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omen and pelvis in children above 140 cm and, especially, above 160 cm. Of the injuries of the lower limbs, a feature of the injury in the car cab is the prevalence of injuries to the knee joints in children above 140 cm. A direct dependence of injuries of all parts of the upper limbs on height was revealed, fractures of the forearm bones has been revealed occurred only in children above 160 cm.The aim of this study is to reveal the features of changes in the structure of the cerebral cortex at different periods of the postmortem period after death from massive blood loss complicated by hemorrhagic shock. The morphological and morphometric features of the nervous and vascular structures were determined during death from blood loss complicated by hemorrhagic shock. The brain of 12 corpses of persons who died from stab and cut wounds of blood vessels and internal organs with sharp instruments at various times of the postmortem period were examined. It was found that as the time elapsed after death from hemorrhagic shock increases, an increase in destructive changes in both neurons and intracerebral vessels is observed in the brain. Autolytic processes to a greater extent occur in the intracerebral vessels in comparison with neurons, which is more pronounced in the later periods. The dimensions of the perineuronal and perivascular spaces in the dynamics of the postmortem period increase synchronously after death from hemorrhagic shock.The aim of this study is to describe the morphological and functional characteristics of the cardiac in sudden infants death syndrome (SIDS) in children under one year of age. Twenty eight cases of SIDS were studied histologically and immunohistochemically. Histological examination of the sectional material was carried out using standard and additional stains. The study of cardiac muscle tissue with routine staining with haematoxylin-eosin revealed interstitial oedema, uneven plethora of blood vessels dystonia and weak plethora of part of the coronary arteries, excess of red blood cells in the veins as well as microcirculatory plethora with stasis of the erythrocytes. Phleomycin D1 An immunohistochemical study revealed a mild over expression of p53 in cellular elements, small-focal expression of CD68 in cardiomyocytes apoptosis intramural areas, activation of mast cells (CD117), expression of ki-67 in macrophages, proliferation of fibroblasts. Additional forensic criteria for the diagnosis of SIDS were determined in the form of atrial endocardial fibrosis and interventricular septum; the expression of CD68, CD117 in fibroblasts, mast cells and lymphocytes; apoptosis of cardiomyocytes (expression of p53), proliferation of fibroblasts and remodeling of the heart (expression of ki-67).

The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting requests of healthcare resources. The aim of this paper is to offer a comprehensive overview of the most important recommendations by the International Guidelines about general surgery, and possibly to invite building common shared guidelines to preserve the potential to provide surgical assistance despite the pandemic.

This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. PubMed, Embase, Cochrane and Web of Science databases were searched.

The searches revealed a total of 18579 articles published up to the end of February 2021. Five articles published between March and May 2020, were included in the present study Guidelines from The European Society of Trauma and Emergency Surgery (ESTES), The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and The European Association for Endoscopic Surgeons (EAES), The Endoscopic and Laparoscopic Surgeons of Asia (ELSA), The European Hernia Society (EHS) and The International Organization for the Study of Inflammatory Bowel Disease (IOS-IBD).

In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.

