Case report: Endovascular stent-graft repair of aortic penetrating trauma, literature review, and case report.

Penetrating aortic injuries are infrequent. Its incidence is unknown because most patients die of hemorrhage even before they receive adequate treatment. Aortic wounds generally require conventional thoracotomy/laparotomy repair and are related to high mortality rates. Recently with the advent of endovascular techniques, most authors prefer endovascular management when feasible due to better (still poor) outcomes. The short- and mid-term results of immediate endovascular repair of traumatic aortic injuries are promising, especially when compared with open surgical treatment, indicating that endovascular therapy is preferable in patients with multi-trauma and traumatic ruptures of the thoracic aorta. Here we present the diagnosis and treatment of a 30 years-old male patient with multiple traumatic stab wounds, including anterior aortic laceration with a grade II aortic lesion successfully managed with an endovascular stent graft.

Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial.

BACKGROUND: Previous observational studies showed higher rates of abdominal wall closure with the use of hypertonic saline in trauma patients with abdominal injuries. However, no randomized controlled trials have been performed on this matter. This double-blind randomized clinical trial assessed the effect of 3% hypertonic saline (HS) solution on primary fascial closure and the timing of abdominal wall closure among patients who underwent damage control laparotomy for bleeding control. METHODS: Double-blind randomized clinical trial. Patients with abdominal injuries requiring damage control laparotomy (DCL) were randomly allocated to receive a 72-h infusion (rate: 50 mL/h) of 3% HS or 0.9 N isotonic saline (NS) after the index DCL. The primary endpoint was the proportion of patients with abdominal wall closure in the first seven days after the index DCL. RESULTS: The study was suspended in the first interim analysis because of futility. A total of 52 patients were included. Of these, 27 and 25 were randomly allocated to NS and HS, respectively. There were no significant differences in the rates of abdominal wall closure between groups (HS: 19 [79.2%] vs. NS: 17 [70.8%]; p = 0.71). In contrast, significantly higher hypernatremia rates were observed in the HS group (HS: 11 [44%] vs. NS: 1 [3.7%]; p < 0.001). CONCLUSION: This double-blind randomized clinical trial showed no benefit of HS solution in primary fascial closure rates. Patients randomized to HS had higher sodium concentrations after the first day and were more likely to present hypernatremia. We do not recommend using HS in patients undergoing damage control laparotomy. Trial registration The trial protocol was registered in clinicaltrials.gov (identifier: NCT02542241).

Reconstrucción de estenosis traqueal benigna: experiencia de un hospital de alta complejidad en Colombia / Reconstruction of benign tracheal stenosis: Experience of a high-level complexity hospital in Colombia

Introducción. La causa más común de estenosis laringotraqueal benigna es iatrogénica, secundaria a intubación orotraqueal. El manejo quirúrgico sigue siendo la alternativa que ha mostrado mejores resultados a largo plazo. El objetivo de este estudio fue analizar la experiencia en el manejo quirúrgico de la estenosis laringotraqueal durante 15 años en un hospital de alta complejidad en Colombia.Métodos. En este estudio se revisaron las historias clínicas de todos los pacientes tratados con reconstrucción de estenosis traqueal benigna, entre los años 2005 y 2020. Para el análisis estadístico se usaron métodos de estadística descriptiva, con análisis de frecuencias y medidas de tendencia central o de dispersión.Resultados. Se identificaron 38 pacientes con estenosis laringotraqueal, con un grado variable de estenosis. La nasofibrolaringoscopia fue bien tolerada y segura para determinar el grado y la longitud de la estenosis. El uso de tomografía sirvió para determinar la extensión y las características anatómicas. Los resultados del presente estudio son similares a los de la literatura en cuanto a complicaciones, mortalidad y falla de la anastomosis. Las complicaciones más frecuentemente reportadas son reestenosis, infección del sitio operatorio, lesión nerviosa y fístula, que en general se presentan en un tercio de los pacientes. Conclusiones. La experiencia de manejo quirúrgico de estenosis laringotraqueal en este hospital permite concluir que la reconstrucción traqueal es una opción segura en nuestro medio. Las tasas de éxito y de falla del tratamiento son equiparables a las reportadas en la literatura.

