BACKGROUND: There are very few cases of cardiac occluder detachment, and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment. This case innovatively used ultrasound guidance combined with digital subtraction angiography (DSA) to completely remove the occluder, accumulating some experience.
METHODS: The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation. After the surgery, the occluder fell off and became free in the left ventricle, which is very dangerous. We innovatively used ultrasound guidance, combined with DSA, and interventional surgery to successfully capture the free occluder using a catcher, completely remove it, and then re implant a new left atrial appendage occluder. After the surgery, the patient recovered very well.
CONCLUSIONS: The size selection of the occluder is slightly conservative, and the shape of the left atrial appendage opening is irregular.

BACKGROUND: Lamellar keratoplasties have had a great impact in the management of corneal edema due to endothelial dysfunction. Minimally invasive transplant techniques such as Descemet Membrane Endothelial Keratoplasty (DMEK) have helped to reduce the morbidity involved in performing penetrating keratoplasty in this type of patient. Even so, these are complex techniques that are not free of complications and require a long line of surgical learning and an even more demanding experience in postoperative management.
METHODS: An 89-year-old woman suffering from Fuchs endothelial dystrophy and undergoing combined cataract and DMEK surgery presented stromal edema predominantly inferior and sectoral detachment of the graft 24 h after the intervention. After re-bubbling in consultations and 4 days later, the graft was observed rolled and free in the anterior chamber. She underwent re-DMEK with preservation of the original graft after 24 h, with de-epithelialization to optimize visualization. The graft was stained with trypan blue and the posterior stroma was protected with air. The graft was reimplanted under intraocular maneuvers and with an air bubble. 24 h after surgery, the adhered graft was observed, with a great decrease in stromal edema. One month later, the patient had a clear cornea, persistent complete graft adhesion, and visual acuity of 0.9.
CONCLUSIONS: The discovery of free roll in the anterior chamber after DMEK surgery constitutes the most complex form of graft detachment. Corneal edema as well as the arrangement of the different intraocular structures are conditions to be considered for the surgical resolution of this complication. In many cases, surgical repositioning of the graft is feasible, which means saving costs without the need to use new donor corneal tissues.

Pulmonary bullae usually grow slowly and have thin walls. However, we have observed 2 cases of abrupt bulla formation immediately after lobectomy and during surgery. The pathologic findings of what can be called visceral pleural detachment are quite distinctive: these bullae had a broad base connected to the lung, and their walls were thick, including the full extent of visceral pleural and peripheral alveolar tissues, which suggests that the visceral pleura were detached from the distal alveoli. High transpleural pressure might be the key factor in the pathogenesis of this type of bulla, unlike previously known types of bullous lung disease.

The present research examines the strength of terror management theory in an indigenous Indian context of religious fair called Magh Mela. It explores how elderly Hindu people deal with death anxiety through practicing Kalpvas in Magh Mela. The research explores the role of social detachment and self-esteem in coping with terror of death. Study 1, a field experiment on 150 Kalpvasis (practitioners of Kalpvas) confirms the significant role of social detachment as an adaptive strategy for coping with death terror. The role of self-esteem did not emerge in the study. Study 2, another field experiment on 62 Kalpvasis confirms results of study 1. Significant role of years of Kalpvas on fear of death shows importance of the religious practices in managing terror related to death. The relation of terror management theory and death anxiety thus follows a different explanation for more indigenous contexts.

A 45-year-old man suffered bifrontoparietal extradural hematoma resulting from head injury, which cause superior sagittal sinus detachment from its subperiosteal loggia. We present the patient who was treated by early surgical evacuation of the hematoma with an excellent outcome and we also perform a review of the current literature.

OBJECTIVE: To present, to our knowledge, the first case of a single bilateral extradural hematoma due to superior sagittal sinus detachment that was treated conservatively with an excellent outcome.
METHODS: Bilateral extradural hematomas are a rare condition, accounting for only 2%-5% of all extradural hematomas. They can be either 2 distinct hematomas on either side or 1 single bilateral hematoma mostly due to sagittal sinus injury, with the latter being the most rare owing to the firm attachment of the sinus to its subperiosteal loggia. These hematomas usually require immediate surgical evacuation, as patients present with decreased level of consciousness, and have good postoperative outcomes. We present a bilateral extradural hematoma due to superior sagittal sinus injury, which was treated conservatively.
RESULTS: The patient had an excellent recovery, with no residual neurological deficits and a Glasgow outcome scale of 5 on discharge.
CONCLUSIONS: Bilateral extradural hematomas due to superior sagittal sinus injury almost always require surgical intervention. We present a patient who was treated conservatively with an excellent outcome and we also perform a review of the current literature.

Mechanical thrombectomy using retrievable stents or stent retriever devices has become the mainstay of intra-arterial therapy for acute ischemic stroke. The recent publication of a series of positive trials supporting intra-arterial therapy as standard of care for the treatment of large vessel occlusion will likely further increase stent retriever use. Rarely, premature stent detachment during thrombectomy may be encountered. In our multicenter case series, we found a rate of detachment of less than 1% (n = 7/1,067), and all were first-generation Solitaire FR devices. A review of the US Food and Drug Administration database of device experience yielded 90 individual adverse reports of detachment. There were 82, 1 and 7 detachments of Solitaire FR (first generation), Solitaire FR2 (second generation) and Trevo devices, respectively. We conclude with a brief overview of the technical and procedural considerations which may be helpful in avoiding this rare complication.

Outbreaks of Bacillus cereus infection/intoxication are not commonly reported because symptoms are often mild, and the disease is self-limiting. However, hypervirulent strains increase health risks. We report a case, which occurred in Argentina, of severe food poisoning illness on a healthy adult woman associated to B. cereus strain MVL2011. The studied strain was highly cytotoxic, showed high ability to detach Caco-2 cells and was positive for the hblA, hblB, and hblC genes of the hbl complex, bceT, entS and ces. As it is considered that B. cereus emetic cluster evolved from a panmictic population of diarrheal strains, B. cereus MVL2011 could constitute an intermediate strain between diarrheal and emetic strains.