Adult intussusception secondary to diverticular disease.

Intussusception is the invagination of a proximal segment of bowel into the lumen of an adjacent distal segment. It is a common condition in the paediatric age group although it rarely occurs in adults. Organic lesions in the bowel wall are the primary cause of adult intussusceptions with malignant neoplasms being the most common. However, we present a rare case of a 92-year-old man diagnosed with an intussusception of the sigmoid-rectal colon secondary to a diverticular stricture.

RQ-00201894: A motilin receptor agonist causing long-lasting facilitation of human gastric cholinergically-mediated contractions.

The aim was to characterise RQ-00201894, a novel non-macrolide motilin agonist, using human recombinant receptors and then investigate its ability to facilitate cholinergic activity in human stomach. A reporter gene assay assessed motilin receptor function. Selectivity of action was determined using a panel of different receptors, ion channels, transporters and enzymes. Cholinergically-mediated muscle contractions were evoked by electrical field stimulation (EFS) of human gastric antrum. The results showed that RQ-00201894, motilin and erythromycin acted as full motilin receptor agonists (EC50: 0.20, 0.11, 69 nM, respectively). In this function, RQ-00201894 had >90-fold selectivity of action over its ability to activate the human ghrelin receptor (EC50 19 nM) and greater selectivity over all other receptors/mechanisms tested. In human stomach RQ-00201894 0.1-30 µM concentration-dependently increased EFS-evoked contractions (up to 1209%; pEC50 6.0). At 0.1-10 µM this activity was usually prolonged. At higher concentrations (3-30 µM) RQ-00201894 also caused a short-lasting muscle contraction, temporally disconnected from the increase in EFS-evoked contractions. RQ-00201894 10 µM did not consistently affect submaximal contractions evoked by carbachol. In conclusion, RQ-00201894 potently and selectively activates the motilin receptor and causes long-lasting facilitation of cholinergic activity in human stomach, an activity thought to correlate with an ability to increase gastric emptying.

Incidental De Garengeot's hernia: A case report of dual pathology to remember.

INTRODUCTION: A De Garengeot's hernia is the very rare dual pathology of a vermiform appendix within a femoral hernia. PRESENTATION OF CASE: We discuss the rare case of a 62 year old female who presented as an emergency with a strangulated femoral hernia. Within the hernia sac a partly necrotic vermiform appendix was discovered. The patient successfully underwent an appendicectomy and repair of her femoral hernia. The post-operative period was uneventful, with no further issues at follow-up. DISCUSSION: Our case report displays the successful treatment of a De Garengeot's hernia as an emergency admission, with a shorter than average admission time, and no post-operative complications. CONCLUSION: This is a rare case of dual pathology, of which we believe there are few published cases.

A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair.

BACKGROUND: A systematic analysis was conducted of randomized controlled trials (RCTs) comparing lightweight mesh (LWM) with heavyweight mesh in laparoscopic inguinal hernia repair. METHODS: Data extracted from the included RCTs were analyzed according to the principles of meta-analysis. RESULTS: Eleven RCTs encompassing 2,189 patients were analyzed. In a fixed-effects model, operating time, postoperative pain, and recurrence rate were statistically similar between LWM and heavyweight mesh. LWM was associated with fewer perioperative complications and a reduced risk for developing chronic groin pain. There was also a reduced risk for developing other groin symptoms, such as foreign body sensations, but it was not statistically significant. CONCLUSIONS: The use of LWM for laparoscopic inguinal hernia repair is not associated with an increased risk for hernia recurrence. LWM reduces the incidence of chronic groin pain, groin stiffness, and foreign body sensations. Therefore, LWM may routinely be used in laparoscopic inguinal hernia repair. However, high-quality RCTs with longer follow-up periods are required to validate these findings.

Comparison of radioguided occult lesion localization (ROLL) and wire localization for non-palpable breast cancers: a meta-analysis.

Four randomized trials encompassing 449 patients of non-palpable breast cancer undergoing with radio-guided occult lesion localization (ROLL) or wire guided localization (WGL). In the fixed effects model, accurate localization, peri-procedural complications, and reoperation rate were comparable between two techniques. Risk of having positive resection margins following WGL was higher. Duration of localization and surgical excision was shorter for ROLL. Volume and weight of the excised occult breast lesion was similar in WGL and ROLL groups.