Thoracic ultrasound for the detection of rib metastases of non-small cell lung cancer

Transthoracic ultrasound has lately emerged as a useful diagnostic tool for respiratory physicians in the diagnosis of diverse pulmonarydiseases, usually including pleural effusion and pneumothorax. However, the use of chest ultrasound may be also critical in the evaluationof chest wall diseases. Therefore, we present an interesting case of a patient with metastases of lung cancer to the rib, detected duringthe chest wall ultrasound examination. By representing a non-invasive, surface-imaging technique with several advantages, chest ultrasoundmay evolve to a valid, bed-side diagnostic tool for the diagnosis and follow up of lung cancer with metastases in the chest wall

“Luck’s always to blame”: silent wounds of a penetrating gunshot trauma sustained 20 years ago

Gunshot tracheal injuries represent life-threatening events and usually necessitate emergent surgical intervention. We report a case of an exceptional finding of a patient with retained ballistic fragments in the soft tissues of the thorax, proximal to the right subclavian artery and the trachea, carrying silently his wounds for two decades without any medical or surgical intervention. The bullet pellet on the upper part of the trachea seen accidentally in the chest computed tomography, was also found during bronchoscopy. In short “luck’s always to blame”

Ultrasonografia klatki piersiowej w wykrywaniu przerzutów niedrobnokomórkowego raka płuca do żeber

Ultrasonografia transtorakalna staje się coraz bardziej użytecznym narzędziem diagnostycznym w pulmonologii. Jest ona stosowana w diagnostyce różnorodnych chorób płuc, najczęściej odmy oraz płynu w jamie opłucnowej. Ultrasonografia klatki piersiowej może mieć jednak także istotne znaczenie w ocenie chorób ściany klatki piersiowej. W pracy przedstawiono przypadek pacjenta z przerzutami raka płuca do żebra, wykrytymi w trakcie badania ultrasonograficznego ściany klatki piersiowej. Ultrasonografia klatki piersiowej, jako posiadająca wiele zalet, nieinwazyjna technika obrazowania powierzchni, może rozwinąć się w ważne, przyłóżkowe narzędzie diagnostyki i obserwacji raka płuca z przerzutami do ściany klatki piersiowej.Ultrasonografia transtorakalna staje się coraz bardziej użytecznym narzędziem diagnostycznym w pulmonologii. Jest ona stosowana w diagnostyce różnorodnych chorób płuc, najczęściej odmy oraz płynu w jamie opłucnowej. Ultrasonografia klatki piersiowej może mieć jednak także istotne znaczenie w ocenie chorób ściany klatki piersiowej. W pracy przedstawiono przypadek pacjenta z przerzutami raka płuca do żebra, wykrytymi w trakcie badania ultrasonograficznego ściany klatki piersiowej. Ultrasonografia klatki piersiowej, jako posiadająca wiele zalet, nieinwazyjna technika obrazowania powierzchni, może rozwinąć się w ważne, przyłóżkowe narzędzie diagnostyki i obserwacji raka płuca z przerzutami do ściany klatki piersiowej

The 2008 Methoni earthquake sequence: the relationship between the earthquake cycle on the subduction interface and coastal uplift in SW Greece

Seismological, GPS and historical data suggest that most of the 40 mm yr$^{-1}$ convergence at the Hellenic Subduction Zone is accommodated through aseismic creep, with earthquakes of $\textit{M}$W ≲ 7 rupturing isolated locked patches of the subduction interface. The size and location of these locked patches are poorly constrained despite their importance for assessment of seismic hazard. We present continuous GPS time-series covering the 2008 MW 6.9 Methoni earthquake, the largest earthquake on the subduction interface since 1960. Post-seismic displacements from this earthquake at onshore GPS sites are comparable in magnitude with the coseismic displacements; elastic-dislocation modelling shows that they are consistent with afterslip on the subduction interface, suggesting that much of this part of the interface is able to slip aseismically and is not locked and accumulating elastic strain. In the Hellenic and other subduction zones, the relationship between earthquakes on the subduction interface and observed long-term coastal uplift is poorly understood. We use cGPS-measured coseismic offsets and seismological body-waveform modelling to constrain centroid locations and depths for the 2008 Methoni $\textit{M}$W 6.9 and 2013 Crete $\textit{M}$W 6.5 earthquakes, showing that the subduction interface reaches the base of the seismogenic layer SW of the coast of Greece. These earthquakes caused subsidence of the coast in regions where the presence of Pliocene–Quaternary marine terraces indicates recent uplift, so we conclude that deformation associated with the earthquake cycle on the subduction interface is not the dominant control on vertical motions of the coastline. It is likely that minor uplift on a short length scale (∼15 km) occurs in the footwalls of normal faults. We suggest, however, that most of the observed Plio-Quaternary coastal uplift in SW Greece is the result of thickening of the overriding crust of the Aegean by reverse faulting or distributed shortening in the accretionary wedge, by underplating of sediment of the Mediterranean seafloor, or a combination of these mechanisms.AH is supported by a Shell Exploration studentship. This study forms part of the NERC- and ESRC-funded project “Earthquakes Without Frontiers” under grant NEJ02001X/1, and was partly funded by the NERC grant “Looking inside the Continents from Space”

