The embryology of persistent cloaca and urogenital sinus malformations / 亚洲男科学杂志(英文版)

Cloacal malformations are characterized by the confluence of the lower urinary tract, the female reproductive tract, and the rectum to create a common channel with a single opening on the perineum. The presence of a cloaca is a normal phase of early human embryological development. Between the 4th and 7th weeks of gestation, the cloaca undergoes subdivision to form the hindgut and urogenital sinus. Failure of this process results in the congenital anomaly termed persistent cloaca (PC). The term urorectal septum malformation sequence (URSMS) is also used to describe this anomaly. The classic description of this process which is still cited in many standard textbooks dates from the 19th century. However, this has been increasingly called into question by the findings of studies using modern scientific methodology. Urogenital sinus anomalies are defined by the confluence of the urethra and vagina to form a common channel of varying length with a single perineal opening. In this condition, the anorectal canal opens separately on the perineum. The presence of a urogenital sinus represents a transient phase of the normal development of the lower genital tract in the female fetus. However, the form of urogenital sinus most commonly encountered in the developed world is a feature of disordered sexual differentiation and does not arise simply from the persistence of the anatomical structure which is a feature of normal fetal development.

The Chikungunya virus: An emerging US pathogen / 世界急诊医学杂志（英文）

BACKGROUND:The Chikungunya (CHIK) virus was recently reported by the CDC to have spread to the United States. We report an early documented case of CHIK from the state of Pennsylvania after a patient recently returned from Haiti in June of 2014. METHODS:A 39-year-old man presented to the emergency department complaining of fever, fatigue, polyarthralgias and a diffuse rash for two days. Four days before, he returned from a mission trip to Haiti and reported that four of his accompanying friends had also become ill. A CHIK antibody titer was obtained and it was found to be positive. During his hospital stay, he responded well to supportive care, including anti-inflammatories, intravenous hydration and anti-emetics. RESULTS:His condition improved within two days and he was ultimately discharged home. CONCLUSIONS:Manifestations of CHIK can be similar to Dengue fever, which is transmitted by the same species of mosquito, and occasionally as a co-infection. Clinicians should include Chikungunya virus in their differential diagnosis of patients who present with fever, polyarthralgia and rash with a recent history of travel to endemic areas, including those within the United States.

Prevalence of Giardiasis in Children Attending Semi-urban Daycare Centres in Guatemala and Comparison of 3 Giardia Detection Tests.

Giardia intestinalis is an intestinal parasite widely prevalent in children attending daycare centres worldwide and has been associated with undernutrition. Stool samples from 48 Guatemalan children (aged 1.5-7 years) attending participating daycare centres were analyzed over five weeks for presence of Giardia intestinalis using light microscopy, ELISA, and rapid dipstick test. Giardia prevalence rates were 43.7% at Week 0 and 44.7% at Week 4, based on ELISA. Intensity, but not prevalence, of infection showed a trend toward decreased weight-for-age (1-tailed p=0.08). We believe that ELISA analysis of stool samples may be further adapted for measuring the intensity of infection in humans.

Interrelation of cardiovascular diseases and periodontal pathologies -a literature review

Oral infections are a source of bacteremic organisms that can infect damaged heart valves causing bacterial endocarditis and other forms of cardiovascular disease including stroke. This review discusses the relationship of oral infections, bacterial endocarditis and coronary artery disease, especially periodontal disease, while suggesting guidelines for best practice clinical management

Use and misuse of emergency services at King Fahad hospital, Riyadh, Saudi Arabia

All attendances at the Emergency Department of King Fahad Hospital, Riyadh, over a 28-day period were studied and categorized on the basis of the urgency of the presenting problems. More than 90% of attenders were classified as non-urgent. Characteristics of attenders, their problems, and the outcome of attendance are described. The findings are used to explore appropriate use of emergency and primary care services and to indicate the need for further studies in this field

Study of obesity with hyperlipidemia in Kuwaiti adults

This study of obesity with hyperlipidaemia was conducted in 124 patients on the out-patient [OP] clinic of the Administration of Food and Nutrition Department for a six month period in 1987. Fifty percent of all patients had excess body weight [Wt] between 20 - 49% above their standard body Wt and the rest had even more than that. In addition, all the patients had elevated serum cholesterol [CHL] of over 6.2 mmol/L. The occurrence of obesity was observed in both sexes from as early as 20 years of age, and a similar observation was made concerning the occurrence of CHL. The occurrence of high risk coronary heart diseases due to elevated lipids was also observed equally from the same age. The dietary habits were of high calorie intake and particularly of high cholesterol containing foods. The calorie intake was as high as 6900 calories with about 53% of fats and 4900 mg of cholesterol. Dietary intervention not only achieved the expected weight loss of one kg per week, but also corrected the abnormal biochemical values of CHL, low density lipoprotein-CHL, high density lipoprotein-CHL and Triglycerides without the intervention of drug therapy. Further research on attributed risk related to different lipid variables and establishment of a Lipid Clinic are recommended