‘Pseudopneumothorax’—Hold that chest tube!

We report a case of herniation of abdominal contents into the left hemithorax in a patient with a history of vague left-sided thoracoabdominal trauma 18 days previous to admission and who also had a recent 1-week history of upper respiratory symptoms, including cough, and then presented with dyspnoea and fever for 3 days. There was no preceding cardiorespiratory pathology of note. We also discuss the epidemiology, pathogenesis and management of blunt-traumatic diaphragmatic rupture

Estudio de las posibilidades de la absorción molecular de alta resolución empleando fuente continua en cámara de grafito para la medida de diferentes isótopos de Sr.

This work proposes the application of HR-CS-GF-MAS for the isotopic analysis of strontium as an approach to study the possibilities of the technique in the analysis of elements with multiple stable isotopes. For this purpose, the SrF molecule will be formed and corrections will be applied to obtain individual isotopic signals.Este trabajo plantea la aplicación de HR-CS-GF-MAS para el análisis isotópico de estroncio como una aproximación al estudio de las posibilidades de la técnica en el análisis de elementos con múltiples isótopos estables. Para ello, se formará la molécula de SrF y se aplicarán correcciones para obtener señales isotópicas individuales

Cu fractionation, isotopic analysis, and data processing <i>via</i> machine learning: new approaches for the diagnosis and follow up of Wilson's disease <i>via</i> ICP-MS

Information about Cu fractionation and Cu isotopic composition can be paramount when investigating Wilson's disease (WD). This information can provide a better understanding of the metabolism of Cu. Most importantly, it may provide an easy way to diagnose and to follow the evolution of WD patients. For such purposes, protocols for Cu determination and Cu isotopic analysis via inductively coupled plasma mass spectrometry were investigated in this work, both in bulk serum and in the exchangeable copper (CuEXC) fractions. The CuEXC protocol provided satisfactory recovery values. Also, no significant mass fractionation during the whole analytical procedure (CuEXC production and/or Cu isolation) was detected. Analyses were carried out in controls (healthy persons), newborns, patients with hepatic disorders, and WD patients. While the results for Cu isotopic analysis are relevant (e.g., δ65Cu values were lower for both WD patients under chelating treatment and patients with hepatic problems in comparison with those values obtained for WD patients under Zn treatments, controls, and newborns) to comprehend Cu metabolism and to follow up the disease, the parameter that can help to better discern between WD patients and the rest of the patients tested (non-WD) was found to be the REC (relative exchangeable Cu). In this study, all the WD patients showed a REC higher than 17%, while the rest showed lower values. However, since establishing a universal threshold is complicated, machine learning was investigated to produce a model that can differentiate between WD and non-WD samples with excellent results (100% accuracy, albeit for a limited sample set). Most importantly, unlike other ML approaches, our model can also provide an uncertainty metric to indicate the reliability of the prediction, overall opening new ways to diagnose WD

COMUNICAÇÃO QUÍMICA ENTRE CÃES MACHOS: URINA E FEZES

A comunicação entre animais pode ocorrer de diversas formas, e em cães essa interação ocorre principalmente por sinais químicos. O presente estudo observou cães machos, adultos e castrados para analisar a marcação química (urinar, raspar e defecar) nesta espécie. O objetivo do experimento foi detectar de que maneira essa marcação pode servir como estímulo olfatório e sua influência na interação entre seus co-especificos, quando há, ou não, contato visual entre os mesmos. Durante os 27 dias de experimento, utilizamos mapas e tabelas para coletar os dados necessários, que posteriormente foram analisados em teste de comparação de variâncias e teste qui-quadrado. O resultado mostrou que os animais estudados utilizam mais a urina do que o raspar e, em menor quantidade, fezes para marcação química; cães sem contato visual marcam mais território com urinar e raspar, do que cães com contato visual; e também que os cães sem contato visual marcam duas vezes mais o território perto de seu canil do que cães com contato visual. Dessa forma, esse trabalho contribui para melhorar a vida do animal em cativeiro, oferecendo condições para este desempenhar seus comportamentos naturais, bem como proporcionar o manejo do recinto de modo a privilegiar as condições sanitárias, minimizando o contato com patógenos veiculados possivelmente por suas excretas

Classification of primary and incisional abdominal wall hernias

A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable.Comparative StudyConsensus Development ConferenceJournal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review

BACKGROUND: Virtual reality (VR) as surgical training tool has become a state-of-the-art technique in training and teaching skills for minimally invasive surgery (MIS). Although intuitively appealing, the true benefits of haptic (VR training) platforms are unknown. Many questions about haptic feedback in the different areas of surgical skills (training) need to be answered before adding costly haptic feedback in VR simulation for MIS training. This study was designed to review the current status and value of haptic feedback in conventional and robot-assisted MIS and training by using virtual reality simulation. METHODS: A systematic review of the literature was undertaken using PubMed and MEDLINE. The following search terms were used: Haptic feedback OR Haptics OR Force feedback AND/OR Minimal Invasive Surgery AND/OR Minimal Access Surgery AND/OR Robotics AND/OR Robotic Surgery AND/OR Endoscopic Surgery AND/OR Virtual Reality AND/OR Simulation OR Surgical Training/Education. RESULTS: The results were assessed according to level of evidence as reflected by the Oxford Centre of Evidence-based Medicine Levels of Evidence. CONCLUSIONS: In the current literature, no firm consensus exists on the importance of haptic feedback in performing minimally invasive surgery. Although the majority of the results show positive assessment of the benefits of force feedback, results are ambivalent and not unanimous on the subject. Benefits are least disputed when related to surgery using robotics, because there is no haptic feedback in currently used robotics. The addition of haptics is believed to reduce surgical errors resulting from a lack of it, especially in knot tying. Little research has been performed in the area of robot-assisted endoscopic surgical training, but results seem promising. Concerning VR training, results indicate that haptic feedback is important during the early phase of psychomotor skill acquisitio

Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Background: Incisional hernias can be associated with pain or discomfort. Surgical repair especially mesh reinforcement, may likewise induce pain. The primary objective was to assess the incidence of pain after hernia repair in patients with and without pre-operative pain or discomfort. The secondary objectives were to determine the preferred mesh type, mesh location and surgical technique in minimizing postoperative pain or discomfort. Materials and methods: A registry-based prospective cohort study was performed, including patients undergoing incisional hernia repair between September 2011 and May 2019. Patients with a minimum follow-up of 3–6 months were included. The incidence of hernia related pain and discomfort was recorded perioperatively. Results: A total of 1312 patients were included. Pre-operatively, 1091 (83%) patients reported pain or discomfort. After hernia repair, 961 (73%) patients did not report pain or discomfort (mean follow-up = 11.1 months). Of the pre-operative asymptomatic patients (n = 221), 44 (20%, moderate or severe pain: n = 14, 32%) reported pain or discomfort after mean follow-up of 10.5 months. Of those patients initially reporting pain or discomfort (n = 1091), 307 (28%, moderate or severe pain: n = 80, 26%) still reported pain or discomfort after a mean follow-up of 11.3 months postoperatively. Conclusion: In symptomatic incisional hernia patients, hernia related complaints may be resolved in the majority of cases undergoing surgical repair. In asymptomatic incisional hernia patients, pain or discomfort may be induced in a considerable number of patients due to surgical repair and one should be aware if this postoperative complication