160 characters for change: China's mobile urban-rural divide

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Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si lo hubiere, y los autores pertenecientes a la UAMLess invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treat‑ ment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could beneft from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. Method The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models—POSSUM Physiological Score (PS), modifed Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade—receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. Results A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p<0.001; 30-day mortality: AUC 0.94, p<0.001; in-hospital major morbidity: AUC 0.73, p<0.001; 30-day major morbidity: AUC 0.70, p<0.001). POSSUM PS with a cutof of 25 (defned in our study as a ‘Chole-POSSUM’ score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96–97% negative predictive value for major complications. Conclusions The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate pre‑ diction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may fnd the most useful feld of actio

Unicameral Bone Cyst in the Proximal Humerus with Secondary Infection in an 18 -Month-Old Foal

An 18-month-old warmblood filly was 4/5 lame on the front right limb at referral and showed severe swelling of the right shoulder region and pain during manipulation of the shoulder region. Radiography revealed a roundish 5 × 7 cm radiolucent area with defined borders within the greater tubercle and the presence of a fracture of the lateral tubercle associated with the cyst. Cellular blood count was 27,500 WBC/μL and serum biochemical analyses revealed fibrinogen of 855 mg/dL. The fractured bone was removed surgically; the cyst debrided and filled with autologous cancellous bone graft. Three and five weeks after surgery the filly was reoperated on because of an osseous sequestrum and a periostal defect on the distal dorsolateral aspect of the pastern of the right hind limb and a septic synovitis of the DFTS of the left hind limb. Fifteen month after surgery the filly was not lame and was introduced to training. Unicameral bone cysts (UBC) are well described lesions, often associated to pathologic fracture in the proximal humerus of children but, until present, no scientific report exists of UBC in the foal. The prompt surgical management had a favorable outcome

Microchimerism and Endocrine Disorders

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Stability of Oscillating Gaseous Masses in Massive Brans-Dicke Gravity

This paper explores the instability of gaseous masses for the radial oscillations in post-Newtonian correction of massive Brans-Dicke gravity. For this purpose, we derive linearized perturbed equation of motion through Lagrangian radial perturbation which leads to the condition of marginal stability. We discuss radius of instability of different polytropic structures in terms of the Schwarzschild radius. It is concluded that our results provide a wide range of difference with those in general relativity and Brans-Dicke gravity.Comment: 31 pages, 11 figures, to appear in IJMP

Contrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors

OBJECTIVE: The purpose of this article is to present the potentials and limits of contrast-enhanced ultrasonography (CEUS) in the characterization of pancreatic tumors, usually hypoechoic or cystic at B-mode ultrasound

Diagnosis with ECG-gated MDCT of floating thrombus in aortic arch in a patient with type-A dissection

Multidetector computed tomography has been shown to be accurate in noninvasive assessment of chest vascular disease. The motion artifacts of the thoracic aorta and the supra-aortic vessels were significantly reduced in the electrocardiogram (ECG)-gated data acquisition. This positive effect of ECG synchronization is more pronounced in the region of the ascending aorta, aortic arch, and proximal descending aorta

Patient selection - clinical and imaging criteria - for percutaneous lung malignancies ablation: a single centre experience and a literature review

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