This study aims to evaluate the role of TUSG in the postoperative period and the detection of early complications after surgical treatment, pulmonary resection, or decortication for infectious and inflammatory thoracic diseases, comparing with the standard method (Chest Radiography ‒ CXR).
Prospective non-randomized self-controlled study. Twenty-one patients over 16 years of age have undergone surgical treatment of inflammatory and infectious lung diseases. These patients were followed up with CXR and TUSG (performed on the 1st and 3rd postoperative days and/or after the chest tube removal).
Both exams demonstrated similar results regarding their ability to safely predict the adequate moment for chest drain removal. TUSG allowed chest drain removal in 30% of cases and CXR in 34%. Statistical analysis demonstrates that both exams have similar capabilities in detecting postoperative changes in the pleural space. However, the authors report that TUSG is statistically more accurate in detecting subcutaneous emphysema than CXR (p = 0.037, Kappa [κ = 0.3068]). The analysis of other parameters showed no statistical difference.
The authors conclude that TUSG in trained hands is equivalent to CXR in searching for postoperative complications regarding the surgical treatment of infectious and inflammatory thoracic diseases and can be used as a complement, and not a substitute, to CXR, when CCT is not feasible, or a more urgent diagnosis is needed.

UNASSIGNED: Situs inversus totalis is characterized by the complete transposition of thoracic and abdominal viscera. Individuals can live asymptomatically with this condition; however, it may be associated with certain abnormalities of the organs involved.
METHODS: Herein, we present a case of a situs inversus totalis woman presented with choledocholithiasis. Elective laparoscopic cholecystectomy was performed on the patient with intraoperative modifications. The patient was discharged in a healthy condition.
UNASSIGNED: Several case reports have documented the typical presentation of cholelithiasis, which is characterized by pain in the left upper quadrant and epigastric region. Our patient exhibited similar symptoms and was diagnosed with choledocholithiasis.
CONCLUSIONS: Diagnostic and therapeutic management of morbidities in SIT individuals can be performed with recommended modifications that can lead to favorable outcomes.

We present a case of a 42-year-old man with DiGeorge syndrome and congenital cardiac anomalies including a type B interrupted aortic arch who had previously undergone two bypasses between the ascending and descending thoracic aorta in childhood. He was found to have a 7.4-cm pseudoaneurysm of the descending thoracic aorta with the left subclavian artery arising from the aneurysm. The patient was treated with a single stage hybrid repair including left common carotid to subclavian bypass followed by thoracic endovascular aortic aneurysm repair.

暂无摘要。

Although kidney transplantation is the best therapeutic option for patients with chronic kidney disease, the immunosuppression required greatly increases susceptibility to infections that are responsible for high post-transplant mortality. Pulmonary tuberculosis (TB) represents a major cause of such infections, and its early diagnosis is therefore quite important. In view of that, we researched the manifestations of active pulmonary TB in kidney transplant recipients, through chest X-ray and computed tomography (CT), as well as determining the number of cases of active pulmonary TB occurring over a 3.5-year period at our institution. We identified four cases of active pulmonary TB in kidney transplant recipients. The CT scans provided information complementary to the chest X-ray findings in all four of those cases. We compared our CT findings with those reported in the literature. We analyzed our experience in conjunction with an extensive review of the literature that was nevertheless limited because few studies have been carried out in lowand middle-income countries, where the incidence of TB is higher.
Apesar de o transplante renal ser a melhor opção terapêutica para pacientes com doença renal crônica, a imunodepressão decorrente desse tratamento eleva muito a suscetibilidade desses pacientes a infecções, responsáveis por altas taxas de mortalidade pós-operatórias. A tuberculose (TB) pulmonar é uma significativa causa dessas infecções, sendo muito importante o seu diagnóstico precoce. Assim, nós pesquisamos as manifestações da TB pulmonar ativa nessa população de transplantados renais por meio de radiografias simples e tomografia computadorizada (TC) do tórax, também para estabelecer o número de casos de TB pulmonar ativa em nossa instituição após levantamento de 3,5 anos. Encontramos quatro casos de TB pulmonar ativa em pacientes transplantados renais. A TC forneceu informações adicionais em relação às radiografias de tórax em 100% dos casos analisados. Comparamos os nossos achados de TC com os relatados na literatura. Somamos a experiência obtida com extensa revisão da literatura, ainda limitada nessa questão, com poucos estudos realizados em países em desenvolvimento onde a incidência de TB é maior.