Introduction. The most common cause of benign laryngotracheal stenosis is iatrogenic, secondary to orotracheal intubation. Surgical management continues to be the alternative that has shown better long-term results. The objective of this study was to analyze the experience in the surgical management of laryngotracheal stenosis for 15 years in a high-level complexity hospital in Colombia.Methods. Medical records of patients treated with reconstruction of benign tracheal stenosis between 2005 and 2020 were reviewed. Descriptive statistical methods were used, with frequency analysis and measures of central tendency or dispersion.Results. Thirthy-eight patients with laryngotracheal stenosis were identified, with a variable degree of stenosis. Nasofibrolaryngoscopy was well tolerated and safe to determine the degree and length of the stenosis. The use of tomography served to determine the extension and anatomical characteristics. The results of the present study are similar to those of the literature in terms of complications, mortality and failure of the anastomosis. The most frequently reported complications are restenosis, surgical site infection, nerve injury, and fistula, which generally occur in one third of patients.Conclusions. The experience of surgical management of laryngotracheal stenosis in our hospital allows us to conclude that tracheal reconstruction is a safe option in our environment. Treatment success and failure rates are comparable to those reported in the literature.

Genetic Algorithm model and data files to assess JONSWAP spectra coefficients: MATLAB code.

This data article presents the structure of a Genetic Algorithm model written in a MATLAB code for finding the 1D JONSWAP spectra parameters when measured raw spectra is not available. The JONSWAP spectra is widely used in Coastal, Offshore, and Ocean Engineering for determining wave parameters for structure designing and numerical modeling. However, finding proper spectra parameters may be difficult because of the limitations of parameterized equations to do so and the high non-linear relation between the alpha and gamma coefficients. This GA model can find the alpha and gamma parameters for specific locations considering sea-state's evolution and water-depth transitions. The application of the GA model of this data article is shown in Rueda-Bayona et al. [1].

Modelling of surface river plume using set-up and input data files of Delft-3D model.

This data article presents set-up and input data files to model a surface river plume through curvilinear nested grid in double-way mode. The hydrodynamic modelling in river deltas with intense transport processes and complex bathymetry such as the Magdalena River delta, requires a mesh grid that ease the natural river discharge into the ocean. The aforementioned may be challenging due to the numerical scheme and stability restrictions of the numerical models that difficult having efficient and effective validated simulations. This dataset files are a reference to perform analysis of the hydrodynamic river deltas, meaningful for optimizing time and resources, easing the planning of measurement campaigns what reduce risks of the personnel and instrumentation during equipment deployment and field work .The application of the set-up and input data files of this data article is shown in Rueda-Bayona et al. [1].

Ecotoxicity and genetic toxicity data from a pulp mill bleaching effluent treated with anaerobic digestion and advanced oxidation process (AOP).

Wastewater treatment contributes to environmental sustainable development indicators such as clean water and sanitation, then, is imperative to improve the mechanisms and process of contaminant removals. The sewage and industrial effluents are the major contributors of pollutants in land and water discharges, and are necessary to enrich the available data for having reference parameters for plant designing and optimization. The physical andchemical assays alone could not be considered sufficient to assess properly the plant performance because complex mixtures demand ecological and biological parameters for a holistic evaluation. Hence, the ecotoxicity and the genetic toxicity measurement become an important tool to complement the conventional water quality parameters, but these parameters are not widely reported in the open access literature. Despite of several studies showed ecotoxicity and the genetic toxicity data, these could be considered not sufficient because the resulted information is derived from single compounds. Considering the scarce data mentioned above this article presents data on the genetic an ecological toxicity of an anaerobic effluent post-treated with ozone and ozone/UV generated by Chaparro et al. [1] and Chaparro and Pires [2].

Set-up and input dataset files of the Delft3d model for hydrodynamic modelling considering wind, waves, tides and currents through multidomain grids.

