OV17 LAPAROSCOPIC REPAIR OF A DIAPHRAGMATIC EVENTRATION

Aim Diaphragmatic eventration (DE) is a rare condition affecting 0,05% of general population. DE is the abnormal elevation of a portion of a entire hemidiaphragm due to a lack of muscle or nerve function. It can be congenital or acquired. The most common cause of DE is cardiac surgery. It can be asymptomatic or present mild symptoms as dispnea, palpitations, pneumonia. Material and Methods 61 years old male with medical history of arterial hypertension, DMII, Hyperlipidemia. He had a motor vehicle accident with 6 to 9 left ribs fractures. One month later complained of dyspnea with shortness of air to normal activity. Rx: elevation of left diaphragm. CT scan: elevation of left diaphragm without rupture, passive atelectasis of inferior left lobe of the lung. He initiated respiratory physiotherapy without improvement of the symptoms. 4 months after the accident, we had a stroke with right hemiparesis. This situation produced worsening of the dyspnea. Physiotherapy was reinforced with recuperation of the hemiparesis, but poor improvement of the dyspnea. 10 months after the accident, surgery was indicated for plication of the diaphragm to improve the respiratory function. Results The video shows the radiological exams and the surgery performed. Laparoscopic diaphragmatic plication with a reinforcement with a coated mesh (Uncoated monofilament polypropylene mesh on the anterior side with an absorbable hydrogel barrier). He was discharge 2 days after surgery. The patient improved significantly in his respiratory symptoms an imaging exams. Conclusions Posttraumatic DE must be treated surgically with low morbidity and good functional results.

Fatigue Testing of Titanium Alloy Ti6Al4V Used in Medical Devices

Because titanium alloy Ti6Al4V features low density, good corrosion resistance and biocompatibility, it a metal of choice for medicine, used in orthopedics, accident surgery and dentistry. The insertion of elements such as nitrogen, carbon, hydrogen, iron or oxygen improve fatigue strength of this material. This paper presents certain basic fatigue and monotonic tests performed on the alloy. We have proposed a unique sample geometry and sample dimensions smaller than the reference ones. The dimensions of the working part of the sample correspond to the geometry of a dental implant connector. This part of the implant has to withstand stresses that are both intricate and variable in time. We performed monotonic tensile strength tests and uniaxial fatigue tests using the Instron 8874 machine. Then, we examined the samples under a stereoscopic microscope and measured the fracture development angle.

High in-hospital mortality of intensive care patients with nucleated red blood cells in blood

The detection of nucleated red blood cells (NRBCs) in blood of patients suffering from a variety of severe diseases is known to be highly associated with increased mortality. Blood analyzers to routinely measure NRBC concentrations are now available. However, the diagnostic and prognostic significance of this parameter for intensive care patients has not been evaluated. Using a Sysmex XE-2100 analyzer, NRBC concentrations were determined in blood samples from 421 patients treated in intensive care units (general and accident surgery, cardiothoracic surgery, and internal medicine) of a university hospital. NRBCs were found at least once in 19.2% of all patients. The mortality of NRBC-positive patients (n = 81) was 42.0% (n = 34); this was significantly higher (p < 0.001) than the mortality of NRBC-negative patients (5.9%, n = 340). The NRBC concentration was 115 ± 4 × 10