Reversed Differential Cyanosis in Two Neonates with Obstructed Supracardiac Total Anomalous Pulmonary Venous Drainage_ Crimson Publishers

 Reversed Differential Cyanosis in Two Neonates with Obstructed Supracardiac Total Anomalous Pulmonary Venous Drainage by Pak-Cheong Chow* in Research in Pediatrics & Neonatology_ The Journal of Pediatrics

Abstract
We reported two neonates with obstructed supracardiac total anomalous pulmonary venous drainage (TAPVD) presented with reverse differential cyanosis. We reviewed the pathophysiology of supracardiac TAPVD in causing reverse differential cyanosis and highlighted the importance of considering TAPVD as the differential diagnosis to facilitate early treatment

Introduction
Generalized cyanosis in newborn can be caused by many pathological conditions and cyanotic congenital heart disease represents one of the important causes. Differential cyanosis refers to the situation where upper limb saturation is higher than lower limb and it is well documented to be caused by persistent pulmonary hypertension in newborn (PPHN) [1] or patients with patent ductus arteriosus and Eisenmenger syndrome in adults [2-4]; Table 1. This has been also reported in a neonate with critical aortic stenosis, hypoplastic aortic arch, pulmonary hypertension and PDA [2]. Reversed differential cyanosis (RDC) referred to the situation when the oxygen saturation of upper limb is lower than that of lower limb, which was classically reported in neonates with transposition of great arteries (TGA) with pulmonary hypertension [2] or TGA with aortic arch obstruction or interruption [5-12]; Table 1. Other causes included supracardiac total anomalous pulmonary venous drainage (TAPVD) [13], isolated right subclavian artery [14], and infants on veno-arterial extracorporeal membrane oxygenation using right carotid artery for cannulation [15]. We herewith reported two cases of obstructed supracardiac TPAVD manifested reversed differential cyanosis.

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Modified Heller´s Esophageal Myotomy Associated with Dor’s Fundoplication A Surgical Alternative for the Treatment of Dolico Megaesophagus_ Crimson Publishers

  Modified Heller´s Esophageal Myotomy Associated with Dor’s Fundoplication A Surgical Alternative for the Treatment of Dolico Megaesophagus by AV Madureira F* in Gastroenterology Medicine & Research_ Gastroenterology Medicine & Research

 

Abstract

The most performed surgery for the treatment of achalasia is Heller´s esophageal myotomy associated or no with anti-reflux fundoplication. We propose in cases of advanced megaesophagus, specifically in the dolico megaesophagus, a technical variation. The aim of this study was to describe Heller´s myotomy modified by Madureira associated with Dor´s fundoplication as an alternative for the treatment of dolico megaesophagus, assessing its effectiveness at through dysphagia scores and quality of life questionnaires.

Materials and methods: Technical Note describing the surgical procedure and presenting the results of three patients with advanced dolico megaesophagus, operated from 2014 to 2017. The technique proposes the dissection of the esophagus intrathoracic, with circumferential release of it, in the most extensive possible by trans hiatal route. Then the esophagus is retracted and fixed circumferentially in the pillars of the diaphragm with six or seven point. The goal is at least on the third part of the esophagus, to achieve its broad mobilization and rectification of it; then is added a traditional Heller myotomy.

Results: The mean dysphagia score in pre-op was 10points and in the post- op was 1.3 points (maximum of 10 points being observed each between the pre and postoperative 8.67 points, 86.7%) The mean hospitalization time was one day. There was no surgical mortality or conversion to open technique. The mean follow-up time was 30.6 months (24-38 months) (Table 1). Heller’s Cardio myotomy modified by Madureira, associated with Dor’s fundoplication is an option to be investigated for the treatment of the dolico megaesophagus.

Keywords: Megaesophagus; Esophageal myotomy; Heller’s myotomy; Dor’s fundoplication; Dysphagia

Summary
Esophageal achalasia is a rare pathology in the population incidence between 0.03 and 1per 100,000 individuals [1]. It doesn’t have age or gender preference. It’s the most common esophageal motility disorder diagnosed [2]. According to his etiology, it can be classified into idiopathic, chagasic, pseudo achalasia. Trimanoma cruzi infection, in the countries of South America (and Brazil), has a relevant impact and is known that about 5% of patients affected by Chagas disease, they turn on achalasia [3] and that the dilation of the esophagus appears to be greater in the chagasic etiology [4]. The pathophysiology of the disease is seen hypertension in the Lower Esophageal Sphincter (LES) and an inability to drive the esophageal content, for aperistalsis or uncoordinated peristaltic movements. Histologically there is destruction or decrease of the mioenteric plexus cells. The condition usually has insidious onset, and its main symptom is dysphagia. Patients are shown to have poor quality of life, are emaciate and are also limited to their work activities. The most commonly used test for diagnosis is the esophageal manometry that evaluates the motility of the esophagus and lower esophageal sphincter pressure (LESP)

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Mini Review of Prostate Cancer Diagnostics_ Crimson Publishers

