The economic benefit of crossbreeding has been well known for many years within dairy production. However, in most countries with an intensive dairy production, an extended use of systematic crossbreeding has not occurred. This may be due to the myth that heterosis is expressed mainly in low-producing herds. The aim ...

Non-invasive brain stimulation promises innovative experimental possibilities for psychology and neuroscience as well as new therapeutic and palliative measures in medicine. Because of its good risk-benefit ratio, non-invasiveness and reversibility as well as its low effort and cost it has good chances of becoming a widespread tool in science, medicine ...

Natural medicinal products have been used for millennia for the treatment of several ailments. Although many have been superseded by conventional pharmaceutical approaches, there is currently a resurgence in the interest in natural products by the general public and the use of complementary and alternative medicine is increasing rapidly in ...

The furniture ergonomic evaluation was carried out through the use of questionnaires and forms in industries. For the ergonomic product analysis, it was used the methodology "Object Ergonomics - Ergonomic System Technical Reading" (design goals and management actions), and measurements of products. The values achieved were compared with the standard ...

The popularity of herbal medicines has risen worldwide. This increase in usage renders safety issues important. Many adverse events of herbal medicines can be attributed to the poor quality of the raw materials or the finished products. Different types of herbal medicines are associated with different problems. Quality issues of ...

In the last three decades, medical doctors have increasingly been exposed to management control measures. This phenomenon has been reflected in a number of studies in various disciplines, including sociology, organisation studies, management, and health service research. This article seeks to provide a comprehensive overview of the studies dealing with ...

Medicinal plants in Uganda and other developing countries have been scientifically demonstrated to have medicinal benefits but few or none have been translated to products for clinical use. Most herbal products developed by local herbalists and sold to the public are not standardized and lack efficacy and safety data to ...

Issues surrounding the impact and management of discarded or waste electronic and electrical equipment (WEEE) have received increasing attention in recent years. This attention stems from the growing quantity and diversity of electronic and electrical equipment (EEE) used by modern society, the increasingly rapid turnover of EEE with the accompanying ...

Early postoperative management in deep brain stimulation-treated patients with dystonia differs from that of patients with essential tremor and Parkinson's disease, mainly due to the usually delayed effects of deep brain stimulation and the heterogenous clinical manifestation and etiologies of dystonia. The present chapter summarizes the available data about and ...

This article reviews (a) risk factors and preoperative considerations of the patient with tracheoesophageal fistula, (b) anesthetic management, including (i) airway management, (ii) induction of anesthesia and monitoring and (iii) postoperative disposition, (c) considerations for concomitant congenital heart disease, (d) considerations for thoracoscopic repair and (e) long-term outcomes and considerations ...

Gastroesophageal reflux represents a physiological phenomenon in the first year of life. The reflux associated with clinical complications is defined as "gastroesophageal reflux disease" (GERD), that may be esophageal or extra-esophageal, as is for respiratory problems. Nuclear medicine investigations have given an important contribution to the diagnostic assessment and therapeutical ...

In recent years successful bronchoscopic management of bronchopleural fistulas (BPFs) by locating its site and then blocking the leaking segment with any of the several agents available has gained recognition. It is now considered as an alternate mode of management of BPF. Here we present a case of non-resolving pneumothorax ...

Although the common indications for therapeutic pancreatic endoscopy - management of ductal strictures and calculi - have remained constants, the last decade has witnessed the emergence of several new endoscopic techniques for managing pancreatic disorders. While many of the advances in therapeutic pancreatic endoscopy have paralleled the shift of endoscopic ...

Bile duct stone management has greatly changed in the past 2 decades. Open surgical techniques have mostly been replaced by transoral endoscopic techniques. Routine common bile duct stones can be managed by standard biliary endoscopic sphincterotomy and extraction. Various advanced transoral techniques can also manage most difficult ductal stones. In ...

An esophagorespiratory fistula (ERF) is an often fatal consequence of esophageal or bronchogenic carcinomas. The preferred treatment is placement of esophageal and/or airway stents. Stent placement must be performed as quickly as possible since patients with ERFs are at a high risk for aspiration pneumonia. In this review, choice of ...

The management of complex bronchopleural fistulas (BPFs) remains a major diagnostic and therapeutic challenge to all chest physicians. Successful management of a fistula revolves around treatment of the associated empyema cavity first. Definitive repair should be accomplished expeditiously to minimize the number of procedures performed. When treatment is protracted, secondary ...

Esophageal atresia is the most common congenital anomaly of the esophagus in newborns. This review article discusses the incidence, embryological classification, diagnosis and associated anomalies of esophageal atresia. Emphasis is placed in the current guidelines of standard surgical management of this congenital condition.

