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1.
Sci Total Environ ; 703: 135508, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31761373

RESUMO

Residues from production of olive oil are generated yearly in great amounts, both in liquid and solid forms. Different waste treatment systems were proposed in literature, to minimize environmental pollution while raising the energy recovery. Anaerobic digestion is one of the available routes to recover energy from waste via production of biogas while reducing organic load and pollutants to the environment. The use of farming and agro industrial wastes as co-substrate in anaerobic digestion can induce benefits related to the simultaneous treatment of different wastes. In particular, co-digestion can significantly enhance the process stability as well as the bio-methane generation. This work aims at reviewing the latest achievements in anaerobic digestion of olive mill residues, focusing on the aspects that can mostly favor the process, principally from a technical but also from an economical point of view. For the mono-digestion processes, methane yields up to 419 LCH4 kgVS-1 were reported for olive mill wastewaters (Calabrò et al. 2018), while a production of 740 LCH4 kgVS-1 was achieved when digesting olive mill solid waste together with olive mill wastewater and milk whey (Battista et al. 2015). An increase up to 143% in the methane yield was also reported when the feedstock was subjected to a 5 days aeration before digesting it in a semi-continuous stirred tank reactor (González-González and Cuadros 2015).


Assuntos
Biocombustíveis , Resíduos Industriais , Metano , Olea , Eliminação de Resíduos Líquidos/métodos , Anaerobiose , Águas Residuárias
2.
Int J Mol Sci ; 20(19)2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31623362

RESUMO

Skeletal muscle regeneration is ensured by satellite cells (SC), which upon activation undergo self-renewal and myogenesis. The correct sequence of healing events may be offset by inflammatory and/or fibrotic factors able to promote fibrosis and consequent muscle wasting. Angiotensin-II (Ang) is an effector peptide of the renin angiotensin system (RAS), of which the direct role in human SCs (hSCs) is still controversial. Based on the hypertrophic and fibrogenic effects of Ang via transient receptor potential canonical (TRPC) channels in cardiac and renal tissues, we hypothesized a similar axis in hSCs. Toward this aim, we demonstrated that hSCs respond to acute Ang stimulation, dose-dependently enhancing p-mTOR, p-AKT, p-ERK1/2 and p-P38. Additionally, sub-acute Ang conditioning increased cell size and promoted trans-differentiation into myofibroblasts. To provide a mechanistic hypothesis on TRPC channel involvement in the processes, we proved that TRPC channels mediate a basal calcium entry into hSCs that is stimulated by acute Ang and strongly amplified by sub-chronic Ang conditioning. Altogether, these findings demonstrate that Ang induces a fate shift of hSCs into myofibroblasts and provide a basis to support a benefit of RAS and TRPC channel blockade to oppose muscle fibrosis.


Assuntos
Angiotensina II/metabolismo , Transdiferenciação Celular , Miofibroblastos/metabolismo , Células Satélites de Músculo Esquelético/metabolismo , Transdução de Sinais , Angiotensina II/farmacologia , Sinalização do Cálcio , Sobrevivência Celular/efeitos dos fármacos , Transdiferenciação Celular/efeitos dos fármacos , Humanos , Hipertrofia , Imagem Molecular , Mioblastos/citologia , Mioblastos/metabolismo , Miofibroblastos/citologia , Sistema Renina-Angiotensina/efeitos dos fármacos , Células Satélites de Músculo Esquelético/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos
3.
Pediatr Int ; 61(10): 1020-1024, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31282046

RESUMO

BACKGROUND: Thyroglossal duct cyst (TDC) is the most common congenital abnormality in the neck in children. The purpose of this study was to perform a comprehensive review of all cases of TDC surgically treated at a single institution and to evaluate the factors that influence the rate of recurrence, and the aesthetic outcome of the surgery on follow up. METHODS: All cases of TDC surgically treated at the Department of Pediatric Surgery at Meyer Hospital from January 2005 to December 2016 were selected. Charts from 248 patients were reviewed and risk factors for recurrence evaluated. A questionnaire was submitted to the patients' parents to determine if postoperative complications were present  and standardized neck pictures were requested, to evaluate the cosmetic result . Microsoft Office Excel 2007 for Windows and Graphpad Prism 6 were used for data management and statistical analysis. RESULTS: Simple cyst excision and post-inflammatory fibrosis (P < 0.05) were assessed as important risk factors for the recurrence of TDC. Recurrence rate on Sistrunk procedure was 5%. Variables such as post-inflammatory fibrosis before surgery (P < 0.001), the positioning of a drain (P < 0.01) and the development of recurrence (P < 0.001), negatively influenced the cosmetic result. No thyroglossal duct cyst carcinoma and no long-term postoperative complications were observed. CONCLUSIONS: Recurrence rates were higher in patients who underwent simple cyst excision instead of the Sistrunk procedure, as already reported in literature. Presence of post-inflammatory fibrosis and positioning of the drain at surgery were associated with higher rates of recurrence, as well as worse cosmetic outcome.

