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Self-expandable metallic stents (SEMS) have been widely used in adults to relieve obstruction secondary to colorectal tumours. However, there is a paucity of literature about their use in children, with only a few case reports describing stent insertion in children with benign colonic conditions. There is one case report on a malignant colonic condition in a child by Hussain et al. in the literature. However, due to the rarity of the condition, there are currently no guidelines from learned societies on colorectal SEMS placement in paediatric patients. We share our experience of using a fully covered SEMS to relieve malignant colonic obstruction in a 6 year-old-child, who was on treatment for T cell lymphoma. This was done as a bridge to surgery, thereby allowing planned surgery, and avoiding colostomy in this child, who went on to have colonic resection with primary anastomosis. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a rare disorder most commonly involving skin, bone and lung. The gastrointestinal tract (GIT) is an uncommon site of disease and only a handful of case reports exist. We present a case of a 15-year old boy with treated LCH involving the skin, bones, central nervous system (CNS) and pituitary gland. He presented with rectal bleeding and on investigation was found to have a single rectal polyp which was confirmed histologically and immunologically to be LCH. Further investigation revealed no other foci of disease. [ABSTRACT FROM AUTHOR]

Background: Self-expandable metallic stents have not only largely replaced surgical gastrojejunostomy for unresectable gastric cancers, but their role as bridging therapy for resectable obstructing tumours is also evolving. Objective: To evaluate the efficacy and safety of pyloric stents in gastric outlet obstruction in patients with gastric cancer and assess survival in patients with resectable obstructing gastric tumours in whom stents were inserted as a bridge to surgery. Methods: We retrospectively reviewed the electronic medical records of patients who underwent self-expandable metallic stent insertion for gastric outlet obstruction due to gastric cancer from January 2014 to March 2019. Results: Out of 161 patients, clinical improvement was observed in 159 (99%) and 156 (97%) at 1 and 12 weeks of stent placement, respectively. None of these patients experienced serious complications, such as perforation or aspiration pneumonia. Of these 161 patients, enteral stents were placed as bridging therapy prior to surgery in 40 (24.8%). Among these, 35 (87.5%) of 40 underwent neo-adjuvant chemotherapy followed by curative surgery. Of the 35 patients, 3 failed to follow-up. One-year survival following curative surgery was 87.5%. Stent helped to reduce vomiting and improve nutrition, measured by the body mass index (p = 0.36) and serum albumin (p = 0.05), over a 4-week period following stent insertion. Conclusion: Pyloric stents are useful in relieving malignant gastric outlet obstruction, maintaining nutrition during neo-adjuvant treatment and improving survival without additional risk of postoperative complications. They have traditionally been used for palliation, but should also be considered as bridging therapy for obstructing resectable gastric tumours during neo-adjuvant treatment. [ABSTRACT FROM AUTHOR]

Surgical robots are safety-critical devices that require multiple domains of safety features. This article focuses on the passive gravity compensation design optimization of a surgical robot. The limits of this optimization are related with the safety features including minimization of the total moving mass/inertia and compactness of the design. The particle swarm optimization method is used as a novel approach for the optimization of a parallel remote-center-of-motion mechanism. A compact design is achieved by partially balancing the mechanism, which also decreases the torque requirements from the actuators. [ABSTRACT FROM AUTHOR]

The article discusses the medical case of a 16-year-old woman who sustained hypertension during her pregnancy. Base on the clinical examinations conducted, hypertension was caused by coarctation of the aorta, which is an unusual cause, hence, the commonest cause of hypertension in pregnancy is preeclampsia. The maternal mortality rate of coarctation is 3-8%, but in the case of the patient, the risk of fetal and maternal morbidity and mortality is high, due to severe pregnancy-induced hypertension in the 3rd trimester and the tight coarctation.