Renal brucelloma: A case report

Descripción del caso clínico: Paciente en contacto habitual con ganado ovino y bovino, astenia, anemia y fiebre de origen desconocido. En este contexto se realizan varias pruebas complementarias, entre ellas un TC abdominal que revela masa renal calcificada. Con la sospecha de brucelosis, tras obtenerse un resultado positivo en Rosa de Bengala, se comienza tratamiento antibiótico y se realiza nefrectomía simple derecha por lumbotomía, la pieza quirúrgica confirmó el diagnóstico con PCR positiva para Brucella Melitensis. Relevancia: Existen muy pocos casos de bruceloma renal descritos en la literatura, por ello, es importante divulgar los casos que surjan para ampliar el conocimiento sobre esta patología y su tratamiento. Implicaciones clínicas: En ocasiones las pruebas no invasivas no son suficientes para su diagnóstico y el tratamiento quirúrgico junto con la antibioterapia es de elección en la mayoría de los casos descritos en la literatura. Conclusiones: La brucelosis es una enfermedad poco frecuente pero endémica en algunas zonas. El diagnóstico suele darse en el contexto de un estudio por fiebre de origen desconocido. El tratamiento del bruceloma renal suele ser la combinación de antibioterapia y cirugía. Clinical case description: A patient in regular contact with cattle and sheep presented with asthenia, anemia, and fever of unknown origin. Among the complementary studies carried out, an abdominal CT scan revealed a calcified renal mass. Brucellosis was suspected, and after a positive Bengal Rose test, antibiotic therapy was begun. Right nephrectomy was performed through lumbotomy and the diagnosis was confirmed by the surgical specimen, with a PCR test positive for Brucella melitensis. Relevance: There are very few cases of renal brucelloma reported in the literature, thus the description of cases that arise is important to broaden the knowledge of the pathology and its treatment. Clinical implications: Noninvasive tests are often not sufficient for making the diagnosis. The surgical approach, together with antibiotic therapy, is the treatment of choice in the majority of the cases reported in the literature. Conclusions: Brucellosis is an uncommon disease, but endemic in certain areas. Diagnosis tends to be made in the context of evaluating cases of fever of unknown origin. The combination of antibiotic therapy and surgery is the usual treatment for renal brucelloma

A hot sub-Neptune in the desert and a temperate super-Earth around faint M dwarfs: Color validation of TOI-4479b and TOI-2081b

We report the discovery and validation of two TESS exoplanets orbiting faint M dwarfs: TOI-4479b and TOI-2081b. We have jointly analyzed space (TESS mission) and ground based (MuSCAT2, MuSCAT3 and SINISTRO instruments) lightcurves using our multi-color photometry transit analysis pipeline. This allowed us to compute contamination limits for both candidates and validate them as planet-sized companions. We found TOI-4479b to be a sub-Neptune-sized planet ($R_{p}=2.82^{+0.65}_{-0.63}~\rm R_{\oplus}$) and TOI-2081b to be a super-Earth-sized planet ($R_{p}=2.04^{+0.50}_{-0.54}~\rm R_{\oplus}$). Furthermore, we obtained that TOI-4479b, with a short orbital period of $1.15890^{+0.00002}_{-0.00001}~\rm days$, lies within the Neptune desert and is in fact the largest nearly ultra-short period planet around an M dwarf known to date. These results make TOI-4479b rare among the currently known exoplanet population around M dwarf stars, and an especially interesting target for spectroscopic follow-up and future studies of planet formation and evolution.Comment: Accepted for publication in Astronomy&Astrophysic

The Discovery and Follow-up of Four Transiting Short-period Sub-Neptunes Orbiting M dwarfs

Sub-Neptunes with $2-3R_\oplus$ are intermediate in size between rocky planets and Neptune-sized planets. The orbital properties and bulk compositions of transiting sub-Neptunes provide clues to the formation and evolution of close-in small planets. In this paper, we present the discovery and follow-up of four sub-Neptunes orbiting M dwarfs (TOI-782, TOI-1448, TOI-2120, and TOI-2406), three of which were newly validated by ground-based follow-up observations and statistical analyses. TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b have radii of $R_\mathrm{p} = 2.740^{+0.082}_{-0.079}\,R_\oplus$, $2.769^{+0.073}_{-0.068}\,R_\oplus$, $2.120\pm0.067\,R_\oplus$, and $2.830^{+0.068}_{-0.066}\,R_\oplus$ and orbital periods of $P = 8.02$, $8.11$, $5.80$, and $3.08$\,days, respectively. Doppler monitoring with Subaru/InfraRed Doppler instrument led to 2$\sigma$ upper limits on the masses of $<19.1\ M_\oplus$,$<19.5\ M_\oplus$,$<6.8\ M_\oplus$, and$<15.6\ M_\oplus$for TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b, respectively. The mass-radius relationship of these four sub-Neptunes testifies to the existence of volatile material in their interiors. These four sub-Neptunes, which are located above the so-called ``radius valley'', are likely to retain a significant atmosphere and/or an icy mantle on the core, such as a water world. We find that at least three of the four sub-Neptunes (TOI-782 b, TOI-2120 b, and TOI-2406 b) orbiting M dwarfs older than 1 Gyr, are likely to have eccentricities of$e \sim 0.2-0.3$. The fact that tidal circularization of their orbits is not achieved over 1 Gyr suggests inefficient tidal dissipation in their interiors.Comment: Accepted for publication in AJ, 32 pages, 17 figures, 6 table

Pelvic and inguinal single-site approach: PISA technique. New minimally invasive technique for lymph node dissection in penile cancer.

20.500.12530/87858To describe our initial experience with a new minimally invasive inguinal and pelvic single-access laparoscopic approach, for performing lymph node dissection (LND) in penile cancer: the Pelvic and Inguinal Single Access (PISA) technique. 10 patients with different penile squamous cell carcinoma stages (cN0 and ≥pT1G3 or cN1/cN2) were operated by means of the PISA technique, between 2015-2018. Intraoperative frozen section analysis was carried out routinely and if ≥2 inguinal nodes (pN2) or extracapsular nodal extension (pN3) are detected, ipsilateral pelvic LND was performed sequentially as a single-stage procedure and using the same surgical incisions. 30-day PCs, estimated blood loss (EBL), transfusion rate, operative time, time to drainage removal, and length of hospital stay (LOS). Medians and ranges of values for selected variables were reported as descriptive statistics. Inguinal LND was bilateral in all cases, and pelvic LND was required in 40%. Total operative time was 120-170 min and median EBL was 66 (30-100) cc. No blood transfusion was required. No intraoperative complications were noted, and postoperative complications rate was 40% (10% major complications-symptomatic inguinal lymphocele). Median LOS was 5.8 (3-10) days. Median time to inguinal drain removal was 4.7 days. Mean number of lymph nodes removed by inguinal LND: 10.25 (8-14). Limited volume retrospective experience from a referral center with short follow-up. Outcomes reported may not be reproducible by surgeons with less experience and skills. PISA is a novel, minimally invasive single-site surgical approach to one stage bilateral inguinal/pelvic LNDs for penile cancer showing a low rate of major complications