A model for predicting court decisions on child custody.

Awarding joint or sole custody is of crucial importance for the lives of both the child and the parents. This paper first models the factors explaining a court's decision to grant child custody and later tests the predictive capacity of the proposed model. We conducted an empirical study using data from 1,884 court rulings, identifying and labeling factual elements, legal principles, and other relevant information. We developed a neural network model that includes eight factual findings, such as the relationship between the parents and their economic resources, the child's opinion, and the psychological report on the type of custody. We performed a temporal validation using cases later in time than those in the training sample for prediction. Our system predicted the court's decisions with an accuracy exceeding 85%. We obtained easy-to-apply decision rules with the decision tree technique. The paper contributes by identifying the factors that best predict joint custody, which is useful for parents, lawyers, and prosecutors. Parents would do well to know these findings before venturing into a courtroom.

Bronchoscopic sclerosis of post-resectional bronchial fistulas.

BACKGROUND: Pulmonary resection is, by far, the primary cause of bronchial fistula. This is a severe complication because of its morbidity and mortality and the related consumption of resources. Definitive closure continues to be a challenge with several therapeutic options, but none are optimal. We describe our experience in bronchoscopic application of ethanolamine and lauromacrogol 400 for the treatment of post-resection bronchial fistulas. METHODS: Clinical records of 8 patients treated using this technique were collected prospectively. The diagnosis of a fistula was confirmed by flexible bronchoscopy. Sclerosis was indicated in the context of multimodal treatment. Sclerosant injection was performed under general anesthesia with a Wang 22G needle through a flexible bronchoscope. The procedure was repeated at 2-week intervals until definitive closure of the fistula was confirmed. RESULTS: Fistula closure was achieved in 7 (87.5%) of the 8 patients, with persistence of the fistula in one patient who could not complete the treatment because of recurrence of his neoplastic pathology. No recurrence or complications related to the technique were registered. CONCLUSIONS: Bronchoscopic sclerosis by means of submucosal injection of lauromacrogol 400 or ethanolamine should be part of the multimodal treatment of bronchopleural fistula after lung resection, pending further studies that contribute to the accurate establishment of optimal indications for this procedure.

[Intrahepatic cholangiocarcinoma on a hydatidic cyst]. / Colangiocarcinoma intrahepático sobre quiste hidatídico.

Cholangiocarcinomas are malignant tumors arising from the bile ducts. One of the factors associated with the development of malignancy is parasitic infections by helminths trematodes that cause liver fluke infections. This association is very common in south-east Asia, but association with liver hydatidosis has not been reported in the scientific literature. We report a case in which these two diseases were associated and required non-radical surgical treatment, since radiological findings were not suspicious for these entities.

[Giant epidermoid splenic cyst]. / Quiste epidermoide esplénico gigante.

Giant epidermoid splenic cysts are rare benign tumors. Their treatment is becoming increasingly less aggressive and more conservative. We report the case of a young woman with a giant epidermoid cyst, which required open total splenectomy, and review the literature on benign congenital tumors of the spleen.

Volvulo gástrico: distintas formas de presentación / Gastric volvulus: different presentations

El vólvulo gástrico es una entidad poco frecuente y con múltiples formas de presentación que dificultan su diagnóstico. Presentamos distintas expresiones clínicas de vólvulo gástrico y diferentes opciones de tratamiento tanto en el cuadro crónico como en el agudo, también las dificultades que existen en el diagnóstico y como pueden condicionar la actuación terapéutica