Migration of surgical clips through a right lobectomy stump mimicking an asthmatic syndrome

The mechanical stapler is routinely used in thoracic surgery practice to attend resection of bronchus and vessels. Herein, we reported a very rare complication as the migration of a titanium surgical clip through a right lobectomy stump. One year after the procedure, the patient complained of persistent cough. A misdiagnosis of asthma was made and she treated for 6 months with bronchodilators, corticosteroid and antihistaminic without success. Thus, patient re-referred of our unit. No clinical signs of infection as fewer, productive cough, dyspnea were present. The laboratory exams were within normal value including white cells. CT scan revealed no abnormalities. Bronchoscopy demonstrated a healed upper bronchus stump without evidence of an actual, open bronchopleural fistula but with clips apparently working their way into the airway, with approximately half of the clip visible within the lumen. The side of the clips that would be open before closure by the surgeon formed the leading edge of the clips visible in the lumen. The clips were successfully removed during flexible bronchoscopy with a forceps usually used for biopsy. After the procedure, the cough disappeared. The endoscopy check after 3 months showed a normal bronchial stump without evidence of fistula

3D change detection analysis of a coastal landslide performed by multi-temporal point clouds comparison

The structure from motion (SfM) photogrammetric technique (FONSTAD et al., 2013) has become a suitable method to obtain high resolution topography data in a wide range of geomorphic environments (PASSALACQUA et al., 2015). SfM is designed to reconstruct the three-dimensional geometry of buildings and objects from randomly acquired images, and represents a low cost option respect to traditional photogrammetric and lidar techniques (FONSTAD et al., 2013). In this way, also the 3D geometry of complex natural surfaces can be achieved with a horizontal and vertical accuracy which depend on the choice of sensor for images acquisition, platform (e.g., UAV, boat, vehicle), and method of assignment of geodetic coordinates to the digital data. In advanced geomorphic applications, repeated photogrammetric surveys at different times allow to detect topographic changes in order to map or monitor erosion, deposition and develop sediment budgets. In this work we present a 3D change detection analysis related to a coastal landslide occurred on 27th October 2013 along the coastal sector of the Campi Flegrei volcanic district, Southern Italy (ESPOSITO et al., 2015). A total of four photogrammetric surveys have been carried out in about two years (Fig. 1), by using a UAV platform for one survey and boats for the other three. In order to accurately define the exterior orientation of images, a topographic survey was also carried out, measuring a series of natural and artificial ground control points external to the landslide area with a long-range Total Station. Images were processed using Agisoft PhotoScan® (http://www.agisoft.com), and 3D point clouds were compared through the "Multiscale Model to Model Cloud Comparison (M3C2)" plugin (LAGUE et al., 2013) included in CloudCompare open source software (http://www.danielgm.net/cc/). The plugin allowed us to estimate orthogonal distances between multitemporal point clouds as well as uncertainty related to each distance measurement. SfM processing of each survey resulted in dense point clouds and high-resolution orthophotos. An average coregistration error between clouds was estimated as 11 cm. As output of the M3C2 distance computation we obtained three new clouds in which each point was characterized by distance and uncertainty attributes (Fig. 2). Points corresponding to statistically significant changes were exported and interpolated in ESRI ArcGis® for volume calculation. Volumetric data show that the landslide deposit at cliff toe was progressively eroded by the sea, while landslide scar was affected by a moderate erosion in the first three months after the 2013 landslide event, as well as by a deep erosion between the second and third surveys. Nevertheless, a negligible eroded volume between 2015 and 2016 surveys was estimated in this area. Deposited sediments decreased through time in the whole landslide area so that, generally, a geomorphic evolution moving towards an equilibrium condition seems to be taking place. The study here described highlights a high potentiality of the SfM and cloud-to-cloud distance computation techniques in geomorphology, both for accurate qualitative and quantitative analysis and for hazard and risk assessment. The studied landslide threats indeed a series of residential buildings located close to the retreating cliff edge

Economic and technical feasibility of betanin and pectin extraction from opuntia ficus-indica peel via microwave-assisted hydrodiffusion

