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International Journal of Surgery Case... Jun 2024A right side diaphragmatic injury was linked to serious trauma to the abdomen, pelvis, and chest. The most significant type of injury was blunt abdominal trauma...
INTRODUCTION
A right side diaphragmatic injury was linked to serious trauma to the abdomen, pelvis, and chest. The most significant type of injury was blunt abdominal trauma sustained in a car collision. The left side was more likely than the right to experience herniation. The stomach and colon were the most often herniated abdominal viscera. In the same location as the diaphragm rupture, there were rib fractures, hemothorax, and liver damage. Delayed diaphragmatic rupture with diaphragmatic hernia is rare and has a mysterious nature.
CASE PRESENTATION
A 68 years old female patient who has repeated history of shortness of breath, for which she treated as lung infection presented with sudden exacerbation of shortness of breath, she witnessed history of blunt trauma 20 years back and up on investigation bowel herniation to the chest cavity diagnosed. Posteriolateral thoracotomy done, the herniated bowel reduced and the diaphragmatic defect repaired. The patient significantly improved and discharged from the hospital smoothly on 4th postoperative day.
DISCUSSION
Careful recording of past history and physical examination are the best approaches in diagnosing delayed presentation of traumatic diaphragmatic rupture. CT scan with reconstruction of the diaphragm is helpful in both diagnosis and differential diagnosis. Surgical therapy after diagnosis is the best treatment.
CONCLUSION
Delayed right side diaphragmatic hernia is a rare entity resulting in grave consequences, In a patient with history of trauma there should be a high index of suspension and patients should undergo imaging and surgical management is the best treatment.
PubMed: 38943935
DOI: 10.1016/j.ijscr.2024.109973 -
Veterinary Medicine and Science Jul 2024Toxoplasma gondii is a widely prevalent zoonotic protozoan parasite in humans and warm-blooded animals worldwide. Infection of humans by this parasite can result in...
BACKGROUND
Toxoplasma gondii is a widely prevalent zoonotic protozoan parasite in humans and warm-blooded animals worldwide. Infection of humans by this parasite can result in severe clinical symptoms, particularly in individuals with congenital toxoplasmosis or immunocompromised patients. Contamination mainly occurs through foodborne routes, especially the consumption of raw or undercooked meat from animals.
OBJECTIVES
The aim of this study was to use PCR to detect T. gondii in tissues and organs of buffaloes and cattle slaughtered at Tabriz slaughterhouse, in Iran.
METHODS
Fifty grams of heart, thigh, diaphragm and tongue from 50 buffaloes and 100 cattle slaughtered at the Tabriz industrial slaughterhouse were selected for sampling using a combination of convenience sampling. The samples were tested using a previously published PCR method.
RESULTS
Out of the 150 animal samples, T. gondii was detected in 10 (6.7%, 95%CI: 3.2-11.9), including one buffalo (2%, 95%CI: 0.1-10.6) and nine cattle (9%, 95%CI: 4.2-16.4). There was no statistically significant difference in the rate of T. gondii infection among cattle based on age and sex (p > 0.05).
CONCLUSIONS
The results indicated a potential risk of T. gondii transmission to humans through the consumption of infected meat. Therefore, appropriate and effective preventive measures should be taken to limit the transmission of this parasite to humans, and the consumption of raw and undercooked meat should be discouraged.
Topics: Animals; Buffaloes; Iran; Cattle; Toxoplasmosis, Animal; Abattoirs; Toxoplasma; Cattle Diseases; Female; Male; Prevalence; Polymerase Chain Reaction
PubMed: 38940227
DOI: 10.1002/vms3.1511 -
Journal of Arrhythmia Jun 2024Hemidiaphragm paralysis, a complication of catheter ablation for atrial fibrillation, can severely affect respiratory function and can lead to paradoxical breathing and...
Improvement in respiratory function and exercise tolerance following video-assisted thoracoscopic diaphragm plication for symptomatic iatrogenic persistent diaphragm paralysis after radiofrequency catheter ablation.
Hemidiaphragm paralysis, a complication of catheter ablation for atrial fibrillation, can severely affect respiratory function and can lead to paradoxical breathing and dyspnea on exertion. A 75-year-old woman with iatrogenic diaphragm paralysis showed improved symptoms, respiratory function, and exercise tolerance after video-assisted thoracoscopic diaphragm plication.
PubMed: 38939779
DOI: 10.1002/joa3.13039 -
Journal of Arrhythmia Jun 2024
Editorial to "Improvement in respiratory function and exercise tolerance following video-assisted thoracoscopic diaphragm plication for symptomatic iatrogenic persistent diaphragm paralysis after radiofrequency catheter ablation"-An essential respiratory physiology every electrophysiologist should...
PubMed: 38939772
DOI: 10.1002/joa3.13064 -
Oncology Letters Aug 2024Liver cancer near the deep diaphragm can be difficult to visualize due to the effects of lung gas, which presents a challenge for microwave ablation (MWA). The present...
