Relationship between craving and impulsivity in patients with alcohol dependence with or without dual disorders in an outpatient treatment center: a descriptive study.

OBJECTIVES: To compare alcohol and other drugs abuse, state impulsivity, craving and the relationship between craving and impulsivity in alcohol-dependent patients with or without dual disorder attending to an alcohol treatment center in Cadiz town. METHOD: An observational, descriptive and transversal study performed on 112 alcohol dependent patient sample who were seeking treatment in ARCA outpatient treatment center in Cadiz. The sample was divided in two groups, according to present dual diagnosis or not. The sample was assessed with an AdHoc sociodemographic and clinical questionnaire and specific scales and interviews that included: 5.0 Mini International Neuropsychiatric Interview results (MINI), State Impulsivity Scale (SIS), and Multidimensional Alcohol Craving Scale (MACS). RESULTS: The prevalence of dual diagnosis was 50%, being the most prevalent disorders: Current and recurrent Major Depressive Episode Mood Disorder, Current Dysthymic Mood Disorder, Panic Disorder and Anxiety Disorder. 52,7% of the total sample had a positive result on the State Impulsivity Scale. No statistically significant results were found on the Craving Scale (neither in the score or in the sub-sections). A relationship between craving and impulsivity were found for all groups and researched items. CONCLUSIONS: As a relationship between craving and impulsivity was observed, these aspects should be considered as main factors for the treatment and evolution of alcohol- dependent patients.

Is age a predisposing factor of postoperative complications after lung resection for primary pulmonary neoplasms? / ¿Es la edad un factor predisponente de complicaciones postoperatorias en las resecciones pulmonares por neoplasias pulmonares primarias?

INTRODUCTION: Age has been classically considered as a determining factor for the development of postoperative complications related to lung resection for bronchogenic carcinoma. The Postoperative Complications Study Group of the Spanish Society of Thoracic Surgery has promoted a registry to analyze this factor. METHODS: A total of 3,307 patients who underwent any type of surgical resection for bronchogenic carcinoma have been systematically and prospectively recorded in any of the 24 units that are part of the group. Several variables related to comorbidity and age, as well as postoperative complications, were analyzed. RESULTS: The mean age of patients was 65,44. Men were significantly more common than female. The most frequent complication was prolonged air leak, which was observed in more than one third of patients. In a univariant analysis, air leak presence and postsurgical atelectasis showed statistical association with patient age, when stratified in age groups. In a multivariate analysis, age was recognized as an independent prognostic factor in relation to air leak onset. However, this could not be confirmed for postoperative atelectasis. CONCLUSION: Age is a predisposing factor for the development of postoperative complications after lung resection. Other associated factors also influence the occurrence of these complications.

Colour assortative pairing in a colour polymorphic lizard is independent of population morph diversity.

Previous work with a colour polymorphic population of Podarcis muralis (Lacertidae) revealed that lizards pair by ventral colour, favouring the same colour (i.e. homomorphic) pairs. Such assortative pairing, which probably results in colour assortative mating, can have consequences for the genetic structure of the population and potentially promote speciation. The population previously studied, located in the Pyrenees, encompasses white, yellow and orange animals, as well as intermediate white-orange and yellow-orange morphs. However, other Pyrenean populations of P. muralis have less ventral colour morphs. Our aim in this study is to test the generality of the assortative colour pairing system, extending our previous analyses to populations with different morph compositions and frequencies. The results show that the assortative pattern of pairing is similar in all the populations analysed and, hence, independent of morph composition and not restricted to pentamorphic populations. This suggests that assortative pairing by colour is a general phenomenon for colour polymorphic populations of P. muralis.

Validation of the Alcohol Use Disorders Identification Test in university students: AUDIT and AUDIT-C. / Validación del test para la identificación de trastornos por uso de alcohol en población universitaria: AUDIT y AUDIT-C.

