HighlightsTorsion of wandering spleen is a rare but important differential diagnosis in patients presenting with acute abdomen.It’s diagnosis should be made promptly before development of life-threatening complications.The best method of confirming the diagnosis is by a CT scan however, Doppler US imaging is an equally helpful modality.Detorsion and splenopexy can be done when spleen is viable. When there is infarction spleen, splenectomy is necessary.

Objective: To evaluate the effect of caffeine on white cell distribution and muscle injury markers in professional soccer players during exercise. Methods: 22 male athletes completed a placebo controlled double blind test protocol to simulate a soccer match, followed by a Yo-Yo intermittent recovery test. Results: Exercise caused an increase in packed cell volume that was enhanced by caffeine. Caffeine and exercise had a synergistic effect on the blood lymphocyte count, which increased by about 38% after exercise, and by an additional 35% when combined with caffeine. Caffeine promoted an exercise independent rise in circulating monocytes, and a synergistic action of exercise and caffeine was observed on segmented neutrophils. Caffeine promoted thrombocytosis. Plasma adenosine deaminase, aspartate aminotransferase, and lactate dehydrogenase concentrations were enhanced by exercise, and alanine transaminase concentration was enhanced in both groups, with a synergistic effect of caffeine. Conclusions: The pronounced increase in the white cell count in the group receiving caffeine appeared to be caused by greater muscle stress and consequently more intense endothelial and muscle cell injury. The use of caffeine may augment the risk of muscle damage in athletes.

Biliary atresia (BA) is a rare but potentially devastating disease. The European Biliary Atresia Registry (EBAR) was set up to improve data collection and to develop a pan-national and interdisciplinary strategy to improve clinical outcomes. From 2001 to 2005, 100 centers from 22 countries registered with EBAR via its website (www.biliary-atresia.com). In June 2006, the first meeting was held to evaluate results and launch further initiatives. During a 5-year period, 60 centers from 19 European countries and Israel sent completed registration forms for a total of 514 BA patients. Assuming the estimated incidence of BA in Europe is 1:18,000 live births, 35% of the expected 1488 patients from all EBAR participating countries were captured, suggesting that reporting arrangements need improvement. At the meeting, the cumulative evaluation of 928 BA patients including patients from other registries with variable follow-up revealed an overall survival of 78% (range from 41% to 92%), of whom 342 patients (37%) have had liver transplants. Survival with native liver ranged from 14% to 75%. There was a marked variance in reported management and outcome by country (e.g., referral patterns, timing of surgery, centralization of surgery). In conclusion, EBAR represents the first attempt at an overall evaluation of the outcome of BA from a pan-European perspective. The natural history and outcome of biliary atresia is of considerable relevance to a European population. It is essential that there is further support for a pan-European registry with coordination of clinical standards, further participation of parent support groups, and implementation of online data entry and multidisciplinary clinical and basic research projects.

Our data suggest that caffeine might decrease systemic urea by decreasing the glutamine serum concentration, which decreases the transportation of ammonia to the liver and thus urea synthesis.

The glycoprotein 130 (gp130) dependent family of cytokines comprises interleukin-6 (IL-6), IL-11, leukemia inhibitory factor (LIF), cardiotrophin-like cytokine (CLC), ciliary neurotrophic factor (CNTF), cardiotrophin-1 (CT-1) and oncostatin M (OSM). These cytokines share the membrane gp130 as a common signal transducer. Recently, it was demonstrated that IL-6 promotes, whereas LIF inhibits fetal lung branching. Thus, in this study, the effects on fetal lung morphogenesis of the other classical members of the gp130-type cytokines (IL-11, CLC, CNTF, CT-1 and OSM) were investigated. We also provide the first description of these cytokines and their common gp130 receptor protein expression patterns during rat lung development. Fetal rat lung explants were cultured in vitro with increasing concentrations of IL-11, CLC, CNTF, CT-1 and OSM. Treated lung explants were morphometrically analyzed and assessed for MAPK, PI3K/AKT and STAT3 signaling modifications. IL-11, which similarly to IL-6 acts through a gp130 homodimer receptor, significantly stimulated lung growth via p38 phosphorylation. On the other hand, CLC, CNTF, CT-1 and OSM, whose receptors are gp130 heterodimers, inhibited lung growth acting in different signal-transducing pathways. Thus, the present study demonstrated that although cytokines of the gp130 family share a common signal transducer, there are specific biological activities for each cytokine on lung development. Indeed, cytokine signaling through gp130 homodimers stimulate, whereas cytokine signaling through gp130 heterodimers inhibit lung branching.