Self-Insertion of Foreign Bodies in Urethra and Bladder: Report of Three Pediatric Cases

Self-inserted urethrovesical foreign bodies are rare in children.We present three cases and discuss the clinical presentation, diagnosis and management of such patients. In case 1, a 16-year-old boy introduced a wire into the urethra and partially into the bladder three days before. In case 2, a 4-year-old boy introduced a hairpin in the urethra in the same day. In case 3, a 11-year-old boy introduced a sewing needle in the urethra a few hours before. Cystourethroscopy and suprapubic cystotomy were used to remove the foreign bodies. The presentation of urethrovesical foreign bodies can vary widely, as can the type of object inserted. Foreign body retrieval is determined by its morphology and the patient’s conditions with the aim to minimise urothelial trauma and preserve erectile function. Definitive treatment is usually the endoscopic removal, however sometimes surgical intervention may be required. It is advocated follow-up with long duration, which is necessary to diagnose the long-term complications including urethral stricture.info:eu-repo/semantics/publishedVersio

Fibre enrichment of cookies to mitigate acrylamide formation and gastrointestinal bioaccessibility

Acrylamide (AA) is a food contaminant with serious health effects. In this work, the addition of dietary fibre was proposed to mitigate AA in cookies and to reduce bioaccesibility in the gastrointestinal trac. The analytical methodology applied for AA quantification was based on solid-liquid extraction (SLE) followed by gas chromatography (GC) coupled to mass spectrometry (MS). Preliminar results with commercial dietary fibres, such as k-carrageenan, arabinogalactan and pectin, indicated that the highest reduction of AA could be obtained with the addition of 5 g of pectin/100 g of flour to cookies recipe. Thus, different sources of pectin were evaluated: commercial pectin (CP) and three apple pomaces (dehydrated apple pomace (DP), sugar removed lyophilized apple pomace (SRL) and sugar removed lyophilized and powdered apple pomace (SRLP)). The highest AA mitigation was obtained with SRL and SRLP (62% and 48% of inhibition). After in vitro digestion, all sources of dietary fibres provided the lowest bioaccessibility results (1346%) compared with control (>63%). (c) 2023 The Author

Upper bounds for number of removed edges in the Erased Configuration Model

Models for generating simple graphs are important in the study of real-world complex networks. A well established example of such a model is the erased configuration model, where each node receives a number of half-edges that are connected to half-edges of other nodes at random, and then self-loops are removed and multiple edges are concatenated to make the graph simple. Although asymptotic results for many properties of this model, such as the limiting degree distribution, are known, the exact speed of convergence in terms of the graph sizes remains an open question. We provide a first answer by analyzing the size dependence of the average number of removed edges in the erased configuration model. By combining known upper bounds with a Tauberian Theorem we obtain upper bounds for the number of removed edges, in terms of the size of the graph. Remarkably, when the degree distribution follows a power-law, we observe three scaling regimes, depending on the power law exponent. Our results provide a strong theoretical basis for evaluating finite-size effects in networks

Optimization of K-edge subtraction imaging using a pixellated spectroscopic detector

Conventional K-edge subtraction imaging is based around the acquisition of two separate images at energies respectively below and above the K-edge of a contrast agent. This implies increased patient dose with respect to a conventional procedure and potentially incorrect image registration due to patient motion. © 2012 IEEE

Long-Term weight loss and metabolic syndrome remission after bariatric surgery: The effect of sex, age, metabolic parameters and surgical technique-a 4-year follow-up study

Introduction: Bariatric surgery is an effective treatment for morbid obesity and its metabolic related comorbidities. However, the literature reports inconsistent results regarding weight loss (WL) and the resolution of comorbidities associated with obesity. Objective: We aim to evaluate long-Term differences in WL between different surgical techniques and the impact of each surgical technique on metabolic parameters (type 2 diabetes mellitus [T2DM], dyslipidemia,hypertension, and metabolic syndrome). We also aim to evaluate the effect of baseline clinical characteristics in WL and in the evolution of metabolic syndrome (MetS) components. Our hypothesis is that different types of surgery have different effects on WL and the prevalence of comorbidities over time. Methods: We retrospectively evaluated WL and metabolic parameter remission (T2DM, dyslipidemia, hypertension, and MetS) during 4 years in 1,837 morbidly obese patients (females, 85%; age, 42.5 ± 10.6 years; BMI, 44.0 ± 5.8) who underwent bariatric surgery (Roux-en-Y gastric bypass [RYGB], laparoscopic sleeve gastrectomy [LSG], and laparoscopic adjustable gastric band [LAGB]). Results: The mean percentage of WL for RYGB, LSG, and LAGB was, respectively, 32.9 ± 8.7, 29.8 ± 9.8, and 16.2 ± 9.6 at 12 months and 30.6 ± 9.1, 22.7 ± 10.0, and 15.8 ± 10.8 at 48 months (p < 0.001), even after adjustment for baseline weight, BMI, age, and sex (p < 0.001). Women had more WL during the first 36 months (p = 0.013 and 0.007 at 12 and 36 months, respectively) and older patients had less WL compared to younger ones (p <0.001), except at 48 months. Patients with T2DM had less WL than those without diabetes after adjustment (sex, age, and surgical technique) during the same period. Patients with hypertension had less WL at 12 months (p = 0.009) and MetS at 24 months (p = 0.020) compared to those without these comorbidities. There was no significant difference regarding the presence of dyslipidemia in WL. The RYGB group showed better results for MetS resolution. Conclusion:During the 4-year follow-up, RYGB was the surgical procedure that caused the highest WL and MetS resolution

Non drowsy obstructive sleep apnea as a potential cause of resistant hypertension: a case report

<p>Abstract</p> <p>Background</p> <p>Obstructive sleep apnea (OSA) and arterial hypertension (AH) are common and underrecognized medical disorders. OSA is a potential risk factor for the development of AH and/or may act as a factor complicating AH management. The symptoms of excessive daytime sleepiness (EDS) are considered essential for the initiation of continuous positive airway pressure (CPAP) therapy, which is a first line treatment of OSA. The medical literature and practice is controversial about the treatment of people with asymptomatic OSA. Thus, OSA patients without EDS may be left at increased cardiovascular risk.</p> <p>Case presentation</p> <p>The report presents a case of 42year old Asian woman with symptoms of heart failure and angina like chest pain upon admission. She didnt experience symptoms of EDS, and the Epworth Sleepiness Scale was seven points. Snoring was reported on direct questioning. The patient had prior medical history of three unsuccessful pregnancies complicated by gestational AH and preeclampsia with C-section during the last pregnancy. The admission blood pressure (BP) was 200/120mm Hg. The patients treatment regimen consisted of five hypotensive medications including diuretic. However, a target BP wasnt achieved in about one and half month. The patient was offered to undergo a polysomnography (PSG) study, which she rejected. One month after discharge the PSG study was done, and this showed an apnea-hypopnea index (AHI) of 46 events per hour. CPAP therapy was initiated with a pressure of 11H₂0cm. After 2months of compliant CPAP use, adherence to pharmacologic regimen and lifestyle modifications the patients BP decreased to 134/82mm Hg.</p> <p>Conclusions</p> <p>OSA and AH are common and often underdiagnosed medical disorders independently imposing excessive cardiovascular risk on a diseased subject. When two conditions coexist the cardiovascular risk is likely much greater. This case highlights a possible clinical phenotype of OSA without EDS and its association with resistant AH. Most importantly a good hypotensive response to medical treatment in tandem with CPAP therapy was achieved in this patient. Thus, it is reasonable to include OSA in the differential list of resistant AH, even if EDS is not clinically obvious.</p