The aim of this study was to determine the psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT and AUDIT-C) in order to detect problems related to the consumption of alcohol in the university population. The sample consisted of 1309 students.A Weekly Alcohol Consumption Diary was used as a gold standard; Cronbach's Alpha, the Kappa index, Spearman's correlation coefficient and exploratory factor analysis were applied for diagnostic reliability and validity, with ROC curves used to establish the different cut-off points. Binge Drinking (BD) episodes were found in 3.9% of men and 4.0% of women with otherwise low-risk drinking patterns. AUDIT identified 20.1% as high-risk drinkers and 6.4% as drinkers with physical-psychological problems and probable alcohol dependence.Cronbach's alpha of 0.75 demonstrates good internal consistency. The best cut-off points for high-risk drinking students were 8 for males and 6 for females. As for problem drinkers and probable ADS, 13 was the best cut-off point for both sexes. In relation to AUDIT-C, 5 and 4 were the best cut-off points for males and females with high-risk patterns, respectively. The criterion validity of AUDIT and AUDIT-C to detect binge drinking episodes was found to have a moderate K value. The results obtained show that AUDIT has good psychometric properties to detect early alcohol abuse disorders in university students; however, it is recommended that the cut-off point be reduced to 8 in men. AUDIT-C improves its predictive value by raising the cut-off point by one unit. Items 2 and 3 should be reviewed to increase its predictive value for BD.

El objetivo de este trabajo fue determinar las propiedades psicométricas de los cuestionarios Alcohol Use Disorders Identification Test (AUDIT y AUDIT-C) para la detección de problemas por consumo de alcohol en universitarios. Participaron 1309 estudiantes, utilizando el Diario de consumo semanal como patrón de referencia y para el análisis de fiabilidad y validez el alfa de Cronbach, análisis exploratorio, índice kappa, coeficiente de correlación de Spearman y curvas ROC para los diferentes puntos de corte. Un 3,9% de hombres y un 4% de mujeres con consumo de riesgo bajo presentaba consumo intensivo de alcohol (BD).AUDIT identificó un 20,1% de Bebedor de riesgo y un 6,4% de Bebedor con problemas físico-psíquicos y probable dependencia alcohólica. El instrumento presentó un alfa-Cronbach de 0,75 demostrando buena consistencia interna. Los puntos de corte óptimos fueron ocho para Bebedor de riesgo en hombres y seis para mujeres; trece puntos para Bebedor con problemas físico-psíquicos y probable dependencia alcohólica en ambos sexos; con AUDIT-C, fueron para Consumo de riesgo cinco para hombres y cuatro para mujeres. La validez de criterio para detectar consumo intensivo de alcohol (BD) con ambas versiones presentó un valor K moderado. Los resultados indican que AUDIT cuenta con adecuadas propiedades psicométricas para detectar precozmente problemas de consumo de alcohol en universitarios, recomendándose reducir su punto de corte a ocho en varones. El AUDIT-C mejora su poder predictivo aumentando en una unidad el punto de corte. Se recomienda revisar los ítems 2 y 3 para aumentar el valor predictivo del BD.

Genetic depletion does not prevent rapid evolution in island-introduced lizards.

Experimental introductions of species have provided some of the most tractable examples of rapid phenotypic changes, which may reflect plasticity, the impact of stochastic processes, or the action of natural selection. Yet to date, very few studies have investigated the neutral and potentially adaptive genetic impacts of experimental introductions. We dissect the role of these processes in shaping the population differentiation of wall lizards in three Croatian islands (Susac, Pod Kopiste, and Pod Mrcaru), including the islet of Pod Mrcaru, where experimentally introduced lizards underwent rapid (~30 generations) phenotypic changes associated with a shift from an insectivorous to a plant-based diet. Using a genomic approach (~82,000 ddRAD loci), we confirmed a founder effect during introduction and very low neutral genetic differentiation between the introduced population and its source. However, genetic depletion did not prevent rapid population growth, as the introduced lizards exhibited population genetic signals of expansion and are known to have reached a high density. Our genome-scan analysis identified just a handful of loci showing large allelic shifts between ecologically divergent populations. This low overall signal of selection suggests that the extreme phenotypic differences observed among populations are determined by a small number of large-effect loci and/or that phenotypic plasticity plays a major role in phenotypic changes. Nonetheless, functional annotation of the outlier loci revealed some candidate genes relevant to diet-induced adaptation, in agreement with the hypothesis of directional selection. Our study provides important insights on the evolutionary potential of bottlenecked populations in response to new selective pressures on short ecological timescales.

