Notes

Dosimetric Examination Between your Standard Volumetrically Modulated Arc Remedy (VMAT) Overall Physique Irradiation (TBI) along with the Fresh Parallel Integrated Complete Marrow Tactic (SIMBa) VMAT TBI.
Although ultrasound (US), CT, FDG-PET/CT and endoscopic evaluation are essential modalities for the diagnosis of intestinal polyposis. Final diagnosis of MLP can only be confirmed after histopathological examination and immunohistochemistry studies. compound3k Surgical resection followed by appropriate chemotherapy is the treatment of choice.

MLP due to DLBCL has rarely been described in young patients under the age of 18 years. link2 We should keep a high index of suspicion for malignant GI lymphoma in cases of intussusception, especially in older children.
MLP due to DLBCL has rarely been described in young patients under the age of 18 years. We should keep a high index of suspicion for malignant GI lymphoma in cases of intussusception, especially in older children.
An adrenal metastasis is uncommon in esophageal cancer. Its diagnosis could be challenging if a percutaneous approach was inaccessible. Moreover, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), a useful adrenal sampling technique, is complicated by the luminal obstruction.

A patient with esophageal cancer accompanying by adrenal mass and established gastrostomy was described. The EUS-FNA of the adrenal lesion was successfully performed via the dilated gastrostomy tract. Adequate tissue for pathological examination was achieved, and the result indicated metastatic squamous cell carcinoma. Chemotherapy was started accordingly.

This report described an uncommon event of adrenal metastasis of esophageal primary. Even though it is possible to perform EUS via the gastrostomy tract, performing EUS from an unusual direction might add some difficulty to an endoscopist, considering that EUS involves image pattern recognition in identifying structures. Thus, this technique should be operated by experienced EUS endoscopists.

Gastrostomy can provide an enteral route for nutrition support in esophageal cancer patients. In addition, it could be an alternative EUS intervention portal when an esophageal stent is not accessible.
Gastrostomy can provide an enteral route for nutrition support in esophageal cancer patients. In addition, it could be an alternative EUS intervention portal when an esophageal stent is not accessible.
In closed abdominal trauma, the spleen is the most frequently injured organ (30-45%). Splenic lesions grades IV-V have higher failure rates with nonoperative management (NOM). The minimally invasive approach is an alternative when NOM fails. This is the first reported case of a patient with splenic and left renal trauma, both grade IV, with combined management, which consisted of a minimally invasive surgical resolution of the splenic trauma and a conservative management of the renal trauma, with a satisfactory recovery of the patient. This contributes to understanding the benefits of minimally invasive surgery in moderate splenic trauma associated with other high-grade injuries.

We present a 45-year-old woman with a multiple trauma after a motorbike vs car traffic accident. On physical examination, she was hemodynamically stable, with abdominal guarding and generalized rebound tenderness associated with multiple upper and lower limb fractures. An abdominal CT scan revealed grade IV splenic and left renal trauma, with moderate hemoperitoneum. A minimally invasive laparoscopic approach for hemoperitoneum drainage and splenectomy was performed.

There is currently no consensus to define the indications for minimally invasive treatment on splenic trauma. While laparotomy is the standard treatment, it is not without potential severe complications, while laparoscopy providing a treatment option in selected cases with hemodynamic stability.

The role of the minimally invasive approach is safe and feasible in selected patients with high-grade splenic lesions and hemodynamic stability, including the association with other organic lesions such as kidney trauma.
The role of the minimally invasive approach is safe and feasible in selected patients with high-grade splenic lesions and hemodynamic stability, including the association with other organic lesions such as kidney trauma.
Reduced port laparoscopic surgery using an umbilical zigzag incision is comparable to conventional multiport laparoscopic surgery. This method is associated with improved cosmesis and decreased wound pain.

A 67-year-old man visited our hospital. He presented emergency room with a chief complaint of right lower abdominal pain by walking. The patient was diagnosed Meckel's diverticulitis by computed tomography (CT). At first, antibiotics therapy and fasting were performed. Three months later, the patient underwent resection of Meckel' diverticulum with zigzag transumbilical laparoscopic surgery. The patient's postoperative course was good, and he rarely felt wound pain. The patient started oral intake three days after surgery, and was discharged 10 days after surgery.

Zigzag transumbilical laparoscopic surgery is very useful for resection of the small intestine. This method is associated with improved cosmesis and decreased wound pain. In the case of Meckel's diverticulitis, we suggest that interval resection of Meckel's diverticulum was very useful as it was an operation that could be performed easily.

Reduced port laparoscopic surgery using an umbilical zigzag incision is considered to be an excellent technique in terms of operability and aesthetic outcomes.
Reduced port laparoscopic surgery using an umbilical zigzag incision is considered to be an excellent technique in terms of operability and aesthetic outcomes.
Isolated sphenoid opacification is a rare pathology. Unlike other sinusitis, the treatment is most often surgical. Only few studies reporting the recurrence rates with long-term follow-ups are available in the literature. In our experience, isolated sphenoid sinusitis tends to have a significant recurrence rate after a first surgical intervention. link3 This study aims to describe our experience with patients operated for isolated sphenoid sinusitis and to compare our reoperation and complication rates with those reported in the literature.

