Long-Term Morbidity of Infantile Eczema

Human mankind is aware of the existence of adverse reactions to foods since classical times. Hippocrates (460-370 BC) reported urticaria and gastrointestinal upset following cow's milk (CM) ingestion.

Lucretius (98-55 BC) wrote "Quod aliiscibus estaliis fuatacre venenum". Galen (131- 219) described allergy to goat's milk. At the turn of this century the first description of acute shock due to CM allergy was published, and Schloss was the first to evaluate skin tests for the diagnosis.

Accordingly the aspiration to influence the natural incidence of atopic illness has piqued physicians' imaginations for a long time. The phenotypic expression of IgE-mediated disorders, which appears regulated by multiple genetic factors and modulated by environmental experiences, has been a target for prevention medicine since the 1920s when dietary intervention was adopted in infancy.

PDF LINK

Preparing for the Rise in Alzheimers Disease Cases: A Proposal for Training Support Personnel

As the baby-boomer generation continues to age, the number of Alzheimer’s disease cases is expected to double in the next decade. The functional disability and need for clinical management associated with this trend will outstrip our current workforce.

Making the correct diagnosis and prescribing cognitive enhancing drugs is relatively easy compared to the time and effort required to educate and support caregivers and help them cope with the complications of neurocognitive disorders such as depression, psychosis, agitation, and growing dependency for basic function.

Ninety five percent of these patients will be managed in home settings that will require time and effort from family members who are traditionally women that manage their own family with children as well as their aging parents, many of whom also work themselves to make ends meet financially. Social service agencies will therefore figure large in this equation to provide day care and in-home help.

PDF LINK

Malaria: What are the Needs for Diagnosis, Treatment and Control?

Malaria is caused by infection with obligate intracellular, singlecelled protozoa of one of the four species of plasmodium, Plasmodium falciparum , Plasmodium vivax , Plasmodium ovale and Plasmodium malaria.

Recent human cases due to Plasmodium Knowles were reported.  Of these, P. falciparum and P. vivax are the most predominant epidemiologically. Malaria is transmitted when a competent vector, the different species of female anopheles mosquitoes, take a blood meal from somebody already infected with malaria.

About 400 species of Anopheles mosquitoes have been described and approximately 30 of these species are potential vectors of malaria that affect humans.Malaria is the world’s most deadly and life-threatening parasitic disease.

PDF LINK

Promoting Palliative Care to Cancer Patients in the Republic of Kazakhstan

The 400-Year Quest for a Good Death , [1] Harold Vanderpool traces the emergence of medical palliation to a proclamation by Sir Francis Bacon in 1605 challenging physicians to offer and continually improve palliative medical care and treatment for dying persons.

Florence Nightingale also contributed significantly to the evolution of what we call palliative care today, although the period of 1895 to 1959 – a time of great advances in medicine – unfortunately led to less appropriate care for the dying, though it contributed to discussions about the ethics of treating the dying. The following period (1960-1981) is described as a time of momentous transition.

The influence of Elisabeth Kübler-Ross and Cicely Saunders emerged, solidifying palliative care concepts in the US and UK, and thereafter worldwide. In 2015 the WHO added palliative care to its family of factsheets for the first time. To date, however, palliative care is largely absent from the global health dialogue and consequently is not practiced in most of the developing world, even though cancer is a leading cause of morbidity and mortality worldwide.

PDF LINK

Endoscopic Repair of Carotid Artery Injury

Intraoperative injury to the Internal Carotid Artery (ICA) during Endoscopic Endonasal Surgery (EES) of the skull base is a rare and well recognized complication which can potentially be associated with high rates of morbidity and mortality. In the event of a traumatic injury to the ICA during EES, hemorrhage might be massive, difficult to control as the access to the sphenoid sinus is limited and the visual field becomes quickly obscured. Bleeding from this vital artery can become lethal within minutes and even when the bleeding is controlled, permanent neurological deficits frequently persist. 

According to the literature, the risk for injury to the ICA following endoscopic tumor resection is around 1%. Many techniques have been developed to manage ICA injury including controlled hypotension, ipsilateral and contralateral neck pressure, proximal control through neck dissection and distal control, with varying degrees of success.

A 57 years old otherwise healthy woman was referred to our institution due to complaints of intense headaches, speech difficulties and dysphagia for 2 weeks. At physical examination the patient demonstrated slurred speech with tongue deviation towards the left. Neck examination and endoscopic flexible fiber optic were normal, and no other neurological deficits were observed.

The operation was performed under general anesthesia using an intraoperative frameless navigation. The surgery was conducted under electrophysiological monitoring. After inferior turbinate lateralization, middle turbinectomy, middle antrostomy, anterior and posterior ethmoidectomy, posterior septectomy and elevation of a nasoseptal flap, the tumor was exposed in the sphenoid sinus. Using a high speed coarse drill, the rostrum and clival tumor extensions were drilled out. The anterior wall of the sphenoid sinus was removed in order to provide a better access.