Liver cancer near the deep diaphragm can be difficult to visualize due to the effects of lung gas, which presents a challenge for microwave ablation (MWA). The present study aimed to investigate the feasibility and efficacy of artificial ascites-assisted MWA for treating liver cancer near the deep diaphragm, as well as the significance of perioperative nursing. A retrospective analysis was conducted on patients who underwent artificial ascites-assisted MWA for liver cancer located near the deep diaphragm between January 2016 and December 2022. Normal saline was utilized as artificial ascites to safeguard the deep diaphragm during MWA. The study recorded the procedural success rate, incidence of major complications, technical efficacy of ablation and local tumor progression (LTP). A total of 62 lesions in 54 patients were included, with 44 men and 10 women, and a mean (± SD) age of 55.64±10.33 years. The ultrasound image quality scores for liver cancer before and after ascites were 3.57±0.79 and 4.89±0.33, respectively, showing a statistically significant difference between the two groups (t=16.324; P<0.05). No diaphragm injury, skin burns at the puncture site or abdominal hemorrhage occurred during the procedure. A single patient developed right-sided pleural effusion, which did not require drainage. The complete ablation rate was 94.4% (51/54) at 1 month post-ablation, with 3 patients experiencing recurrence and receiving additional MWA treatment. The median follow-up time for the patients in this study was 21 months (range, 12-45 months), with a LTP rate of 5.6% (3/54). In conclusion, MWA assisted by artificial ascites is a safe and effective treatment for liver cancer near the deep diaphragm. Furthermore, perioperative treatment and rehabilitation of the patients with high-quality nursing is beneficial.
PubMed: 38939625
DOI: 10.3892/ol.2024.14515 -
JACC. Advances Nov 2023There is limited data regarding the interplay of anatomic and physiologic parameters with exercise capacity in adults with native or recurrent nonsevere coarctation of...
BACKGROUND
There is limited data regarding the interplay of anatomic and physiologic parameters with exercise capacity in adults with native or recurrent nonsevere coarctation of the aorta (CoA).
OBJECTIVES
The objective of this study was to use exercise stress echocardiography and cardiac magnetic resonance imaging to identify anatomic and physiologic correlates of exercise capacity in these patients.
METHODS
We conducted a single-center retrospective analysis of 54 adults with nonsevere CoA (repaired or unrepaired) followed at our institution between 2015 and 2020. Resting coarctation gradients were obtained using echocardiography. Exercise gradients and functional capacity were assessed using exercise stress echocardiography. Aorta anatomy was obtained using magnetic resonance imaging.
RESULTS
Coarctation-to-diaphragm ratio correlated with minutes of exercise (r = 0.56, < 0.01) and metabolic equivalents (r = 0.49, < 0.01). These relationships remained significant after controlling for use of beta-blockers, valvular disease, and type of coarctation repair. Minutes of exercise correlated with mean resting gradients (r = -0.39, < 0.05). Coarctation-to-diaphragm ratio correlated with peak and mean resting gradients (r = -0.34, < 0.05; r = -0.48, < 0.01). Patients with coarctation-to-diaphragm ratio ≤0.7 achieved fewer metabolic equivalents (11.1 ± 1.9 vs 12.8 ± 2.2, < 0.05) and minutes of exercise (10.3 ± 2.0 vs 12.6 ± 2.7, < 0.05).
CONCLUSIONS
In patients with nonsevere native or recurrent CoA, reduced exercise capacity is correlated with coarctation severity by anatomic size and gradients. Those with a coarctation-to-diaphragm ratio ≤0.7 may represent a subset of patients with nonsevere CoA whose clinical symptoms are only elicited with exercise stress testing. Exercise stress testing and cross-sectional imaging may help identify those who could be considered for earlier coarctation intervention.
PubMed: 38938731
DOI: 10.1016/j.jacadv.2023.100672 -
Journal of Medical Case Reports Jun 2024We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use.
BACKGROUND
We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use.
CASE PRESENTATION
This case presents a 17-year-old white male experiencing rhinolalia following ecstasy ingestion at a rave. Subsequent chest X-ray revealed extensive surgical emphysema, along with a continuous diaphragm sign indicative of pneumomediastinum. Computed tomography confirmed the diagnosis. The patient was managed conservatively with strict monitoring and 6 hourly electrocardiograms. Follow-up computed tomography on day 3 showed resolution of pneumomediastinum and surgical emphysema, and the patient was safely discharged. Notably, the patient experienced a temporary rhinolalia during the acute phase, which resolved spontaneously as his condition improved.
CONCLUSIONS
This case underscores the importance of considering spontaneous pneumomediastinum and surgical emphysema in the differential diagnosis of young individuals presenting with acute symptoms after drug use.
