Inflammatory parameters as predictive factors for complicated appendicitis: A retrospective cohort study.

INTRODUCTION: Acute appendicitis is a major cause of acute abdomen. Although its diagnosis is clinical, it is often supported by complementary diagnostic tests. Sometimes, delay in diagnosis can lead to worsening of the clinical picture, resulting in a complicated acute appendicitis. Some series have studied some clinical and analytical parameters as possible predictors of complicated acute appendicitis. STUDY DESIGN: A retrospective analysis of patients admitted for acute appendicitis and undergoing appendectomy between January 2014 and December 2017 was performed in order to assess the possible existence of preoperative analytical predictive factors for complicated acute appendicitis (such as leukocytosis, C-reactive protein and ratio between neutrophils and lymphocytes). RESULTS: 841 patients underwent emergency appendectomy during the analysed period. This initial sample was divided into two groups: Group 1 with patients with uncomplicated acute appendicitis and Group 2 with patients with complicated acute appendicitis. Group 2's presentation age, duration of symptoms and hospital stay was significantly higher than Group 1. Regarding analytical parameters, the measurement of leukocytes, C-reactive protein and ratio between neutrophils and lymphocytes was significantly higher in patients with complicated acute appendicitis. After a multivariate analysis, it was found that only C-reactive protein was a good predictor of complicated acute appendicitis. CONCLUSION: Several publications have studied and demonstrated the possible use of certain analytical parameters as predictors of complicated acute appendicitis. In our study, C-reactive protein proved to be a good independent predictor of complicated acute appendicitis and, therefore, when an assay of this protein exceeds 63.3 mg/L, faster surgical approach should be considered due to the high probability of the presence of a complicated picture of this clinical entity.

Pocket-Sized Portable Labs: Control Engineering Practice Made Easy in Covid-19 Pandemic Times.

New pocket-sized laboratories are proving to be an excellent tool as complementary equipment that students and lecturers can deploy to test control engineering design techniques. Here, the description and outcome results of an IFAC activity funded project entitled as Pocket-Sized Portable Labs: Control Engineering Practice Made Easy are presented. The project was executed in Portugal, from January 2021 to the end of June 2021, during the SARS-CoV2 pandemic. The global aim of this project was to motivate pre-university students to enroll in control engineering courses by showing and demonstrating that simple practical experiments may be easily accomplished using portable pocket-size laboratories.

Caracterización clínica y epidemiológica de pacientes con infecciones respiratorias agudas en Timor Leste

RESUMEN Introducción: Las infecciones respiratorias agudas son una de las primeras causas de morbilidad y mortalidad en Timor Leste y el mundo. Objetivo: Describir las características clínicas y epidemiológicas de pacientes con infecciones respiratorias agudas en Timor Leste. Métodos: Estudio descriptivo transversal realizado en el Hospital Nacional Guido Valadares de Timor Leste entre enero y abril de 2021. La población de estudio estuvo integrada por todos los pacientes atendidos por dicha causa en el período y lugar antes mencionado. La muestra estuvo integrada por 108 pacientes atendidos por esta afección en servicios de otorrinolaringología, medicina interna y emergencia del hospital durante el período estudiado. El dato primario se recogió de las historias clínicas utilizando una planilla de recolección de datos. El análisis de la información incluyó la distribución de frecuencias absolutas y relativas de todas las variables estudiadas. Resultados: Predominaron el sexo femenino con 51,9 % y el grupo de edad de 19 a 29 años con 38,0 %. Los más afectados fueron los estudiantes con 36,1 % y las amas de casa con 27,8 %. Las infecciones que más se diagnosticaron fueron la neumonía y la otitis con 32,4 y 18,5 %, respectivamente. La manifestación clínica más referida fue la tos (23,7 %). Conclusiones: La enfermedad afectó fundamentalmente a estudiantes y amas de casa, ambos jóvenes, independientemente de su nivel educacional y sexo, en los que la neumonía fue la infección respiratoria más diagnosticada, sin síntomas y signos atípicos.