4.
Med Biol Eng Comput ; 57(8): 1727-1735, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31154586

RESUMO

To date, standard methods for assessing the severity of chest wall deformities are mostly linked to X-ray and CT scans. However, the use of radiations limits their use when there is a need to monitor the development of the pathology over time. This is particularly important when dealing with patients suffering from Pectus Carinatum, whose treatment mainly requires the use of corrective braces and a systematic supervision. In recent years, the assessment of severity of chest deformities by means of radiation-free devices became increasingly popular but not yet adopted as standard clinical practice. The present study aims to define an objective measure by defining a severity index (named External Pectus Carinatum Index) used to monitor the course of the disease during treatment. Computed on the optical acquisition of the patients' chest by means of an appositely devised, fast and easy-to-use, body scanner, the proposed index has been validated on a sample composed of a control group and a group of Pectus Carinatum patients. The index proved to be reliable and accurate in the characterization of the pathology, enabling the definition of a threshold that allows to distinguish the cases of patients with PC from those of healthy subjects. Graphical abstract.


Assuntos
Imagem Tridimensional/métodos , Monitorização Fisiológica/métodos , Pectus Carinatum/diagnóstico por imagem , Pectus Carinatum/fisiopatologia , Adolescente , Braquetes , Estudos de Casos e Controles , Criança , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Monitorização Fisiológica/instrumentação , Pectus Carinatum/terapia , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X/métodos
5.
Ann Thorac Surg ; 107(4): 1253-1258, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30508532

RESUMO

PURPOSE: Pectus arcuatum is an anterior chest wall deformity that requires transverse wedge sternotomy. Determining and delivering the correct cutting angle are crucial for successful correction. This report describes the early clinical experience with a novel cutting template technology able to deliver the optimal cutting angle. DESCRIPTION: From patients' computed tomographic scans, the optimal cutting angle is obtained using computer-aided design. A template comprising slots tilted at the right cutting angle and a safety block to avoid damaging the posterior periosteum is printed through additive manufacturing. EVALUATION: The template allows surgeons to perform a precise wedge sternotomy, safely sparing the posterior periosteum in all patients, without complications. Postoperative chest roentgenograms and clinical photographs demonstrate optimal sternal realignment and cosmetic outcome. In this report, the mean operative time was 110 minutes. All patients were successfully discharged, with a mean length of stay of 4 days. CONCLUSIONS: Transverse wedge sternotomy aided by a computer-aided design-devised cutting template may reduce the technical challenge of this procedure, thereby increasing its safety and reducing operative times and hospital stay. Further research on long-term patient outcomes is necessary.


Assuntos
Projeto Auxiliado por Computador , Imagem Tridimensional , Pectus Carinatum/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Esternotomia/métodos , Adolescente , Placas Ósseas , Parafusos Ósseos , Feminino , Humanos , Masculino , Pectus Carinatum/diagnóstico por imagem , Cuidados Pré-Operatórios/métodos , Recuperação de Função Fisiológica/fisiologia , Medição de Risco , Amostragem , Índice de Gravidade de Doença , Esternotomia/instrumentação , Resultado do Tratamento , Adulto Jovem
6.
Fetal Pediatr Pathol ; 37(4): 263-269, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30188242

RESUMO

INTRODUCTION: Lymphangiomas are benign tumors/malformations, characterized by proliferation of the lymphatic vessels. They may arise anywhere, although the most common localizations are the head-neck region and the axilla. To date, only 21 cases of lymphangioma of the ovary in a 60-year literature survey have been reported. CASE REPORT: A 16-year-old female patient with long standing abdominal distension had 40 cm × 15 cm × 29 cm ovarian lymphangioma. CONCLUSIONS: Our case highlights that lymphangiomas can occur in the adolescent population and should be added to the differential diagnosis of ovarian masses in this age group.


