Economic impact of childhood obesity on health systems: a systematic review

The primary purpose of this study is to analyse the costs related to childhood obesity (CO) with reference to different models of healthcare systems. A systematic review of the economic impact of CO on healthcare systems was conducted by searching the main electronic scientific databases. Cost-of-illness (COI) analyses of children aged under 18 years who had been diagnosed as overweight or obese published up to July 2010 were considered. Short- and long-term consequences of CO were taken into account. In order to appraise the quality of the included studies, the British Medical Journal referees' checklist was used. About 3,844 COI analyses were initially found and 10 were finally considered in the current review: two studies referred to Beveridge and eight referred to Voluntary health insurance models. No studies have been conducted within a Bismarck model. Six studies considered in-patient costs, four studies estimated outpatient and primary care costs and seven studies considered pharmaceutical costs. The average quality of the included analyses was medium. The analysis confirmed the significance of CO related costs and the heterogeneity among available studies, which made it impossible to compare the different healthcare models.

A rare case of retrocaval ureter associated with persistent left vena cava

We report a rare case of a retrocaval ureter associated with a left inferior vena cava transposition and with concomitant nephrolithiasis in a young woman already surgically treated during her first years of life for cardiovascular disease. Diagnosis and surgical procedure are described, including the use of a flexible ureterorenoscope to facilitate kidney stone removal.

Surface properties of Ascaris suum eggs: hydrophobic potential and Lewis acid-base interactions

The cell surface properties of Ascaris suum eggs were investigated to determine the hydrophobic properties of eggs of different origins. Hydrophobic potential measurements were based on adhesion to hydrocarbons. Freshly laid eggs with or without the external coat and eggs that had been stored for 3 months at -20 degrees C were tested. The hydrophobic potential differed according to the hydrocarbon used (hexadecane or octane) and the eggs tested (stored or fresh). The hydrophobic potential with octane was 95% for fresh eggs and 72% for eggs stored at -20 degrees C. Tests with Ascaris eggs with and without an external coat showed similar hydrophobic characteristics; the presence or absence of this external structure did not appear to influence hydrophobic interactions. Acidic interactions also appeared to play no part in the adhesion of eggs to the surface of octane emulsions.

The effect of liming on the microbiological quality of urban sludge

Treatments applied to sludge in order to stabilise and dehydrate them may give notable inactivation of microorganisms. This is observed when sludge is exposed either to high temperature or drastic pH when residual sludge is limed. The control of virological, parasitological and bacteriological sludge quality by detecting pathogenic microorganisms is slow and too expensive to be commonly practised. Thus, it is possible to replace pathogenic microorganisms detection by that of contamination indicators. The aim of this study was to determine the influence of liming on the behaviour of pathogenic microorganisms detected in urban sludge. The detection of Salmonella and helminth eggs was carried out in liquid sludge (2-3% dryness) and solid sludge (23% dryness) with added lime (0-45% weight/dry weight) and stored for 24 h-46 weeks. The results showed that liming modified some characteristics such as temperature, dryness and pH of the sludge. It appeared that, whatever the percentage of added lime, the temperature of liquid sludge did not change while it increased by about 9 degrees C when 30-45% lime was added to solid sludge. In the same way, the dryness of liquid sludge did not change during the liming, whereas the dryness of 45% limed solid sludge increased from 23% to 31%. Finally, 15%, 30% and 45% liming gave a pH of at least 10, 11.5 and 12, respectively, although the pH increase depended on the sludge type. The efficiency of liming was considered to be related to the pH and not to the percentage of added lime. Three factors determined the efficiency of pathogen elimination: (a) the pH reached by the sludge, (b) the period of liming activity and (c) the dryness of the sludge. Salmonella were eliminated from liquid sludge in 24 h at pH 10.7 and from solid sludge in 24 h at pH 10.0. Viable helminth egg concentration decreased to 3 eggs/10 g DM in liquid sludge in 14 d at pH 11.9 and 60 d at pH 11.6. In solid sludge, egg reduction was achieved in 24 h at pH 12.5, 7 d at pH 12.0 and 14 d at pH 11.5. From this study, it appeared that liming resulted in a much better microbiological quality of liquid sludge if its pH was maintained at 11.6 over 60 d or at pH 11.9 for 14 d. Solid sludge needed to be maintained at pH 11.5 for 14 d, pH 12.0 for 7 d or pH 12.5 for 24 h to achieve similar results.

Endourological treatment of large neoplasm in the lower tract of the ureter

Conservative endourological treatment of transitional cell carcinoma of renal pelvis and ureter is controversial. The treatment should be reserved for selected cases and for low grade, low stage, monofocal tumors. Personal experience with endourological treatment of a transitional cell carcinoma of the lower tract of the ureter is presented.

Cystic neuroendocrine retroperitoneal carcinoma

Retroperitoneal tumors are rare. Most of these tumors arise from mesothelial or connective tissues in the retroperitoneum. We report the first case, for us, of a cystic neuroendocrine retroperitoneal carcinoma in a 71-year-old woman. The discussion is focused on the radiographic findings, immunohistochemical studies and the controversial diagnosis.