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Current research based on positive results and obtained experience of a previous publication has developed a training course of metrology based on sustainable characteristics such as remote control freeware applications, share of valuable resources, distance learning methodology and active participation of the students. This is based on a remote control operation using special software, with a real CMM. Although the CMM was placed at the University o fZarag o za (Spain), ten students from Greece, with the valuable help of a remote control freeware application, participated in real time measuring process from their own computers under the supervision of two instructors. The results of the remote operation of the CM M were very successful. A feeling of responsibility for using a remote piece of equipment and the extra care that the students should prove created a more stimulating learning environment. Moreover, according to the students' opinion, the process as a whole was impressive and provided a unique experience. More effort has to be made in order to increase the number of the participants and the number of the used pieces of equipment. [ABSTRACT FROM AUTHOR]

The objective of this work is to present an approach to increase the number of students who could be accommodated in a laboratory for gear measuring course without the need to increase the number of physical equipment. The approach is based on a remote control freeware application, and special design of the locations of the audiovisual media. Students participated in a real time measuring process from their own computers under the supervision of the instructor. The methodology was assessed by means of a class experience in a measurement laboratory, where a group of students attended the explanations of two lecturers. During the session, the participants were able to control a coordinate measuring machine from their laptops. Finally, students' satisfaction was assessed with a questionnaire based on five-level Likert items, obtaining positive results. [ABSTRACT FROM AUTHOR]

Temporary work at height is one of the primary causes of construction accidents that result in serious injuries and fatalities. Many of these accidents occur because of falls from scaffolding and work platforms. In Europe, scaffolding equipment for temporary work at height is regulated by several directives. A directive is a legislative act of the European Union, which requires member states to achieve a particular result without dictating the means of achieving that result. In this sense, the European standard is of great interest because it facilitates compliance with the requirements of a directive regarding temporary work at height. This paper presents the results of a research study that was conducted in Spain between March 2003 and 2004, in which 146 construction sites were inspected with a view to examining the scaffolding surface at each site. The building sites with scaffolding that complied with a European standard were compared with those with older (nonstandard) scaffolding. Both types were qualitatively evaluated to ascertain their safety levels. The findings reported in this paper demonstrate that the standardization of scaffolding equipment had a direct and positive impact on work safety conditions at construction sites. Consequently, fomenting standardization of scaffolding equipment in the construction industry can contribute to improving work safety conditions as has occurred in Spain. The methodology in the authors' paper can also be applied in other countries to evaluate their regulations or codes regarding personal protective equipment. [ABSTRACT FROM AUTHOR]

Hydroxyurea (HU) constitutes the first-line treatment in most patients with essential thrombocythemia (ET), but criteria for changing therapy are not clearly established. The prognostic value of complete hematological response (CHR) and resistance/intolerance to HU was assessed in 1080 patients from the Spanish Registry of ET, classified according to revised IPSET-Thrombosis stratification (Very low- n = 61, Low- n = 83, Intermediate- n = 261, and High-risk n = 675). With a median therapy duration of 5 years, CHR was registered in 720 (67%) patients (1-year probability 51%) and resistance/intolerance in 219 (20%) patients (5-years probability 13%). After correction by other risk factors, High-risk patients achieving CHR showed a reduced risk of arterial thrombosis (HR: 0.35, 95%CI: 0.2-0.6, p = 0.001) and a trend towards lower risk of venous thrombosis (HR: 0.45, 95%CI: 0.2-1.02, p = 0.06) whereas no association was observed for intermediate- or low-risk patients. In comparison with non-responders, intermediate- and high-risk patients achieving CHR had longer survival and lower myelofibrosis incidence. Development of resistance/intolerance to HU, mainly cytopenia, was associated with higher probability of myelofibrosis but no effect on survival or thrombotic risk was demonstrated. In conclusion, CHR with HU is associated with better outcomes and might be an early indicator for selecting candidates to second-line clinical trials., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