Assuntos
Linfangioma/patologia , Neoplasias Ovarianas/patologia , Adolescente , Feminino , Humanos
7.
Ann Thorac Surg ; 106(1): 221-227, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29549009

RESUMO

BACKGROUND: Current approaches to quantifying the severity of pectus excavatum require internal measurements based on cross-sectional imaging. The aim of this study is to exploit a novel index evaluated on the external surface of the chest with a three-dimensional (3D) optical scanner. METHODS: Fifty-one children (41 male, 10 female) between 2 and 17 years of age were evaluated with a 3D optical scanner. Pectus excavatum severity was calculated by using an ad hoc instant 3D scanner and defining an automatic procedure to generate an optical 3D correction index (CI3D). For the latter, an ideal threshold was derived from a statistical analysis, and five blind surveys were collected from pediatric specialists on chest wall deformities. The CI3D was then correlated with blind clinical assessments of PE severity. RESULTS: The cutoff thresholds were determined to optimally discriminate between six degrees of severity of PE patients by a correlation analysis. The correlation coefficient obtained by matching the CI3D with the average subjective severity shows that the proposed method outperforms traditional approaches. CONCLUSIONS: The optical 3D index has a good match with the average subjective assessment in distinguishing patients with mild to severe PE. This innovative approach offers several advantages over existing indices, as it is repeatable and does not require cross-sectional imaging. The index might be particularly suitable for monitoring the efficacy of nonoperative treatment and, in the future, for designing an optimal personalized usage of therapeutic devices.


Assuntos
Tórax em Funil/diagnóstico por imagem , Imagem Tridimensional , Dispositivos Ópticos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Tórax em Funil/fisiopatologia , Tórax em Funil/cirurgia , Humanos , Itália , Masculino , Prognóstico , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Parede Torácica/anormalidades , Parede Torácica/diagnóstico por imagem , Parede Torácica/cirurgia , Resultado do Tratamento
8.
Eur J Cardiothorac Surg ; 52(4): 710-717, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-29156016

RESUMO

OBJECTIVES: Patients with pectus excavatum (PE) after prior sternotomy for cardiac surgery present unique challenges for repair of PE. Open repairs have been recommended because of concerns about sternal adhesions and cardiac injury. We report a multi-institutional experience with repair utilizing substernal Nuss bars in this patient population. METHODS: Surgeons from the Chest Wall International Group were queried for experience and retrospective data on PE repair using sub-sternal Nuss bars in patients with a history of median sternotomy for cardiac surgery (November 2000 to August 2015). A descriptive analysis was performed. RESULTS: Data for 75 patients were available from 14 centres. The median age at PE repair was 9.5 years (interquartile range 10.9), and the median Haller index was 3.9 (interquartile range 1.43); 56% of the patients were men. The median time to PE repair was 6.4 years (interquartile range 7.886) after prior cardiac surgery. Twelve patients (16%) required resternotomy before support bar placement: 7 pre-emptively and 5 emergently. Sternal elevation before bar placement was used in 34 patients (45%) and thoracoscopy in 67 patients (89%). Standby with cardiopulmonary bypass was available at 9 centres (64%). Inadvertent cardiac injury occurred in 5 cases (7%) without mortality. CONCLUSIONS: Over a broad range of institutions, substernal Nuss bars were used in PE repair for patients with a history of sternotomy for cardiac surgery. Several technique modifications were reported and may have facilitated repair. Cardiac injury occurred in 7% of cases, and appropriate resources should be available in the event of complications. Prophylactic resternotomy was reported at a minority of centres.


