Fecal calprotectin and lactoferrin are useful triage tools to differentiate organic intestinal disorders from functional disorders. They also have a role in monitoring inflammatory bowel disease activity and predicting relapse.
Background -The effect on subsequent respiratory function of spinal stabilisation for scoliosis in Duchenne muscular dystrophy is unclear. In order to clarify this clinical problem, changes in the forced vital capacity of a group of children with Duchenne muscular dystrophy who had undergone spinal surgery were measured and compared with a group of children with Duchenne muscular dystrophy who had not had surgery. Methods -In this retrospective study 17 boys with Duchenne muscular dystrophy who underwent spinal stabilisation at a mean age of 14-9 years (surgical group) were compared with 21 boys with Duchenne muscular dystrophy who had not had surgery (non-surgical group). The mean (SD) Cobb angle of the surgical group at 14-9 years was 57 (16.4)0, and of the non-surgical group at 15 years was 45 (29.9)°. Forced vital capacity expressed as percentage predicted (% FVC) was measured in total over a seven year period in the surgical group and over 6 5 years in the non-surgical group, and regression equations were calculated. Survival curves for both groups were also constructed. Results -No difference was found between spinal stabilisation (surgical group) and the non-surgical group in the rate of deterioration of % FVC which was 3-5% per year. There was no difference in survival in either group. Conclusions -Spinal stabilisation in Duchenne muscular dystrophy does not alter the decline in pulmonary function, nor does it improve survival.
Mesenteric angiography for lower gastrointestinal bleeding effectively identifies the site of bleeding in 48% of patients and allows embolization in 45%. Embolization achieves clinical success in 76% of patients but repeat embolization is associated with a high rate of complications.
In adolescent idiopathic scoliosis, neither the presentation with a stable spinal deformity, nor presentation with a severe deformity requiring surgery is associated with melatonin deficiency.
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