Persistent Hiccups Following Stapedectomy

Objective: We report a case of a 37 year-old man who developed persistent hiccups after elective stapedectomy. Method and Results: The diagnostic approach is discussed as well as the non-pharmacologic and pharmacologic treatments and overall management. The aim is to stress that there is a variety of potential factors that can induce hiccups perioperatively and in cases like this a step by step approach must be taken. Conclusion: Persistent hiccups are very rare following stapedectomy, control of them is crucial for the successful outcome. The trigger may be more than one factors and the good response to treatment may be due to dealing successfully with more than one thing

Identification and modeling of key logistics processes in the Agrifood Sector

As logistics become a substantial part of a firm's operations, the corresponding processes increases in importance. Identifying key logistics processes using a structured approach will align their outcomes to deliver the business goals, design appropriate measures and allocate sufficient resources for their improvement. This paper proposes a systematic methodology for the identification, categorization and prioritization of logistics processes, using a binary linear programming model. The identified key logistics processes are modeled by creating a number of UML diagrams and document them by the use of a pre-defined template. These processes include both inbound and supply chain - wide logistics activities and have a critical effect on the operational performance of an agrifood business entity. Companies can focus on these key logistics processes in order to optimize their critical aspects such as time and cost issues, resources planning and scheduling, as well as, queues and delay

A Large Laryngeal Mucocele Causing Progressive upper Airway Obstruction and Cervical Swelling

Laryngocele (LC) is an uncommon clinical entity, occasionally associated with fatal complications. If its neck becomes obstructed, mucous accumulates and then a laryngeal mucocele (LMC) is formed. Reports of LMCs are rare in the literature. A fluid-filled combined LMC in a 48 year-old Greek construction worker with presenting symptoms of cervical swelling and dysphonia is described. The male patient was surgically treated via an external approach. A LC rarely becomes symptomatic and infection unusually occurs. Magnetic resonance imaging depicts in detail the size, extension and structure of the neck mass and remains the diagnostic gold standard, providing superior soft-tissue discrimination, in cases of a concurrent laryngeal tumor. Histopathological examination confirms diagnosis, since there is always a high index of suspicion for malignancy. Established guidelines regarding surgical treatment of a LC do not exist. Although during the last two decades micro laryngoscopy with CO2 laser has gained popularity for the treatment of an internal LC, the external approach still remains the method of choice in cases of a combined LMC

Unusual Axillary Artery Branching Pattern Associated with Multiple Neural Variations

OBJECTIVE: This report presents a unilateral branching pattern of the axillary artery (AA) represented by an unusual common trunk division, vessel multiplications and concomitant neural variations. CASE REPORT: In a Greek male cadaver, the right AA branched into a subscapular trunk and two accessory lateral thoracic arteries of variable origin and course. Concomitantly, a high-level interconnection between the musculocutaneous and median nerves was identified, as an accessory lateral root of the median nerve. More interestingly, a rare innervation of the upper part of the latissimus dorsi muscle by a lower subscapular nerve was also revealed. CONCLUSION: In-depth knowledge of the typical and variant AA branching patterns and coexisting neural variations is of paramount importance for surgeons and interventional physicians, for a safer diagnosis and for performing uneventful procedures in that area. Copyright © 2021 by Academy of Sciences and Arts of Bosnia and Herzegovina

Monitoring and operational results of a hybrid solar-biomass heating system

Solar thermal systems, that provide auxiliary energy for space heating, represent a growing opportunity in European countries like Austria and Germany. However, such systems are as yet not widely known in the rest of Europe, unlike thermosyphon water heating systems. In addition, the need for energy conservation and reduction of CO2 emissions, to combat climate change, demands the use and advance of renewable energy sources in new sectors than for common domestic water heating. The purpose of this research work is to present a full cycle of operational results of a hybrid solar thermal-biomass space heating system in Greece. The hybrid heating system was installed at the Centre for Renewable Energy Sources (CRES), Pikermi, central Greece in September 2005 with the intension to provide all the heat requirements for a specific office block of 60 m2 area. The system was analyzed and optimized over a period of 6 months. The solar contribution during the actual measurement period (60% of the operating period) covered 52.9% of the total heating demand. The operational results of this unit from November 2005 till April of 2006 are presented and analyzed. The main parameters presented here include the operation of the system, the results, the coverage fraction (f%) of the solar and the biomass subsystems, the actions taken to increase its efficiency and the technical problems faced along with possible solutions to overcome them

The Cutting Edge on Advances in ICT Systems in Agriculture †

[No abstract available

Body Mass Index Is Independently Associated with the Presence of Ischemia in Myocardial Perfusion Imaging

Background and Objectives: Obesity has been linked to various cardiovascular risk factors, increased incidence of coronary artery disease, and myocardial perfusion defects. The aim of this study was to investigate if body mass index (BMI) and waist circumference (WC) were associated with myocardial perfusion defects. Materials and Methods: A total of 308 consecutive patients who had myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) and a complete medical record on file were studied retrospectively. Results: The median age was 69 (61–76) years, the BMI was 27.6 (24.4–30.7) kg/m2, and the WC was 110 (102–118) cm. Of the 308 patients, 239 patients (77.6%) had myocardial ischemia. A positive test for ischemia was more frequent in men compared to women (72 vs. 28%, p < 0.001). Within the male group, BMI and WC were not significantly different between the ischemia and non-ischemia groups. In contrast, within the female group, both BMI (30.2 vs. 27.1 kg/m2, p = 0.002) and WC (112 vs. 105.5 cm, p = 0.020) were significantly higher in the ischemia group. Multivariable logistic regression showed that male sex and BMI were the only two independent predictors of ischemia in our patient population. Conclusions: This study showed that BMI was an independent predictor of ischemia in our patient population