Role of Nose to Pelvis Imaging in the Evaluation of Foreign Body Ingestion: A Case of Magnet Ingestion in a 2-Year-Old

Foreign body ingestion (FBI) of small-rare-earth-magnets (SREM) sets are associated with high morbidity and mortality, as these tend to cause significant mucosal injury. Current clinical guidelines for the evaluation of FBI do not include imaging of the nose and neck. A 2-year-old patient presented with known SREM ingestion, with location confirmed in the right lower quadrant on imaging at the time of initial evaluation. Subsequent imaging involving the neck revealed additional magnets lodged in the patient's hypopharynx, which were missed on initial evaluation. This case highlights the importance of considering advanced imaging of the nose and neck to uncover extraintestinal foreign bodies.

The biodiversity of species and their rates of extinction, distribution, and protection

Recent studies clarify where the most vulnerable species live, where and how humanity changes the planet, and how this drives extinctions. We assess key statistics about species, their distribution, and their status. Most are undescribed. Those we know best have large geographical ranges and are often common within them. Most known species have small ranges. The numbers of small-ranged species are increasing quickly, even in well-known taxa. They are geographically concentrated and are disproportionately likely to be threatened or already extinct. Current rates of extinction are about 1000 times the likely background rate of extinction. Future rates depend on many factors and are poised to increase. Although there has been rapid progress in developing protected areas, such efforts are not ecologically representative, nor do they optimally protect biodiversity.

The prevalence of abnormal metabolic parameters in obese and overweight children

BACKGROUND

This retrospective study aimed to determine the prevalence of abnormal metabolic parameters in obese children and its correlation to the degree of obesity determined by body mass index (BMI).

METHODS

In total, 101 children seen at the Pediatric Gastroenterology Obesity Clinic at Stony Brook Children's University Hospital were enrolled in the study. The degree of obesity was characterized according to the following formula: (patient's BMI/BMI at 95th percentile) × 100%, with class I obesity >100%-120%, class II obesity >120%-140%, and class III obesity >140%. A set of metabolic parameters was evaluated in these patients. Frequency distributions of all study variables were examined using the χ(2) test of independence. Mean differences among the obesity classes and continuous measures were examined using 1-way analysis of variance.

RESULTS

Within our study population, we found that 80% of our obese children had a low high-density lipoprotein (HDL) cholesterol level, 58% had elevated fasting insulin levels, and 32% had an elevated alanine aminotransferase (ALT) level. Class II obese children had a 2-fold higher ALT value when compared with class I children (P = .036). Fasting insulin, ALT, HDL cholesterol, and triglyceride levels trended with class of obesity.

CONCLUSION

Obese children in classes II and III are at higher risk for developing abnormal laboratory values. We recommend obese children be further classified to reflect the severity of the obesity since this has predictive significance for comorbidities. Obesity classes I, II, and III could help serve as a screening tool to help communicate risk assessment.

Prospects for monitoring freshwater ecosystems towards the 2010 targets

Human activities have severely affected the condition of freshwater ecosystems worldwide. Physical alteration, habitat loss, water withdrawal, pollution, overexploitation and the introduction of non-native species all contribute to the decline in freshwater species. Today, freshwater species are, in general, at higher risk of extinction than those in forests, grasslands and coastal ecosystems. For North America alone, the projected extinction rate for freshwater fauna is five times greater than that for terrestrial fauna--a rate comparable to the species loss in tropical rainforest. Because many of these extinctions go unseen, the level of assessment and knowledge of the status and trends of freshwater species are still very poor, with species going extinct before they are even taxonomically classified. Increasing human population growth and achieving the sustainable development targets set forth in 2002 will place even higher demands on the already stressed freshwater ecosystems, unless an integrated approach to managing water for people and ecosystems is implemented by a broad constituency. To inform and implement policies that support an integrated approach to water management, as well as to measure progress in halting the rapid decline in freshwater species, basin-level indicators describing the condition and threats to freshwater ecosystems and species are required. This paper discusses the extent and quality of data available on the number and size of populations of freshwater species, as well as the change in the extent and condition of natural freshwater habitats. The paper presents indicators that can be applied at multiple scales, highlighting the usefulness of using remote sensing and geographical information systems technologies to fill some of the existing information gaps. Finally, the paper includes an analysis of major data gaps and information needs with respect to freshwater species to measure progress towards the 2010 biodiversity targets.