Feasibility of size-specific organ-dose estimates based on water equivalent diameter for common head CT examinations: a Monte Carlo study.

Computed tomography dose index (CTDI) is an unreliable dose estimate outside of the standard CTDI phantom diameters (16 and 32 cm). Size-specific dose estimate (SSDE) for head computed tomography (CT) examination was studied in the American Association of Physicists in Medicine Report 293 to provide SSDE coefficient factors based on water equivalent diameter as size metrics. However, it is limited to one protocol and for a fully irradiated organ. This study aimed to evaluate the dependency of normalized organ dose (ND) on water equivalent diameter as a size metric in three common protocols: routine head, paranasal sinus, and temporal bone. CTDIwmeasurements were performed for outlined protocols in the Siemens Emotion 16-slice-configuration scanner. Geant4 Application for Tomographic Emission Monte Carlo simulation platform, coupled with ten GSF patient models, was used to estimate organ doses. CT scanner system was modeled. Helical CT scans were simulated using constructor scan parameters and calculated scan lengths of each patient model. Organ doses provided by simulations were normalized to CTDIvol. The water equivalent diameters (Dw) of patient models were obtained via relationships betweenDwand both effective diameter for a sample of patients' data.NDs received by fully, partially, and non-directly irradiated organs were then reported as a function ofDw. For fully irradiated organs, brain (R2> 0.92), eyes (R2> 0.88), and eye lens (R2> 0.89) correlate well withDw. For the rest of the results, a poor correlation was observed. For partially irradiated organs, the exception was scalp (R2= 0.93) in temporal bone CT. For non-directly irradiated organs, the exception was thyroid (R2> 0.90) and lungs (R2> 0.91) in routine head CT. ND correlates well in routine head CT than other protocols. For the most part, no relationship seems to exist betweenR2and scan percentage coverage. The results have revealed additional factors that may influence the ND andDwrelationship, which explains the need for more studies in the future to investigate the effect of scan conditions and organ anatomy variation.

Allergic rhinitis: diagnosis and management.

Allergic rhinitis affects 20% of the population of the UK. It confers a significant health burden upon the individual as it affects the patient's quality of life and is associated with serious comorbidities including asthma, sinusitis and conjunctivitis. Owing to its prevalence, it has a significant economic impact through its effects on education, productivity and use of healthcare resources. This review focuses on the management of allergic rhinitis and potential future treatments, because of the lack of clear national guidelines and because this illness is often misdiagnosed and mismanaged. The article provides a comprehensive overview of allergic rhinitis and illustrates the assessment criteria for various subcategories.

Diagnostic Reference Levels for Paediatric Head Computed Tomography in Morocco: A Nationwide Survey.

The purpose of this study was to establish the diagnostic reference levels (DRLs) for paediatric head computed tomography (CT) in Morocco and to assess the effective doses received during head CT examinations. The data of 1007 patients were collected retrospectively from Moroccan university children's hospitals. The sample was classified per age group:<1, 1-5, 5-10 and 10-15 years. The proposed DRLs were defined as 75th percentile of the distributions, which were in terms of CT dose index of 26.98, 28.88, 34.00 and 38.20 mGy and dose length product of 461.64, 540.06, 627.20 and 705.98 mGy.cm, respectively. The effective doses estimated were 3.6, 2.9, 2 and 1.79 mSv, respectively. The DRLs reported in Morocco were compared with those of other countries, which were based on the same age grouping method, including Thailand, Switzerland, Japan and the international DRLs. Our initiative via the determination of the first Moroccan diagnostic reference levels for paediatric head CT must be a starting point to spread this investigation towards other examinations and imaging modalities.

A study of fluid intake from beverages in a sample of healthy French children, adolescents and adults.

