Sebaceous gland tumors and internal malignancy in the context of Muir-Torre syndrome. A case report and review of the literature

BACKGROUND: The Muir-Torre syndrome is a rare autosomal dominant condition and is currently considered a subtype of the more common hereditary nonpolyposis colorectal cancer syndrome, in which multiple primary malignancies occur together with sebaceous gland tumors. CASE PRESENTATION: We describe a case of a 62-year-old woman with three primary colorectal tumors, genital tumor, and sebaceous adenomas and present her family history of three generations. Our case represents the first case reported from Greece in the international literature. CONCLUSION: Recognition of the syndrome in patients with sebaceous gland tumors should facilitate early detection of subsequent malignancies if the patient is entered into appropriate screening programs

Estimation of the stress related to conservative scoliosis therapy: an analysis based on BSSQ questionnaires

BACKGROUND: Adolescent girls treated with a brace for scoliosis are submitted to prolonged stress related to both the disease and the therapy. Currently proposed quality of life questionnaires are focused on the outcome of therapy. Bad Sobernheim Stress Questionnaire (BSSQ) enables monitoring of patients being under treatment with a brace or exercises. The aim of the study was to assess the stress level in conservatively managed scoliotic girls using BSSQ. MATERIALS AND METHODS: 111 girls, aged 14,2 ± 2,2 years, mean Cobb angle of the primary curve 42,8° ± 17,0° and mean Bunnell angle of 11,4° ± 4,5° were examined with two versions of BSSQ (Deformity and Brace). The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. RESULTS: The BSSQ Deformity revealed the median of 17 points in patients managed with exercises (from 4 to 24 points), 18 in patients managed with a brace (from 8 to 24 points) and 12 in patients before surgery (from 3 to 21 points). Braced patients who completed both questionnaires (n = 50) revealed significantly higher score with BSSQ Deformity (median = 18) comparing to BSSQ Brace (median = 9). There was a correlation between the total score of BSSQ Deformity and the Cobb angle (r = -0,34), Bunnell primary curve rotation (r = -0,34) and Bunnell sum of rotation (r = -0,33) but not with the age of patients. CONCLUSION: Scoliotic adolescents managed with exercises and brace suffered little stress from the deformity. The brace increased the level of stress over the stress induced by the deformity. The stress level correlated with clinical deformity (Bunnell angle), radiological deformity (Cobb angle) and the type of treatment (exercises, bracing, surgery). Bad Sobernheim Stress Questionnaires are simple and helpful in the management of girls treated conservatively for idiopathic scoliosis

Συσχέτιση Σεισμικών Παραμέτρων και Ολικών Δεικτών Βλάβης σε Κατασκευές Οπλισμένου Σκυροδέματος

In the present work, a correlation is made between seismic intensity parameters and total damage indicators of reinforced concrete structures. For this purpose, natural ground motions recordings were used, from which intensity measures were calculated and alternatives were proposed. Then, through dynamic inelastic time history analyzes, damage indices were evaluated for 1st and 2nd order theory (P-Delta effects). The correlation between each seismic parameter and the corresponding damage index was made through polynomial regressions. Seismic parameters that do not take into account the characteristics of the building, showed a minimal or moderate correlation, while spectral parameters of velocities and energies explain the change of damage indices in percentages above 80 or even 90 per cent.Στην παρούσα εργασία πραγματοποιείται συσχέτιση μεταξύ σεισμικών παραμέτρων έντα-σης και ολικών δεικτών βλάβης σε κατασκευές οπλισμένου σκυροδέματος. Για αυτόν τον σκοπό, χρησιμοποιήθηκαν καταγραφές πραγματικών σεισμών, από τις οποίες υπολογίστηκαν παράμετροι, που χαρακτηρίζουν ένα επιταχυνσιογράφημα και προτάθηκαν εναλλακτικές τους. Στη συνέχεια μέσω δυναμικών ανελαστικών αναλύσεων χρονοϊστορίας αποτιμήθηκαν δείκτες βλάβης για θεωρία 1ης και 2ης τάξης. Η συσχέτιση μεταξύ του εκάστοτε ζεύγους σεισμικής παραμέτρου και δείκτη βλάβης έγινε μέσω πολυωνυμικών παλινδρομήσεων. Σεισμικές παρά-μετροι που δεν λαμβάνουν υπόψη τους τα χαρακτηριστικά του ταλαντωτή, παρουσίασαν ελάχιστη ή μέτρια συσχέτιση, ενώ φασματικές παράμετροι ταχυτήτων και ενεργειών ερμη-νεύουν τη μεταβολή των δεικτών βλάβης σε ποσοστά άνω του 80 ή και 90 τοις εκατό

Double Duct to Mucosa Pancreaticojejunostomy for Bifid Pancreatic Duct following Pylorus Preserving Pancreaticoduodenectomy: A Case Report

