Maternal and developmental toxicity of the hallucinogenic plant-based beverage ayahuasca in rats.

Rats were treated orally with ayahuasca (AYA) on gestation days (GD) 6-20 at doses corresponding to one-(1X) to eight-fold (8X) the average dose taken by a human adult in a religious ritual, and the pregnancy outcome evaluated on GD21. Rats treated with 4X and 8X doses died during the treatment period (44 and 52%), and those that survived showed kidney injury. Rats surviving the 8X dose showed neuronal loss in hippocampal regions and in the raphe nuclei, and those from the 2X dose neuronal loss in CA1. Delayed intrauterine growth, induced embryo deaths and increased occurrence of foetal anomalies were observed at the 8X dose. At non-lethal doses, AYA enhanced embryolethality and the incidence of foetal soft-tissue and skeleton anomalies. This study suggested that AYA is developmentally toxic and that its daily use by pregnant women may pose risks for the conceptus.

Laparoscopic selective clipping of upper moiety vasculature and ureter without partial nephrectomy: A novel technique for pediatric urinary incontinence due to ectopic ureter associated with poor functioning upper renal moiety.

OBJECTIVE: The aim of this study was to present a novel laparoscopic technique for persistent urinary incontinence in pediatrics due to ectopic ureter associated with poor functioning upper renal moiety. METHODS: This technique consisted of laparoscopic clipping of the upper moiety artery and vein. The ectopic ureter was also clipped afterwards without upper pole partial nephrectomy. RESULTS: The patient was a seven-year-old girl with persistent urinary incontinence and confirmation of duplex kidney with poor functioning upper moiety in pre-operative investigations. The upper moiety ureter was ectopically drained to the vaginal cavity. She was immediately dry after surgery and discharged on the second postoperative day. During the follow-up period of 14 months, she was continent and symptom-free. Hydronephrosis was not visualized in follow-up ultrasonography. CONCLUSIONS: This laparoscopic upper renal moiety vascular and ureteral clipping without partial nephrectomy could serve as a promising, safe and simple alternative in the treatment of patients with ectopic ureter associated with poor functioning renal moiety. Also, ipsilateral normal functioning moiety would not be associated with potential morbidity in this technique.

Bladder diverticulum arising adjacent to an ectopic ureter presenting as a cystic mass.

Acquired bladder diverticula due to bladder outlet obstruction are not uncommon in the adult male population. Congenital diverticula originate adjacent to the trigone and are rarely diagnosed in adults. We report an unusual case of a diverticulum arising adjacent to an ectopic ureter located on the left lateral wall near the dome of the bladder. Although the diverticulum appeared to be congenital, its large size was likely a result of high pressure voiding. The patient underwent a transurethral resection of the prostate to reduce his bladder outlet obstruction, and subsequently underwent an open diverticulectomy.

Megacystis microcolon intestinal hypoperistalsis syndrome with bilateral duplicated systems.

A 29-year-old multigravida woman presented for her second prenatal ultrasound evaluation at 30 weeks of gestation. The study showed a female fetus, bilateral duplicated systems with severe hydronephrosis in the upper pole moieties and a massively distended bladder. Initial interpretation suggested ectopic/obstructing bilateral ureteroceles. To evaluate these findings further, a prenatal magnetic resonance imaging scan was obtained, documenting the absence of ureteroceles. The presumptive diagnosis of megacystis microcolon intestinal hypoperistalsis syndrome was made. After birth, contrast enema confirmed the presence of microcolon. This appears to be the first reported case of megacystis microcolon intestinal hypoperistalsis syndrome with bilateral duplex systems evaluated with prenatal magnetic resonance imaging.

Coexistant gastric duplication and accessory pancreas: clinical manifestations, embryogenesis, and treatment.

Combined gastric and pancreatic duplications are uncommon. Although patients usually present with symptoms of intestinal obstruction, gastrointestinal (GI) bleeding may occur if the duplication ulcerates and erodes into a neighboring hollow viscus. An upper GI series and barium enema are helpful in making a diagnosis. Combined duplications probably are produced during embryologic development by traction along a neuroenteric band between the stomach and pancreas. Simple surgical excision is the treatment of choice.