As the number of Internet users grows, the increase in smart devices interconnected through the Internet of Things (IoT) have contributed to improvements in the functionality of everyday products and enhancement of user experience. Yet, they affect user privacy and render personal data more vulnerable. To foster a digital future fully aware of user privacy requirements, a line of design research emerges that focuses on balancing product innovation with user data protection. This matter relates to sociocultural, economic, and technological aspects, and its core is a human-centered design strategy. Still, there is a gap in academic research oriented towards guiding product developers on how to consider personal data privacy concerns when designing honest IoT devices. To define this gap and delve deeper into this relevant topic, this paper presents a systematic literature review of recent academic research using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. This review focuses on prevalent research topics such as data privacy, personal data, data surveillance, and user behaviour in IoT. The result is a state-of-the-art compilation of 45 scientific studies mapping the most relevant concepts and approaches for product development in the last ten years of research, aligned with some central research questions. The Discussion and Conclusion sections provide a deep understanding of the complexity of the fast-changing landscape of privacy and personal data management using IoT products. Finally, this study proposes future academic research directions devoted to providing product designer specific, specialised help from different (yet interconnected) scientific approaches., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Cytogenetic assessment in myelofibrosis is essential for risk stratification and patient management. However, an informative karyotype is unavailable in a significant proportion of patients. Optical genome mapping (OGM) is a promising technique that allows for a high-resolution assessment of chromosomal aberrations (structural variants, copy number variants, and loss of heterozygosity) in a single workflow. In this study, peripheral blood samples from a series of 21 myelofibrosis patients were analyzed via OGM. We assessed the clinical impact of the application of OGM for disease risk stratification using the DIPSS-plus, GIPSS, and MIPSS70+v2 prognostic scores compared with the standard-of-care approach. OGM, in combination with NGS, allowed for risk classification in all cases, compared to only 52% when conventional techniques were used. Cases with unsuccessful karyotypes ( n = 10) using conventional techniques were fully characterized using OGM. In total, 19 additional cryptic aberrations were identified in 9 out of 21 patients (43%). No alterations were found via OGM in 4/21 patients with previously normal karyotypes. OGM upgraded the risk category for three patients with available karyotypes. This is the first study using OGM in myelofibrosis. Our data support that OGM is a valuable tool that can greatly contribute to improve disease risk stratification in myelofibrosis patients.

Various complications occur after a biliary-digestive reconstruction. Volvulus of a segment of the biliodigestive loop has not been described. Two patients who underwent biliodigestive bypass, years later, began with sudden and intense abdominal pain, associated with a volvulus with necrosis of a segment of this biliodigestive loop. This complication occurred many years after the initial correction, and manifested with sudden abdominal pain without impaired liver function, as occurred in these patients., (Copyright: © 2023 Permanyer.)

Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) with heterogeneous clinical course. Allogeneic hematopoietic cell transplantation remains the only curative therapy, but its morbidity and mortality require careful candidate selection. Therefore, accurate disease risk prognostication is critical for treatment decision-making. We obtained registry data from patients diagnosed with MF in 60 Spanish institutions (N = 1386). These were randomly divided into a training set (80%) and a test set (20%). A machine learning (ML) technique (random forest) was used to model overall survival (OS) and leukemia-free survival (LFS) in the training set, and the results were validated in the test set. We derived the AIPSS-MF (Artificial Intelligence Prognostic Scoring System for Myelofibrosis) model, which was based on 8 clinical variables at diagnosis and achieved high accuracy in predicting OS (training set c-index, 0.750; test set c-index, 0.744) and LFS (training set c-index, 0.697; test set c-index, 0.703). No improvement was obtained with the inclusion of MPN driver mutations in the model. We were unable to adequately assess the potential benefit of including adverse cytogenetics or high-risk mutations due to the lack of these data in many patients. AIPSS-MF was superior to the IPSS regardless of MF subtype and age range and outperformed the MYSEC-PM in patients with secondary MF. In conclusion, we have developed a prediction model based exclusively on clinical variables that provides individualized prognostic estimates in patients with primary and secondary MF. The use of AIPSS-MF in combination with predictive models that incorporate genetic information may improve disease risk stratification., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)