Assuntos
Tórax em Funil/cirurgia , Cardiopatias/complicações , Próteses e Implantes , Esternotomia , Esterno/cirurgia , Parede Torácica/cirurgia , Toracoplastia/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Criança , Feminino , Tórax em Funil/complicações , Cardiopatias/cirurgia , Humanos , Masculino , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
9.
J Laparoendosc Adv Surg Tech A ; 27(12): 1326-1327, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29087764

RESUMO

INTRODUCTION: Nuss bar removal after minimally invasive repair of pectus excavatum in patients where bar ends are not palpable, can be a challenging procedure for the surgeon; a blind dissection toward the bar edges may lead to intercostal vessels or deep intercostal muscle injuries. In this article, we describe a fast, repeatable, low-cost technique to detect bar edge and stabilizers. METHODS: A perioperative scan is performed by means of a portable ultrasonograph a few minutes before the operation. The bar edge stabilizer is detected as a hyperechogenic image with a concentric crescent while the bar edge is detected as a hyperechogenic dashed line with net edges. The scan is performed, and the actual projection on the skin of the metal plaque bulk is then labeled on the patient's chest by an ink marker. CONCLUSIONS: We believe that this method may improve morbidity, operative time, and consequently, hospitalization length and costs.


Assuntos
Remoção de Dispositivo/métodos , Tórax em Funil/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Ultrassonografia de Intervenção/métodos , Humanos , Duração da Cirurgia , Estudos Retrospectivos
10.
J Pediatr Surg ; 52(12): 1891-1897, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28951013

RESUMO

BACKGROUND/PURPOSE: To date, the optimal management of asymptomatic congenital lung malformations (CLMs) is still debated. There is still scant and controversial information regarding the long-term assessment of pulmonary function (PF) after lobectomy in children. The aim of this study is to evaluate PF in children who underwent lobectomy for CLM in infancy, hypothesizing that patients operated during the first year of life retain a normal lung function. METHODS: Children operated between 2005 and 2016 at our institution underwent PF evaluation through spirometry/whole-body plethysmography, forced oscillation technique, and multiple-breath inert gas wash-out. RESULTS: Out of 85 patients who underwent lobectomy at a median age of 5months, 50 met the inclusion criteria, and 28 patients were tested. More than 80% of patients had normal FEV1 and FVC. The mean FEV1, FVC, FEF25-75% values were higher in the patients operated before reaching one year of age. CONCLUSIONS: The long-term outcome after lobectomy was excellent for most patients, as they retained a normal long-term PF. Therefore, for asymptomatic patients, a surgical approach before one year of age to avoid complications such as malignancy and to ensure an optimal PF catch-up could be beneficial. LEVEL OF EVIDENCE: III - Treatment Studies.


Assuntos
Pneumopatias/congênito , Pneumopatias/cirurgia , Pneumonectomia/métodos , Anormalidades do Sistema Respiratório/cirurgia , Criança , Pré-Escolar , Feminino , Volume Expiratório Forçado , Humanos , Lactente , Masculino , Testes de Função Respiratória , Espirometria , Fatores de Tempo , Capacidade Vital
11.
J Laparoendosc Adv Surg Tech A ; 27(7): 748-753, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28445085

RESUMO

BACKGROUND: In the past decade, the minimally invasive repair of pectus excavatum (MIRPE) has become the treatment of choice for severe pectus excavatum (PE), proving acceptable to excellent cosmetic results. Recently, autologous fat grafting (FG) has been identified in aesthetic and reconstructive surgery to ideally handle volume and contour defects. We report our experience about FG in the treatment of residual minor defects after MIRPE and a proposal for a new indication of this largely adopted technique. MATERIALS AND METHODS: From April 2012 to April 2015, 127 patients underwent bar removal. At outpatient check, a questionnaire was adopted to investigate aesthetic outcome prior and after surgery (3 months postoperation); scoring options varied from 4 to 0 [4, excellent; 3, very good; 2, good; 1, acceptable; and 0, unacceptable]. In patients scoring less than "good," we proposed FG at the same operating session of bar removal. The donor areas were the abdomen, trochanteric region, and inner thigh. The tissue was gently collected through a thin cannula, filtrated, and then promptly injected into the defect. RESULTS: Eleven patients (8.8%) have been selected for FG. No complications have been detected during the follow-up period (range 1-36 months). In three cases, we performed further FG procedure to achieve an optimal result. Questionnaire reported an increased mean score from 1.8 to 2.7. CONCLUSION: In our early experience, FG has provided satisfactory cosmetic results. With the present report we advocate FG as a minimally invasive "tool" to achieve better defect correction after MIRPE. These preliminary results suggest that FG could be a worthwhile resource in treating chest wall malformations.


