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Background: the management of postoperative esophageal leaks is a huge therapeutic challenge. Thanks to the advances in endoscopy, treatment with esophageal stents has been proposed as a valid option. Aims: the main objective of the study was to evaluate the effectiveness and safety of the use of fully covered esophageal metal stents in the treatment of postoperative esophageal leaks. Methods: a retrospective observational study was performed in patients with postoperative esophageal leaks, treated with fully covered self-expandable metal stents between June 2011 and May 2018. Results: twenty-five patients were evaluated and 34 stents were placed. The closure of the leak was observed in 21 patients after removal of the stent, with an overall technical success rate of 84 %. The mean time with a stent placed for closure of the fistula was 55.7 ± 27.11 days/patient (mean of 39 ± 24.30 days/stent). The most frequent complication was a partial distal stent migration (7/34 stents), followed by five cases of complete migration into the stomach. Conclusions: endoscopic treatment with fully covered self-expandable metal stents seems to be an effective and safe first-line treatment for postoperative esophageal leaks, according to the experience in our center.

The aim of this study was to characterize monocyte-derived macrophages (M-DM) from blood and ascites of cirrhotic patients comparatively with those obtained from blood of healthy controls. The phenotypic profile based on CD14/CD16 expression was analyzed by flow cytometry. Cells were isolated and stimulated in vitro with LPS and heat killed Candida albicans. Phosphorylation of ERK, c-Jun, p38 MAPK, and PKB/Akt was analyzed by Western blotting. A novel CD14(high)CD16(high) M-DM subpopulation is present in ascites (∼33%). The CD14(++)CD16(+) intermediate subset is increased in the blood of cirrhotic patients (∼from 4% to 11%) and is predominant in ascites (49%), while the classical CD14(++)CD16(-) subpopulation is notably reduced in ascites (18%). Basal hyperactivation of ERK and JNK/c-Jun pathways observed in ascites M-DM correlates with CD14/CD16 high expressing subsets, while PI3K/PKB does it with the CD16 low expressing cells. In vitro LPS treatment highly increases ERK1/2, PKB/Akt and c-Jun phosphorylation, while that of p38 MAPK is decreased in M-DM from ascites compared to control blood M-DM. Stimulation of healthy blood M-DM with LPS and C. albicans induced higher phosphorylation levels of p38 than those from ascites. Regarding cytokines secretion, in vitro activated M-DM from ascites of cirrhotic patients produced significantly higher amounts of IL-6, IL-10 and TNF-α, and lower levels of IL-1β and IL-12 than control blood M-DM. In conclusion, a new subpopulation of CD14(high)CD16(high) peritoneal M-DM has been identified in ascites of cirrhotic patients, which is very sensitive to LPS stimulation.

We obtain an expression for the second derivative of the line in a PT diagram denoting a first-order phase transition for a pure hydrostatic system. Our result goes beyond the classical Clausius–Clapeyron equation, which provides only the first derivative of the pressure with respect to the temperature along the transition line. We present two pedagogical derivations suitable for an undergraduate thermodynamics class; the first one uses derivatives of the entropy while the second one uses derivatives of the enthalpy. The final expression for the second derivative involves only standard thermodynamic quantities such as the specific heats, the isothermal compressibilities, and the coefficients of thermal expansion of the two phases at the transition line. As an illustration, we compute the second derivatives of the freezing and vaporization lines of water at atmospheric pressure, and show that at this pressure the freezing line is concave down (negative second derivative) while the vaporization line is concave up (positive second derivative).

We present the case of a patient under study due to ascites in which a mass located on the gastric wall was observed during ultrasonography. Further studies (upper endoscopy and computed tomography) confirmed this finding. After an ultrasound-guided percutaneous biopsy, diagnosis of gastric schwannoma was made as intense S-100 expression was found. Surgery was rejected due to the bad clinical situation of the patient and because the mass was an asymptomatic benign tumor.

We discuss the general conditions under which reversible thermodynamic work, like reversible heat, admits an integrating factor. We present simple examples in which work does and does not admit an integrating factor, and briefly comment on the significance of this integrating factor if it exists. Resumen. Analizamos las condiciones generales bajo las cuales el trabajo termodinamico reversible, como ocurre con el calor reversible, admite un factor integrante. Damos ejemplos sencillos en los que el trabajo reversible admite un factor integrante, y ejemplos en los que el factor integrante no existe. Tambien comentamos brevemente el significado, cuando existe, de dicho factor integrante.

We propose a microcanonical simulation of the caloric equation of state to study first order phase transitions on classical statistical systems. We present a modified version of the microcanonical Monte Carlo method to obtain numerically the caloric equation. We illustrate it by a simulation of the four-dimensional Z 2 lattice gauge theory near its phase transition.

The ground-state energy, staggered magnetization, and correlation function are computed for the two-dimensional spin-(1/2 quantum antiferromagnetic Heisenberg model (believed to be relevant to the high-temperature superconducting materials without doping) on lattices up to 24\ifmmode\times\else\texttimes\fi{}24 by Monte Carlo methods extrapolated to zero temperature. A more accurate value for the ground-state energy is determined by the method of Neumann and Ulam by extrapolating from lattices up to 12\ifmmode\times\else\texttimes\fi{}12.

The two physical parameters needed to specify the long-wavelength properties of a spin-1/2 quantum antiferromagnet are determined numerically. The fluctuation-induced renormalization of the stiffness constant differs by 40% from the expansion results of Oguchi, necessitating a corresponding adjustment in the value of the exchange deduced from the measured correlation length.

On presente des resultats analytiques et numeriques pour des monopoles en theorie de jauge reticulee U(1) a 4 dimensions avec des champs de Higgs de charge arbitraire