Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Textbook of Paediatrics

In recent years, the role of human microbiota as a short- and long-term health promoter and modulator has been affirmed and progressively strengthened. In the course of one's life, each subject is colonized by a great number of bacteria, which constitute its specific and individual microbiota. Human bacterial colonization starts during fetal life, in opposition to the previous paradigm of the "sterile womb". Placenta, amniotic fluid, cord blood and fetal tissues each have their own specific microbiota, influenced by maternal health and habits and having a decisive influence on pregnancy outcome and offspring outcome. The maternal microbiota, especially that colonizing the genital system, starts to influence the outcome of pregnancy already before conception, modulating fertility and the success rate of fertilization, even in the case of assisted reproduction techniques. During the perinatal period, neonatal microbiota seems influenced by delivery mode, drug administration and many other conditions. Special attention must be reserved for early neonatal nutrition, because breastfeeding allows the transmission of a specific and unique lactobiome able to modulate and positively affect the neonatal gut microbiota. Our narrative review aims to investigate the currently identified pre- and peri-natal factors influencing neonatal microbiota, before conception, during pregnancy, pre- and post-delivery, since the early microbiota influences the whole life of each subject.

https://www.mdpi.com/2075-1729/11/2/148/pdf

When a Neonate Is Born, So Is a Microbiota.

Intestinal barrier immaturity, or "leaky gut," is the proximate cause of susceptibility to necrotizing enterocolitis in preterm neonates. However, the impact of intestinal microbiota development on intestinal mucosal barrier maturation has not been evaluated in this population. In this study, we investigated a longitudinally sampled cohort of 38 preterm infants < 33 weeks gestation monitored for intestinal permeability (IP) and fecal microbiota during the first 2 weeks of life. Rapid decrease in IP indicating intestinal barrier function maturation correlated with significant increase in community diversity. In particular, members of the Clostridiales and Bifidobacterium were highly transcriptionally active, and progressively increasing abundance in Clostridiales was significantly associated with decreased intestinal permeability. Further, neonatal factors previously identified to promote intestinal barrier maturation, including early exclusive breastmilk feeding and shorter duration antibiotic exposure, associate with the early colonization of the intestinal microbiota by members of the Clostridiales, which altogether are associated with improved intestinal barrier function in preterm infants.

/pdf/microbial-biomarkers-of-intestinal-barrier-maturation-in-3tjhtam76j.pdf

Microbial Biomarkers of Intestinal Barrier Maturation in Preterm Infants.

All FY2011 data 1 Number of Ambulatory Care Units in which department participates 2 Includes non-operating revenue 3 Includes all gifts and endowments and is also included in " All Funds Revenue " above

[Physical medicine & rehabilitation].

From a public health perspective, substance abuse has long been a source of major concern, both for the individual’s health and for wider society as a whole. The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug (see the tables) (Nutt et al. (2007)). The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it: (1) the direct physical harm of the substance to the individual user, (2) the tendency of the drug to induce dependence, and (3) the effect of abuse of the drug on families, communities, and society (Gable (2004, 1993)). In this report, we discuss published evidence relating to the harm of substance misuse and consider the neuropsychopharmacological mechanisms behind addiction in an attempt to gain an improved picture of the potential devastation that abuse of these substances may evoke.

/pdf/the-destructive-capacity-of-drug-abuse-an-overview-exploring-1vi9swp0bs.pdf

The Destructive Capacity of Drug Abuse: An Overview Exploring the Harmful Potential of Drug Abuse Both to the Individual and to Society

Background. One of the most serious gastrointestinal disorders occurring in neonates is necrotising enterocolitis (NEC). It is recognised as the most common intra-abdominal emergency and is the leading cause of short bowel syndrome. With extremely high mortality and morbidity, this enigmatic disease remains a challenge for neonatologists around the world as its definite aetiology has yet to be determined. As current medical knowledge stands, there is no single well-defined cause of NEC. Instead, there are nearly 20 risk factors that are proposed to increase the likelihood of developing NEC. Aims and Objectives. The aim of this project was to conduct a comprehensive literature review around the 20 or so well-documented and less well-documented risk factors for necrotising enterocolitis. Materials and Methods. Searches of the Medline, Embase, and Science direct databases were conducted using the words “necrotising enterocolitis + the risk factor in question” for example, “necrotising enterocolitis + dehydration.” Search results were ordered by relevance with bias given to more recent publications. Conclusion. This literature review has demonstrated the complexity of necrotising enterocolitis and emphasised the likely multifactorial aetiology. Further research is needed to investigate the extent to which each risk factor is implicated in necrotising enterocolitis.

/pdf/what-really-causes-necrotising-enterocolitis-176bng2pbp.pdf

What Really Causes Necrotising Enterocolitis

We report the case of a 72-year-old woman suffering with severe plantar fasciitis who received a therapeutic corticosteroid injection. Two-and-a-half years after the injection she developed a small calcified lump under the skin which subsequently caused ulceration and infection. She went on to develop a diabetic foot infection requiring an extended course of intravenous antibiotics.

/pdf/plantar-fascia-calcification-a-sequelae-of-corticosteroid-39yh0tg36l.pdf

Plantar fascia calcification a sequelae of corticosteroid injection in the treatment of recalcitrant plantar fasciitis

We report the rare case of a 75-year-old man who was hospitalised following referral by his general practitioner with a 4-day history of worsening groin pain. Initial radiographs demonstrated an isolated avulsion fracture of the lesser trochanter. There were associated bony changes indicating pathological bone disease, likely secondary to bony metastasis. Further investigation revealed a renal mass almost certainly consistent with a renal cell carcinoma. This case emphasises the importance of having a high index of suspicion for neoplastic pathology when low impact injuries result in fractures.

https://casereports.bmj.com/content/casereports/2014/bcr-2013-202590.full.pdf

Lesser trochanter fracture: the presenting feature of a more sinister pathology

A 68-year-old man presented acutely with periorbital pain and proptosis of the right eye, on a background of generalised pain and weight loss Imaging showed bilateral signal abnormalities in the basal skull extending into the extraconal orbits with compression of the right optic nerve His medical history revealed symptoms in keeping with benign prostatic hypertrophy However, the prostate was irregular on rectal examination and prostate-specific antigen was markedly raised at 1880 ng/dl A provisional diagnosis of metastatic prostatic carcinoma was made based on the clinical and radiological picture This was later confirmed to be metastatic adenocarcinoma through means of tissue diagnosis

/pdf/unilateral-proptosis-an-unusual-presentation-of-prostatic-2k3fgwpu4s.pdf

Unilateral proptosis: an unusual presentation of prostatic carcinoma

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