Inflammatory pseudotumor and myofibroblastic inflammatory tumor. Diagnostic criteria and prognostic differences.

INTRODUCTION: Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules. METHODS: Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis. RESULTS: Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didn't find any loco-regional or distant recurrence in the patients studied. CONCLUSION: IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role.

Inflammatory pseudotumor and myofibroblastic inflammatory tumor. Diagnostic criteria and prognostic differences. / Seudotumor inflamatorio y tumor miofibroblástico inflamatorio. Criterios diagnósticos y diferencias pronósticas.

INTRODUCTION: Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules. METHODS: Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis. RESULTS: Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didnt find any loco-regional or distant recurrence in the patients studied. CONCLUSION: IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role.

Prognostic significance of histopathological factors in survival and recurrence of atypical carcinoid tumours.

OBJECTIVES: Atypical carcinoids are neuroendocrine neoplasms of intermediate degree and low frequency. The aim of this study is to analyse their clinical characteristics and the importance of different histopathological factors in their prognosis. METHODS: Multicentre cooperative group EMETNE prospectively reviewed 153 patients operated on between 1998 and 2016 with diagnosis of atypical carcinoids. Clinical variables and histopathological features were assessed. RESULTS: Mean age was 54.36 years, similar for both genders. Concerning pathological study, mean tumour size was 31.7 mm. Rosettes were presented in 17% of the cases and tumoural necrosis in 23.3%. The cell proliferation factor Ki-67 index was 10.7%. The 2- and 5-year overall survival rates were 95.8% and 88.9%, respectively. In the univariate study, statistically significant differences in survival were found for each of the categories of T, N and M factors. Mitotic index and quantification of expression of Ki-67 showed influence in overall survival, although without statistical significance. In the multivariate analysis, factors N, M and mitotic index behaved as independent prognostic factors related to survival. Median disease-free interval in the series was 163.35 months. In cases with loco-regional recurrence, 53% had positive hiliar or mediastinal nodal involvement at the time of the surgery. In the univariate analysis, we observed statistically significant differences in disease-free interval in patients with nodal involvement (P = 0.024) and non-anatomical resections (P = 0.04). Histological characteristics showed no statistically significant differences in disease-free interval. CONCLUSIONS: Lymph node involvement, the development of distant metastasis and mitotic index, more than Ki-67 determination, were shown as independent prognostic factors related to survival of these patients.

Epithelioid angiosarcoma of the lung with pleural metastases: a rare cause of haemoptysis clinicopathological conference.

Angiosarcomas are a rare type of malignant vascular tumour characterised by proliferation of tumour cells with vascular endothelial features. These tumours are usually very aggressive and overall mortality is very high. Pulmonary angiosarcomas are usually secondary tumours, and only a few primary cases have been reported. We present a case of a 56 year-old male with persistent haemoptysis secondary to lung epithelioid angiosarcoma with pleural metastases.

Factors associated with the evolution of attitudes towards mental illness in a cohort of nursing students.