Purpose: To evaluate the safety and efficacy of conventional laparoscopic vs open Lich-Gregoir ureteral reimplantation in pediatric vesicoureteral reflux., Material and Methods: A retrospective study was conducted in a tertiary care hospital. Patients with vesicoureteral reflux who underwent open or laparoscopic Lich-Gregoir ureteral reimplantation from 2013-2020 were included.  The primary outcome was resolution of reflux. Complications and perioperative characteristics were evaluated. The outcomes between open and laparoscopic surgery were analyzed., Results: A total of 110 patients and 150 ureters were included. The mean age was 4.5 years ± 3.4 and 73.6% were females. A total of 125 ureters (83.3%) underwent laparoscopic and 25 (16.6%) open Lich-Gregoir vesicoureteral reimplantation (5:1 Ratio). Resolution was reported in 112 (89.6%) for laparoscopy and 21 (84%) for open surgery (P = .42). Mean surgical time for laparoscopy and open surgery were 142.4 min ± 64.4 and 153 min ± 40, respectively (P =.29). Mean bleeding (9.5 mL ± 11.2 vs 29.6 mL ± 22.8) and length of hospital stay (2.4 days ± 2.3 vs 5.05 ± 3.1) were significantly higher with open surgery (P < .001). No significant difference in complications was reported between open surgery (32%) and laparoscopic approach (22.4%) (P = .305)., Conclusion: Conventional laparoscopic vesicoureteral reimplantation with the Lich-Gregoir technique has an acceptable success rate comparable with open surgery, with shorter hospital stay, less bleeding, and less need of transfusion.

The purpose of the present study was to assay the in vitro and in vivo anthelmintic activity (AA) of Caesalpinia coriaria (Cc) mature fruits against the nematode Haemonchus contortus (Hc). The Hc infective larvae were used to assess the in vitro AA through larval mortality assay. The exposure of larvae to the different treatments was performed in 96-well microtitration plates. The treatments were as follows: hydroalcoholic extract (HA-E, at 25-100 mg/mL), aqueous fraction (Aq-F, at 12.5-50 mg/mL), organic fraction (EtOAc-F at 12.5-50 mg/mL), compounds (1, methyl gallate and 2, gallic acid at 1.25-10 mg/mL), positive control (ivermectin at 5 mg/mL) and two negative controls (distilled water and 4% methanol). After exposure, dead and live larvae were quantified and results were compared to their controls. The in vivo assay was carried out by a faecal egg count reduction test (FECRT); artificially infected goat kids (F1: Boer x Nubia) were treated with Cc ground dried fruits to assess the AA. The treatments were established as follows: G1-untreated goats (negative control), G2-goats dewormed with ivermectin (positive control), G3-goats fed with Cc mature fruits (10% of their diet). Results in both in vitro and in vivo assays were analysed using an ANOVA through random design, applying a general linear model and mixed models. The in vitro results showed an evident larvicidal effect of the HA-E, EtOAc-F from Cc, indicating that the compound responsible for the AA was gallic acid. The results of the in vivo study corroborated the anthelmintic properties of Cc, reaching 78.6% reduction in the elimination of Hc eggs per gram of faeces. This plant represents a potential natural anthelmintic for the control of haemonchosis in goats under grazing conditions. Future studies should standardise the Cc extract or dried fruits for use in the management of nematodiasis in goat herds., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2022. Published by Elsevier Inc.)

Available data have proved insufficient to develop consensus recommendations on the prevention of thrombosis and bleeding in myelofibrosis (MF). We evaluated the incidence and risk factors of vascular complications in 1613 patients from the Spanish Myelofibrosis Registry. Over a total of 6981 patient-years at risk, 6.4% of the study population had at least one thrombotic event after MF diagnosis, amounting to an incidence rate of 1.65 per 100 patient-years. Prior history of thrombosis, the JAK2 mutation, and the intermediate-2/high-risk International Prognostic Scoring System (IPSS) categories conferred an increased thrombotic risk after adjustment for the risk-modifying effect of anti-thrombotic and cytoreductive treatments. History of thrombosis and the JAK2 mutation allowed us to pinpoint a group of patients at higher risk of early thrombosis. No decreased incidence of thrombosis was observed while patients were on anti-thrombotic or cytoreductive treatment. An increased risk of venous thrombosis was found during treatment with immunomodulatory agents. A total of 5.3% of patients had at least one episode of major bleeding, resulting in an incidence rate of 1.5 events per 100 patient-years. Patients in the intermediate-2/high-risk IPSS categories treated with anti-coagulants had an almost sevenfold increased risk of major bleeding. These findings should prove useful for guiding decision-making in clinical practice., (© 2022 British Society for Haematology and John Wiley & Sons Ltd.)

