Management of a primary Grynfeltt's hernia.

Lumbar hernia is a rare disease, which can be acquired spontaneously or secondarily (post-traumatically, postoperatively…) or congenitally. It results from the existence of areas of weakness between the different muscles forming the posterior abdominal wall: the deep-seated Grynfeltt triangle and the superficial Jean-Louis Petit triangle.

Enhanced Avulsion Technique for Brachioplasty and Cruroplasty: Minimizing Complications and Ensuring Patient Safety.

Background Brachioplasty and cruroplasty are commonly performed aesthetic procedures, but they are not without their risks. Among the potential complications, the development of seroma or hematoma is particularly concerning. In this article, we present a modified avulsion technique designed to reduce complications and improve patient outcomes.

A systematic review of Nightmare prevalence in children.

The purpose of this narrative review was to describe prevalence rates of nightmares and nightmare disorder in school-aged youth according to sample characteristics and methods used to assess nightmares. We searched PsychINFO, PubMed, and CINAHL databases to identify empirical peer-reviewed articles and grey literature published between 2001 and 2021. Sixty-nine studies from 23 countries were included.

Methodological changes to improve retention: Results from two pediatric cognitive behavioral therapy studies.

Objective: Retention is challenging in clinical research with pediatric populations. The retention obstacles that are experienced in adult samples are compounded because child samples depend on caregiver support and engagement. The present paper describes retention improvements following protocol adaptations across a pair of cognitive behavioral pilot studies for nightmare sufferers aged 6-17.

Seasonality of top-down control of bacterioplankton at two central Red Sea sites with different trophic status.

The role of bottom-up (nutrient availability) and top-down (grazers and viruses mortality) controls on tropical bacterioplankton have been rarely investigated simultaneously from a seasonal perspective. We have assessed them through monthly samplings over 2 years in inshore and offshore waters of the central Red Sea differing in trophic status. Flow cytometric analysis allowed us to distinguish five groups of heterotrophic bacteria based on physiological properties (nucleic acid content, membrane integrity and active respiration), three groups of cyanobacteria (two populations of Synechococcus and Prochlorococcus), heterotrophic nanoflagellates (HNFs) and three groups of viruses based on nucleic acid content.

Vitamins and minerals: A means for surviving the COVID-19 pandemic or just a myth?

A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) that was initially reported from Wuhan, China in December 2019, was declared a pandemic by the WHO in March 2020. Considering the current COVID-19 pandemic, where there are no specific effective preventive or therapeutic drugs available, a healthy immune system is one of the most important tools that should be considered. Vitamins and minerals supplements have been well known to help the immune system in battling viral infections in general.

Right Ventricular Dysfunction and Short-Term Outcomes Following Left-Sided Valvular Surgery: An Echocardiographic Study.

Background The prognostic value of echocardiographic evaluation of right ventricular (RV) function in patients undergoing left-sided valvular surgery has not been well described. The objective of this study is to determine the role of broad echocardiographic assessment of RV function in predicting short-term outcomes after valvular surgery. Methods and Results Preoperative echocardiographic data, perioperative adverse outcomes, and 30-day mortality were analyzed in patients who underwent left-sided valvular surgery from 2006 to 2014.

Patent foramen ovale closure in the management of cryptogenic stroke: a review of current literature and guideline statements.

Objective: The management recommendations for patent foramen ovale (PFO) closure in cryptogenic stroke are rapidly evolving. The data has expanded recently with four major trials demonstrating superiority of percutaneous device closure over medical management in preventing cryptogenic stroke recurrence. This paper aims to review the current literature for referring physicians who may encounter patients with patent foramen ovale before referring these patients to stroke specialists and/or interventional cardiologists.

Superior vena cava thrombosis and dilated cardiomyopathy as initial presentations of Behcet's disease.

Background: Bechet's disease (BD) is a relatively rare disease that causes recurrent oral and genital ulcers in addition to a variety of systemic manifestations. Concomitant superior-vena-cava (SVC) thrombosis and cardiac involvement with dilated cardiomyopathy (DCM) as initial presentations for BD is considered rare.

Case Presentation: A 32-year-old-man presenting with intractable headaches and dyspnea.

A single, shared origin for all three coronary arteries from the right coronary cusp: a case report.

Background: Anomalous coronary arteries occur in less than 1% of the population and have been implicated in sudden cardiac and exercise-related death. The most common variant involves the left circumflex artery arising from a separate ostium than the left coronary artery. This case demonstrates a rare variation in which all three coronary arteries arise from a shared, single, ostium originating from the right coronary cusp.

Intra-Arterial Hemodynamics to Guide the Percutaneous Treatment of a Difficult-to-Engage Transplant Renal Artery Stenosis.

Transplant renal artery stenosis (TRAS) is the most frequent vascular complication after renal transplantation. TRAS is associated with resistant hypertension and allograft dysfunction, early diagnosis and either endovascular or surgical treatment is crucial to preserve graft function. Noninvasive imaging can usually detect the underlying stenosis.