WHAT IS KNOWN ON THE SUBJECT?: People with mental health difficulties have poorer physical health than the general population. The stigmatizing attitude of health professionals impacts the quality of care for these people. There is a broad background on the effectiveness of activities based on theoretical training, clinical practices or social contact to improve nursing students' attitudes towards people with mental health difficulties. There is an important need to assess whether the benefits identified in the short term are maintained in the longer term. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The positive evolution of attitudes towards mental illness does not last over time. Some students' attitude towards people with a mental health difficulty worsened in the final stage of their training after completing clinical practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is necessary for tutors incorporate an understanding of stigma throughout the degree training and to discuss with the students the emotional aspects experienced during the performance of clinical practices. The design of any anti-stigma intervention must include the factor of "time". ABSTRACT: Introduction The stigma of health professionals is a contributing factor to morbi-mortality among people with mental health difficulties. There is a lack of research on long-term outcomes in nursing students. Objective To identify factors associated with the evolution of stigmatizing attitudes towards mental illness in a cohort of students trained in mental health. Method A prospective observational study of the impact of training in mental health care. Age, gender, stigma, level of previous familiarity with mental illness, self-education by Internet, academic performance and the place where practicums are conducted were evaluated on three occasions over 15 months. Results Academic performance, online consultation and the size or origin of the theoretical group were indicators of better attitudes. The positive evolution of attitudes does not last over time. Discussion Instability over time could be explained by students' experience in the practicum, although the time itself has been identified as a determining factor. Practical implications Further studies should be promoted in academia to assess the content of mental health training and its influence on the evolution of the stigmatizing attitude. It is also necessary to address stigma in small groups, where students with better academic results lead anti-stigma activities.

Dehydration constrains thermoregulation and space use in lizards.

Climate change is negatively affecting many species. The increase in mean air temperature is often associated with shifts in distribution, changes in phenology, and local extinctions. Other factors that only partially correlate with air temperature, like water shortage, may also contribute to the negative consequences of climate change. Although the effect of temperature on lizards' ecophysiology is highly studied, many lizards are also at risks of increased water loss and dehydration, which are predicted to increase under climate change. Here we aimed for the first time to explore if lacertid lizards exposed to dehydration thermoregulate less precisely than hydrated lizards and if dehydrated lizards are less active, change the daily pattern of thermoregulation and balance water balance against thermoregulation. We exposed four lizard species with differences in the thermal preference to thermal gradients with or without a source of water. We measured preferred body temperatures, daily pattern of thermoregulation, and the use of space. Dehydration negatively affected thermoregulation in all investigated species. Dehydrated lizards reduced their preferred body temperature and showed a species-specific pattern of hourly change in thermal preference. Furthermore, they more frequently used the colder parts of the gradients and spent more time hidden. Lizards experiencing dehydration may suffer a reduction in survival and fitness because of poor thermoregulation. Similarly, they may spend more time hidden, waiting for more favourable weather conditions. Such inactivity may carry ecological costs especially in those regions that undergo either short or prolonged periods of droughts.

Alcohol consumption patterns of university students of health sciences. / Patrones de consumo de alcohol en estudiantes universitarios de Ciencias de la Salud.

AIM: To describe the alcohol drinking patterns and binge drinking episodes (BDE) in a sample of Health Science students, as well as identify associated factors. METHOD: It is a descriptive study, in which sociodemographic variables and a weekly alcohol consumption diary recording the number of standard drinking units consumed at different times of the day are collected by means of a self-administered questionnaire. RESULTS: 286 students (66.1% women) from Cadiz University (193 Medical students and 93 Nursing students), with a mean age of 21.1 (SD 2.8) years, took part in this study. Forty-four point 8percent of the students live with their families. Sixty-five point 7percent of the students drank alcohol in the previous week, this was more usual in the males. The weekly alcohol consumption pattern was 74.5% for low-risk alcohol consumption, 21% for moderate-risk and 4.5% for a high-risk consumption. Thirty-three point 9percent had 1-2 BDE over the previous week apart from their weekly consumption pattern. Twenty-six point 6percent of the students who were emancipated had moderate-risk consumption, 8.2% had a high-risk consumption and 41.8% had a binge drinking episode. There were statistically significant associations between the weekly consumption pattern regarding sex, habitual residence and BDE variables. CONCLUSIONS: More than half the students had taken alcohol the previous week, mainly at weekends. The high prevalence of BDE is highlighted. We propose enhancing early detection and prevention campaigns in this population.

Environmental temperatures shape thermal physiology as well as diversification and genome-wide substitution rates in lizards.