Background: Ruxolitinib is approved for patients with polycythemia vera (PV) who are resistant/intolerant to hydroxyurea, but its impact on preventing thrombosis or disease-progression is unknown., Methods: A retrospective, real-world analysis was performed on the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to subsequent treatment with ruxolitinib (n = 105) or the best available therapy (BAT; n = 272). Survival probabilities and rates of thrombosis, hemorrhage, acute myeloid leukemia, myelofibrosis, and second primary cancers were calculated according to treatment. To minimize biases in treatment allocation, all results were adjusted by a propensity score for receiving ruxolitinib or BAT., Results: Patients receiving ruxolitinib had a significantly lower rate of arterial thrombosis than those on BAT (0.4% vs 2.3% per year; P = .03), and this persisted as a trend after adjustment for the propensity to have received the drug (incidence rate ratio, 0.18; 95% confidence interval, 0.02-1.3; P = .09). There were no significant differences in the rates of venous thrombosis (0.8% and 1.1% for ruxolitinib and BAT, respectively; P = .7) and major bleeding (0.8% and 0.9%, respectively; P = .9). Ruxolitinib exposure was not associated with a higher rate of second primary cancers, including all types of neoplasia, noncutaneous cancers, and nonmelanoma skin cancers. After a median follow-up of 3.5 years, there were no differences in survival or progression to acute leukemia or myelofibrosis between the 2 groups., Conclusions: The results suggest that ruxolitinib treatment for PV patients with resistance/intolerance to hydroxyurea may reduce the incidence of arterial thrombosis., Lay Summary: Ruxolitinib is better than other available therapies in achieving hematocrit control and symptom relief in patients with polycythemia vera who are resistant/intolerant to hydroxyurea, but we still do not know whether ruxolitinib provides an additional benefit in preventing thrombosis or disease progression. We retrospectively studied the outcomes of 377 patients with resistance/intolerance to hydroxyurea from the Spanish Registry of Polycythemia Vera according to whether they subsequently received ruxolitinib (n = 105) or the best available therapy (n = 272). Our findings suggest that ruxolitinib could reduce the incidence of arterial thrombosis, but a disease-modifying effect could not be demonstrated for ruxolitinib in this patient population., (© 2022 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Background: Minimally invasive surgery has a different visual and tactile perception compared with conventional surgery, which could lead to complications, especially in complex procedures. In these cases, flexible endoscopy can facilitate and prevent complications in minimally invasive procedures in children. The study aimed to clarify the utility of intraoperative endoscopy as an adjuvant to minimally invasive surgery in children. Materials and Methods: This retrospective study reviewed the medical records of pediatric patients who had undergone endoscopy during a minimally invasive surgery to treat an upper digestive pathology between January 2000 and December 2020. Results: The study included 83 patients who underwent a laparoscopic procedure with simultaneous endoscopy. The diagnosis was peptic stenosis in 9 patients, achalasia in 23, congenital embryonic tracheobronchial remnants in 4, re-fundoplication in 42, esophageal duplication in 2, superior mesenteric artery syndrome in 2, and giant gastric hemangioma in 1 patient. With adjuvant endoscopy, 7 digestive perforations were noted, 11 cases of short esophagus were diagnosed, and the permeability of the anastomosis was confirmed in 6 cases. No complications were related with the endoscopy procedures. Discussion: Minimally invasive surgery has a few special and tactile limitations that can lead to complications in certain procedures. Simultaneous digestive endoscopy in the upper gastrointestinal tract facilitates organ identification and dissection. Conclusion: Digestive endoscopy is an excellent adjunct to minimally invasive surgery in children because it facilitates and identifies complications and ensures safer minimally invasive surgeries. Future prospective studies are required to assess this conclusion.

Introducción: Se define como quiste de colédoco gigante aquel con un diámetro ≥ 10 cm. A pesar de que el abordaje laparoscópico ha sido contraindicado, se presenta el caso de un adolescente con un quiste de colédoco gigante resuelto por laparoscopía. Caso clínico: Paciente de sexo masculino de 14 años con un quiste de colédoco gigante tratado con anastomosis hepático-duodenal laparoscópica. Conclusiones: El tamaño promedio de los quistes de colédoco tratados por laparoscopía es de 40 mm. No se recomienda la resección de quistes gigantes por mínima invasión debido a adherencias y restricción del campo visual. En este caso se realizó un tratamiento laparoscópico de manera exitosa.