Investigating the feasibility of betanin and pectin extraction from Opuntia ficus-indica peel via microwave-assisted hydrodiffusion and gravity, this study identifies selected important economic and technical aspects associated with this innovative production route starting from prickly pear fruit discards. Which benefits would be derived from this process? Would production be limited to Opuntia-growing countries or, likewise to what happens with dried lemon peel chiefly imported from Argentina, would production take place abroad also? Can distributed manufacturing based on clean extraction technology compete with centralized production using conventional chemical processes

The Latest Trends in Electric Vehicles Batteries

Global energy demand is rapidly increasing due to population and economic growth, especially in large emerging countries, which will account for 90% of energy demand growth to 2035. Electric vehicles (EVs) play a paramount role in the electrification revolution towards the reduction of the carbon footprint. Here, we review all the major trends in Li-ion batteries technologies used in EVs. We conclude that only five types of cathodes are used and that most of the EV companies use Nickel Manganese Cobalt oxide (NMC). Most of the Li-ion batteries anodes are graphite-based. Positive and negative electrodes are reviewed in detail as well as future trends such as the effort to reduce the Cobalt content. The electrolyte is a liquid/gel flammable solvent usually containing a LiFeP6 salt. The electrolyte makes the battery and battery pack unsafe, which drives the research and development to replace the flammable liquid by a solid electrolyte

Immunochemical investigation of allergenic residues in experimental and commercially-available wines fined with egg white proteins

Proteinaceous egg whites are widely used as a fining agent during the production of red wines. Residues of egg white in the final wine could present a risk for individuals allergic to eggs. This study investigated the presence of allergenic residues in both red and white wines fined with egg whites. Experimental and commercially available wines fined with egg whites, with or without subsequent bentonite fining, were studied. Unfined wines were used as negative controls. The physicochemical characteristics of each wine were determined to assess their possible role in enhancing or hindering the elimination of allergenic residues from wine. The amount of egg white protein residues was investigated both by a specifically developed/validated ELISA test and by immunoblotting. Both immunochemical tests used the same anti-total egg white protein antibody and were highly sensitive to the allergen. No egg white protein was detected in the wines studied in either immunochemical test, irrespective of the physicochemical characteristics of the wine, the type and dosage of the fining agent and the oenological process used. The risk of adverse reactions in egg-allergic individuals should therefore be considered negligible, but the exemption from labelling should be allowed only when the absence of residues is confirmed by analytical controls. \ua9 2014 Elsevier Ltd. All rights reserved

Spinocerebellar ataxia 27B: episodic symptoms and acetazolamide response in 34 patients

Ashton C et al report a retrospective multi-centre cohort of 34 patients from Canada, France, Austria and Australia with spinocerebellar ataxia 27B, describing the common feature of episodic ataxia and other episodic features, as well as the inefficacy of acetazolamide in these patients

A new device to seal large coronary aneurysms: a case report

<p>Abstract</p> <p>Introduction</p> <p>Coronary artery aneurysm is an uncommon disease. It is defined as a coronary artery dilatation, exceeding the diameter of the normal adjacent segment or the diameter of the patient's largest coronary vessel by 1.5 to 2 times. Coronary artery aneurysms are typically diagnosed by coronary angiography. The prognosis of coronary artery aneurysm is not well known and the management is challenging.</p> <p>Case presentation</p> <p>A 68-year-old Italian-Caucasian man presented to our hospital with angina. Coronary angiography revealed a large coronary aneurysm of the right coronary artery, which was successfully treated by the percutaneous implantation of an MGuard™stent.</p> <p>Conclusion</p> <p>This case report provides evidence that coronary artery aneurysms, even if very large, can be safely treated by MGuard™stent implantation. We strongly emphasize the high flexibility and good deliverability of this device, which leads to the complete exclusion of the aneurysm mediated by the process of endothelization of its thin mesh sleeves.</p

Frequency of GAA-FGF14 Ataxia in a Large Cohort of Brazilian Patients With Unsolved Adult-Onset Cerebellar Ataxia