Climatic conditions changing over time and space shape the evolution of organisms at multiple levels, including temperate lizards in the family Lacertidae. Here we reconstruct a dated phylogenetic tree of 262 lacertid species based on a supermatrix relying on novel phylogenomic datasets and fossil calibrations. Diversification of lacertids was accompanied by an increasing disparity among occupied bioclimatic niches, especially in the last 10 Ma, during a period of progressive global cooling. Temperate species also underwent a genome-wide slowdown in molecular substitution rates compared to tropical and desert-adapted lacertids. Evaporative water loss and preferred temperature are correlated with bioclimatic parameters, indicating physiological adaptations to climate. Tropical, but also some populations of cool-adapted species experience maximum temperatures close to their preferred temperatures. We hypothesize these species-specific physiological preferences may constitute a handicap to prevail under rapid global warming, and contribute to explaining local lizard extinctions in cool and humid climates.

N-mixture models reliably estimate the abundance of small vertebrates.

Accurate measures of species abundance are essential to identify conservation strategies. N-mixture models are increasingly used to estimate abundance on the basis of species counts. In this study we tested whether abundance estimates obtained using N-mixture models provide consistent results with more traditional approaches requiring capture (capture-mark recapture and removal sampling). We focused on endemic, threatened species of amphibians and reptiles in Italy, for which accurate abundance data are needed for conservation assessments: the Lanza's Alpine salamander Salamandra lanzai, the Ambrosi's cave salamander Hydromantes ambrosii and the Aeolian wall lizard Podarcis raffonei. In visual counts, detection probability was variable among species, ranging between 0.14 (Alpine salamanders) and 0.60 (cave salamanders). For all the species, abundance estimates obtained using N-mixture models showed limited differences with the ones obtained through capture-mark-recapture or removal sampling. The match was particularly accurate for cave salamanders in sites with limited abundance and for lizards, nevertheless non-incorporating heterogeneity of detection probability increased bias. N-mixture models provide reliable abundance estimates that are comparable with the ones of more traditional approaches, and offer additional advantages such as a smaller sampling effort and no need of manipulating individuals, which in turn reduces the risk of harming animals and spreading diseases.

Differences between craving and health-related quality of life in patients with alcohol dependence with or without dual pathology in outpatient treatment: A descriptive study. / Diferencias entre craving y calidad de vida relacionada con la salud en pacientes con dependencia alcohólica con o sin enfermedad dual en tratamiento ambulatorio: estudio descriptivo.

BACKGROUND AND OBJECTIVE: Dual diagnosis is the coexistence of an addictive disorder and another mental disorder. The objective is to estimate cravings and self-reported quality of life in a sample of patients with alcoholic dependence, with or without dual pathology, who attend an outpatient treatment centre. PATIENTS AND METHOD: A cross-sectional study of 112 patients (56 dual and 56 non-dual), diagnosed with alcohol dependence according to DSM-IV-TR. The presence of cravings is determined by the Multidimensional Alcohol Craving Scale and quality of life through the SF-36 Health Questionnaire. RESULTS: There are no statistically significant differences in cravings in either subgroup; the latter tend to refer to lower alcohol cravings than non-dual patients. The dual patients have a worse quality of life in all categories evaluated, highlighting a worse quality of life in the categories: social function, emotional role, vitality and general health. Females present a lower quality of life emphasising those of social function and emotional role. No differences were detected in relation to cravings between the 2 groups. CONCLUSIONS: In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, we should consider focusing on the evaluation of cravings and quality of life. In order to perform a correct clinical and therapeutic approach for patients with alcohol dependence, it is necessary to consider cravings and quality of life, since these parameters are important for the evaluation of patients with alcohol dependence.

[Influence of delay of surgery on the survival of patients with bronchogenic carcinoma]. / Influencia de la demora quirúrgica en la supervivencia de los pacientes intervenidos por carcinoma broncogénico.