The present study assessed the criteria for initiating cytoreduction and response to conventional therapies in 1446 patients with essential thrombocythemia (ET), 267 (17%) of which were CALR-mutated. In low risk patients, time from diagnosis to cytoreduction was shorter in CALR-positive than in the other genotypes (2·8, 3·2, 7·4 and 12·5 years for CALR, MPL, JAK2V617F and TN, respectively, P < 0·0001). A total of 1104 (76%) patients received cytoreductive treatment with hydroxycarbamide (HC) (n = 977), anagrelide (n = 113), or others (n = 14). The estimated cumulative rates of complete haematological response (CR) at 12 months were 40 % and 67% in CALR and JAK2V617F genotypes, respectively. Median time to CR was 192 days for JAK2V617F, 343 for TN, 433 for MPL, and 705 for CALR genotypes (P < 0·0001). Duration of CR was shorter in CALR-mutated ET than in the remaining patients (P = 0·003). In CALR-positive patients, HC and anagrelide had similar efficacy in terms of response rates and duration. CALR-mutated patients developed resistance/intolerance to HC more frequently (5%, 23%, 27% and 15% for JAK2V617F, CALR, MPL and TN, respectively; P < 0·0001). In conclusion, conventional cytoreductive agents are less effective in CALR-mutated ET, highlighting the need for new treatment modalities and redefinition of haematologic targets for patients with this genotype., (© 2020 British Society for Haematology and John Wiley & Sons Ltd.)

Antecedentes: La pancreatitis es una enfermedad rara. La obstrucción es común y se puede corregir con endoscopia; si fracasa, necesitará cirugía., Caso Clínico: Reportamos un paciente con pancreatitis secundaria a páncreas divisum. Se realizó derivación tipo DuVal laparoscópica. Varón de 12 años, con múltiples cuadros de pancreatitis y fallidos intentos de esfinteroplastias. La colangiorresonancia mostró páncreas divisum. Se realizó una derivación tipo DuVal por laparoscopia. Seguimiento de 5 años. No ha habido recurrencia del dolor y la lipasa se normalizó a los 6 meses. El conducto pancreático no estaba dilatado. Ante la dificultad para hacer una anastomosis lateral se utilizó la técnica laparoscópica propuesta por DuVal., Background: Pancreatitis is rare. Obstruction is common. They can be corrected with endoscopy, if they fail they need surgery., Case Report: We reported a patient with pancreatitis secondary to pancreas divisum, laparoscopic DuVal shunt was performed. Male 12 years, multiple pancreatitis pictures and failed sphinteroplasty attempts. Colangio resonance showed pancreas divisum. A DuVal-type shunt was built for laparoscopy. Follow-up 5 years. There has been no recurrence of pain and lipase was normalized at 6 months. The pancreatic duct was not dilated, in the face of difficulty making a lateral anastomosis was used the technique proposed by DuVal by laparoscopic approach., (Copyright: © 2021 Permanyer.)

A multi-approach characterization of three earth hummock fields has been conducted to understand the morphometrical characteristics and distribution pattern of these periglacial features in the Zackenberg Valley, NE Greenland. Earth hummocks develop in poorly-drained areas affected by intense cryogenic conditions. An accurate analysis of the morphometrical properties of hundreds of earth hummocks distributed between different Early Holocene moraine systems of the eastern slope of the Zackenberg Valley reveals an important control of microtopography on their distribution. Sedimentological analysis of selected earth hummocks shows evidence of alternating organic-rich layers and mineral units. Radiocarbon dates of the basal organic layers in contact with the permafrost table yielded ages 615 ± 25 and 1755 ± 60 cal yr BP, with lower sedimentation rates over the last centuries when soil formation prevailed. Geochemical analysis of the soils (Glacic Reductaquic Cryosols) showed also significant differences in the properties and composition among the soils of the different fields of hummocks., Competing Interests: Declaration of competing interest Authors of this manuscript declare no conflict of interest related to this study., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The present study investigated the performance of three ceramic inserts in terms of the micro-geometry (nose radius and cutting edge type) with the aid of a 3D finite element (FE) model. A set of nine simulation runs was performed according to three levels of cutting speed and feed rate with respect to a predefined depth of cut and tool nose radius. The yielded results were compared to the experimental values that were acquired at identical cutting conditions as the simulated ones for verification purposes. Consequently, two more sets of nine simulations each were carried out so that a total of 27 turning simulation runs would adduce. The two extra sets corresponded to the same cutting conditions, but to different cutting tools (with varied nose radius). Moreover, a prediction model was established based on statistical methodologies such as the response surface methodology (RSM) and the analysis of variance (ANOVA), further investigating the relationship between the critical parameters (cutting speed, feed rate, and nose radius) and their influence on the generated turning force components. The comparison between the experimental values of the cutting force components and the simulated ones demonstrated an increased correlation that exceeded 89%. Similarly, the values derived from the statistical model were in compliance with the equivalent FE model values due to the verified adequacy.