BACKGROUND/OBJECTIVES: To assess the intake of fluid in healthy French children, adolescents, adults and seniors, considering amounts, types of beverages, time and place of consumption. SUBJECTS/METHODS: Data regarding fluid intake were extracted and analyzed from the National Intake Survey, which was conducted in quota samples of the French population (Comportement et Consommations Alimentaires en France study). Seven-day questionnaires were administered to free-living individuals in 2002-2003. A total of 566 children (aged 6-11 years), 333 adolescents (aged 12-19 years), 831 adults (aged 20-54 years) and 443 seniors (aged >or=55 years) were included in this study. RESULTS: The average total intake of fluid was 1-1.3 l per day depending on age groups. Water accounted for about one-half of daily fluid intake. The contribution of other types of beverages varied with age (for example, dairy drinks in children and adolescents; alcoholic drinks in adults and seniors). Intake of sodas (including regular and light) was highest in adolescents (169 ml a day). Beverages were mainly consumed at home during meals. CONCLUSIONS: This is the first description of fluid intake in French children, adolescents, adults and seniors, considering amounts, types of beverages, time and place of intake. It shows that water is the main source of fluid in all age groups. Selection of various types of beverages is different according to age.

[Colorectal cancer discovered during pregnancy]. / Cancer rectocolique et grossesse: à propos de deux cas.

Colorectal carcinoma during pregnancy is very rare. Prognosis is severe because of the advanced stage due to delay in diagnosis and the aggressiveness of this widespread metastatic disease. We present two cases of colorectal cancers, discovered during pregnancy, as well as the results of a literature review to apprehend this clinical situation, and we describe recommended medical and surgical management.

[Double dislocation of the fifth metacarpal]. / Luxation bipolaire du cinquième métacarpien.

A case of simultaneous dorsal dislocation of the metacarpophalangeal and carpometacarpal joints in the little finger is presented. The patient required an open reduction of the metacarpophalangeal joint, the carpometacarpal joint was reduced simultaneously. Thirty month post-operatively there was no subluxation of either joint.

[Nonalcoholic steatohepatitis]. / La stéatohépatite non alcoolique.

Nonalcoholic steatohepatitis (NASH) is a condition characterized by excessive deposition of fat in the liver (steatosis), inflammation and hepatocellular necrosis. While steatosis alone is generally a benign and stable condition, NASH can have a dire prognosis in a minority of patients, mainly because of fibrosis occurrence and progression to cirrhosis. Life-threatening complications such as liver failure and hepatocellular carcinoma have been described in NASH-induced cirrhosis. Insulin resistance is almost universally found in patients with NASH and the main risk factors for this condition are overweight and diabetes. Improvement in insulin sensitivity, whether achieved by diet, exercise and/or pharmacological interventions, results in a dramatic reduction of liver fat and inflammation and fibrosis as well. Therefore NASH should be viewed as the hepatic phenotypic manifestation of insulin resistance and a bona fide component of the metabolic syndrome. Liver injury should be assessed in diabetic and/or obese patients and the mechanisms by which insulin resistance promotes liver damage needs to be elucidated. The encouraging results of the use of PPARgamma agonists and, in particular, rosiglitazone, in human or experimental models of NASH, justifies future large-scale, randomized controlled trials.

[Giant pleomorphic adenoma of the submaxillary gland: case report]. / Adénome pléomorphe géant de la glande sous-maxillaire: à propos d'une observation.

We report an exceptional case of giant cell tumor of the submaxillary gland in a 76-year-old woman. The tumor progressed slowly over a period of 40 years. Submaxillectomy removed a 3-kg mass before fixation. The postoperative period was uneventful and the patient was discharged fifteen days later. Pathology examination revealed a pleomorphous adenoma developed within the salivary gland.

Five-week intake of short-chain fructo-oligosaccharides increases intestinal absorption and status of magnesium in postmenopausal women.