This article contains the set-up and input files of the implementation of Delft3D model to determine extreme hydrodynamic forces performed in Rueda-Bayona et al. [1]. The model was configured with a multidomain grid using double-way communication between the hydrodynamic and wave module. The multidomain grids solve faster than single and nested grids because require less grid points to calculate. Also, the double-way communication between the hydrodynamic and wave modules allows to consider the non-linear interactions of wind, waves, tides and currents. Because there are no modelling examples related to multidomain grids in the open access official web site of Delft3d model, this data contributes to increase the availability information of this necessity. Finally, the files of this article are ready to be run in the Delft3D model to perform a sensitivity test recommended in Rueda-Bayona et al. [1].

Data supporting the forecast of electricity generation capacity from non-conventional renewable energy sources in Colombia.

The data included in this study was calculated based on data provided by the national project registry provided by the Colombian government. The data forecasts the evolution of the power generation capacity registered in non-conventional renewable energy source projects in three scenarios of implementation of the power generation capacity registered in the projects. Results can be used to benchmark non-conventional renewable energy sources in Colombia, interpret the effectiveness of renewable policies, and monitor the evolution of non-conventional renewable-based power generation. The data presented in the article relates to the research study: A look to the electricity generation from non-conventional renewable energy sources in Colombia [1].

A clinical series of packing the wound tract for arresting traumatic hemorrhage from injuries of the lung parenchyma as a feasible damage control technique.

Background: Tractotomy has become the standard of care for transfixing through-and-through lung injuries as it can be performed quickly with little blood loss and a low risk of complications. However, packing with laparotomy pads could be a feasible alternative to tractotomy on selected patients. We describe a series of four patients with lung trauma in which packing of the pulmonary wound tract was used as the primary and unique surgical strategy for arresting hemorrhage from injuries of the lung parenchyma. Methods: Packing of the traumatic tract is achieved by gently pulling a laparotomy pad with a Rochester clamp and adjusting it to the cavity to stop the bleeding. The pack is removed in a subsequent surgery by moistening and tractioning it softly to avoid additional damage. The operation is completed by manual compression of the wounded lobe. We present a case series of our experience with this approach. Results: From 2012 to 2016, we treated four patients with the described method. The mechanism was penetrating in all them. The clinical condition was of exsanguinations with multiple sources of hemorrhage. There were three patients with peripheral injuries to the lung and one with a central injury to the pulmonary parenchyma. Bleeding was stopped in all the cases. Three patients survived. A patient had recurrent pneumothorax which was resolved with a second chest tube. Conclusion: Packing of the traumatic tract allowed rapid and safe treatment of transfixing through-and-through pulmonary wounds in exsanguinating patients under damage control from several bleeding sources.

Wind and power density data of strategic offshore locations in the Colombian Caribbean coast.

The high potential of wind speed in the Colombian Caribbean coast is an opportunity to develop offshore wind energy technology. This article contains the wind speed and wind power density in four strategic locations in Colombia (Cartagena, Barranquilla, Santa Marta and La Guajira) at different elevations. The dataset from this study is related to the research paper "Renewables energies in Colombia and the opportunity for the offshore wind technology published in Journal of Cleaner Production (Rueda-Bayona et al.) [1]. Reading and processing numerous files stored in databases could be challenging because it demands software programming to do so, what could difficult the access to valuable data for the community. Also, high compressed files such as NetCDF formats demand specialised software which is not easy obtaining and utilising because it requires skills in a programming language. Then, this study used the NARR-NOAA database [2] and generated local wind and power density data stored in Excel sheets to ease their utilisation.

Effect of abdominal negative-pressure wound therapy on the measurement of intra-abdominal pressure.

