Laparoscopic Management for Carcinoid Metastasis to the Spleen

We report a rare case of a laparoscopic splenectomy performed for a carcinoid metastasis. The patient represented with pleuritic left-sided chest pain from pleural deposits 9 years following resection of a primary lung carcinoid tumour. They were found to have a 4.7 cm splenic lesion on CT with a probable left acetabular metastasis demonstrated on Gallium PET scan. The patient underwent laparoscopic splenectomy for debulking treatment of the splenic lesion that was confirmed to be a splenic metastasis of the resected carcinoid lung tumour. Following an uncomplicated recovery, the patient was discharged on the second postoperative day. On discharge, she received adjuvant therapy with Lutetium 177 DOTATATE. This is the first report of a carcinoid splenic metastasis successfully treated with laparoscopic splenectomy

Schwann Cells Overexpressing FGF-2 Alone or Combined with Manual Stimulation Do Not Promote Functional Recovery after Facial Nerve Injury

Purpose. To determine whether transplantation of Schwann cells (SCs) overexpressing different isoforms of fibroblast growth factor 2 (FGF-2) combined with manual stimulation (MS) of vibrissal muscles improves recovery after facial nerve transection in adult rat. Procedures. Transected facial nerves were entubulated with collagen alone or collagen plus naïve SCs or transfected SCs. Half of the rats received daily MS. Collateral branching was quantified from motoneuron counts after retrograde labeling from 3 facial nerve branches. Quality assessment of endplate reinnervation was combined with video-based vibrissal function analysis. Results. There was no difference in the extent of collateral axonal branching. The proportion of polyinnervated motor endplates for either naïve SCs or FGF-2 over-expressing SCs was identical. Postoperative MS also failed to improve recovery. Conclusions. Neither FGF-2 isoform changed the extent of collateral branching or polyinnervation of motor endplates; furthermore, this motoneuron response could not be overridden by MS

A Critique of ‘Neoliberal Autonomy’: The Rhetoric of Ownership Society

Ownership Society, Neoliberal(ism), Autonomy, Social Security privatization,

Characterisation of the impact and features of trampoline park-related injuries

Introduction Numerous studies have described indoor trampoline park (ITP)-related injury patterns, but they have shown heterogeneous results. No such study has been performed in Germany to date. The aim of this study was to analyse the specific trampoline-related injury patterns found in our population. Methods This retrospective study included patients suffering from ITP-related injuries between 1 October 2016 and 30 April 2018. 258 patients were included in the analysis. Patients were categorised depending on different variables including age, sex, site of injury, diagnosis, length of admission and treatment using SPSS. Results In the 19-month study period, 258 patients with ITP-related injuries were recruited. Single ITP-related injuries were diagnosed in 250 (96.9 %) patients. The median age of this group was 22 years (IQR 15-28). 126 (50.4 %) injuries were suffered by men and 124 (49.6 %) by women. 168 (67.2 %) injuries occurred in the lower extremity. Sprains (n = 114, 45.6 %) and fractures without joint dislocation (n = 59, 23.6 %) were the most common diagnoses. Males suffered significantly more often from injuries of the upper extremity (26.2 vs. 9.7 %; p = 0.010), while females most commonly suffered from injuries of the lower extremity (79.8 vs. 54.8 %; p < 0.001). 45 (18 %) patients required hospital admission and twenty-five (10.0 %) patients required surgery. Eight (3.1 %) patients suffered from injuries in more than one anatomic location. Conclusions ITP-related injuries were more prevalent in adults compared with children. The lower limb was the most affected anatomic location in all ages. The pattern of the injuries was heterogeneous, and their respective treatment represents a major challenge for traumatology surgeons

MDCT evaluation of injuries after tram accidents in pedestrians

Multidetector computed tomography (MDCT) is especially suited for emergency diagnostics in multiple trauma patients. The objectives of this study were to investigate the types and frequencies of injuries associated with tram accidents in pedestrians. Eighteen consecutive pedestrian patients with multiple traumas after tram accidents were evaluated with MDCT in our Level I Trauma Center. The mean age in our patient cohort was 36.9 years with a range from 14–92 years. There was a trend for accident events occurring more commonly during the winter months in middle-aged men, often under the influence of alcohol. Patients were divided into two groups with unilateral or complex injury patterns. In both groups, leading diagnoses were head (83.3%) and thorax injuries (66.6%). Abdominal injuries (44.4%) were less common and mainly found in the complex injuries group. The most serious injuries occurred in the complex injuries group when the victim was caught under or between tramcars. A wide range of injuries is associated with tram accidents in pedestrians, which can be classified into two main injury patterns, unilateral and complex. The life-limiting injuries in this setting involved the head with a mortality rate of 22.2% (four patients) in our cohort