Resection of a giant nonparasitic splenic cyst by minilaparoscopy.

A female patient, 20 years old, with a history of a progressive increase in abdominal volume on the left side, starting 3 years ago, with no associated symptoms and no history of trauma. Ultrasonography and a computed tomography scan of the abdomen were performed, which revealed a large splenomegaly, and a partial minilaparoscopic splenectomy was indicated. We opted for unroofing of the cyst, and the procedure was uneventful, with a total surgical time of 47 min. The patient progressed clinically well, without abdominal pain, being discharged on the 2nd post-operative day.

A new hybrid mini-laparoscopic technique for Spigelian hernia.

We describe the original technique used for the treatment of a patient who presented with pain and bulging in the abdomen, who was diagnosed with Spigelian hernia (SH) using ultrasound. In this case, the hernia occurred in the anterolateral abdominal wall with herniation of the distal ileum and mesentery, in addition to a large right inguinal hernia. A mini-laparoscopic approach was proposed; due to Child-A hepatic cirrhosis, it was done by a hybrid technique, using a harmonic scalpel. The primary closure of the hernia defects was performed, followed by the placement of a polypropylene mesh in the preperitoneal space. The mesh was fixed. In this case, the inguinal hernia was homolateral to the SH. Following the surgery, the patient had no further complications, being discharged the day after the procedure.

Resection of giant hepatic cyst by hybrid minilaparoscopy.

A female patient, 59-year-old, was complaining of abdominal pain in the right hypochondrium and mesogastrium for 6 months. Ultrasonography and abdominal computed tomography were performed, both confirming a large hepatic cyst (10.6 cm × 7.6 cm × 7.3 cm) on the left lobe. A hybrid minilaparoscopic resection was proposed. We opted for unroofing the cyst, and the procedure was uneventfully performed, with a total surgical time of 60 min. In the post-operative the patient did well, with minimal abdominal pain, being discharged on the 5th post-operative day, after drain removal due to the use of intravenous antibiotic therapy.

Bioinformatics Analysis of the Human Surfaceome Reveals New Targets for a Variety of Tumor Types.

It is estimated that 10 to 20% of all genes in the human genome encode cell surface proteins and due to their subcellular localization these proteins represent excellent targets for cancer diagnosis and therapeutics. Therefore, a precise characterization of the surfaceome set in different types of tumor is needed. Using TCGA data from 15 different tumor types and a new method to identify cancer genes, the S-score, we identified several potential therapeutic targets within the surfaceome set. This allowed us to expand a previous analysis from us and provided a clear characterization of the human surfaceome in the tumor landscape. Moreover, we present evidence that a three-gene set-WNT5A, CNGA2, and IGSF9B-can be used as a signature associated with shorter survival in breast cancer patients. The data made available here will help the community to develop more efficient diagnostic and therapeutic tools for a variety of tumor types.

Graph analysis of dream reports is especially informative about psychosis.

Early psychiatry investigated dreams to understand psychopathologies. Contemporary psychiatry, which neglects dreams, has been criticized for lack of objectivity. In search of quantitative insight into the structure of psychotic speech, we investigated speech graph attributes (SGA) in patients with schizophrenia, bipolar disorder type I, and non-psychotic controls as they reported waking and dream contents. Schizophrenic subjects spoke with reduced connectivity, in tight correlation with negative and cognitive symptoms measured by standard psychometric scales. Bipolar and control subjects were undistinguishable by waking reports, but in dream reports bipolar subjects showed significantly less connectivity. Dream-related SGA outperformed psychometric scores or waking-related data for group sorting. Altogether, the results indicate that online and offline processing, the two most fundamental modes of brain operation, produce nearly opposite effects on recollections: While dreaming exposes differences in the mnemonic records across individuals, waking dampens distinctions. The results also demonstrate the feasibility of the differential diagnosis of psychosis based on the analysis of dream graphs, pointing to a fast, low-cost and language-invariant tool for psychiatric diagnosis and the objective search for biomarkers. The Freudian notion that "dreams are the royal road to the unconscious" is clinically useful, after all.

Implante de stent no tronco da coronária esquerda näo protegido de paciente com choque cardiogênico / Stenting of unprotected left main coronary artery in a patient with cardiogenic shock

Mulher de 64 anos apresentou edema pulmonar e choque cardiogênico após cinecoronariografia que revelou lesão severa suboclusiva em troco de coronária esquerda (TCE) dominante. Foi submetida a angioplastia de urgência com implante de stent no TCE, com sucesso. Após evolução satisfatória, teve alta no 6º dia.