Different degrees of ischaemic injury in the right and left ventricle in cases of severe, nonfatal, pulmonary embolism.

Pulmonary fat embolism (PFE) is a common complication of blunt force traumas with bone fractures. Severe forms cause impedance to right ventricular (RV) ejection, with eventual right heart ischaemia and failure. In a prospective study, we have investigated 220 consecutive autopsy cases (73 females, 147 males, mean age 52.1 years, min 14 years, max 91 years). PFE was detected in 52 cases that were divided into three groups according to the degree of PFE (1-3). A fourth group of cases of violent death without PFE was used for comparison. In each case, histology (H&E, Masson) and immunohistochemistry (fibronectin and C5b-9) were performed on six cardiac samples (anterior, lateral and posterior wall of both ventricles). The degree of cardiac damage was registered in each sample and the mean degree of damage was calculated in each case at the RV and left ventricle (LV). Moreover, a parameter ∆ that is the difference between the mean damage at the RV and the LV was calculated in each case. The results were compared within each group and between the groups. In the present study, we could not detect prevalent RV damage in cases of high degree PFE as we did in our previous investigation. In the group PFE3 the difference of the degree of damage between the RV and LV was higher than the one observed in the groups PFE0-2 with the antibody anti-fibronectin. Prevalent right ventricular stress in cases of severe PFE may explain this observation.

Léiomyosarcome de la veine cave inférieure. A propos de trois observations [Leiomyosarcoma of the inferior vena cava. Three cases].

We report three new cases of leiomyosarcoma of the inferior vena cava observed between 1985 and 1990. Two of them developed in women and one in a man. The age of the patients were 56, 29 and 57 years. The three tumors have been removed completely. One patient received postoperative radio- and chemotherapy and is well 68 months after excision. One patient developed liver metastasis 18 months after resection despite chemotherapy and died after 3 years. The last one refused postoperative radio- and chemotherapy, developed massive local recurrence and pulmonary metastasis three months postoperatively, and is still alive with disease after 8 months. The diagnostic modalities of these rare tumors as well as the problems created by their surgical resection and the need for a complementary treatment are discussed.

Pontages veineux in situ. Indications, technique et résultats. A propos d'une étude prospective de 26 cas consécutifs [In situ venous grafts. Indications, technique and results. Prospective study of 26 consecutive cases].

The in situ saphenous vein bypass has been introduced in our department since 1989. A total of 26 bypasses in 22 patients have been followed prospectively. Indications for revascularisation have been severe arterial insufficiency in 73% of the cases (stage III or IV). With the exception of one postoperative death (myocardial infarction), all the patients have recovered uneventfully, with a regression to stage I. No amputation has been necessary. Morbidity has been 30%, with mainly minor local complications. The primary patency rate is 83% at one year and 78% after 2 and 3 years, whereas the secondary patency rate is 91% at one year, and remains constant thereafter up to 3 years. Considering our results and those from the literature, we believe that the in situ technique is very valuable, especially for below-knee vascular reconstruction. Technical difficulties of the method are analysed.

Supernumerary premolars. Report of 10 cases

Supernumerary premolars are 'extra' teeth morphologically belonging to the premolar group. Hyperdontia affecting premolars can be single (when only one supernumerary tooth is found), multiple (if several teeth are involved) or related to a syndrome such as cleidocranial dysplasia. Supernumerary premolars are the third most frequent group of supernumerary teeth, following mesiodens and fourth molars; the prevalence among the general population ranges from 0.09-0.64%. The present study describes 10 cases of supernumerary premolars treated in our Service of Oral and Maxillofacial Surgery of the Dental Clinic of the University of Barcelona. A late onset was demonstrated in one case, contrasting the present pantomograph with another obtained 5 years before. In only one case did the presence of a supernumerary premolar alter normal tooth eruption. Two supernumerary premolars were affected by follicular cysts

Erupted odontomas: a report of three cases and review of the literature

Introduction: Odontomas are benign odontogenic tumors composed of enamel, dentine, cement and pulp tissue. They are usually clinically asymptomatic, but often associated with tooth eruption disturbances. In exceptional cases the odontoma erupts into the mouth. The present study reports three cases of odontomas erupted into the oral cavity and reviews the literature. Clinical cases: The first case was an 11-year-old girl with impacted 4.6 associated to a radiopaque mass measuring about 2 cm in diameter. The histological diagnosis was complex odontoma. A clinical and radiological follow-up of 4.6 was carried out until its spontaneous eruption. The second case was a 26-year-old male presenting a hard, yellowish-brown mass located distal to the upper left second molar. Computed tomography confi rmed the presence of a radiopaque lesion, and the histopathological study confirmed a complex odontoma. The third patient was a 27-year-old male reporting tongue irritation due to tooth eruption in the inferior lingual region. A periapical radiograph revealed a mixed radiopaque lesion associated to impacted 3.2. The histological report in this case indicated a compound odontoma. Discussion: Odontomas erupting into the oral cavity are rare. The first case was published in 1980, and since then only 17 cases have been reported in the literature. Eight of the 17 cases were complex odontomas; the rest were compound odontomas. Pain, swelling and infection were the most common symptoms, and 13 cases presented an impacted tooth associated with the lesion

Malignant metastasizing solitary fibrous tumors of the liver: a report of three cases.