Management of giant pedunculated polyps can be a challenge for therapeutic endoscopists, mainly because such polyps are not found in commonplace and experience from their management is limited. We describe a novel use of endoclips that induces significant polyp volume reduction, thereby facilitating the endoscopic removal of giant pedunculated polyps.

This article looks at the current techniques and equipment recommended for the management of the difficult intubation scenario in pediatric practice. We discuss the general considerations including preoperative preparation, the preferred anesthetic technique and the use of both rigid laryngoscopic and fiberoptic techniques for intubation. The unanticipated scenario is also ...

Laryngotracheo-esophageal cleft is a rare congenital anomaly that occurs when the trachea and esophagus fail to separate during fetal development. Clinical severity varies greatly in anatomic cleft extent. We report the successful management of the airway of a neonate with type IV laryngotracheo-esophageal cleft for the gastric division surgery by ...

Chylothorax carries significant mortality and morbidity. Patients with high-output chylothorax have traditionally been managed by surgical treatment if nonoperative management has proved unsuccessful. Newer, more recent percutaneous techniques used to treat chylothorax are safer and less invasive than surgery. We present three cases that have been successfully managed using these ...

To review 12 cases of anovestibular fistula with normal anal opening. Retrospective analysis of 12 children with anovestibular fistula and normal anal opening were treated between the years 2000 and 2007. Of these, 11 patients were diagnosed as having acquired anovestibular fistula with normal anal opening and were managed by ...

INTRODUCTION: Laparoscopic assisted nephroureterectomy is a well established technique for managing the upper urinary tract urothelial cancer. However, management of the distal ureter remains a controversial issue. We describe a modified method of cystoscopic loop ligation and detachment of the distal ureter. TECHNICAL CONSIDERATION: We performed transperitoneal laparoscopic assisted nephroureterectomy ...

Adenoidectomy is a common ENT procedure performed in hospitals in Malaysia. Adenoidectomy is indicated in patients with recurrent adenoiditis, nasal obstruction or sleep apnoea secondary to adenoid hypertrophy when conservative management has failed. Over the years, there are advances in the techniques of adenoidectomy, from the conventional transoral to endoscopic ...

PURPOSE OF REVIEW: To focus on the technique and results of a single percutaneous puncture for the management of staghorn renal calculi. RECENT FINDINGS: The success rate for treating staghorn calculi with a single percutaneous puncture is over 90%. Animal and clinical studies seem to suggest that a single percutaneous ...

This report documents a new endoscopic management modality for congenital membranous stenosis in the third portion of the duodenum. Standard approaches to duodenal stenosis in newborns include a laparotomy with an enteroenterostomy, bypassing the obstruction, or a duodenoduodenostomy with excision. We successfully developed a modification of the endoscopic treatment modality ...

A high proportion of genitourinary fistulas have an obstetric origin. Obstetric fistulas are caused by prolonged obstructed labor coupled with a lack of medical attention. While successful management with prolonged bladder drainage has occasionally been reported, mature fistulas require formal operative repair, and it is crucial that the first repair ...

No Abstract. <i> Nigrian Journal of Clinical Practice </i> Vol.9 (1) 2006: pp.84-86

This article presents the reflections of an experienced fistula surgeon and an epidemiologist on the current knowledge base for obstetric fistula. The incidence, prevention, and management of vesico-vaginal and recto-vaginal fistula are discussed. The authors call for more randomized controlled trials to determine the effectiveness of surgical interventions for fistula ...

Many predators face a complex step of prey preparation before consumption. Octopuses faced with bivalve prey use several techniques to penetrate the shells to gain access to the meat inside. When given prey of mussels Mytilus trossulus, Manila clams Venerupis philippinarum, and littleneck clams Protothaca staminea, Enteroctopus dofleini solved the ...

A 73-year-old former smoker with previous occupational exposure to asbestos presented with a pneumothorax that was initially managed by simple aspiration. Despite this, it re-accumulated and a bronchopleural fistula was suspected. A video-assisted thoracoscopic procedure was performed and revealed an abnormally thickened pleura that turned out to be a mesothelioma. ...

Nonvariceal upper gastrointestinal bleeding (NVUGIB) is an important condition facing gastroenterologists. The focus of this article is the management of NVUGIB, with a particular emphasis on the endoscopic modalities and techniques that are most effective for various bleeding etiologies. Attention also is given to medical management, risk assessment, and issues ...

SummaryAnal fistula is a common cause of perianal sepsis in surgical practice. We share our experience in the management of a high fistula in ano caused by hidradenitis suppurativa an uncommon condition in Ghana.

The repair of inguinal hernia and hydrocele is one of the most common operations in a pediatric surgery practice. This work reviews current concepts in the management of the inguinal hernia and hydrocele. The authors describe current concepts of anesthetic management of children undergoing repair of inguinal hernia. The authors ...