Assuntos
Tórax em Funil/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Satisfação do Paciente , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Esterno/cirurgia , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
13.
Pediatr Rep ; 8(3): 6487, 2016 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-27777701

RESUMO

Bacterial growth of peritoneal fluid specimens obtained during surgical procedures for acute appendicitis may be useful to optimize further antibiotic therapy in complicated cases. DNA amplification represents a fast technique to detect microbial sequences. We aimed to compare the potential of DNA amplification versus traditional bacterial growth culture highlighting advantages and drawbacks in a surgical setting. Peritoneal fluid specimens were collected during surgery from 36 children who underwent appendectomy between May and December 2012. Real-time polymerase chain reaction (RT-PCR) and cultures were performed on each sample. RT-PCR showed an amplification of 16S in 18/36 samples, Escherichia coli (in 7 cases), Pseudomonas aeruginosa (3), Fusobacterium necrophorum (3), Adenovirus (2), E.coli (1), Klebsiella pneumoniae (1), Serratia marcescens/Enterobacter cloacae (1). Bacterial growth was instead observed only in four patients (3 E.coli and 1 P.aeruginosa and Bacteroides ovatus). Preoperative C-reactive protein and inflammation degree, the most reliable indicators of bacterial translocation, were elevated as expected. DNA amplification was a quick and useful method to detect pathogens and it was even more valuable in detecting aggressive pathogens such as anaerobes, difficult to preserve in biological cultures; its drawbacks were the lack of biological growths and of antibiograms. In our pilot study RT-PCR and cultures did not influence the way patients were treated.

15.
J Laparoendosc Adv Surg Tech A ; 26(9): 734-9, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27529379

RESUMO

BACKGROUND: Pectus excavatum (PE) is known to be associated with adolescent idiopathic scoliosis (AIS). The correction of severe PE requires a mini-invasive procedure (MIRPE), with a metal bar positioned and left in the chest for 3 years. Adolescence seems to be the more appropriate time not only for MIRPE but also for AIS peak progression. This study was designed to answer the question whether, in adolescents, MIRPE could affect mild/moderate AIS. METHODS: We carried out a meta-analysis focused on defining the natural progression of untreated AIS. Inclusion criteria were as follows: AIS patients -age 10-18 years old -Cobb angle <40°-none treated as orthotics/electrostimulation/surgery. The expected outcome was the percentage of patients who improved, worsened, or hold steady of their condition at follow-up. Between 2008 and 2014, we followed up a cohort of 67 adolescents with severe PE treated with MIRPE, assessing whether AIS underwent a modification in the period between bar insertion and removal. RESULTS: Meta-analysis included 9 studies with 1641 AIS patients. Although heterogeneous (I(2) = 99.5%, P < .0001), the overall percentage of progression for untreated AIS was 42.5% (CI 18.2%-72.2%). In our follow-up group who underwent MIRPE, 34 out of 67 patients had concurrent AIS with a Cobb angle >10° (range 10°-45°). We demonstrated that MIRPE had a favorable effect on AIS, with a mean improvement of 1.5° (CI 0.64-2.44; P = .0011). CONCLUSION: In our PE patients with AIS, MIRPE had a beneficial effect also on the spine. From our preliminary results, it seems that MIRPE should be offered during puberty as a timely option for treating PE and stabilizing mild/moderate scoliosis progression, when concurrent.


Assuntos
Progressão da Doença , Tórax em Funil/complicações , Tórax em Funil/cirurgia , Escoliose/complicações , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Índice de Gravidade de Doença , Adulto Jovem
16.
Gynecol Endocrinol ; 32(10): 787-791, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27250513

