Volume 5 Issue 4, April 2008

The consumption of fish that are high in omega-3 fatty acids has been shown to have cardioprotective benefits; however, these benefits are tempered by the risk of mercury poisoning. This Viewpoint article discusses the benefits and potentially harmful effects of a fish diet, and considers the amount and type of fish that should be consumed to obtain the most benefit with the least risk of toxicity.

Childhood obesity is at epidemic proportions globally and its management is controversial. This Viewpoint considers the role of surgery for pediatric extreme obesity and the prevalence of this type of bariatric surgery. Guidelines for the use of bariatric surgery, clinical outcomes, and future research avenues are also discussed.

Functional vomiting, cyclic vomiting syndrome and chronic idiopathic nausea are fairly rare but highly disabling disorders. Although there is a dearth of randomized, controlled treatment trials for these disorders, interest in their etiology and treatment is increasing. In this Review, the authors consider the nomenclature, pathophysiology, clinical presentation and management of these functional gastroduodenal disorders, with a particular focus on cyclic vomiting syndrome.

Liver transplantation is a successful treatment for selected patients with end-stage liver disease and is unrivalled amongst other forms of solid organ transplantation in the ability of the recipient to develop long-term tolerance to the allograft. In this Review, the authors consider work that has highlighted the mechanisms underpinning liver allograft tolerance. In particular, the emerging role of regulatory T cells (T_REGS) is emphasized, along with the relative impact of current immunosuppressive therapies.

This article considers the case of a 22-year-old female with congenital disorder of glycosylation type Ib and a history of congenital hepatic fibrosis, portal hypertension and esophageal varices, who presented with edema, diarrhea, hypoalbuminemia and pancytopenia. Protein-losing enteropathy was diagnosed. As previous mannose therapy was associated with diarrhea and abdominal pain, albumin was infused followed by intravenous and subcutaneous therapy with unfractionated heparin.

This Case Study discusses a 57-year-old male diagnosed with an aortoenteric fistula secondary to aortic graft surgery. The case highlights the importance of performing multidetector CT as soon as possible in patients who are suspected to have this condition so a quick diagnosis can be made.