Topics: Humans; Male; Mediastinal Emphysema; N-Methyl-3,4-methylenedioxyamphetamine; Adolescent; Tomography, X-Ray Computed; Subcutaneous Emphysema; Diagnosis, Differential
PubMed: 38937843
DOI: 10.1186/s13256-024-04618-9 -
Materials (Basel, Switzerland) Jun 2024A combined stamping-bulging forming process was proposed to achieve high-precision forming of large-diameter, ultra-thin-walled, superalloy welded S-type corrugated...
A combined stamping-bulging forming process was proposed to achieve high-precision forming of large-diameter, ultra-thin-walled, superalloy welded S-type corrugated diaphragms. The underlying principle is to enhance the diaphragm's forming accuracy by increasing the plastic deformation region and reducing springback. Using the ABAQUS version 6.14 finite element analysis software, finite element models were constructed for the stamping, hydraulic bulging, and combined stamping-bulging forming processes of the welded S-type metal corrugated diaphragms. A comparative analysis was conducted on the forming processes of the welded S-type metal corrugated diaphragms under the three forming methods, focusing on equivalent stress, distribution of wall thickness, and forming accuracy. This analysis determined the optimal forming process and the corresponding process parameters for superalloy welded S-type metal corrugated diaphragms. The results show that under a constant drawing force, as the bulging pressure increases, the plastic deformation of the straight sections of the diaphragm becomes more pronounced, resulting in improved shape accuracy. The combined stamping-bulging forming process guarantees the highest degree of shape accuracy for the diaphragm. The optimal process parameters were identified as a 30 t force and a 5 MPa pressure, with a maximum shape error of 0.02 mm. Concerning a plate thickness of 0.3 mm, the maximum deviation rate was found to be 6.7%, which represents a 30% improvement over traditional stamping processes. The maximum wall thinning rate was found to be 3.3%, a 1% reduction compared to traditional stamping processes, confirming the process's feasibility.
PubMed: 38930198
DOI: 10.3390/ma17122829 -
Antioxidants (Basel, Switzerland) May 2024Duchenne muscular dystrophy (DMD) is one of the most frequent and severe childhood muscle diseases. Its pathophysiology is multifaceted and still incompletely...
Duchenne muscular dystrophy (DMD) is one of the most frequent and severe childhood muscle diseases. Its pathophysiology is multifaceted and still incompletely understood, but we and others have previously shown that oxidative stress plays an important role. In particular, we have demonstrated that inhibition of mitochondrial monoamine oxidases could improve some functional and biohumoral markers of the pathology. In the present study we report the use of dystrophic mice to evaluate the efficacy of a dual monoamine oxidase B (MAO-B)/semicarbazide-sensitive amine oxidase (SSAO) inhibitor, PXS-5131, in reducing inflammation and fibrosis and improving muscle function. We found that a one-month treatment starting at three months of age was able to decrease reactive oxygen species (ROS) production, fibrosis, and inflammatory infiltrate in the tibialis anterior (TA) and diaphragm muscles. Importantly, we also observed a marked improvement in the capacity of the gastrocnemius muscle to maintain its force when challenged with eccentric contractions. Upon performing a bulk RNA-seq analysis, PXS-5131 treatment affected the expression of genes involved in inflammatory processes and tissue remodeling. We also studied the effect of prolonged treatment in older dystrophic mice, and found that a three-month administration of PXS-5131 was able to greatly reduce the progression of fibrosis not only in the diaphragm but also in the heart. Taken together, these results suggest that PXS-5131 is an effective inhibitor of fibrosis and inflammation in dystrophic muscles, a finding that could open a new therapeutic avenue for DMD patients.
PubMed: 38929061
DOI: 10.3390/antiox13060622 -
Foods (Basel, Switzerland) Jun 2024This study aims to improve press equipment for safflower oil production by using a mechanism that optimizes pressure distribution within screw turns. A detailed analysis...
This study aims to improve press equipment for safflower oil production by using a mechanism that optimizes pressure distribution within screw turns. A detailed analysis of the main components of the produced safflower oil was performed, encompassing both quantitative and qualitative assessments. Through the exploration of dependencies governing the safflower oil pressing process on the screw press, the optimal parameters were determined. As a result of the research, the optimal diaphragm gap between the gape cylinder and the pressing screw was determined, with the optimal oil yield percentage achieved at ω = 6.2 rad/s and δ = 5 mm. The study also compared the performance of the existing Dream Modern ODM-01 screw press and its upgraded version by analyzing the extracted oil. The results reveal changes in the quantitative and qualitative composition of the main oil components following the operation of the existing and the modernized screw presses. For instance, the amount of unsaturated fatty acids, such as oleic acid (7.7 ± 0.566%), linoleic acid (85.3 ± 1.185%), and linolenic acid (1.2 ± 0.223%), increased. There was an increase in the presence of inorganic substances in safflower oil: iron (0.023 ± 0.031 mg/kg), phosphorus (0.086 ± 0.059 mg/kg), silicium (0.136 ± 0.075 mg/kg), and others. The findings of this study hold significant commercial value and offer promising prospects for global market implementation.
PubMed: 38928850
DOI: 10.3390/foods13121909