 Mini Review of Prostate Cancer Diagnostics by Besarion Partsvania* in Novel Approaches in Cancer Study_ Journal of Cancer Research

 

Abstract
According to the World Health Organization (WHO) prostate cancer is the second cause of cancer death in men worldwide [1,2]. Some advanced prostate cancers have well known symptoms. However non-cancerous diseases of the prostate, such as benign prostatic hyperplasia (BPH) cause same symptoms. On the other hand, at very early stages, prostate cancer has no symptoms, the tumor dimension is quite small, and it is extremely difficult to detect it. If prostate cancer is detected at an early stage, it can be successfully cured by different methods. At the later stages, treatment or surgery has very low efficiency. Prostate cancer can often be found by measuring the amount of PSA in the blood. Most healthy men have levels under 4 nano-grams per milliliter (ng/mL) of blood. When prostate cancer develops, the PSA level usually goes above 4. However, for determination of the existence of cancer, some additional methods are used: for example: PSA velocity [3,4] and/or PSA density. Besides, measurement of the ratio of free to total PSA is additional tool in prostate cancer diagnosis [5]. However, the major drawback of PSA determination is its relative lack of specificity. The PSA level can also be increased by benign prostate hyperplasia (BPH) - a noncancerous enlargement of the prostate, prostatitis, etc.

Digital rectal examination (DRE) is one of methods for prostate cancer diagnosis. The vast majority of prostatic carcinomas arise in the peripheral zone of the prostate. This part of the gland is accessible by DRE [6,7]. The DRE screening test for prostate cancer requires to assess the size, shape, and texture of the prostate and nearby organs. The sensitivity and specificity of a DRE examination is subject to a physician’s skill, the clinician’s ability to interpret what is felt, and the nature of the patient’s disease. Although DRE can detect prostate cancer, it has limited sensitivity. Unfortunately, many cancers detected using DRE are either locally or regionally advanced. Prostate cancer may be identified on Trans-rectal ultrasound (TRUS) as a hypoechoic lesion. However, only 60% of prostate cancers appear hypoechoic on ultrasound while most of the remaining cancers appear isoechoic with respect to the surrounding parenchyma [8]. Because other disease processes, such as BPH and prostatitis may have a similar appearance to prostate cancer, it is impossible to reliably differentiate these lesions from prostate cancer based on ultrasonographic characteristics alone. Consequently, TRUS should not be used as a first line screening study as it lacks acceptable specificity

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Development of A Small-Scale Indigenous Shea Butter Processing Plant in Nigeria: A Review_ Crimson Publishers

 Development of A Small-Scale Indigenous Shea Butter Processing Plant in Nigeria: A Review by Gana IM* in Novel Techniques in Nutrition and Food Science_ food science journals

 

Abstract
The increase demand of shea butter and its product globally has contributed immensely in its traditional household and small-scale production in countries where it is present. This production method is laborious, time consuming and tedious. Also, the shea butter obtained is of low grade and quality as result of contamination from either the type of equipment used, or the processing method adopted. In other to address all these shortcomings a small-scale mechanized shea butter production plant was developed. The plant is made up of the following machines; sheller, crusher, steam roaster, miller and mixer. The development of this plant has mechanized the major unit operations of shea butter production. It has made easier and faster processing of shea butter and thus, serves as a training center for local processors and a catalyst for the development of shea butter industry in Nigeria. It can bring improvement in the productivity of the shea butter to meet up with local and international demands. The developed plant produced 0.45kg of shea butter from 1kg of shea nut and processed 12.5kg of shea paste in 10min. It has input and throughput capacities of 600kg of shea nut and 270kg of shea butter respectively, in 8hours operational time per day. The total cost of establishment of the plant is $2650

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Opinion on a Reliable Rock Engineering Tool-Box for Mining Industry_ Crimson Publishers

 Opinion on a Reliable Rock Engineering Tool-Box for Mining Industry by Eivind Grøv* in Aspects in Mining & Mineral Science_ Mining and Mineral Science journals

 

Abstract

Along the development of human being, there are several important inventions that completely change the way we live. Such inventions may be “fire”, “electricity”, and now “Information Technology - IT”. It is difficult to imagine our life now without IT, and it is the same situation in mining industry. It is quite common today that rock engineering projects in general, and particularly mining projects are planned and developed with help of computer added tool-numerical model. The model can be performed in 2D or 3D in order to provide engineering parameters for decision making. The engineering parameters can be development and distribution of stress, strain, and displacement for stability analyses. It can also be vibration and seismicity related to mining process, and so on…. Information provided from numerical models is always an important source of information making decision. However, decision makers are always “stuck” with a question that “How can I trust the information from numerical model?” In our opinion, it is a long process with a more complete toolbox rather than only numerical model alone for appropriately to answer to that question. With over 50 years of research and development, SINTEF has developed a reliable rock engineering tool to deal with the challenges. The tool is a combination of three components “investigation tools”, “numerical modelling”, and “site monitoring”. We use the term “TRIPOD” for the methodology

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