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Query: UMLS:C0019270 (hernia)
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Even in endemic zones, congenital malaria, first described in 1876, is rarely encountered. The incidence has greatly increased however over the last 10 years suggesting several diagnostic problems. We observed a case of infected twins born to an asymptomatic mother which would throw some light on the pathophysiology involved in congenital transmission. A 2-month old infant was hospitalized for surgical cure of an umbilical hernia. Haemolytic anaemia (6.3 g/dl) and fever (39 degrees C) were observed during the postoperative period. A wide spectrum antibiotherapy was prescribed but the temperature remained at 39 degrees C. A blood swab cultured one week after the operation revealed Plasmodium falciparum. The infant's twin sister was in apparently good health but was also found to be anaemic (6.1 mg/dl Hg) and a blood sample was positive for P. falciparum. For the mother, the search for parasites was negative. Serology tests performed at diagnosis revealed anti-P. falciparum antibodies at 1/1600, 1/3200 and 1/6400 in the infant, his twin sister and the mother. Outcome was favourable. The mother had arrived in France from Togo 14 months earlier and had not returned to an endemic zone. She had had frequent episodes of fever in Togo and had taken quinine, but no episode of fever had occurred during the pregnancy or delivery. This twin case of vertical mother-infant transmission is the equivalent to transfusional malaria since red cells pass the placental barrier near the end of pregnancy, even when no placental lesion exists. Congenital transfusional malaria must however be dissociated from congenital infective malaria resulting from early primoinfection in endemic areas.
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PMID:[Congenital malaria. A case observed in twins born to an asymptomatic mother]. 807 37

During his life in the army in 1252 - 1261, Luo Tianyi wrote down case records taken from his patients, including soldiers, military officials and their relatives. In addition to infectious diseases such as malaria, dysentery, vomiting and diarrhea and seasonal epidemics, he also treated psychosis, digestive disorders, cold damage, beriberi, coughing and cold in the legs and external diseases such as eye diseases, boils and carbuncles, hernia. The therapeutics he applied included recipes, pills, powders, pastes as well as acu - moxibustion.
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PMID:[Effective case records of Luo Tianyi in the army as recorded in Wei Sheng Bao Jian (hygienic precious minor)]. 1162 77

At the Hospital in Lund a new central building was opened in 1850 bringing the total number of beds up to 150. In the same year the hospital was divided into one "External" department including surgery and the maternity ward and one "Internal" including medicine and the ward for venereal diseases. We reviewed the patient charts and the yearly reports from 1851 to 1860 including 40 autopsy reports from this period. During these years, 8,785 patients were admitted, 2,292 of these for syphilis. Mean hospitalization time in the surgical department was 55-60 years, average 35-45 days, in the medical department a mean of around 45 days. The longest hospital stay was 350-900 days, mostly for patients with joint diseases, probably mainly tuberculosis. The number of patients admitted each year, the number of hospital days, age distribution of the patients and costs are presented in diagrams. The mean age of the patients was around 28 years, and the largest 5-year group was 16-20 years. Syphilis, various manifestations of tuberculosis and different kinds of diffuse gastric trouble were dominating diagnoses. Infectious diseases were common and serious during these years, but only very few patients, apart from the diagnoses mentioned above, were admitted to the hospital. Chlorosis, anaemia and rheumatic disorders were common. Hirudines, cupping, in some cases venesection or cauterization, locally irritating cataplasms, laxatives and enemas were dominating parts of the therapeutic resources. The operative activity was very moderate, only a total of 275 operations were performed for incarcerated hernia, stone, cataract, external tumour and injuries. Medical drugs were collected mostly from plants but various preparations of iron, mercury and lead and their salts were also frequently used. Quinine was the only drug for fevers, not only for malaria,. Several lay "bonesetters" were active in the area, the best known of whom, belonging to a family active for 200 years, were mentioned with some criticism in a few patient charts. Clinical education for the medical students was conducted by A.S. Bruzelius, director of the "Institutum Clinicum", and the professors of surgery and medicine had only limited access to inpatients for their teaching. In 1850, Bruzelius was relieved from the teaching of internal medicine, and this became the reason to divide the hospital into the two departments. The organization of medical education in Sweden was much discussed during most of last century after the Karolinska Institute in Stockholm was opened in 1812 as an addition to the universities in Uppsala and Lund. In 1859 a committee suggested that, since the number of patients available for the medical students in Uppsala and Lund (which we can verify for Lund) were very modest compared to the hospitals in Stockholm, all medical education should be concentrated to one medical school in Stockholm. Fortunately, it all ended with a compromise. Otherwise, the two universities might have been closed completely, since the faculties of medicine were very important parts of the universities of this time.
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PMID:[The hospital in Lund during the 1850's]. 1163 43

Adriaan van den Spiegel (1578-1625) was a Flemish anatomist and physician. He was one of the most prominent anatomists at the University of Padua during the 17th century and became professor of anatomy and surgery there in 1619. He was privileged to have two of the most accomplished anatomists of that period, Fabricius ab Aquapendente and Iulius Casserius, as his teachers. His anatomical works were published after his death by his pupil Bucretius and his son-in-law Liberalis Crema, with illustrations procured from Casserius's unpublished anatomical atlas. He contributed significantly to establishing basic morphological facts about the developing embryo in his text De formato foetu liber singularis. In his book De humani corporis fabrica libri decem, Spiegel's lobe (caudate lobe) of the liver and the linea semilunaris (Spiegel's line) on the lateral side of the rectus abdominis muscle were described for the first time. Subsequently, Spigelian aponeurosis (between the lateral margin of the rectus abdominis and the linea semilunaris) and Spigelian hernia (lateral ventral hernia) were named after him. He was a renowned physician in his time and was the first to give a detailed description of malaria. He made significant contributions as a botanist: the genus Spigelia, which has six species, is named after him.
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PMID:Adriaan van den Spiegel (1578-1625): anatomist, physician, and botanist. 2481 Dec 38