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

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

Experimental determination of the permeability of engineering textiles: Benchmark II

In this second international permeability benchmark, the in-plane permeability values of a carbon fabric were studied by twelve research groups worldwide. One participant also investigated the deformation of the tested carbon fabric. The aim of this work was to obtain comparable results in order to make a step toward standardization of permeability measurements. Unidirectional injections were thus conducted to determine the unsaturated in-plane permeability tensor of the fabric. Procedures used by participants were specified in the guidelines defined for this benchmark. Participants were asked to use the same values for parameters such as fiber volume fraction, injection pressure and fluid viscosity to minimize sources of scatter. The comparison of the results from each participant was encouraging. The scatter between data obtained while respecting the guidelines was below 25%. However, a higher dispersion was observed when some parameters differed from the recommendations of this exercise.The authors are grateful to J.M. Beraud from Hexcel Fabrics for his support that made possible this exercise. The contributions of J.B. Alms, N.C. Correia, S. Advani, E. Ruiz and P.C.T. Goncalves to the preparation of the guidelines document and templates are acknowledged by the participants of this benchmark.Vernet, N.; Ruiz, E.; Advani, S.; Alms, JB.; Aubert, M.; Barburski, M.; Barari, B.... (2014). Experimental determination of the permeability of engineering textiles: Benchmark II. Composites Part A: Applied Science and Manufacturing. 61:172-184. doi:10.1016/j.compositesa.2014.02.010S1721846

Incidence and Risk of QTc Interval Prolongation among Cancer Patients Treated with Vandetanib: A Systematic Review and Meta-analysis

Vandetanib is a multikinase inhibitor that is under assessment for the treatment of various cancers. QTc interval prolongation is one of the major adverse effects of this drug, but the reported incidence varies substantially among clinical trials. We performed a systematic review and meta-analysis to obtain a better understanding in the risk of QTc interval prolongation among cancer patients administered vandetanib.Eligible studies were phase II and III prospective clinical trials that involved cancer patients who were prescribed vandetanib 300 mg/d and that included data on QTc interval prolongation. The overall incidence and risk of QTc interval prolongation were calculated using random-effects or fixed-effects models, depending on the heterogeneity of the included studies. Nine trials with 2,188 patients were included for the meta-analysis. The overall incidence of all-grade and high-grade QTc interval prolongation was 16.4% (95% CI, 8.1-30.4%) and 3.7% (8.1-30.4%), respectively, among non-thyroid cancer patients, and 18.0% (10.7-28.6%) and 12.0% (4.5-28.0%), respectively, among thyroid cancer patients. Patients with thyroid cancer who had longer treatment duration also had a higher incidence of high-grade events, with a relative risk of 3.24 (1.57-6.71), than patients who had non-thyroid cancer. Vandetanib was associated with a significantly increased risk of all-grade QTc interval prolongation with overall Peto odds ratios of 7.26 (4.36-12.09) and 5.70 (3.09-10.53) among patients with non-thyroid cancer and thyroid cancer, respectively, compared to the controls.Treatment with vandetanib is associated with a significant increase in the overall incidence and risk of QTc interval prolongation. Different cancer types and treatment durations may affect the risk of developing high-grade QTc interval prolongation