Musculoskeletal aetiologies account for most patients presenting with chest pain. Intercostal neuralgia is a lesser-known cause of musculoskeletal chest pain, which can present a diagnostic challenge with nonspecific imaging findings. We report a case of a 31-year-old male who presented with severe lower thoracic and chest wall pain following a suspected viral infection, where Magnetic Resonance Imaging (MRI) revealed characteristic features of denervation oedema within the affected intercostal muscles. This pattern of imaging findings in intercostal neuralgia is sparely described in the current literature. MRI along with history and examination was crucial in diagnosing the condition and excluding other potential causes of musculoskeletal chest wall pain on this occasion. The patient\'s symptoms were subsequently managed conservatively. The case highlights the importance of considering intercostal neuralgia as a potential cause of chest wall pain, particularly in the setting of post viral infection and absence of preceding mechanical musculoskeletal injury and explores an uncommon yet characteristic imaging finding which may be important in diagnosing the condition.
Nustatyti raumenų ir skeleto skausmų priežastį yra aktualu daugumai pacientų, besikreipiančių dėl skausmo krūtinės plote. Tarpšonkaulinė neuralgija yra nedažna raumenų ir skeleto krūtinės srities skausmų priežastis. Ją nustatyti iš gaunamos vaizdinės informacijos gali būti sunku, nes joje nėra jokių išskirtinių požymių.
UNASSIGNED: 31 metų vyras kreipėsi dėl intensyvaus skausmo apatinėje krūtinės ląstos dalyje bei krūtinės sienoje. Skausmas atsirado po, kaip spėjama, virusinės infekcijos. Magnetinio rezonanso tyrimas (MRI) atskleidė įprastinius denervacijos edemos požymius pažeistuose tarpšonkauliniuose raumenyse. Tokios tendencijos vaizdinėje medžiagoje tarpšonkaulinės neuralgijos atveju net ir naujausioje literatūroje yra menkai aprašytos. MRI, ligos istorija ir paciento apžiūra buvo itin svarbios nustatant skausmo priežastį ir atmetant kitas galimas raumenų ir skeleto krūtinės sienos skausmą sukeliančias priežastis šiuo konkrečiu atveju. Anksčiau paciento simptomai buvo išgydyti konservatyviais metodais. Šis atvejis atskleidžia, kaip svarbu atsižvelgti į tarpšonkaulinės neuralgijos galimybę kaip į galimą krūtinės sienos skausmo priežastį, ypač jei buvo persirgta virusine liga ir nėra žinoma buvus jokių ankstesnių mechaninių raumenų ar skeleto traumų. Šiuo atveju ištyrėme nedažną, tačiau vis dėlto standartinę diagnozę, gautą iš vaizdinės medžiagos, kuri gali būti svarbi nustatant šią sveikatos problemą.

UNASSIGNED: Emerging technologies have increasingly been adopted in spine surgery in the attempt to increase precision and improve outcomes. Robotic assistance is an area of significant interest, with proposed benefits including increased accuracy, decreased complication rates, and decreased radiation exposure. The purpose of this review is to provide an overview of the currently available robotic assistance systems and their associated outcomes and limitations.
UNASSIGNED: A review of national databases was performed using key terms \"robotic\", \"spine\", and \"surgery\" for literature from 2014 to 2023. Studies that aimed to describe the utilities of endoscopic surgeries, associated outcomes, limitations, and future directions were included. Studies that were not in English were excluded.
UNASSIGNED: This review includes a brief overview of the history of robotic spine surgery as well as its clinical outcomes, limitations, and future directions.
UNASSIGNED: Robotic-assisted spine surgery has seen increasing use in the attempt to increase precision and improve outcomes and has been associated with increased accuracy in pedicle screw placement and decreased complication rates. Barriers to its adoption include a significant learning curve, possibly longer operative cases, and significant associated costs. As robotic assistance continues to become increasingly popular in spine surgery, it is critical for surgeons to understand the technology available and the associated outcomes to make informed decisions when considering which system to incorporate into their practice.