Ruxolitinib is a potent Janus kinase (JAK) 1/JAK2 inhibitor approved for the treatment of myelofibrosis (MF). Ruxolitinib was assessed in JUMP, a large (N = 2233), phase 3b, expanded-access study in MF in countries without access to ruxolitinib outside a clinical trial, which included patients with low platelet counts (<100 × 10 9 /l) and patients without splenomegaly - populations that have not been extensively studied. The most common adverse events (AEs) were anaemia and thrombocytopenia, but they rarely led to discontinuation (overall, 5·4%; low-platelet cohort, 12·3%). As expected, rates of worsening thrombocytopenia were higher in the low-platelet cohort (all grades, 73·2% vs. 53·5% overall); rates of anaemia were similar (all grades, 52·9% vs. 59·5%). Non-haematologic AEs, including infections, were mainly grade 1/2. Overall, ruxolitinib led to meaningful reductions in spleen length and symptoms, including in patients with low platelet counts, and symptom improvements in patients without splenomegaly. In this trial, the largest study of ruxolitinib in patients with MF to date, the safety profile was consistent with previous reports, with no new safety concerns identified. This study confirms findings from the COMFORT studies and supports the use of ruxolitinib in patients with platelet counts of 50-100 × 10 9 /l. (ClinicalTrials.gov identifier NCT01493414)., (© 2020 British Society for Haematology and John Wiley & Sons Ltd.)

Objective: To review the diagnostic methodology in pediatric patients with obstruction of the lower third of the esophagus as well as minimally invasive therapeutic options. Materials and Methods: Retrospective study carried out reviewing records of children with esophageal obstruction diagnostic, from 2000 to 2018. They were divided into Group I stenosis secondary to reflux; Group II achalasia; and Group III embryonic remnants. Results: Thirty-three patients. Group I: 7; esophageal barium swallow irregular stenosis of the distal third and endoscopy irregular stenosis in 7. Treated with laparoscopic fundoplication 2, Collis Nissen 5. Group II: 22 patients, age X = 11.55 years. All with dysphagia and symmetrical stenosis of esophagogastric junction. Fifteen underwent manometry and all underwent intraoperative endoscopy. All had laparoscopic myotomy, with 2 perforations and no conversions, 2 patients had subsequent dysphagia to solids, and they did not need esophageal dilatation. Group III: 4 patients, stenosis was above esophagogastric junction. On endoscopy, inflammation was present in all 3 with irregular esophagogastric junction and difficulty passing endoscope. Three patients underwent laparoscopic resection and anastomosis. One patient leaked and developed a fistula. One patient has not been operated upon as yet. Conclusions: In those patients, the best surgical option depends upon the diagnosis. Esophageal barium studies and endoscopy allow discerning among them.

Introducción: Las hernias femorales son raras en la infancia. El defecto está abajo del ligamento inguinal. La frecuencia de un diagnóstico erróneo es de hasta el 75%. Pueden ser resueltas mediante cirugía abierta o laparoscópica., Objetivo: Comunicar el caso de un niño con hernia femoral resuelto mediante laparoscopía., Caso Clínico: Varón de 5 años, con antecedente de criptorquidia bilateral resuelta a los 2 años de edad. Padecimiento actual con 1 mes de evolución, con aumento de volumen en el tercio externo de la ingle. El ultrasonido reportó un defecto aponeurótico junto a los vasos femorales derechos. Abordaje laparoscópico, con hallazgos de defecto por abajo del ligamento inguinal. Sin recidiva a los 12 meses de seguimiento., Discusión: Las hernias femorales son raras en los niños y su diagnóstico es difícil. La exploración laparoscópica permitió identificarla al encontrar un defecto por abajo del ligamento inguinal y junto a los vasos femorales independiente del anillo inguinal profundo y de la fascia transversal., Introduction: Femoral hernias are rare in children. The defect is below the inguinal ligament. The frequency of a misdiagnosis is up to 75%. They can be resolved by open or laparoscopic surgery., Objective: To report the case of a child with femoral hernia, resolved by laparoscopy., Case Report: Male, 5 years old, with a history of bilateral cryptorchidism resolved at 2 years of age. Current condition with a month of evolution with an increase in volume in the outer third of the groin. Ultrasound reported aponeurotic defect along with the right femoral vessels. Laparoscopic approach, with defect findings below the inguinal ligament. No recurrence at 12 months follow-up., Discussion: Femoral hernias are rare in children, their diagnosis is difficult. Laparoscopic examination allowed its identification, finding a defect below the inguinal ligament and adjacent to the femoral vessels independent of the deep inguinal ring and the transversalis fascia., (Copyright: © 2020 Permanyer.)

