Bronchial stump reinforcement with an azygous vein flap

Bronchial stump reinforcement has been shown to significantly reduce the incidence of bronchopleural fistulas. Various coverage techniques have been described in the literature. While the azygous vein flap is an easy, safe and effective reinforcement option for right-sided bronchial stumps, the flap is not widely adopted, with little mention in the literature, partly due to surgeons' uneasiness with the technique. In this report, we describe an easy-to-adopt approach to azygous vein bronchial reinforcement

Novel thoracoscopic approach to posterior mediastinal goiters: report of two cases

Trans-cervical resection of posterior mediastinal goiters is usually very difficult, requiring a high thoracotomy. Until recently, using conventional video-assisted thoracoscopic surgery to resect such tumors has been technically difficult and unsafe. By virtue of 3 dimensional visualization, greater dexterity, and more accurate dissection, the Da Vinci robot, for the first time, enables a completely minimally invasive approach to the posterior superior mediastinum

Toward a Multidisciplinary Strategy for the Classification and Reuse of Iron and Manganese Mining Wastes

The aim of this paper is to evaluate an integrated multidisciplinary strategy for the characterization of mining waste, their possible recycling and reuse. The use of Fe-Mn rich wastes in arsenic removal and phosphorus recovery from water and the phytoextraction potential of metals and their possible recovery from biomass are evaluated

Indagine ambientale nei pressi di un impianto di discarica

La presente tesi di laurea ha come obiettivo l’analisi delle matrici ambientali (13 campioni di acque superficiali, 6 di suoli e 5 di sedimenti) campionate nella zona circostante la discarica “Tre Monti” di Imola e il materiale di ricoprimento dei rifiuti, al fine di confrontare i risultati ottenuti con le normative relative allo stato di qualità ambientale e con i risultati ottenuti da altri studi eseguiti nella zona. Le attività principali sono state la pianificazione dell’indagine, il campionamento, il trattamento in preparazione alle analisi, le analisi, l’elaborazione dei risultati e loro discussione. Per le acque superficiali sono stati registrati in campo diversi parametri chimici e in laboratorio sono state sottoposte ad analisi con spettrofotometro, cromatografo ionico, FAAS e GFAAS. Suoli, sedimenti ed eluato del materiale di ricoprimento sono stati sottoposti ad analisi FAAS e GFAAS. Suoli, sedimenti e ricoprimento sono stati inoltre sottoposti ad analisi XRF e LOI. Le analisi FAAS e GFAAS in tutti i casi sono state applicate per la definizione delle concentrazioni degli elementi metallici principali. Per suoli e sedimenti, sono stati osservati alcuni superamenti delle CSC previste dalla normativa. Dal confronto con gli altri studi, per i suoli e per le acque si è osservata una generale concordanza, mentre le concentrazioni dei sedimenti presentano differenze anche significative. Infine, le analisi svolte sul materiale di ricoprimento hanno permesso la sua caratterizzazione dal punto di vista chimico, e dal confronto dei risultati ottenuti dall’analisi sull’eluato con i limiti normativi è stato possibile osservare un unico superamento

Scrivere a scuola. Analisi di alcuni testi salentini del XIX sec.

Il contributo riguarda la lingua scritta nella scuola elementare e superiore alla fine dell''800. Si basa sull'analisi di un corpus di elaborati scritti di una scuola salentina

Tibial bypass for limb salvage using polytetrafluoroethylene and a distal vein patch

Objective: Tibial artery bypass for limb salvage may be required in patients without adequate autogenous vein. The interposition of venous tissue at the distal anastomosis has been advocated to improve the results of prosthetic grafts to tibial arteries. Having reported on technical feasibility and an early experience with polytetrafluoroethylene (PTFE) and a distal vein patch (DVP), we examine the results of this technique with 4-year follow-up. Methods: From July 1993 to July 1999, 514 tibial bypass grafts were performed, with 80 bypass grafts in 79 patients with PTFE/DVP as the conduit. Patient demographics included 39 men and 40 women (mean age, 67 years); 42 had diabetes mellitus (53%), 16 had renal failure (20%), and 48 had Eagle criteria for increased cardiac risk (60%). Indications for revascularization were rest pain in 39 (49%) and tissue loss in 41 (51%). Lack of adequate vein resulted from previous failed lower extremity bypass graft (47 [59%]), previous coronary bypass graft (21 [26%]), unsuitable vein (8 [ 10%]), and absent vein due to ligation and stripping (4 [5%]). Follow-up ranged from 1 to 48 months. Results are reported as primary patency or limb salvage ± SE. Results: Bypass grafts originated from the common femoral artery (40 [50%]), the superficial femoral artery (6 [8%]), and the external iliac artery (34 [43%]). Recipient arteries included anterior tibial (17 [21%]), posterior tibial (28 [35%]), and peroneal (35 [44%]). Four-year primary patency and limb salvage rates were 62.89% ± 10.6% and 79.21% ± 8.45%, respectively. There was a 24% mortality rate during the follow-up period. Acute failure occurred in 7 grafts with 5 immediate amputations and 2 revisions. A total of 17 grafts failed during the follow-up period, leading to 11 amputations. Conclusion: The DVP technique allows PTFE bypass grafts to tibial arteries with acceptable long-term patency and limb salvage

Spontaneous pneumomediastinum: diagnostic and therapeutic interventions

Abstract Objectives The objective of this case series is to review our experience with spontaneous pneumomediastinum, review the available literature, and refine the current clinical approach to this uncommon condition. Methods The case notes of all patients admitted to the George Washington University Medical Center with spontaneous pneumomediastinum from April 2005 to June 2008 were retrospectively reviewed, indentifying seventeen patients on whom various data was collected and analyzed. Results The typical patient is a young man. The commonest presenting complaint is chest pain. Odynophagia and subcutaneous emphysema are common. Leucocytosis is uncommon. The need for swallow studies, antibiotics, and prolonged hospitalization is uncommon. Most patients have no recurrences or sequelae on long-term follow-up. Conclusion Spontaneous pneumomediastinum is an uncommon, self-limiting condition. Due to concerns for the integrity of the aero-digestive tract, the finding of spontaneous pneumomediastinum usually results in unnecessary radiological investigations, dietary restriction and antibiotic administration with prolonged hospitalization.</p