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espanolLa enfermedad de Hirschsprung es un trastorno congenito, caracterizado por la ausencia de celulas del sistema nervioso enterico en la parte mas distal del intestino, cuya manifestacion clinica mas frecuente es el retraso de la salida del meconio. Hay varias formas de presentacion de la enfermedad, siendo la mas frecuente la rectosigmoidea. La historia clinica, el examen fisico, el enema de contraste y la radiografia de abdomen son utiles para orientar la sospecha diagnostica, pero el diagnostico definitivo se realiza mediante la toma adecuada de biopsias. El tratamiento de la enfermedad sin asociacion de complicaciones es principalmente quirurgico y la tecnica de eleccion dependera de la forma de la enfermedad. EnglishHirschsprung's disease is a congenital disorder, characterized by the absence of cells of the enteric nervous system in the most distal part of the intestine, the most frequent clinical manifestation of which is the delay in the exit of meconium. There are several forms of presentation of the disease, the most frequent being the rectosigmoid variant. The clinical history, physical examination, contrast enema, and abdominal radiography are useful to guide the diagnostic suspicion, but the definitive diagnosis is made by taking adequate biopsies. The treatment of the disease without association of complications is mainly surgical and the technique of choice will depend on the form of the disease.

Accessibility to immunohistochemistry (IHC) is invaluable to proper diagnosis and treatment of pediatric patients with malignant neoplasms. Whereas IHC is widely available in anatomic pathology laboratories in high-income countries, access to it in anatomic pathology laboratories of low- and middle-income countries remains a struggle, with many limitations. To advance the quality of the pathology service offered to children with cancer in areas with limited resources, a 5-day pathology training workshop was offered to pathologists and histotechnologists from various countries of the Central American and Caribbean region. An initial assessment of the workshop participants’ current laboratory capacities was performed, and a regional training center was selected. Didactic and hands-on activities were offered, and review and evaluation of the IHC slides produced during the training course were compared with original slides from the participants’ sites. This model of intensive 5-day training appears to be effective and can potentially be used in other budget-constrained regions. Moreover, it can serve as a continuing education activity for pathologists and histotechnologists, and as part of validations and quality improvement projects to build capacity and develop IHC assay proficiency in low- and middle-income countries.

Objectives We conducted a prospective randomized trial to compare the clinical impact of conventional risk factor modification to that associated with the addition of coronary artery calcium (CAC) scanning. Background Although CAC scanning predicts cardiac events, its impact on subsequent medical management and coronary artery disease risk is not known. Methods We assigned 2,137 volunteers to groups that either did undergo CAC scanning or did not undergo CAC scanning before risk factor counseling. The primary end point was 4-year change in coronary artery disease risk factors and Framingham Risk Score. We also compared the groups for differences in downstream medical resource utilization. Results Compared with the no-scan group, the scan group showed a net favorable change in systolic blood pressure (p = 0.02), low-density lipoprotein cholesterol (p = 0.04), and waist circumference for those with increased abdominal girth (p = 0.01), and tendency to weight loss among overweight subjects (p = 0.07). While there was a mean rise in Framingham Risk Score (FRS) in the no-scan group, FRS remained static in the scan group (0.7 ± 5.1 vs. 0.002 ± 4.9, p = 0.003). Within the scan group, increasing baseline CAC score was associated with a dose-response improvement in systolic and diastolic blood pressure (p Conclusions Compared with no scanning, randomization to CAC scanning was associated with superior coronary artery disease risk factor control without increasing downstream medical testing. Further study of CAC scanning, including pre-specified treatment recommendations, to assess its impact of cardiovascular outcomes is warranted. (Early Identification of Subclinical Atherosclerosis Using Non-Invasive Imaging Research [EISNER]; NCT00927693)

ObjectivesWe compared the prevalence and extent of coronary artery calcium (CAC) among persons with the metabolic syndrome (MetS), diabetes, and neither condition.BackgroundThe prevalence and extent of CAC has not been compared among those with MetS, diabetes, or neither condition.MethodsOf 1,823 persons (36% female) age 20 to 79 years who had screening for CAC by computed tomography, 279 had MetS, 150 had diabetes, and the remainder (n = 1,394) had neither condition. Metabolic syndrome was defined with ≥3 of the following: body mass index ≥30 kg/m2; high-density lipoprotein cholesterol 20% 10-year risk of CHD or CAC ≥75th percentile for age and gender. Risk factor-adjusted odds for the presence of CAC were 1.40 (95% confidence interval [CI] 1.05 to 1.87) among those with MetS and 1.67 (95% CI 1.12 to 2.50) among those with diabetes, versus those with neither condition.ConclusionsThose with MetS or diabetes have an increased likelihood of CAC compared with those having neither condition.

Beyond providing energy through its high starch content, the potato tuber can make a significant contribution to the dietary intake of certain minerals including potassium, phosphorous, magnesium and iron, as well as of vitamin C, dietary fibres and phenolic compounds. While some animal and human studies have shown beneficial associations between the consumption of potato, or some of its components, and health, some other studies could not confirm these positive effects. Numerous factors may indeed influence (i) the composition of the potato tuber itself, i.e. genotype, environmental conditions during growth, post-harvest storage conditions, cooking and processing, and (ii) the bioaccessibility and bioavailability of its components, affecting the final bioactivity. The purpose of this paper is to provide a brief overview of potato composition variability followed by an analysis of potential health-promoting effects and bioavailability of specific components including iron and phenolic compounds. It appeared that the various components of the potato matrix might interact with each other at the intestinal level, leading to favourable or detrimental effects on their bioavailability. The consumption of a potato cultivar with a high level of phenolic compounds may improve the health status of an individual regarding its risk of developing chronic diseases on the one hand, but may reduce iron absorption on the other hand, putting an individual at risk of micronutrient deficiency. Tailoring potato varieties or products to match the population nutritional needs appears therefore of major importance. © 2015 European Association for Potato Research