Cuerpo extraño intra-abdominal postquirúrgico simulador de neoplasia. Presentación de un caso y revisión de la bibliografía

Introducción: los textilomas son materiales textiles quirúrgicos que permanecen en el abdomen tras cirugías previas. Resulta muy dificil evaluar su incidencia debído a las implicaciones médico legales de ahí el interés en la publicación de este tipo de patología Caso clínico: mujer de 76 años a la que se había realizado una histerectomía más doble anexectomía 6 meses antes de su ingreso en nuestro hospital, al parecer sin complicaciones perioperatorias. Cuando fue valorada en nuestro hospital presentaba cuadro clínico que simulaba una neoplasia maligna. En nuestro caso, la enferma tenía signos y síntomas propios de una neoplasia intra abdominal avanzada, tales como: anemia de procesos crónicos, pérdida importante de peso y tumor abdominal palpable. El procedimiento diagnóstico combinó tomografía computada y colonoscopia, objetivando como causa del cuadro clínico la presencia de textiloma intra abdominal. La paciente fue intervenida precisando 3 resecciones intestinales para extraer el cuerpo extraño, siendo el postoperatorio satisfactorio y permanece asintomática hasta la fecha. Conclusión: los textilomas intra-abdominales son excepcionales, si bien su diagnóstico debe realizarse con pruebas de imagen, y si se sospecha neoplasia digestivas, estudios endoscópicos. El diagnóstico diferencial prioritario deberá realizarse con tumores malignos intra abdominales. Introduction: Gossypibomas or textilomas are materials remain in the abdomen after surgery. It is very difficult to assess its impact due to medico-legal implications, hence the interest in the publication of this type of pathology. Clinical case: Women of 76 years who had undergone a hysterectomy more double anexectomy 6 months before admission to our hospital, apparently without perioperative complications. When she was assessed in our hospital had a clinical picture simulating a malignancy. In our case, the patient had signs and symptoms of advanced intra-abdominal malignancy, such as anemia of chronic, significant weight loss and palpable abdominal mass. The diagnostic procedure combined computed tomography and colonoscopy, aiming to cause the signs of intra-abdominal gossypiboma. The patient was operated 3 bowel resections pointing to extract the foreign body, with satisfactory postoperative and remaining asymptomatic till date. Conclusion: Intra-abdominal gossypibomas are exceptional, although the diagnosis is made through imaging and, if suspected GI neoplasm, endoscopic studies. The primary differential diagnosis must be made with intra-abdominal malignancies

Neuroblastoma olfatorio. Todo lo que el radiólogo debe saber

Olfactory neuroblastoma (ONB) is a rare malignant tumor that originates from olfactory neuroepithelial cells. Its early diagnosis is difficult due to the low specificity of the symptoms. Imaging tests play an important role in its diagnosis and surgical planning so it is important that radiologists know their findings and the different classifications that will help to choose the most appropriate treatment for each tumor

Robust discrete choice models with t-distributed kernel errors

Models that are robust to aberrant choice behaviour have received limited attention in dis-crete choice analysis. In this paper, we analyse two robust alternatives to the multinomialprobit (MNP) model. Both alternative models belong to the family of robit models, whosekernel error distributions are heavy-tailed t-distributions. The first model is the multino-mial robit (MNR) model in which a generic degrees of freedom parameter controls theheavy-tailedness of the kernel error distribution. The second alternative, the generalisedmultinomial robit (Gen-MNR) model, has not been studied in the literature before and ismore flexible than MNR, as it allows for alternative-specific marginal heavy-tailednessof the kernel error distribution. For both models, we devise scalable and gradient-freeBayes estimators. We compare MNP, MNR and Gen-MNR in a simulation study and acase study on transport mode choice behaviour. We find that both MNR and Gen-MNRdeliver significantly better in-sample fit and out-of-sample predictive accuracy than MNP.Gen-MNR outperforms MNR due to its more flexible kernel error distribution. Also,Gen-MNR gives more reasonable elasticity estimates than MNP and MNR, in particularregarding the demand for under-represented alternatives in a class-imbalanced dataset

Sterilization policies in the EMS countries: an empirical analysis

SIGLEBibliothek Weltwirtschaft Kiel C 144763 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Metodos de calculo de espesadores por ensayos discontinuos

SIGLEESSpai

A performance evaluation for the EMS: a discriminant analysis approach

SIGLEBibliothek Weltwirtschaft Kiel C 143638 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Rational expectations in European economies

Bibliothek Weltwirtschaft Kiel C 148579 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman