Risk evaluation and mitigation against flood danger in an arid environment. A case study (El Bayadh region, Algeria).

Floods are among the most serious and devastating phenomena of natural disasters. Cities adjacent to flood-prone areas in the last decades have played a major role in increasing the potential adverse effects of flood damage. This research study aims to evaluate and mitigate the risks of flood events in the El Bayadh region, which suffers from poor infrastructure and drained networks. To achieve this, it is necessary to evaluate rainfall intensities and their limits for durations from 0.167 to 24 h with return periods from 2 to 1000 years. Eight different frequency analysis distributions were fit to the historical rainfall data series over 43 years (1970-2012) using hypothesis-based goodness tests and information-based criteria. The most appropriate distributions were used to develop the rainfall intensity-duration-frequency (IDF) and flood risk-duration-frequency (RDF) curves for the study area. The results show that high-intensity rainfall values last for short durations, while high flood risk values last for intermediate durations. The results of the flood RDF curves can provide useful information for policy makers to make the right decisions regarding the effectiveness of the region's protection structures against future flood risks.

Metastasising pleomorphic salivary gland adenoma presenting as synchronous pulmonary and hepatic metastases.

Pleomorphic salivary adenomas (PAs) are the commonest benign tumours of glandular origin in the head and neck. Occasionally PAs undergo malignant transformation to carcinoma-ex-PA and can metastasise. More rarely they metastasise without malignant transformation of the primary tumour. We present a case of a benign pleomorphic salivary gland adenoma, presenting 7 years later with multiple liver metastases and a synchronous pulmonary metastasis. Histological analysis of the lung and liver lesions confirmed a diagnosis of metastasising pleomorphic adenoma (MPA). The lung lesion was fully excised, but the multifocal nature of the liver lesions rendered them inoperable. The patient is being managed conservatively and to date has no local recurrence of the primary salivary gland tumour or any further metastases. To the best of our knowledge this is the first case of MPA with simultaneous metastasis to both lungs and liver, and also the first to describe multiple liver metastases.

Closed suction drainage improves clinical outcome in patients undergoing endoscopic vein harvesting for coronary artery bypass grafting.

BACKGROUND: Endoscopic vein harvesting (EVH) is a widely accepted technique for coronary artery bypass grafting, with well-reported benefits. However, EVH is associated with severe hematoma formation at incision sites, resulting in postoperative pain. We hypothesized that the use of a leg wound drain at the incision site may reduce these comorbidities. METHODS: One hundred consecutive patients were prospectively randomly allocated into two groups of 50: group 1 with leg wound drains, and group 2 without drains. Group 1 patients underwent EVH followed by closure with a size 10 high vacuum leg wound drain (20 kPa), whereas group 2 underwent EVH followed by closure without a leg wound drain. Patients were assessed for postoperative pain, wound infection, and satisfaction using validated scoring systems immediately after surgery. RESULTS: Pain at rest (p < 0.001) and with movement (p < 0.001), incidence of hematoma (p < 0.001), and patient satisfaction (p < 0.001) were significantly improved in the drain group at days 1 to 7 and remained significant at week 6 after surgery. Interestingly, the use of antibiotics (6% versus 24%, p = 0.012) and the number of general practitioner visits (6% versus 26%, p = 0.012) were lower in the drain group compared with the no-drain group. However, there were no differences in the length of hospital stay between the two groups after surgery. CONCLUSIONS: Our findings indicate that the use of a high vacuum leg drain after EVH for long saphenous vein is of clear therapeutic benefit in the early postoperative period. We also report that this technique may reduce antibiotic administration and general practitioner visits after patient discharge.