Background: Short esophagus is a disability to obtain a proper portion of abdominal esophagus, thus a lengthening technique is required. Collis approach is the best option., Objective: To demonstrate effectiveness of laparoscopic Collis-Nissen approach in children., Method: Retrospective and descriptive case series performed in children with reflux and short esophagus, Collis esophagoplasty was carried out with stapler, together with fundoplication. Age, symptomatology, surgical background, oral nutrition beginning, hospital stay, complications and reflux control were recorded., Results: Eight children, 4-15 years old were treated from 2005 to 2017. Three of them with slipped fundoplication background and two with esophageal atresia. The rest of the children had no background, two of them with stenosis. Symptoms; cough 8/8, abdominal pain 5/8, dysphagia 3/8. Without complications. Oral nutrition beginning at the 5 th day. Up to 10 years follow-up, with complete remission of the symptomatology in 6 years., Discussion: Since a true short esophagus diagnosis depends on transurgical findings, pediatric surgeons should notice this entity when practicing any antireflux procedure. Laparoscopic Collis-Nissen approach is safe and efficient in these patients., (Copyright: © 2020 Permanyer.)

Purpose: (1) To improve the accuracy of global and regional alveolar-recruitment quantification in CT scan pairs by accounting for lung-tissue displacements and deformation, (2) To propose a method for local-recruitment calculation., Methods: Recruitment was calculated by subtracting the quantity of non-aerated lung tissues between expiration and inspiration. To assess global recruitment, lung boundaries were first interactively delineated at inspiration, and then they were warped based on automatic image registration to define the boundaries at expiration. To calculate regional recruitment, the lung mask defined at inspiration was cut into pieces, and these were also warped to encompass the same tissues at expiration. Local-recruitment map was calculated as follows: For each voxel at expiration, the matching location at inspiration was determined by image registration, non-aerated voxels were counted in the neighborhood of the respective locations, and the voxel count difference was normalized by the neighborhood size. The methods were evaluated on 120 image pairs of 12 pigs with experimental acute respiratory distress syndrome., Results: The dispersion of global- and regional-recruitment values decreased when using image registration, compared to the conventional approach neglecting tissue motion. Local-recruitment maps overlaid onto the original images were visually consistent, and the sum of these values over the whole lungs was very close to the global-recruitment estimate, except four outliers., Conclusions: Image registration can compensate lung-tissue displacements and deformation, thus improving the quantification of alveolar recruitment. Local-recruitment calculation can also benefit from image registration, and its values can be overlaid onto the original image to display a local-recruitment map. They also can be integrated over arbitrarily shaped regions to assess regional or global recruitment.

Objective: To present our experience in the treatment of the severe tracheomalacia by thoracoscopic approach, as well as its diagnostic methodology, surgical technique, post-operatory evolution and complications., Clinical Cases: From 2016 to 2017, three patients, 3, 9 and 12 months old, were treated. They showed multiple near sudden death events and had an absolute dependence to assisted ventilation. Pre-operatory bronchoscopy evinced tracheal severe malacia. Thoracic angiotomography discarded other extrinsic tracheal compression causes. A left thoracoscopic aortopexy was practiced with a bronchoscopical trans-operatory control; with improvement in tracheal space. Just one patient is still awaiting cannula removal, without symptomatology recurrence in a 3-20 months follow up., Conclusions: The thoracoscopic aortopexy is a safe and effective technique to treat primary and severe tracheomalacia in children., (Copyright: © 2019 Permanyer.)