An Unexpected Foreign Body (a Thermometer) in the Bladder: A Case Report

Foreign bodies in the bladder are rarely observed because of difficult access. These patients usually have a mental disorder, a background of intense sexual perversion, or inquisitiveness. A 48-year-old, deaf, and mentally retarded woman was referred to the nephrology clinic for severe anemia and impaired renal function. Imaging tests showed a mercury thermometer positioned in the bladder and a stone, 5 cm in diameter, around it. This had caused bilateral ureteral obstruction. The patient underwent an open cysteotomy. Obstructive uropathy is one of the causes of kidney failure; therefore, foreign bodies should be included in the differential diagnosis. Keywords: Bladder, Foreign bodies, Obstructive uropathy, Thermomete

Incidence, risk factors, and outcome of portal vein thrombosis after laparoscopic-assisted splenectomy in β-thalassemia patients: A prospective exploratory study

Background: Portal vein system thrombosis (PVT) is an infrequent but potentially serious complication after laparoscopic splenectomy. Patients with β-thalassemia are at higher risk as they have splenomegaly and hypercoagulability. Subjects and Methods: Forty-eight β-thalassemia patients who underwent hand-assisted laparoscopic splenectomy or laparoscopic splenectomy were studied prospectively with pre- and postoperative Doppler ultrasonography or computed tomography scanning. Results: The incidence of PVT was 8.3% (95% confidence interval [CI] 0.2%-16.4%) (4 of 48 patients). Spleen weight was the only independent factor associated with the presence of PVT. The odds ratio for spleen weight (100 g increase) was 1.46 (95% CI 1.10-1.94, P=.010). Receiver operator characteristic curve analysis showed that the optimal cutoff of spleen weight to the prediction of PVT was 1543 g. Thrombosis resolution was observed after a median of 165 days. Conclusions: Patients with β-thalassemia who undergo laparoscopic-assisted splenectomy are at high risk of postoperative PVT. Close postoperative surveillance and aggressive coagulation prophylaxis are needed in these patients. Larger studies are required to confirm the present findings. © Mary Ann Liebert, Inc

Psychiatric disorder associated with vacuum-assisted breast biopsy clip placement: A case report

Introduction: Vacuum-assisted breast biopsy is a minimally invasive technique that has been used increasingly in the treatment of mammographically detected, non-palpable breast lesions. Clip placement at the biopsy site is standard practice after vacuum-assisted breast biopsy. Case presentation: We present the case of a 62-year-old woman with suspicious microcalcifications in her left breast. The patient was informed about vacuum-assisted breast biopsy, including clip placement. During the course of taking the patient's history, she communicated excellently, her demeanor was normal, she disclosed no intake of psychiatric medication and had not been diagnosed with any psychiatric disorders. Subsequently, the patient underwent vacuum-assisted breast biopsy (11 G) under local anesthesia. A clip was placed at the biopsy site. The pathological diagnosis was of sclerosing adenosis. At the 6-month mammographic follow-up, the radiologist mentioned the existence of the metallic clip in her breast. Subsequently, the woman presented complaining about "being spied [upon] by an implanted clip in [her] breast" and repeatedly requested the removal of the clip. The patient was referred to the specialized psychiatrist of our breast unit for evaluation. The Mental State Examination found that systematized paranoid ideas of persecutory type dominated her daily routines. At the time, she believed that the implanted clip was one of several pieces of equipment being used to keep her under surveillance, the other equipment being her telephone, cameras and television. Quite surprisingly, she had never had a consultation with a mental health professional. The patient appeared depressed and her insight into her condition was impaired. The prevalent diagnosis was schizotypal disorder, whereas the differential diagnosis comprised delusional disorder of persecutory type, affective disorder with psychotic features or comorbid delusional disorder with major depression. Conclusion: This is the first report of a psychiatric disorder being brought to the fore using a vacuum-assisted breast biopsy clip. Vacuum-assisted breast biopsy, and breast biopsy in general, represent a significant experience, encompassing anxiety and pain; it may thus aggravate psychiatric conditions. Apart from these well-established factors, other aspects, such as the clip, may occasionally become significant. In a modern breast unit, the evaluation of patients should be multidisciplinary. A psychiatrist may be needed for optimal management of anxiety-related issues, as well as for the detection of psychiatric disorders. © 2008 Zografos et al; licensee BioMed Central Ltd

Prospective comparative study of the efficacy of staple-line reinforcement in laparoscopic sleeve gastrectomy

Background Staple-line reinforcement has been used with promising results in laparoscopic gastric bypass in order to reduce leakage, increase staple-line integrity, and diminish staple-site bleeding. The purpose of this study was to determine if staple-line reinforcement with bovine pericardial strips reduces surgical complications of laparoscopic sleeve gastrectomy (LSG). Methods This is a prospective comparative study of all patients who underwent LSG by a standard operative team in an 18-month period. Patients were enrolled in group A if they received staple-line reinforcement and in group B when not. The staple line was reinforced with bovine pericardium strips [Peri-Strips Dry (R) (PSD)]. Results In total, 187 patients, with a median preoperative BMI of 45.3 kg/m(2) (range = 35.1-72.7), underwent LSG. Ninety-six patients were enrolled in group A and 91 in group B; the two groups were comparable in their various characteristics. Morbidity rate representing grade III-IV surgical complications reached 7.4% and mortality rate was 0.5%. Reinforcement with PSD significantly reduced the occurrence of bleeding from the staple line and intra-abdominal collections (P = 0.012 and 0.026). The leak rate was not significantly reduced in group A. Patients in group A required fewer days of hospitalization. Conclusions Reinforcement of the staple line in LSG resulted in significantly fewer surgical complications compared to standard stapling of the gastric tube. The additional cost due to the reinforcement of the staple line may be counterbalanced by the reduction in the length of hospitalization

Testbeds for the Implementation of 5G in the European Union: The Innovative Case of the 5G-DRIVE Project

An essential part of the actual EU policy towards promoting and validating 5G applications and of related solutions is via the establishment of an explicit plan and of a detailed roadmap for trials, tests and experimental activities though dedicated testbeds, in parallel with the current research and development activities coming from the 5G-PPP framework. The present paper discusses the fundamental role of the proposed trials' initiatives within the broader European framework for the establishment and the promotion of 5G and also analyses the corresponding streams as indispensable parts of the 5G-PPP context, aiming to support innovation and growth. In addition, as part of the broader initiative for trial actions we identify the case of the 5G-DRIVE project that aims to realise 5G deployment scenarios (i.e., enhanced Mobile Broadband and Vehicle-to-Everything communications), between the EU and China, by discussing the fundamental features of the respective trials sites. © IFIP International Federation for Information Processing 2019

Lipoma induced jejunojejunal intussusception

Intussusception in adults is rare. The clinical picture of intussusception in adults is subtle and the diagnosis is, therefore, elusive. The presence of a structural abnormality in the great majority of the adult cases mandates high clinical suspicion. Gastrointestinal lipomas are rare benign tumors and intussusception due to a gastrointestinal lipoma constitutes an infrequent clinical entity. The present report describes a case of jejunojejunal intussusception in an adult with a history of severe episodes of hematochezia and colicky upper abdominal pain. The diagnosis was suspected preoperatively but computed tomography scan could not rule out malignancy. Exploratory laparotomy revealed jejunojejunal intussusception secondary to a lipoma which was successfully treated with segmental intestinal resection. © 2007 WJG. All rights reserved