We conducted an electronic chart review of patients operated at the CHU de Québec between 2007 and 2018 for isolated sphenoid sinusitis.

29 patients were analyzed. All patients had a sphenoidectomy with a transnasal approach. The reoperation rate was 10.3% (3/29) and the mean recurrence time was 15 (9-26) months. Among the patients reoperated, 2 patients had a fungus ball and one had a mucocele. Both patients with fungal balls had reossification of their sphenoidal ostium whereas the patient with the mucocele rather had a mucosal closure. No patient encountered any serious post-operative complication. Median duration of follow-up was 44 months (IQR 25-68) for the 29 patients analyzed in our study.

Reoperation rates reported in the literature are probably underestimated. Our series emphasizes the importance of long-term follow-up for these pathologies. Highly inflammatory and chronic conditions such as fungal diseases could be linked to an increase in the occurrence of relapses.
Reoperation rates reported in the literature are probably underestimated. Our series emphasizes the importance of long-term follow-up for these pathologies. Highly inflammatory and chronic conditions such as fungal diseases could be linked to an increase in the occurrence of relapses.
Carney triad is a rare entity of unknown etiology, characterized by the association of tumors with low incidence such as gastric leiomyosarcoma, pulmonary chondroma and extra-adrenal paraganglioma. We show a case of Carney triad diagnosed in our center that has some different characteristics to the typical presentation of this patology, and a review of the literature.

We present the case of a 47-year-old men who was admitted to our hospital for upper gastrointestinal bleeding and anemia. The patient was diagnosed of gastric GIST (gastrointestinal stromal tumor), pulmonary nodule and retroperitoneal nodule close to iliac bifurcation. A review of his medical history revealed that he had undergone surgery at 18-year-old for gastric leiomiosarcoma, subtotal gastrectomy performed with gastroenteric anastomosis type Billroth II. The patient underwent total gastrectomy with a end-lateral esophago-jejune mechanical anastomosis and retroperitoneal tumor was also excised. Pathological result confirmed gastric GIST, and extra-adrenal paraganglioma.

We review the available literature to determinate the characteristics and the most appropriate management for this syndrome. The trend is surgical treatment of gastric GIST and paraganglioma, preferred conservative treatment in pulmonary chondroma. It is under discussion whether gastric tumors Carney syndrome is considered GIST, because the Carney triad lesions in stomach are different clinically, pathologically, and etiologically from GIST of stomach.

Carney's triad is a low prevalence entity, with a limited number of publications, so the presentation of the syndrome may be different from the presentation described in the literature.
Carney's triad is a low prevalence entity, with a limited number of publications, so the presentation of the syndrome may be different from the presentation described in the literature.COVID-19 has transformed day-to-day functioning and exacerbated mental health concerns. The current study examines preliminary feasibility and acceptability of a VA CONNECT - a novel 10-session, manualized telehealth group intervention integrating skills training and social support to develop a Safety & Resilience Plan for Veterans experiencing COVID-related stress. Data from the first 20 participants support the intervention's feasibility and acceptability. Strengths, limitations, and suggestions for improvement of the intervention are noted. Collaboration with other VA researchers would aid in protocol dissemination and evaluation of VA CONNECT's utility for reducing COVID-19-related stress, loneliness, and mental health symptoms.Nitrogen losses from intensive agricultural production may end up as high nitrate (NO3-) concentrations in groundwater, with a long-term impact on groundwater quality. The main objective of this study was to evaluate the impact of fertilization practices used for grape cultivation on groundwater quality of Tidone Valley, northwest of Italy, following an integrated socio-hydrogeological approach that consists on (i) the involvement of 175 farmers in the description of agricultural and fertilization practices, using a survey of ad hoc questionnaires, (ii) the evaluation of NO3- occurrence in groundwater and (iii) the identification of NO3- sources through isotopic and hydrochemical analysis. In this area, as for certain particular Apennines shallow aquifers, groundwater is of reduced interest due to its limited storage capacity and there are insufficient wells currently monitored by the local Environmental Agency (ARPAE) to evaluate the impact of agricultural fertilization on existing local aquifers. Farmers' qation of regional groundwater.In recent years, microalgal feedstocks have gained immense potential for sustainable biofuel production. Thermochemical, biochemical conversions and transesterification processes are employed for biofuel production. Especially, the transesterification process of lipid molecules to fatty acid alkyl esters (FAAE) is being widely employed for biodiesel production. In the case of the extractive transesterification process, biodiesel is produced from the extracted microalgal oil. Whereas In-situ (reactive) transesterification allows the direct conversion of microalgae to biodiesel avoiding the sequential steps, which subsequently reduces the production cost. Though microalgae have the highest potential to be an alternate renewable feedstock, the minimization of biofuel production cost is still a challenge. The biorefinery approaches that rely on simple cascade processes involving cost-effective technologies are the need of an hour for sustainable bioenergy production using microalgae. At the same time, combining the biorefineries for both (i) high value-low volume (food and health supplements) and (ii) low value- high volume (waste remediation, bioenergy) from microalgae involves regulatory and technical problems.
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