Laparoscopic splenectomy with selective intra-corporeal ligation of splenic hilar vessels for high grade splenic injury - video vignette.

A 59-year-old hemodynamically stable female is admitted following a domestic fall with blunt left sided thoraco-abdominal trauma. She lived alone and had multiple comorbidities including hepatitis C virus positive splenomegaly, chronic psychosis with a history of opioid and alcohol abuse. A CT-scan of thorax and abdomen with IV contrast showed left lung contusions and multiple left rib fractures with no pneumothorax, a high grade splenic injury with intra-parenchymal hematoma and small arterial blushes in the superior splenic pole associated with celiac trunk stenosis, mild intra-abdominal free fluid and grade II injury to the left kidney. This article is protected by copyright. All rights reserved.

Breakfast: a multidisciplinary approach.

BACKGROUND: The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning. DISCUSSION: Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely. SUMMARY: The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being.