OBJECTIVE: Bronchogenic carcinoma is the main cause of tumor-related deaths among men in Spain. The British Thoracic Society recommends that no longer than 4 weeks should pass from the moment a patient s name is placed on a waiting list until surgery takes place. We analyzed the influence of time until surgery on survival in patients with lung cancer. PATIENTS AND METHODS: We operated on 108 patients diagnosed with bronchogenic carcinoma between January 1, 2001 and December 31, 2002. The time until surgery was defined by the date of application for care in our department until the moment of surgery. RESULTS: The mean time on the waiting list was 56.87 days. No significant differences in mean wait-list times could be found in relation to tumor stage, type of surgery, patient age, or complete resection rate. The median survival in this patient series was 35 months. No significant differences in survival were found in relation to time until surgery in either the univariate or multivariate analysis. Pathologic stage, complete resection of the tumor, and patient age were prognostic factors. CONCLUSIONS: We found no evidence that delaying surgery affects survival in lung cancer patients. However, efforts should be made to reduce surgical wait-list times to bring them into line with the recommendations of scientific societies.

[Video-assisted thoracic surgery to treat spinal deformities: climbing the learning curve]. / Cirugía torácica videoasistida de las deformidades espinales: afrontando la curva de aprendizaje.

OBJECTIVE: The aim of this study was to analyze the impact of the learning curve on the preliminary results of video-assisted thoracic surgery for spinal deformities in a general hospital setting. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 15 patients who underwent video-assisted thoracic surgery performed by a multidisciplinary team comprising orthopedic and thoracic surgeons. Endoscopic anterior release and fusion were followed by posterior instrumentation in a single procedure. Demographic, orthopedic, morbidity, and mortality statistics were compiled for the 15 patients and compared to results reported for similar series. RESULTS: Endoscopic surgery was indicated for 15 patients: 11 women (73.3%) and 4 men (26.7%). The median age was 15 years (interquartile range [IQR], 14-19 years). Three patients (20%) required conversion to thoracotomy. There were 2 serious (13.3%) and 3 minor complications (20%). They all resolved satisfactorily and there was no perioperative mortality. The median Cobb angle was 71 degrees (IQR, 63.75 degrees -75.25 degrees ) before surgery and 41 degrees (IQR, 30 degrees -50 degrees ) after surgery. Median duration of surgery was 360 minutes (IQR, 300-360 minutes), duration of postoperative recovery unit stay was 1.5 days (IQR, 1-2.75 days), and total hospital stay was 11.5 days (IQR, 8.25-14 days). CONCLUSIONS: Despite the complexity of video-assisted thoracic surgical procedures, we believe they will become the standard approach to treating spinal deformities in the near future. By working together in general hospital settings, orthopedic and thoracic surgeons can help to overcome the steep yet manageable learning curve.

Primary pulmonary synovial sarcoma: a rare neoplasm.

Primary pulmonary synovial sarcoma is an extremely rare tumor with an unknown cause. The diagnosis is established after other primary lung malignancies or metastatic extrathoracic sarcoma have been excluded. We report the case of a 69-year-old man who presented with a well-defined mass in the right upper lobe on a chest X-ray. A video-assisted thoracoscopic surgery (VATS) right upper lobectomy was performed. Immunohistochemically, neoplastic cells were positive for vimentin, CD56 and Bcl-2, and focally positive for CD99, epithelial membrane antigen and cytokeratin 7 and 19. The cytogenetic study revealed a SYT genetic reassortment. So, the final pathological diagnosis was primary pulmonary synovial sarcoma.

Nonintubated bilateral single port thoracoscopic sympathectomy in the context of an outpatient program, the least invasive management for hyperhidrosis surgery.

Primary hyperhidrosis is a frequent dysfunctional disorder characterized by excessive sweating in amounts greater than required for physiological needs. Surgery remains the mainstay of treatment when there is no response to medical therapies. Traditionally, thoracoscopic sympathectomy is performed routinely by means of general anesthesia with endotracheal intubation. Here we report the least invasive management for hyperhidrosis surgery, a nonintubated bilateral single port thoracoscopic sympathectomy in the context of an outpatient program.