Esophageal atresia associating gastrointestinal malformations: a study of clinical approach

Digestive tract malformations requiring surgical repair in association with esophageal atresia are rare occurrences. Because of this uncommon presentation of esophageal atresia, its evaluation and management are often difficult, requiring extensive workup and multiple surgical procedures. We present our experience with esophageal atresia associating gastrointestinal congenital anomalies in the last 10 years. Clinical and surgical perspectives were pointed willing to make relevant observations in matters of diagnosis and treatment strategy in these patients. Therefore, 7 cases resembling this pattern were identified – duodenal atresia and anorectal malformation being the most common coexistent malformations. All the cases exhibited technical and procedural staging difficulties that we shaped according to the patient’s general picture in the absence of a standardized approach. Careful preoperative follow-up, multidisciplinary communication, watchful waiting and an individually patient-shaped approach are elementary requirements for good outcomes in complex cases of EA

Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature

The megaureter accounts for almost a quarter of all urinary tract dilations diagnosed in utero and is the second leading cause of hydronephrosis in newborns, following pyeloureteral junction obstruction. The current standard treatment for progressive or persistent, symptomatic primary obstructive megaureter is ureteral anti-reflux reimplantation, which can be associated with ureteral remodeling or plication. Due to the associated morbidity, postoperative recovery challenges, and the complications that may arise from the open surgical approach, there has been a natural inclination towards validating new minimally invasive techniques. This study reviews the literature, extracting data from three major international databases, from 1998 to 2022. Out of 1172 initially identified articles, only 52 were deemed eligible, analyzing 1764 patients and 1981 renal units. Results show that 65% of cases required surgical intervention, with minimally invasive techniques constituting 56% of these procedures. High-pressure endoscopic balloon dilation was the preferred endourologic technique. The degree of ureterohydronephrosis is considered one of the factors indicating the need for surgery. There is an inverse relationship between the diameter of the ureter and the likelihood of spontaneous resolution. Conditions such as renal hypoplasia, renal dysplasia, or ectopic ureteral insertion strongly indicate a poor prognosis. Endoscopic surgical techniques for treating primary obstructive megaureter can be definitive, firstline treatment options. In selected cases, they might be at least as effective and safe as the open approach, but with advantages like quicker recovery, fewer complications, shorter hospital stays, and reduced costs

A pedunculated esophageal chondromatous hamartoma in a child

Esophageal tumors are uncommon in pediatric population and most of them are benign. Esophageal hamartomas have been reported extremely rare in children. These can present as intramural tumors of the esophageal wall or as polyps. Dysphagia is the main symptom described in their case, but other specific symptoms are also reported. Such symptoms encountered in clinical practice are represented by obstructive apnea episodes and bradycardia, poor weight gain, epigastric or retrosternal pain, hematemesis or melena, dysphonia or tracheal sounds. Diagnosis can be delayed due to the insidious onset and non-specific symptoms, therefore patient’s compliance to follow-up and broad, careful evaluation are mandatory. Preoperative imagistic assessment is extremely important for a precise definition of the tumor’s anatomical relations, especially when facing large tumors located in the posterior mediastinum. Herein we report a case of a large chondromatous polypoid hamartoma of the esophagus in a 9 years old boy, emphasizing over the diagnosis and surgical challenges we have met, along with comments on illustrative similar cases reported in the literature

Avoiding High Pressure Abdominal Closure of Congenital Abdominal Wall Defects—One Step Further to Improve Outcomes

The main goal of surgical treatment for gastroschisis and omphalocele is the reduction of viscera in the abdominal cavity and closure of the abdomen, but the challenge is to succeed without the detrimental effects of increased intraabdominal pressure. In this regard, we performed a retrospective study for all patients admitted for gastroschisis and omphalocele to the Neonatal Intensive Care Unit of ‘Marie Sklodowska Curie’ Emergency Clinical Hospital for Children, from January 2011 until June 2021. Our aim was to highlight the presence of postoperative abdominal compartment syndrome. We observed that six out of forty-seven patients developed clinical signs of abdominal compartment syndrome, five associated with primary closure and one with staged closure with a polyvinyl chloride patch. Following the results, we decided to implement the trans-bladder measurement of intraabdominal pressure to avoid closing the abdomen at pressures higher than 10 mmHg in order to prevent the development of abdominal compartment syndrome. We consider that there is still place for the improvement of congenital abdominal wall defects management and that the measurement of intraabdominal pressure might help us reach our goal

Preliminary results of proton inelastic scattering on 57^{57}Fe

International audienceA proton inelastic scattering experiment on a 57Fe target was performed at the 9 MV TANDEM facility of Horia Hulubei-National Institute of Physics and Nuclear Engineering, Bucharest-Măgurele, Romania. The purpose was to determine the γ-production cross sections of the transitions observed in the 57Fe(p, p’γ)57Fe reaction. The detection system consisted of 4 HPGe detectors for detection and a Faraday cup for beam integration. The proton energy was varied from 5 to 16 MeV, in 1-MeV steps. In the current analysis, experimental cross sections were determined only for the high-volume detectors, placed at 110◦ and 150◦ with respect to the beam axis. This work presents the data analysis procedure and the preliminary experimental cross sections for the most intense transitions decaying from the first seven excited states in 57Fe. The results are compared with TALYS 1.9 theoretical calculations performed using default input parameters

Absolute cross sections of the

Absolute cross sections for the 86Sr(α,n)89Zr reaction at energies close to the Gamow window are reported. Three thin SrF2 targets were irradiated using the 9 MV Tandem facility in IFIN-HH Bucharest that delivered α beams for the activation process. Two high-purity Germanium detectors were used to measure the induced activity of 89Zr in a low background environment. The experimental results are in very good agreement with Hauser-Feshbach statistical model calculations performed with the TALYS code

Absolute cross sections of the 86Sr(α,n)89Zr reaction at energies of astrophysical interest

Absolute cross sections for the 86Sr(α,n)89Zr reaction at energies close to the Gamow window are reported. Three thin SrF2 targets were irradiated using the 9 MV Tandem facility in IFIN-HH Bucharest that delivered α beams for the activation process. Two high-purity Germanium detectors were used to measure the induced activity of 89Zr in a low background environment. The experimental results are in very good agreement with Hauser-Feshbach statistical model calculations performed with the TALYS code

Gamma spectroscopy of even even Ytterbium isotopes.pdf

30th Symposium of the Hellenic Nuclear Physics Society (HNPS-2022), 7-8 October 2022, Ioannina, Greece</p