RESUMEN
Acute diverticulitis of the appendix (ADA), though uncommon, often presents similarly to acute appendicitis but carries a higher risk of complications such as perforation and malignancy. We report the case of a male patient in his 50s with acute right iliac fossa abdominal pain, diagnosed via CT scan with ADA. Urgent laparoscopic appendicectomy was performed, and the patient was discharged without further issues. This case highlights the importance of promptly identifying and managing such conditions to minimise complications and improve outcomes. Despite the overlap in symptoms between appendiceal diverticulitis and acute appendicitis, accurate diagnosis is crucial for appropriate treatment. Healthcare providers should maintain a high index of suspicion, particularly in older patients presenting with an acute appendicitis, like clinical picture to ensure timely intervention and optimal patient care.
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Abdomen Agudo , Apendicitis , Apéndice , Diverticulitis , Humanos , Masculino , Abdomen Agudo/diagnóstico , Dolor Abdominal/diagnóstico , Enfermedad Aguda , Apendicectomía/efectos adversos , Apendicitis/diagnóstico por imagen , Apendicitis/cirugía , Apéndice/diagnóstico por imagen , Apéndice/cirugía , Apéndice/patología , Diagnóstico Diferencial , Diverticulitis/diagnóstico por imagen , Diverticulitis/cirugía , Dolor Pélvico/complicaciones , Persona de Mediana EdadRESUMEN
BACKGROUND AND OBJECTIVE: This study considers dynamic modeling of the cerebral arterial circulation and reconstructing an atlas for the electrical conductivity of the brain. Electrical conductivity is a governing parameter in several electrophysiological modalities applied in neuroscience, such as electroencephalography (EEG), transcranial electrical stimulation (tES), and electrical impedance tomography (EIT). While high-resolution 7-Tesla (T) Magnetic Resonance Imaging (MRI) data allow for reconstructing the cerebral arteries with a cross-sectional diameter larger than the voxel size, electrical conductivity cannot be directly inferred from MRI data. Brain models of electrophysiology typically associate each brain tissue compartment with a constant electrical conductivity, omitting any dynamic effects of cerebral blood circulation. Incorporating those effects poses the challenge of solving a system of incompressible Navier-Stokes equations (NSEs) in a realistic multi-compartment head model. However, using a simplified circulation model is well-motivated since, on the one hand, the complete system does not always have a numerically stable solution and, on the other hand, the full set of arteries cannot be perfectly reconstructed from the MRI data, meaning that any solution will be approximative. METHODS: We postulate that circulation in the distinguishable arteries can be estimated via the pressure-Poisson equation (PPE), which is coupled with Fick's law of diffusion for microcirculation. To establish a fluid exchange model between arteries and microarteries, a boundary condition derived from the Hagen-Poisseuille model is applied. The relationship between the estimated volumetric blood concentration and the electrical conductivity of the brain tissue is approximated through Archie's law for fluid flow in porous media. RESULTS: Through the formulation of the PPE and a set of boundary conditions (BCs) based on the Hagen-Poisseuille model, we obtained an equivalent formulation of the incompressible Stokes equation (SE). Thus, allowing effective blood pressure estimation in cerebral arteries segmented from open 7T MRI data. CONCLUSIONS: As a result of this research, we developed and built a useful modeling framework that accounts for the effects of dynamic blood flow on a novel MRI-based electrical conductivity atlas. The electrical conductivity perturbation obtained in numerical experiments has an appropriate overall match with previous studies on this subject. Further research to validate these results will be necessary.
Asunto(s)
Encéfalo , Cabeza , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Conductividad Eléctrica , Simulación por Computador , Arterias Cerebrales/diagnóstico por imagenRESUMEN
Main management for the frontal sinus fracture is using the pericranial flap. Pericranial flaps based on the supraorbital and supratrochlear vasculature have previously been used with significant success for the separation of intracranial and extracranial spaces after major trauma. Defect closure was modified due to lack of the frontal periosteum; the graft was made from the temporal side of periosteum to make primary periosteal flap longer. Defect closure could be optimum. Evaluation for 6 months showed a significant improvement without major complications. In this article, we propose a new modification technique as one of promising alternatives.
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BACKGROUND: Patient and public involvement and engagement (PPIE) is recognized as important for improved quality in health service provision and research. Vitamin D is one area where PPIE has potential to benefit public health initiatives, particularly for women and children with increased skin pigmentation (ie at high risk of deficiency) who are easily overlooked. OBJECTIVE: We report findings from a community PPIE event that explored the knowledge, barriers and promoters for optimal vitamin D status amongst an exemplar high-risk and easily overlooked population group. METHODS: Two researchers and one PPIE lead facilitated a single group discussion with twenty members of the Somali community from across west London. All attendees were women of reproductive age, or knew a mother and child that could benefit from a targeted initiative. The discussion was recorded, transcribed verbatim, organized and coded using NVivo 12 Pro to identify emergent themes underpinned by the Health Behaviour Model. RESULTS: Attendees thought community safety and competing demands of technology and education impacted on sun exposure and lifestyle activity. Language barriers impacted on access to health care. Attendees also felt the mother figure was 'the most important' influencer of both child and wider community health. DISCUSSION: Although further discourse is needed, this event emphasizes that it is important that the public voice is heard in informing, designing and evaluating appropriate public health interventions amongst specific ethnic groups. Insights from this Somali population have suggested benefit from using verbal health messages that are specifically targeted at mothers, compared with the general population.
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Participación de la Comunidad , Educación en Salud/métodos , Deficiencia de Vitamina D/prevención & control , Adolescente , Adulto , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Londres , Masculino , Persona de Mediana Edad , Somalia/etnología , Luz Solar , Adulto JovenRESUMEN
BACKGROUND: Due to the rising demands for a Canadian workforce with science, technology, engineering, and math (STEM)-related education, there is a need to increase youth engagement in STEM education and programming. Research, however, has shown that youth residing in low-income communities are disproportionately affected by psychosocial barriers, which often inhibit meaningful engagement in STEM programming. Visions of Science Network for Learning (VoSNL) was designed and implemented to address these existing barriers. VoSNL is a charitable organization in Southern Ontario, Canada, that provides weekly community-based STEM programming to low-income and marginalized youth during out-of-school time. VoSNL programming is delivered directly within the community and is free-of-charge for all youth in order to minimize barriers of physical and financial accessibility. The purpose of this report was to provide a detailed description of a core program within VoSNL-Community Science Clubs-and summarize the findings of a process evaluation, specifically the successes and challenges of implementing a community-based, out-of-school STEM program. RESULTS: Program successes are outlined along with the challenges that have been identified through program implementation. Successes include (a) delivering the program within a community context, (b) opportunities for consistent engagement, and (c) establishing positive youth-staff relationships. Challenges include (a) navigating community-based issues, (b) conducting outreach and promotion, and (c) accommodating a wide age range of youth. Further, lessons learned from an evaluation of program implementation are also discussed. CONCLUSIONS: This report provides one of the first program descriptions and process evaluations of a community-based, youth-focused STEM program within a Canadian context. The findings in this report have helped to improve the delivery and evaluation of the VoSNL program and may act as a catalyst for program expansion to reach more youth in marginalized communities. Further, the findings can also provide a strong framework for programmers interested in implementing STEM youth programming in a community context, assist in the replication of similar models in other locations, and enhance STEM learning amongst youth.