Bifid pancreatic duct represents a relatively rare anatomical variation of the pancreatic ductal system, in which the main pancreatic duct is bifurcated along its length. This paper describes the challenging surgical management of a 68-year-old male patient, with presumptive diagnosis of periampullary malignancy who underwent a successful double duct to mucosa pancreaticojejunostomy for bifid pancreatic duct. Following pylorus preserving pancreaticoduodenectomy, careful intraoperative inspection of the cut surface of the residual dorsal pancreas identified the main in addition to the secondary pancreatic duct orifice. Bifid duct anatomy was confirmed via intraoperative probing and direct visualization of the ductal orifices. A decision was made for the performance of an end-to-site double duct to mucosa pancreaticojejunostomy. Postoperative outcome was favorable without any complications. Although bifid pancreatic duct is relatively rare, pancreatic surgeons should be aware of this anatomical variation and be familiar with the surgical techniques for its successful management. Lack of knowledge and surgical expertise for dealing with this anatomical variant may lead to serious, life threatening postoperative complications following pancreatic resections

Structural Damage Prediction of a Reinforced Concrete Frame under Single and Multiple Seismic Events Using Machine Learning Algorithms

Advanced machine learning algorithms have the potential to be successfully applied to many areas of system modelling. In the present study, the capability of ten machine learning algorithms to predict the structural damage of an 8-storey reinforced concrete frame building subjected to single and successive ground motions is examined. From this point of view, the initial damage state of the structural system, as well as 16 well-known ground motion intensity measures, are adopted as the features of the machine-learning algorithms that aim to predict the structural damage after each seismic event. The structural analyses are performed considering both real and artificial ground motion sequences, while the structural damage is expressed in terms of two overall damage indices. The comparative study results in the most efficient damage index, as well as the most promising machine learning algorithm in predicting the structural response of a reinforced concrete building under single or multiple seismic events. Finally, the configured methodology is deployed in a user-friendly web application.Keywords: seismic sequence; machine learning algorithms; repeated earthquakes; structural damage prediction; intensity measures; damage accumulation; machine learning; artificial neural networ

Structural Damage Prediction Under Seismic Sequence Using Neural Networks

Advanced machine learning algorithms, such as neural networks, have the potential to be successfully applied to many areas of system modelling. Several studies have been already conducted on forecasting structural damage due to individual earthquakes, ignoring the influence of seismic sequences, using neural networks. In the present study, an ensemble neural network approach is applied to predict the final structural damage of an 8-storey reinforced concrete frame under real and artificial ground motion sequences. Successive earthquakes consisted of two seismic events are utilised. We considered 16 well-known ground motion intensity measures and the structural damage that occurred by the first earthquake as the features of the machine-learning problem, while the final structural damage was the target. After the first seismic events and after the seismic sequences, both actual values of damage indices are calculated through nonlinear time history analysis. The machine-learning model is trained using the dataset generated from artificial sequences. Finally, the predictive capacity of the fitted neural network is accessed using the natural seismic sequences as a test set

Repair of an inguinoscrotal hernia containing the urinary bladder: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cases of patients with inguinoscrotal hernia containing the urinary bladder are very rare. These patients usually present with frequent episodes of urinary tract infection, difficulty in walking, pollakisuria and difficulty in initiating micturition because of incarceration of the urinary bladder into the scrotum.</p> <p>Case presentation</p> <p>We describe the case of an 80-year-old Caucasian man with an incarcerated urinary bladder into the scrotum who underwent surgical repair with mesh.</p> <p>Conclusions</p> <p>Diagnosis of such cases often requires not only clinical examination but also specialized radiological examinations to show the ectopic position of the urinary bladder. Surgical repair in these patients is a real challenge for surgeons.</p

Development and preliminary validation of Brace Questionnaire (BrQ): a new instrument for measuring quality of life of brace treated scoliotics

BACKGROUND: The quality of life among children with idiopathic scoliosis during their adolescence has been reported to be affected by the brace itself. However, a controversy exists whether brace treated scoliotics experience a poor quality of life, thus there is a need for the development of a brace-oriented instrument, as the now-existing questionnaires that are commonly used, such as the SRS -22, take into consideration the effects of both the conservative and the surgical treatment on quality of life of scoliotic children. The aim of the present study is to assess the validity and reliability of Brace Questionnaire (BrQ), a new instrument for measuring quality of life of scoliotic adolescents who are treated conservatively with a brace. MATERIAL-METHOD: Methodology of development involved literature review, patient and health care professionals' in-depth interviews and content validity analysis on patients. A validation study was performed on 28 brace treated scoliotic children aged between 9 and 18 years old. BrQ was assessed for the following psychometric properties: item convergent validity, floor and ceiling effects, internal consistency reliability, clinical validity and responsiveness to change. RESULTS: BrQ is self administrated and developmentally appropriate for ages 9 to 18 years old and is consisted of 34 Likert-scale items associated with eight domains: general health perception, physical functioning, emotional functioning, self esteem and aesthetics, vitality, school activity, bodily pain and social functioning of scoliotic children treated conservatively with a brace. The subscales of these eight dimensions can be combined to produce a total score. Higher scores mean a better quality of life. An item convergent validity ≥ 0.40 was satisfied by all items in the present study. A satisfactory internal consistency reliability for the BrQ was recorded (Cronbach's alpha coefficient was 0.82). There were no floor or ceiling effects. The correlation between BrQ overall scores and mild and moderate scoliosis was statistically significant (p < 0.001), revealing high clinical validity. An increase in effect sizes for the patient with improved scoliotic curves indicates that the BrQ is responsive to change in health status. CONCLUSION: BrQ is reliable, valid and responsive to change in adolescents with IS who are treated conservatively with a brace