The Significance of Clinical Awareness of Anatomical Variations

So far, diverse congenital anatomical variations have been recognized as a consequence of failed developmental process during early embryogenesis [...

The Impact of COVID-19 Pandemic on Surgical Treatment of Resectable Non-Small Cell Lung Cancer in Greece

Background: The coronavirus disease (COVID-19) pandemic has posed an unprecedented challenge to health systems, and has significantly affected the healthcare of lung cancer patients. The aim of our study was to assess the impact of COVID-19 on early lung cancer patients’ surgical treatment. Methods: All consecutive patients with early-stage non-small cell lung cancer eligible for surgical treatment stage I/II and resectable stage III, referred to our department during the first wave of COVID-19 between February to May 2020, were included and compared with those on the exact corresponding quarter in 2019, one year before the pandemic. Waiting time to surgical treatment, increase of tumor’s size and increase on lung cancer stage were recorded and compared. All subjects were followed up for 12 months. Multiple linear and logistic regression models were applied to assess the differences in the management of the studied groups adjusting for potential confounders. Results: Sixty-one patients with early-stage lung cancer were included in the study; 28 (median age 67 years, SD: 7.1) during the pandemic and 33 (median age 67.1 years, SD: 7.5) one year earlier. A significantly longer period of waiting for treatment and an increase in tumor size were observed during the pandemic compared to before the pandemic [median time 47 days, interquartile rate (IQR): 23–100] vs. [median time 18 days, IQR: 11–23], p < 0.001. No significant differences were detected in the increase of the stage of lung cancer between the subgroups. Conclusion: The COVID-19 pandemic had a significant impact on surgical and oncological care, leading to significant delays on treatment and an increase in tumor size in early-stage lung cancer patients

Pulmonary hemorrhage in patients receiving anti-platelets- a case series and a suggested therapeutic algorithm

Antiplatelet therapy including aspirin and thienopyridine agents (such as clopidogrel, prasugrel and ticagrelor) are often used in patients with coronary disease. Pulmonary hemorrhage due to antiplatelet therapy although very rare, when excessive, is a life-threatening event. So far, there is lack of specific guidelines for the management of these patients. We report a case series of 5 patients receiving antiplatelet therapy who were admitted to the hospital due to pulmonary hemorrhage related to antiplatelet therapy. We also propose an algorithm on the management of these patients taking into consideration the balance between thrombotic and bleeding risk and the severity of the hemorrhage

Integrated heterodyne laser Doppler vibrometer based on stress-optic frequency shift in silicon nitride

Abstract We demonstrate a compact heterodyne Laser Doppler Vibrometer (LDV) based on the realization of optical frequency shift in the silicon nitride photonic integration platform (TriPleX). We theoretically study, and experimentally evaluate two different photonic integrated optical frequency shifters (OFSs), utilizing serrodyne and single-sideband (SSB) modulation. Both OFSs employ stress-optic modulators (SOMs) based on the non-resonant piezoelectrical actuation of lead zirconate titanate (PZT) thin-films, deposited on top of the silicon nitride waveguides with a wafer-scale process. To improve the modulation bandwidth of the SOMs we investigate a novel configuration of the electrodes used for the actuation, where both electrodes are placed on top of the PZT layer. Using this top-top electrode configuration we report frequency shift of 100 kHz and 2.5 MHz, and suppression ratio of the unwanted sidebands of 22.1 dB and 39 dB, using the serrodyne and the SSB OFS, respectively. The best performing SOM structure induces 0.25π peak-to-peak sinusoidal phase-shift with 156 mW power dissipation at 2.5 MHz. We use the SSB-OFS in our compact LDV system to demonstrate vibration measurements in the kHz regime. The system comprises a dual-polarization coherent detector built in the PolyBoard platform, utilizing hybrid integration of InP photodiodes (PDs). High quality LDV performance with measurement of vibration frequencies up to several hundreds of kHz and displacement resolution of 10 pm are supported with our system