RESUMO

This study analyzes updated clinical, diagnostic, and surgical directions for the treatment of ovarian neoplasms in children and adolescents, comparing them with a retrospective analysis of 32 cases treated in two Pediatric Surgery University Institutions. From January 2005 to December 2015, 32 pediatric patients were surgically treated for 32 ovarian tumors: 28 (87.5%) benign and 4 (12.5%) malignant neoplastic lesions. Median age at surgery was 11.2 years (12.8 years in patients with benign neoplasms, 7.25 years in patients with malignant ones). All patients with malignant and 25% of patients with benign ovarian lesions had elevated serum level of tumors markers. The surgical approach was laparotomic in 62.5% and laparoscopic in 37.5%; 81.2% surgeries were performed in elective surgery and 18.8% in emergency. Intraoperative frozen section analysis was performed in 18.75% of patients. The most frequent surgery (96.8%) was unilateral oophorectomy. After a median follow-up of 76 months (range 6-132 months), 31/32 patients are alive and disease-free. In case of malignant tumors, fertility-sparing surgery with accurate staging must be performed. Laparoscopic multiport is the gold standard approach for benign pediatric ovarian neoplasms, but the use of laparoscopy in full respect of oncological principles also for early stage malignant tumors is currently increased.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia/métodos , Neoplasias Ovarianas/cirurgia , Adolescente , Criança , Feminino , Seguimentos , Humanos , Resultado do Tratamento
17.
Pediatr Int ; 58(7): 601-3, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27072876

RESUMO

Thoraco-abdominal trauma can in rare cases involve diaphragmatic rupture and subsequent herniation of intra-abdominal contents. We report a case of this complication in a 5-year-old boy who was injured in a car crash, and who manifested respiratory distress and hemodynamic instability after 48 h of being monitored in the pediatric intensive care unit. Multiple radiologic investigations were inconclusive and the definite diagnosis was established only on thoracoscopic exploration.


Assuntos
Diafragma/diagnóstico por imagem , Hérnia Diafragmática Traumática/diagnóstico , Herniorrafia/métodos , Toracoscopia/métodos , Pré-Escolar , Diafragma/lesões , Hérnia Diafragmática Traumática/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X
18.
Ann Thorac Surg ; 99(6): e131-5, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26046903

RESUMO

Congenital sternal cleft is a rare chest wall malformation. Because of the flexibility of the chest in infants, surgical repair should be performed by primary closure in the neonatal period. In adolescents and adults, different techniques have been suggested to overcome the lack of sternal bone tissue. We describe a very rare case of an 18-year-old woman with a complete bifid sternum associated with pectus excavatum for whom a satisfactory cosmetic and functional result was obtained by adequate surgical planning, which entailed a combination of two standardized surgical techniques.


Assuntos
Anormalidades Múltiplas , Tórax em Funil/cirurgia , Anormalidades Musculoesqueléticas/cirurgia , Esterno/anormalidades , Parede Torácica/anormalidades , Toracoplastia/métodos , Adolescente , Feminino , Seguimentos , Tórax em Funil/diagnóstico por imagem , Humanos , Anormalidades Musculoesqueléticas/diagnóstico por imagem , Esterno/diagnóstico por imagem , Esterno/cirurgia , Tomografia Computadorizada por Raios X
19.
Pediatr Int ; 57(4): 724-6, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25869095

RESUMO

Cystic lesions deriving from the omentum are rare benign clinical conditions of uncertain etiopathogenesis. In this report we describe a case of antenatal diagnosed intra-abdominal cystic mass, which, due to the absence of symptomatology and constant ultrasound morphology over time, did not require immediate treatment. The present patient was followed up until surgery, which was performed at 4 years of age: on laparoscopy a cyst within the greater omentum was identified and excised. Histopathology indicated a cyst with epidermoid structure, which is unusual among the omental cysts reported in the literature.


Assuntos
Cisto Epidérmico/diagnóstico , Omento/patologia , Doenças Peritoneais/diagnóstico , Pré-Escolar , Cisto Epidérmico/cirurgia , Humanos , Recém-Nascido , Laparoscopia , Doenças Peritoneais/cirurgia
20.
Aesthetic Plast Surg ; 39(3): 414-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25762154

RESUMO

UNLABELLED: The umbilicus has a paramount aesthetical function for the abdomen and when removed due to a surgical procedure, an umbilicoplasty is mandatory: indeed, its absence could contribute to the development of psychological disorders, especially in childhood. Herein, we describe a straightforward technique to obtain a seemingly natural umbilical scar. This technique, easily taught in a general pediatric surgery environment, may be amenable for any kind of umbilical reconstruction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Granuloma/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Umbigo/cirurgia , Úraco/cirurgia , Cicatrização/fisiologia , Pré-Escolar , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/cirurgia , Feminino , Seguimentos , Granuloma/patologia , Humanos , Técnicas de Sutura , Fatores de Tempo , Resultado do Tratamento , Umbigo/fisiopatologia , Úraco/anormalidades
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