OBJECTIVES: Intronic FGF14 GAA repeat expansions have recently been found to be a common cause of hereditary ataxia (GAA-FGF14 ataxia; SCA27B). The global epidemiology and regional prevalence of this newly reported disorder remain to be established. In this study, we investigated the frequency of GAA-FGF14 ataxia in a large cohort of Brazilian patients with unsolved adult-onset ataxia. METHODS: We recruited 93 index patients with genetically unsolved adult-onset ataxia despite extensive genetic investigation and genotyped the FGF14 repeat locus. Patients were recruited across 4 different regions of Brazil. RESULTS: Of the 93 index patients, 8 (9%) carried an FGF14 (GAA)≥250 expansion. The expansion was also identified in 1 affected relative. Seven patients were of European descent, 1 was of African descent, and 1was of admixed American ancestry. One patient carrying a (GAA)376 expansion developed ataxia at age 28 years, confirming that GAA-FGF14 ataxia can occur before the age of 30 years. One patient displayed episodic symptoms, while none had downbeat nystagmus. Cerebellar atrophy was observed on brain MRI in 7 of 8 patients (87%). DISCUSSION: Our results suggest that GAA-FGF14 ataxia is a common cause of adult-onset ataxia in the Brazilian population, although larger studies are needed to fully define its epidemiology

Optimized testing strategy for the diagnosis of GAA-FGF14 ataxia/spinocerebellar ataxia 27B

Dominantly inherited GAA repeat expansions in FGF14 are a common cause of spinocerebellar ataxia (GAA-FGF14 ataxia; spinocerebellar ataxia 27B). Molecular confirmation of FGF14 GAA repeat expansions has thus far mostly relied on long-read sequencing, a technology that is not yet widely available in clinical laboratories. We developed and validated a strategy to detect FGF14 GAA repeat expansions using long-range PCR, bidirectional repeat-primed PCRs, and Sanger sequencing. We compared this strategy to targeted nanopore sequencing in a cohort of 22 French Canadian patients and next validated it in a cohort of 53 French index patients with unsolved ataxia. Method comparison showed that capillary electrophoresis of long-range PCR amplification products significantly underestimated expansion sizes compared to nanopore sequencing (slope, 0.87 [95% CI, 0.81 to 0.93]; intercept, 14.58 [95% CI, − 2.48 to 31.12]) and gel electrophoresis (slope, 0.84 [95% CI, 0.78 to 0.97]; intercept, 21.34 [95% CI, − 27.66 to 40.22]). The latter techniques yielded similar size estimates. Following calibration with internal controls, expansion size estimates were similar between capillary electrophoresis and nanopore sequencing (slope: 0.98 [95% CI, 0.92 to 1.04]; intercept: 10.62 [95% CI, − 7.49 to 27.71]), and gel electrophoresis (slope: 0.94 [95% CI, 0.88 to 1.09]; intercept: 18.81 [95% CI, − 41.93 to 39.15]). Diagnosis was accurately confirmed for all 22 French Canadian patients using this strategy. We also identified 9 French patients (9/53; 17%) and 2 of their relatives who carried an FGF14 (GAA)≥250 expansion. This novel strategy reliably detected and sized FGF14 GAA expansions, and compared favorably to long-read sequencing

The role of thyroid hormone nuclear receptors in the heart: evidence from pharmacological approaches

This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained—at least partly—by the induction of a local ‘hypothyroid-like condition’ in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding of T3 to thyroid hormone receptors (TR) alpha-1 and beta-1 in vitro, and on the expression of particular T3-dependent genes in vivo. In the heart, amiodarone decreases heart rate and alpha myosin heavy chain expression (mediated via TR alpha-1), and increases sarcoplasmic reticulum calcium-activated ATPase and beta myosin heavy chain expression (mediated via TR beta-1). Recent data show a significant similarity in expression profiles of 8,435 genes in the heart of hypothyroid and amiodarone-treated animals, although similarities do not always exist in transcripts of ion channel genes. Induction of a hypothyroid cardiac phenotype by amiodarone may be advantageous by decreasing energy demands and increasing energy availability