BACKGROUND: In critically ill surgical patients undergoing abdominal negative-pressure wound therapy (NPWT), it remains uncertain whether or not intra-abdominal pressure (IAP) measurements should be obtained when NPWT is activated. We aimed to determine agreement between IAP measured with and without NPWT. METHODS: In this analytic cross-sectional study, critically ill surgical adults (≥18 y) requiring abdominal NPWT for temporary abdominal closure after a damage control laparotomy were selected. Patients with urinary tract injuries or with pelvic packing were excluded. Paired IAP measures were performed in the same patient, with and without NPWT; two different operators performed the measures unaware of the other's result. Bland-Altman methods assessed the agreement between the two measures. Subgroup analyses (trauma and nontrauma) were performed. RESULTS: There were 198 IAP measures (99 pairs) in 38 patients. Mean IAP with and without NPWT were 8.33 (standard deviation 4.01) and 8.65 (standard deviation 4.04), respectively. Mean IAP difference was -0.323 (95% confidence interval -0.748 to 0.101), and reference range for difference was -4.579 to 3.932 (P = 0.864). From 112 IAP measures (56 pairs) in 21 trauma patients, mean IAP difference was -0.268 (95% confidence interval -0.867 to 0.331), and reference range for the difference was -4.740 to 4.204 (P = 0.427). CONCLUSIONS: There was no statistically significant disagreement in IAP measures. IAP could be measured with or without NPWT. In critically ill surgical patients with abdominal NPWT for temporary abdominal closure, monitoring and management of IAP either with or without NPWT is recommended.

Pen Devices for Insulin Self-Administration Compared With Needle and Vial: Systematic Review of the Literature and Meta-Analysis.

OBJECTIVES: Pen devices offer advantages compared with vial and syringe (VaS). The purpose of this article was to evaluate efficacy of pen devices compared to VaS. METHODS: A systematic review of literature was performed in 8 different databases. References were independently screened and selected. Primary observational or experimental studies comparing pen devices with VaS for insulin administrations were included. Studies on specific populations were excluded. Risk of bias was evaluated using appropriate tools. Data on glycosylated hemoglobin (HbA1c), hypoglycemia, adherence, persistence, patient preference, and quality of life (QOL) were collected. Meta-analysis was performed when appropriate. Heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses of the available data was done. RESULTS: In all, 10 348 articles were screened. A total of 17 studies were finally selected: 7 experimental and 10 analytical. The populations of the included articles were mainly composed of adults with type 2 diabetes mellitus. Important risk of bias was found in all of the articles, particularly experimental studies. Meta-analyses were performed for HbA1c, hypoglycemia, adherence and persistence. Pen device showed better results in mean HbA1c change, patients with hypoglycemia, adherence and persistence compared to VaS. No difference was observed in number of patients achieving <7% HbA1c. Preference studies showed a tendency favoring pen devices, however nonvalidated tools were used. One QoL study showed improvements in some subscales of SF-36. CONCLUSIONS: There is evidence that pen devices offer benefits in clinical and, less clearly, patient-reported outcomes compared to VaS for insulin administration. However, these results should be taken with caution.

Flebitis asociada con accesos venosos periféricos en niños: revisión sistemática de la literatura / Peripheral venous catheter associated phlebitis in children: A systematic review

Objetivo: Realizar una revisión sistemática de la literatura sobre la aparición de flebitis en niños, relacionada con catéteres venosos periféricos cortos. Metodología: Se buscó en las bases de datos PubMed, Scopus y Scielo, con los términos libres catéter venoso, infección, flebitis y sinónimos, sin límite de idioma, publicados en los últimos 10 años (desde las recomendaciones del CDC). Resultados: De un total inicial de 1.486 referencias, se seleccionaron 9 artículos que midieran la frecuencia de flebitis y su relación con el tiempo de permanencia del catéter. Estos fueron realizados en poblaciones heterogéneas, con diferentes definiciones de flebitis, y distintos desenlaces de interés; el tiempo de aparición de flebitis fue un desenlace secundario en todos. Discusión: A diferencia de los adultos, en niños no hay estudios encaminados a evaluar el tiempo adecuado de permanencia del catéter venoso periférico corto. Se requiere más investigación en este campo.

Objective: To carry out a systematic review of the literature on the occurrence of phlebitis related to short peripheral venous catheters in children. Methodology: We searched PubMed, Scopus and Scielo databases using venous catheter, infection, phlebitis and synonyms as free terms, no language restriction, in the last 10 years (since the CDC made its recommendations). Results: From an initial total of 1486 references, 9 measured the frequency of phlebitis and its relationship to the time of catheter placement. These studies were performed on heterogeneous populations, with varying definitions of phlebitis and various outcomes of interest. The time of occurrence of phlebitis was always a secondary endpoint. Discussion: Unlike adults, in children there are no studies assessing the appropriate amount oftime to maintain a short peripheral venous catheter. More research is needed in this field.