Causes of Failure to Capture in Pacemakers and Implantable Cardioverter-defibrillators.

The number of patients with implantable electronic cardiac devices is continuously increasing. As more pacemakers and implantable cardioverter-defibrillators (ICDs) are being placed, a basic understanding of some troubleshooting for devices is becoming essential. Loss of capture can be an emergent presentation for an unstable patient and can be encountered intermittently in hospitalized patients.

Resin Alcoholic Extract Ameliorates High Fat Diet Induced Obesity via Regulation of UCP1 and Adiponectin Proteins Expression in Rats.

This study was performed to evaluate anti-obesity potential of resin ethanolic extract (CME) with the respect to expression of leptin, adiponectin and uncoupling protein 1 (UCP1) in rats. Control rats fed basal diet. Second group fed basal diet and administered CME (500 mg/kg bw) orally for 14 weeks.

Weekly variations of viruses and heterotrophic nanoflagellates and their potential impact on bacterioplankton in shallow waters of the central Red Sea.

Bacterioplankton play a pivotal role in marine ecosystems. However, their temporal dynamics and underlying control mechanisms are poorly understood in tropical regions such as the Red Sea. Here, we assessed the impact of bottom-up (resource availability) and top-down (viruses and heterotrophic nanoflagellates) controls on bacterioplankton abundances by weekly sampling a coastal central Red Sea site in 2017.

Auscultation Serendipitously Leading to the Discovery of a Type A Aortic Dissection: The Lost Art of Physical Examination.

In the current era of rapidly advancing and evolving medicine, a huge emphasis has been placed on the utilization of diagnostic tests and imaging, as well as on following updated guidelines, at the expense of focusing on clinical exams and honing these skills. Poor physical exam skills is a definite risk to patient safety, as they might lead to the misdiagnosis of, sometimes, fatal diseases. In this case, we discuss a case of complicated aortic dissection type A that initially presented to us as a case of worsening chronic graft rejection.

[Hormonal contraception and vascular risk: CNGOF Contraception Guidelines].

Venous thromboembolism and arterial ischemic events are the main deleterious diseases associated with the use of combined hormonal contraceptives (CHC). Even though their composition has been substantially improved, the vascular risk persists with the most recent CHCs use. If the vascular risk associated with CHCs containing 50μg EE is significantly higher than with those containing less than 50μg, there is no evidence that the CHCs containing either 30 or 20μg of EE induce different venous risks.

Challenges in Treatment of Inappropriate Sinus Tachycardia.

Background: Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a sinus heart rate inexplicably higher than one hundred beats per minute at rest that is associated with symptoms like palpitations, dyspnea or dizziness in the absence of primary causes of tachycardia. The diagnosis requires exclusion of other causes of tachycardia including medications/substances (such as anti-cholinergic, beta-blocker withdrawal, caffeine, and alcohol) or medical conditions (such as panic attacks, pulmonary embolism, fever, hyperthyroidism, hypovolemia, anemia, and pain).

Methods: Work up should include an EKG to differentiate other causes of tachycardia, 24 hour- Holter monitor if indicated, serum thyroid levels, hemoglobin levels and toxicology screen.

Histopathology of the idiopathic interstitial pneumonias (IIP): A review.

The 2013 American Thoracic Society/European Respiratory Society consensus classification update of the idiopathic interstitial pneumonias (IIP) included several important modifications to the organization and spectrum of the diseases that were proposed in an earlier multidisciplinary consensus document in 2002. The histopathology of the now 'major' and 'rare' IIP is presented here with exposition of the newly included entity of a distinctive upper lobe fibrotic lung disease referred to as idiopathic pleuroparenchymal fibroelastosis. The 'rare histological patterns' of acute fibrinous and organizing pneumonia and bronchiolocentric patterns of interstitial pneumonia are illustrated and discussed.

[Pneumonia in the inmunocompromised host: perspective through images diagnosis and a Bayesian inference].

Introduction: The population of immunocompromised patients has increased in recent decades. Many of these patients eventually present infectious complications including pneumonia, which is a diagnostic that must to be prompt and accurate.

Objective: To review the basis of the diagnosis of pneumonia in the immunocompromised patient.

[Survival of patients with biopsy-proven idiopathic pulmonary fibrosis: Chilean National Thorax Institute experience].

Background: Idiopathic Pulmonary Fibrosis (IPF) is the most prevalent of all interstitial lung diseases. The usual underlying pathological picture is an interstitial pneumonia (UIP).

Aim: To describe the evolution of a Chilean cohort of patients with IPF.

Hybrid models identified a 12-gene signature for lung cancer prognosis and chemoresponse prediction.

Background: Lung cancer remains the leading cause of cancer-related deaths worldwide. The recurrence rate ranges from 35-50% among early stage non-small cell lung cancer patients. To date, there is no fully-validated and clinically applied prognostic gene signature for personalized treatment.