Obstruction of passage of a catheter through esophagus in a newborn is mostly diagnosed as esophageal atresia (EA) with or without tracheo esophageal fistula (TEF). Rarely a traumatic instrumentation may produce pharyngeal or upper esophageal perforation and attempt at passage of a catheter may produce a false passage submucosally called ...

A bronchobiliary fistula is an abnormal communication between the biliary tree and the airway that can result in debilitating amounts of bilioptysis, or bile-stained sputum. The authors present an approach for the conservative management of a bronchobiliary fistula in a patient who failed traditional conservative therapy and refused surgical intervention.

We describe a case of esophageal perforation that resulted from a fishbone. A 71-year-old man had had a fishbone impacted in the lower esophagus for 2 days. At presentation, the bone was dislodged at endoscopy; one round opening in a deep ulceration was detected when the fishbone was removed. The ...

Conjunctivo dacrocysto rhinal fistula is an abnormal communication between the conjunctival sac and nose through the lacrimal sac. This is a rare and infrequent complication of acute dacrocystitis and only scanty literature is available. Its management requires two layered closure, one for nasal lining and the other for the conjunctiva. ...

Although the incidence of caustic ingestion is declining, the management of caustic esophageal strictures remains a challenge. Mitomycin C (MMC) inhibits fibroblast proliferation and is effective in reducing scar in animal experiments. We report the case of a child with a distal esophageal stricture from lye ingestion managed with MMC. ...

Complete esophageal stenosis secondary to peptic stricture in the upper esophagus is rare. It is, however a serious medical problem that may require otolaryngologic intervention because of life-threatening dysphagia and weight loss. We report the case of an elderly patient who presented with an upper esophageal stricture, without the typical ...

The surgical management of congenital diaphragmatic hernias has traditionally been via laparotomy or thoracotomy. Although laparoscopic and thoracoscopic repairs have been described, most reports are in older infants. We describe a method for primary thoracoscopic repair applied in the immediate neonatal period when no posterolateral rim of diaphragm exists. This ...

Significant advances in endoscopic, radiologic, and surgical techniques have transformed the management of pancreatic pseudocysts. The present review focuses upon advances in the endoscopic management of pseudocysts and incorporation of these techniques into an overall management approach. Findings with endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography often guide the choice ...

A 90-year-old woman sustained a proximal esophageal perforation following transesophageal echocardiography. The perforation originated at the site of a Zenker's diverticulum and resulted in a false passage to the diaphragm. Initial management involved endoscopic placement of drains into the mediastinum in addition to bilateral chest drains and a gastrostomy. Following ...

Retained foley suprapubic catheters are a common occurrence in urologic practice. The gold standard is to remove the catheter by minimally invasive methods, with as little discomfort to the patients as possible and without leaving any fragments of latex, which could form a nidus for calculus formation. The procedure described ...

BACKGROUND: Pancreatico-bronchial fistulas are a rare complication of acute or chronic pancreatitis. Both conservative and surgical management have been described previously. CASE OUTLINE: The management of a 68-year-old woman with acute pancreatitis complicated by a pancreatico-bronchial fistula was reviewed. CT scanning and magnetic resonance cholangio-pancreatography demonstrated a pancreatic pseudocyst with ...

ATP-dependent glucokinase is suggested to have evolved from a hypothetical polyphosphate (polyP)-dependent glucokinase (polyP-GK) via a bifunctional polyP/ATP glucokinase (polyP/ATP-GK). Here we showed that polyP-GK is present in a polyP-accumulating bacterium, Microlunatus phosphovorus. The polyP-GK produced glucose-6-P(i) from glucose and polyP, but it could not phosphorylate glucose with ATP. The ...

We report a case of ventilator auto-triggering resulting from tuberculous bronchopleural fistula being managed with chest tube suction. Early recognition of bronchopleural fistula-related auto-triggering is extremely important. Auto-triggering can lead to serious adverse effects, including severe hyperventilation and inappropriate escalation of sedatives and/or neuromuscular blockers (administered to reduce spontaneous breathing ...

We describe the use of a silicone septal button in the management of a patient who developed a large tracheo-oesophageal fistula following primary puncture as part of a total laryngectomy. The button was easily inserted, well tolerated and prevented leakage of solids into the trachea, allowing the patient to eat.

The appropriate management of labyrinthine fistulae has been debated in the literature for years. After several recent cases of labyrinthine fistulae at our institution, a review of the published data regarding hearing outcome with fistula management was undertaken. Results of this critical review were presented at departmental grand rounds. The ...

Bronchobiliary fistula is defined as the passage of bile in the bronchi and in the sputum (bilioptysis). This rare disorder is associated with significant morbidity. Authors review the anaesthetic management of bronchobiliary fistula and recommend the use of double lumen endotracheal tube even in cases with a closed/sealed bronchobiliary fistula.