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Karia Ba Mohamed, Morocco

Children presenting with acute abdominal pains at emergency rooms are frequent, but few of them require a pediatric surgeon. However it can be dangerous for the patient (and for the physician = major cause of prosecutions) to misdiagnose those cases. Children with «classic» gastroenteritis may prove to have a perforated appendicitis, while those with tender abdomens may suffer pneumonia or streptococcal pharyngitis, and a comatous child may have an intussusception and not a metabolic disease. We review the diagnostic and management of some common causes of surgical abominal pains in children to help the physicians to avoid some pitfalls, and to involve the pediatric surgeons at an early stage. Source

AIM: Evaluate the care of burn sequel of the hand in the services of orthopaedic trauma and paediatric in the teaching hospital Gabriel Touré. METHOdS: It was about a longitudinal and prospective study lasting from Jun 2006 to January 2008 in all the children aged from 0 to 14 years with burn sequel of the hand admitted and treated in the services of orthopaedic- trauma and paediatric surgery of Gabriel Touré. Patients with an incomplete file or lost during the study were not included. RESULTS: In 20 months we brought together 40 cases of burn sequel of hand. The mean age of the patients was 8.5 years. There were 18 boys and 22 girls. The sex-ratio was 1.22 for girls. The causal agent was more frequently thermal (85%) by hot liquid. Burn was caused by domestic accident in 95%. 14 of our patients were seen by a doctor after 24 months of burn and another 14 were after 36 months. A functional deficit was noted to the physical examination in all our patients. The treatment was surgical in 26 patients. Results were judged well in 16 cases, little good in 8 and bad 2 case. A good initial treatment done in a fear condition permit to reduce the number of sequel of the hand and to stay less severe. Source

Haie-Meder C.,Institute Of Cancerologie Gustave Roussy | Mazeron R.,Institute Of Cancerologie Gustave Roussy | Martelli H.,Service de Chirurgie Pediatrique | Oberlin O.,Institute Of Cancerologie Gustave Roussy
Cancer/Radiotherapie | Year: 2013

Brachytherapy in paediatric malignancies is rarely used, limited to expert institutions. The most frequent tumour sites treated with brachytherapy are gynaecological rhabdomyosarcomas, and prostate/bladder rhabdomyosarcomas. Ballistic advantages make brachytherapy technique the treatment of choice, with a high and selective protection of organs at risk. Techniques, brachytherapy modalities (low dose-rate, high dose-rate, pulsed dose-rate), doses and indications vary according to centres. Brachytherapy advantages are in relation with ballistic properties, allowing a very high dose to the target with normal tissue sparing. This review analyzes brachytherapy techniques, indications and results according to the two most frequent tumour sites: gynaecological and bladder/prostate tumours. This technique requires a muldisciplinary approach. © 2013. Source

Oesophageal atresia is an extreme surgical emergency of the first week of birth. Authors report 10 cases treated in 5 years in two hospitals of Yaounde in Cameroon. This study high line: Difficulties of oesophageal atresia management in less medicalised countries. Possible solutions in this context. Source

Pean N.,University Paris - Sud | Pean N.,University Paris Diderot | Doignon I.,University Paris - Sud | Garcin I.,University Paris - Sud | And 12 more authors.
Hepatology | Year: 2013

Many regulatory pathways are involved in liver regeneration after partial hepatectomy (PH) to initiate growth, protect liver cells, and sustain functions of the remnant liver. Bile acids (BAs), whose levels rise in the blood early after PH, stimulate both hepatocyte proliferation and protection, in part through their binding to the nuclear farnesoid X receptor (FXR). However, the effect of the BA receptor, TGR5 (G-protein-coupled BA receptor 1) after PH remains to be studied. Liver histology, hepatocyte proliferation, BA concentrations (plasma, bile, liver, urine, and feces), bile flow and composition, and cytokine production were studied in wild-type (WT) and TGR5 KO (knockout) mice before and after PH. BA composition (plasma, bile, liver, urine, and feces) was more hydrophobic in TGR5 KO than in WT mice. After PH, severe hepatocyte necrosis, prolonged cholestasis, exacerbated inflammatory response, and delayed regeneration were observed in TGR5 KO mice. Although hepatocyte adaptive response to post-PH BA overload was similar in WT and TGR5 KO mice, kidney and biliary adaptive responses were strongly impaired in TGR5 KO mice. Cholestyramine treatment, as well as Kupffer cell depletion, significantly improved the post-PH TGR5 KO mice phenotype. After bile duct ligation or upon a cholic acid-enriched diet, TGR5 KO mice exhibited more severe liver injury than WT as well as impaired BA elimination in urine. Conclusion: TGR5 is crucial for liver protection against BA overload after PH, primarily through the control of bile hydrophobicity and cytokine secretion. In the absence of TGR5, intrahepatic stasis of abnormally hydrophobic bile and excessive inflammation, in association with impaired bile flow adaptation and deficient urinary BA efflux, lead to BA overload-induced liver injury and delayed regeneration. © 2013 by the American Association for the Study of Liver Diseases. Source

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