Spontaneous spinal epidural hematoma (SSEH) rarely occurs. Without early diagnosis, SSEH can lead to the acute onset of neurologic deficits. We report the case of a 65-year-old male with diabetes mellitus who was admitted to our emergency department with a chief complaint of sharp and severe pain in the left scapula and behind the sternum. He was misdiagnosed with cardiovascular disease until the onset of progressive bilateral paraplegia and lower limb numbness. Magnetic resonance imaging revealed a ventral thoracic SSEH. Surgical treatment to remove epidural hematoma and laminectomy for decompression were performed. Except for urine retention, bilateral lower limb paraplegia and numbness were alleviated postoperatively. Due to the high risk of poor neurological outcomes without treatment or with delayed intervention, timely surgical evacuation of the hematoma and hemostasis are recommended to ensure favorable neurological outcomes.

UNASSIGNED: Thoracic disc calcification is a radiological finding which may be incidental or diagnosed in patients presenting with myelopathy due to spinal cord compression. We performed a study to analyze the imaging patterns of calcified thoracic discs (CTDs).
UNASSIGNED: A retrospective review of the spinal and radiology database of a tertiary referral orthopedic hospital was conducted for the incidence of CTDs between 2007 and 2020. Patients\' demographics and radiological findings were recorded. The relationship between disc size, morphology, spinal cord compression, and management was assessed.
UNASSIGNED: Fifty-one cases of CTDs were identified. The mean size of CTD was 806.2 mm3 (range: 144-2340). The most common level of disc calcification was T9-T10 (24%) in 12 patients. Thoracic disc calcifications in our series commonly involved disc \"protrusion\" in 67% (34 patients), followed by \"mushroom\" type in 31% (16 patients) and \"extrusion\" in 2% (1 patient). 37% (19 patients) had spinal cord compression with 12% (6 patients) undergoing surgical interventions. There was no statistically significant difference in the mean sizes of CTD between the groups with and without spinal cord compression (P = 0.566, independent sample t-test). Patients with \"mushroom\" type calcification were more likely to have surgical intervention (P = 0.01, Fisher\'s exact test).
UNASSIGNED: Thoracic disc calcifications, while common, can still be underdiagnosed till late myelopathic deterioration. Care of the elderly physicians, spinal surgeons, and radiologists need to be aware of them to guide diagnosis and management. Our study demonstrates that disc morphology plays a vital role in myelopathic presentation and therefore determines the need for surgical intervention instead of the absolute size of disc calcification.

UNASSIGNED: To identify factors and barriers, which affect the utilisation of spinal manipulation and mobilisation among infants, children, and adolescents.
UNASSIGNED: Twenty-six international expert physiotherapists in manual therapy and paediatrics were invited to participate in a Delphi investigation using QualtricsⓇ. In Round-1 physiotherapists selected from a list of factors and barriers affecting their decision to use spinal manipulation and mobilisation in the paediatric population and had opportunity to add to the list. Round-2 asked respondents to select as many factors and barriers that they agreed with, resulting in a frequency count. The subset of responses to questions around barriers and facilitators are the focus of this study.
UNASSIGNED: Twelve physiotherapists completed both rounds of the survey. Medical diagnosis, mechanism of injury, patient presentation, tolerance to handling, and therapist\'s knowledge of techniques were the dominant deciding factors to use spinal manipulation and mobilisation among infants, children, and adolescents across spinal levels. More than 90% of the respondents selected manipulation as inappropriate among infants as their top barrier. Additional dominant barriers to using spinal manipulation among infants and children identified by ≥ 75% of the respondents included fear of injuring the patient, fear of litigation, lack of communication, lack of evidence, lack of guardian consent, and precision of the examination to inform clinical reasoning.
UNASSIGNED: This international survey provides much needed insight regarding the factors and barriers physiotherapists should consider when contemplating the utilisation of spinal mobilisation and manipulation in the paediatric population.