RESUMEN
Acute cholecystitis (AC) and acute appendicitis (AA), independently, are among the most commonly diagnosed conditions in the emergency department (ED). However, their synchronous presentation is very rare. Here, we present a 31-year-old man with worsening right flank abdominal pain, nausea, and vomiting. Physical examination results were significant for moderate to severe right upper abdominal quadrant pain with a positive Murphy's sign and right lower quadrant pain with rebound. Workup in the ED revealed leukocytosis with a left shift, and the abdominal ultrasound and computerized tomography scan showed AA and AC. A literature review revealed a paucity of publications on concomitant AA and AC. Reporting new cases will contribute to improving our understanding of the biology, natural history, and management of this rare pathological combination.
RESUMEN
Current radiologic and medication administration is systematic and has widespread side effects; however, the administration of microbubbles and nanobubbles (MNBs) has the possibility to provide therapeutic and diagnostic information without the same ramifications. Microbubbles (MBs), for instance, have been used for ultrasound (US) imaging due to their ability to remain in vessels when exposed to ultrasonic waves. On the other hand, nanobubbles (NBs) can be used for further therapeutic benefits, including chronic treatments for osteoporosis and cancer, gene delivery, and treatment for acute conditions, such as brain infections and urinary tract infections (UTIs). Clinical trials are also being conducted for different administrations and utilizations of MNBs. Overall, there are large horizons for the benefits of MNBs in radiology, general medicine, surgery, and many more medical applications. As such, this review aims to evaluate the most recent publications from 2016 to 2022 to report the current uses and innovations for MNBs.
RESUMEN
Advancing clock times by 1 h in the spring to daylight savings time and setting clock times back 1 h in the autumn to standard time disrupts circadian timing, sleep and skilled motor behavior such as driving an automobile. It is unknown if endurance performance is impacted by daylight savings transition (DST). The natural experiment described here examined whether exposure to a DST in the 10 h prior to the start of a marathon race was associated with a different mean completion time compared to participants who ran the same course but were unexposed to a recent DST. The primary outcome was the average running time of finishers of United States marathons that were completed on either spring-DST or autumn-DST days in the years 2000-2018. Comparisons were made to results from the same marathon held in a different year that was not run on a DST day. Data were obtained from the public data base marathonguide.com/results. Analysis of the primary outcome used paired samples t-tests weighted by sample size. Spring and autumn data were analyzed separately. Eighteen spring and 29 autumn marathons met the inclusion criteria. Compared to control marathons, the weighted spring-DST performance was worse by 12.3 min (4.1%; P < .001) and equal to a moderate standardized effect size of 0.57 while autumn-DST was trivially worse by 1.4 min (0.5%), which was equivalent to an effect size of 0.13. Ambient temperatures for the DST and control races did not differ for either the spring (10.6 vs. 8.9â; P = .212) or autumn marathons (7.6 vs. 9.3â; P = .131). Within the limitations of a natural experiment research design, it is concluded that the findings support worse running performance in marathon races held in the spring on the day of transition to daylight savings time when there is a forced circadian change and sleep loss.
