dermal elastosis: a distinct clinicopathologic entity?

Two patients, aged 72 and 69 years, had skin lesions clinically resembling pseudoxanthoma elasticum (PXE). On histologic examination, the lesions showed an increased accumulation of normal-appearing elastic fibers lacking the abnormalities that characterize PXE. Similar lesions have been described previously in two elderly patients by Tojima et al.