Fermentable carbohydrates have been shown to be nondigestible by human enzymes in the small intestine but are fermented extensively in the large bowel to short-chain fatty acids (SCFAs), which can increase mineral absorption. It has been shown that feeding such carbohydrates including short-chain fructo-oligosaccharides (sc-FOSs) increases intestinal magnesium (Mg) absorption in animals, but their beneficial impact on Mg absorption in humans still remains to be established. Therefore, this work aimed to investigate the effect of moderate daily doses of sc-FOSs (10 g/day) on the intestinal absorption and status of Mg in postmenopausal women without hormone replacement therapy (HRT). Eleven healthy postmenopausal women aged 59 +/- 6 years (mean +/- SD) received for 5 weeks sc-FOS or sucrose (placebo) treatments according to a randomized, double-blind, crossover design separated by a washout period of at least 3 weeks. Subjects ingested 87.5 mg of stable isotope 25Mg together with a fecal marker. Subsequently, feces were collected for 5-7 days. An inductively coupled plasma mass spectrometer (ICP/MS) was used for 25Mg stable isotope measurements in feces, urine, and blood. Mg levels were assessed also at the beginning and at the end of each treatment in plasma, erythrocytes, and urine. These measurements allowed for the determination of net intestinal Mg absorption and Mg status. The results show that the addition of 10 g sc-FOS to the diet increased Mg absorption by 12.3%, from 30.2 +/- 5.0% (placebo treatment) to 33.9 +/- 7.2% (sc-FOS treatment; mean +/- SD; p < 0.02). This increase in intestinal Mg absorption was accompanied by an increase in plasma 25Mg level and led to a higher urinary 25Mg excretion. This is the first time that such an effect is shown in humans. The overall conclusion of this work is that the ingestion of moderate doses of sc-FOS did improve intestinal Mg absorption and status in postmenopausal women. Because of the important role of Mg in many cellular functions, such Mg absorption improvement may be particularly interesting when the dietary intake of Mg is limited.

[Giant pleomorphic adenoma of the submaxillar gland: a case report]. / Adénome pléomorphe géant de la glande sous-maxillaire à propos d'une observation.

The authors are reporting of an exceptional case of giant cell tumor of the submaxillar gland in a lady of 76 years old. She presents a progressively slow evolution within a period of 40 years. After a standard check up, a submaxillectomy was carded out. The weight of the operated mass was 3 kg before the pathological fixation. The post-operative period was without any problems and the patient was discharged after fifteen days. The anatomo-pathological examination concluded a pleomophic adenoma developed by the salivery gland.

The rhamnogalacturonan-II dimer decreases intestinal absorption and tissue accumulation of lead in rats.

The rhamnogalacturonan-II dimer (dRG-II) forms strong complexes in vitro with lead (Pb) and other selected cations. We examined the in vivo bioavailability of Pb complexed with dRG-II and the effect of unleaded dRG-II on the intestinal absorption and tissue retention of Pb in rats. Forty male Wistar rats were divided into four groups. Each group consumed a purified control diet for 3 wk or the same diet supplemented with: i) 3 mg of Pb/kg, ii) 0.5 g of leaded dRG-II/kg, or iii) 0.5 g of leaded dRG-II/kg and 4.5 g of unleaded dRG-II/kg. The leaded dRG-II provided approximately 3 mg of Pb/kg of diet. A chemical balance study was conducted during the last 5 d of the 3-wk study, and blood and organs were sampled for Pb and mineral analyses. The apparent intestinal absorptions of Pb were 62.3, 15.2, 11.8 and -0.1%, and Pb balances were 1.9, 9.6, 5.6 and -0.2 microg/d for the control and the three experimental groups, respectively. The Pb complexed with dRG-II was less available than Pb acetate, as reflected by significantly lower blood and tissue Pb levels. The addition of unleaded dRG-II decreased the intestinal absorption and the tissue retention of Pb significantly. We further found that the apparent absorption and status of magnesium, zinc and iron were unaffected by Pb treatment or dRG-II addition. We conclude that dRG-II may be useful in decreasing toxicity related to chronic Pb exposure. Human studies will be necessary however, to further evaluate the clinical utility of this beneficial effect.