ABSTRACT Introduction: Acute respiratory infections are one of the leading causes of morbidity and mortality in Timor Leste and the world. Objective: To describe the clinical and epidemiological characteristics of patients with acute respiratory infections in Timor Leste. Methods: A cross-sectional descriptive study was carried out at Guido Valadares National Hospital in Timor Leste from January to April 2021. The study population was made up of all the patients treated due to this cause in the aforementioned period and place. The sample consisted of 108 patients treated for this condition in otorhinolaryngology, internal medicine and hospital emergency services during the period studied. Primary data was collected from medical records using a data collection form. The analysis of the information included the distribution of absolute and relative frequencies of all the variables studied. Results: The female sex prevailed in 51.9% and the age group from 19 to 29 years in 38.0%. The most affected were students in 36.1% and housewives in 27.8%. The most diagnosed infections were pneumonia and otitis in 32.4% and 18.5% respectively. The most reported clinical manifestation was cough (23.7%). Conclusions: The disease mainly affected students and housewives, both young, regardless of their educational level and sex, in whom pneumonia was the most diagnosed respiratory infection, without atypical symptoms and signs.

Perianal Paget Disease: Different Entities With the Same Name.

Extramammary Paget disease (EMPD) is a rare form of cancer that involves skin areas rich in apocrine glands. The common sites of occurrence include the vulva, perianal region, perineum, and axilla. Perianal Paget disease (PPD) is a subset of EMPD, which arises in the perianal skin. The disease commonly presents with a thickened plaque-like lesion with erythema or white scaly appearance. It is generally classified into two categories based on the origin of the tumor cells: (1) primary PPD if the tumor arises from intraepidermal cells and (2) secondary PPD if cancer originates from the underlying colorectal or urinary tract neoplasm. Due to its rarity, only a few sporadic case reports have been published in the literature, and treatment methods are yet to be standardized. In light of this, we report two PPD cases with different etiopathogenesis and staging: one involved only the perianal skin without regional or metastatic disease, and was not accompanied by visceral adenocarcinomas although there was a previous history of sigmoid adenocarcinoma; the other was probably secondary to an anal canal tumor spreading with disseminated disease involving the perianal and perineum area with bilateral inguinal, pelvic lymph node, and liver metastasis. The treatment plans and the outcomes of both cases were necessarily different from each other.

Small bowel obstruction due to intraluminal metastasis from malignant melanoma.

The most common form of presentation of malignant melanoma is cutaneous. However, it is important to notice that it can occur in any part of the body, mostly from metastatic route. Gastrointestinal forms of symptomatic metastasis are rare, making it sometimes difficult to diagnose. We present a rare case of an 84-year-old female with a small bowel obstruction due to melanoma metastasis. She was treated with an enterectomy, with no surgical or post-operative complications. Although surgery should be reserved from symptomatic patients, some authors refer to it as a palliative treatment with improvement in long-term survival.

Inflammatory myofibroblastic tumor presenting as ileocecal intussusception-A case report.

INTRODUCTION: Inflammatory myofibroblastic tumor (IMFT) is an uncommon mesenchymal solid tumor commonly documented in children and young adults. It is usually located in lungs however, extrapulmonary involvement has also been reported. Here we report a case of IMFT presenting as an ileocecal intussusception. PRESENTATION OF CASE: A 55-year-old man presented with a two months history of colicky abdominal pain, more intense at the right inferior abdominal quadrant, and unintentional weight loss of 8kg in the previous four months. Computer tomography showed an image of intussusception at the cecum. Colonoscopy demonstrated a pediculated tubular lesion, with the base near ileocecal valve. We performed a right hemicolectomy. Histopathological examination of the tumor revealed an IMFT. DISCUSSION: IMFT usually affects lungs with rare gastrointestinal involvement. Clinical presentation is related with location of the neoplasm. Intussusception in adults presents with non-specific symptoms and classical image signs facilitate preoperative diagnosis. IMFT diagnosis is histopathological which usually implies surgical resection. Complete surgical excision, with microscopically clear margins, is the mainstain of treatment, with virtually no local recurrence or metastasis. CONCLUSION: Gastrointestinal IMFT are rare in the adult population and clinical features depend on its location. Surgical approach with total excision of the neoplasm confirms the diagnosis. Prognosis is good with the main prognostic indicator being the adequacy of the primary excision.