Solitary fibrous tumors are rare neoplasms of mesenchymal origin that have been reported in various other extrathoracic sites, including the liver. We present a case series of three malignant solitary fibrous tumors of the liver, occurring in two women 74 and 80 years old and one 65-year-old man. No clinical features were predictive of malignancy except the large sizes and synchronous presence of lung metastases in two of the three cases. Histological examinations revealed the presence of high pleomorphic cellularity with nuclear atypia, necrosis and high mitotic ratios. All patients died of disease progression.

Anàlisi del recurs pilot "cases d'infants: nou paradigma d'atenció i tractament a la infància i l'adolescència".

El treball que es presenta a continuació és una recerca aplicada, consistent en l’anàlisi descriptiva d’una mostra d’infants i adolescents de 5 a 19 anys atesos al projecte “Cases d’Infants” des del desembre de 2010 fins al juliol de 2013. Aquesta investigació pretén donar a conèixer la nova perspectiva o paradigma d’atenció a la infància i l’adolescència a Catalunya que neix de la Llei dels Drets i les Oportunitats de la Infància i l’Adolescència (LDOIA, maig de 2010): basada en la prevenció, el model sistèmic i de complexitat, la col·laboració de la família com a element de canvi, el treball en xarxa i interprofessionalitat, la participació dels infants i adolescents, i la territorialitat, principalment. Un cop feta aquesta aproximació teòrica, s’ha concretat identificant aquesta nova perspectiva al projecte pilot “Cases d’Infants” (nascut al setembre de 2010), el qual desplega les actuacions que sorgeixen d’aquesta filosofia de treball i suport. Per a elaborar aquesta recerca s’ha emprat un disseny d’investigació no experimental descriptiu, on s’han associat i comparat variables per tal d’identificar interferències en les relacions –a través de proves estadístiques-, i proposar una certa tendència i pronòstic de les característiques del perfil atès al projecte i les interferències d’algunes variables amb el recurs final de l’infant o adolescent. Finalment, s’extreuen unes conclusions en relació a la bibliografia inicial i els resultats obtinguts en l’anàlisi de la mostra estudiada.

Comparação da disponibilidade de radiação solar global e fotoperíodo entre as regiões vinícolas de Campo Belo do Sul-SC, Brasil e Pech Rouge, França

Realizaram-se a caracterização e a comparação da disponibilidade de radiação solar global e do fotoperíodo para o Planalto de Santa Catarina, representado por Campo Belo do Sul (latitude -28º00'00'', longitude -51º00'00'' e altitude de 950 metros), e para a região Mediterrânea do Sul da França, representada por Pech Rouge (latitude 43º08'35'', longitude 03º07'59'' altitude de 1,5 metro). Este estudo foi realizado para a fase de maturação das variedades de videira Chardonnay, Portan, Syrah, Viognier, Carignan, Grenache, Marselan, Mourvèdre e Cabernet Sauvignon. Foram também avaliadas as durações do fotoperíodo anual, do período noturno, da radiação solar global, da radiação solar e da insolação máxima no período de maturação, para ambas as localidades. As diferenças de comportamento fenológico e das posições geográficas dos dois locais promoveram diferenças quanto à disponibilidade e intensidade da radiação solar global, assim como do fotoperíodo. Apesar da uma maior transmissividade da atmosfera para Pech Rouge, o Planalto Catarinense apresentou maior disponibilidade e intensidade de radiação solar durante a fase de maturação da videira. Também, o acúmulo de horas de fotoperíodo foi superior no Planalto Catarinense do que em Pech Rouge. Estas diferenças de disponibilidade de radiação solar e fotoperíodo foram provenientes da menor duração da fase de maturação para Pech Rouge, da declinação solar em relação aos dois locais por ocasião da ocorrência desta fase e da diferença da camada atmosférica resultante da diferença de altitude.

Rainfall is a risk factor for sporadic cases of Legionella pneumophila Pneumonia

It is not known whether rainfall increases the risk of sporadic cases of Legionella pneumonia. We sought to test this hypothesis in a prospective observational cohort study of non-immunosuppressed adults hospitalized for community-acquired pneumonia (1995-2011). Cases with Legionella pneumonia were compared with those with non-Legionella pneumonia. Using daily rainfall data obtained from the regional meteorological service we examined patterns of rainfall over the days prior to admission in each study group. Of 4168 patients, 231 (5.5%) had Legionella pneumonia. The diagnosis was based on one or more of the following: sputum (41 cases), antigenuria (206) and serology (98). Daily rainfall average was 0.556 liters/m2 in the Legionella pneumonia group vs. 0.328 liters/m2 for non-Legionella pneumonia cases (p = 0.04). A ROC curve was plotted to compare the incidence of Legionella pneumonia and the weighted median rainfall. The cut-off point was 0.42 (AUC 0.54). Patients who were admitted to hospital with a prior weighted median rainfall higher than 0.42 were more likely to have Legionella pneumonia (OR 1.35; 95% CI 1.02-1.78; p = .03). Spearman Rho correlations revealed a relationship between Legionella pneumonia and rainfall average during each two-week reporting period (0.14; p = 0.003). No relationship was found between rainfall average and non-Legionella pneumonia cases (−0.06; p = 0.24). As a conclusion, rainfall is a significant risk factor for sporadic Legionella pneumonia. Physicians should carefully consider Legionella pneumonia when selecting diagnostic tests and antimicrobial therapy for patients presenting with CAP after periods of rainfall.