In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.The incidence of right-sided infective endocarditis (RSIE) is steadily increasing and it has been reported to be associated with high risk of embolic events (EE). Aim of our study was to identify the clinical characteristics of patients with RSIE complicated by PE. Indeed, the identification of patients at high risk of significant PE who will benefit from a more aggressive therapeutic strategy may improve the prognosis. From January 2015 to September 2020, 176 patients (Pts) in 6 centers were found to have definite RSIE complicated by PE. Advanced imaging for PE including computed tomography pulmonary angiography (CTPA) was performed in 28 pts (16%) who represent our study group (24 male, mean age 50.6 ±18.29 years). They all underwent transesophageal echocardiography (TEE), in 12 cases (43%) also three-dimensional (3D) TEE, and 27 patients (99%) had both TEE and transthoracic echocardiography (TTE). A total of 53 vegetations (V) were detected. In 18 pts (64%) two or more vegetations were found. Native tricusFurther prospective studies are required to better confirm our hypothesis.Mantle cell lymphoma is a subtype of B-cell non-Hodgkin's lymphoma. Most cases of the disease have extranodal involvement at the time of the initial diagnosis; however, endobronchial involvement is rare. A 51-year-old woman was referred to our hospital because a chest CT showed pathological tissue in the right hilum englobing the pulmonary artery, the left main bronchus and their main lobar branches appearing to be small in caliber, multiple lymphadenopathies up to 4 cm in size in the subcarinal region. A bronchoscopy revealed stenotic lumen with infiltrated hyperemic mucosa of the left upper lobar bronchus and the left lower lobar bronchus. She was diagnosed as having mantle cell lymphoma based on an endobronchial biopsy and transbronchial needle aspiration. The diagnosis was confirmed using immunohistochemical staining.Erasmus syndrome is the association of the exposure to silica and the subsequent development of systemic sclerosis, a rare occurrence, with scarce data in medical literature, which can be attributed to little knowledge of the syndrome and underdiagnosis. It is important to recognize this association as it has a worse respiratory prognosis than the idiopathic form of systemic sclerosis and since autoimmune diseases are rarer in men, it is easy to do exposure research when they occur. We describe the case of a 59-year-old man, a bricklayer by craft since the age of 15, who presented with respiratory symptoms and skin alterations and in whom this syndrome was diagnosed during his recent admission.Cardiomyopathies (CMPs) are diseases of the heart muscle. They include a variety of myocardial disorders that manifest with various structural and functional phenotypes and are frequently genetic. Myocardial disease caused by known cardiovascular causes (such as hypertension, ischemic heart disease, or valvular disease) should be distinguished from CMPs for classification and management purposes. Identification of various CMP phenotypes relies primarily upon echocardiographic evaluation. In selected cases, cardiac magnetic resonance imaging (CMR) or computed tomography may be useful to identify and localize fatty infiltration, inflammation, scar/fibrosis, focal hypertrophy, and better visualize the left ventricular apex and right ventricle. CMR imaging has emerged as a comprehensive tool for the diagnosis and follow-up of patients with CMPs. The accuracy and reproducibility in evaluating cardiac structures, the unique ability of non-invasive tissue characterization and the lack of ionizing radiation, make CMR very attractive as a potential "all-in-one technique". Indeed, it provides valuable data to confirm or establish the diagnosis, screen subclinical cases, identify aetiology, establish the prognosis. Additionally, it provides information for setting a risk stratification (based on evaluation of proved independent prognostic factors as ejection fraction, end-systolic-volume, myocardial fibrosis) and follow-up. Last, it helps to monitor the response to the therapy. In this review, the pivotal role of CMR in the comprehensive evaluation of patients with CMP is discussed, highlighting the key features guiding differential diagnosis and the assessment of prognosis.Diabetics who develop severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) are more likely to have severe disease, higher odds of intensive care requirement and mortality. Fifteen percent of patients have new onset hyperglycemia. We studied the comparative outcomes between prior DM, newly detected hyperglycemia and assessed role of secondary sepsis on mortality. RWe performed a r etrospective study of confirmed SARS-CoV-2 patients at a tertiary care hospital in Chennai, India. Patients were divided as 2 groups (Group 1 With preexisting diabetes mellitus, Group 2 With newly diagnosed hyperglycemia due to newly detected diabetes mellitus or non-diabetic hyperglycemia. Clinical and laboratory data was analysed. Two hundred and thirty eight patients had prior-diabetes mellitus (Group 1) and 40 had newly diagnosed hyperglycemia (Group 2). Thirty four of group 1 and 7 of group 2 patients required intensive care. Mean capillary blood glucose (MCBG) during hospital stay was 207 mg/dl (Group 1) and 192 mg/dl (Group 2). Twentysix patients (9.3%) had secondary sepsis of which sixteen died. Logistic regression identified secondary sepsis(p6 fold elevation in D-dimer were strong predictors of mortality. Steroid use possibly contributed to secondary sepsis. Early identification and aggressive management of secondary sepsis are necessary for diabetics.

The aim of this study was to compare the hypertrophic adaptations to barbell or flywheel squat exercise added to regular in-season soccer training.

Quadriceps' (rectus femoris [RF], vastus medialis [VM] and vastus lateralis [VL]) cross-sectional area (CSA) in its portions (proximal [PROX], middle [MID], and distal [DIST]) was measured on both legs before and after a 6-week barbell (80 to 90 % one-maximum repetition; n=7) or flywheel (0.0611 to 0.0811 Kg·m2; n=7) in an U19 professional soccer team using a 3T magnetic resonance imagery. Both groups underwent 5 sets × 6 reps per session of squat separated by 3-min rest, while controlling the time under tension (within 0.5 and 0.8 s).

The barbell squat group experienced moderate CSA increments in the VMMID and the VLDIST of the right leg (d=0.98-0.99). Additionally, the flywheel group experience large CSA increments in the RFMID, VLPROX and VLMID of the right leg (d=1.00-1.84). On average, flywheel squat training largely produced greater force during exercips muscles' CSA as mechanism underlying strength/power adaptations.