Bowel Obstruction as the Initial Presentation of Urothelial Carcinoma.

Bowel obstructions are one of the main causes of hospital admissions for acute abdominal pain. In addition, bladder cancer is one of the most common cancers in the world. This said, bowel obstruction and bladder cancer are very frequent diseases but the same cannot be said about the association between these two pathologies. We report a unique case of an 80-year-old patient admitted to the emergency room with a bowel obstruction caused by a urothelial carcinoma with adrenal metastasis. The patient underwent an urgent laparotomy, and intraoperative inspection of the peritoneal cavity confirmed a large tumorous mass suspected of gastrointestinal etiology. The mass infiltrated the ileum and sigmoid colon and was apparently in contact with the bladder wall. An en-bloc resection of the lesion was performed. An R0 excison was not possible and fragments of the lesion were excised from the bladder wall for separate analysis. Histopathological examination of the resected specimen described a high-grade, undifferentiated urothelial carcinoma that originated in the bladder and invaded the ileum and sigmoid colon. The presence of an invasive urothelial carcinoma presenting with bowel obstruction represents an unexpected diagnosis and, although rare, the surgeon must be aware of this possibility. This case should serve as a reminder that a broad differential diagnosis should be considered when investigating an abdominal tumor.

Spatial Distribution of Air Pollution, Hotspots and Sources in an Urban-Industrial Area in the Lisbon Metropolitan Area, Portugal-A Biomonitoring Approach.

This study aimed to understand the influence of industries (including steelworks, lime factories, and industry of metal waste management and treatment) on the air quality of the urban-industrial area of Seixal (Portugal), where the local population has often expressed concerns regarding the air quality. The adopted strategy was based on biomonitoring of air pollution using transplanted lichens distributed over a grid to cover the study area. Moreover, the study was conducted during the first period of national lockdown due to COVID-19, whereas local industries kept their normal working schedule. Using a set of different statistical analysis approaches (such as enrichment and contamination factors, Spearman correlations, and evaluation of spatial patterns) to the chemical content of the exposed transplanted lichens, it was possible to assess hotspots of air pollution and to identify five sources affecting the local air quality: (i) a soil source of natural origin (based on Al, Si, and Ti), (ii) a soil source of natural and anthropogenic origins (based on Fe and Mg), (iii) a source from the local industrial activity, namely steelworks (based on Co, Cr, Mn, Pb, and Zn); (iv) a source from the road traffic (based on Cr, Cu, and Zn), and (v) a source of biomass burning (based on Br and K). The impact of the industries located in the study area on the local air quality was identified (namely, the steelworks), confirming the concerns of the local population. This valuable information is essential to improve future planning and optimize the assessment of particulate matter levels by reference methods, which will allow a quantitative analysis of the issue, based on national and European legislation, and to define the quantitative contribution of pollution sources and to design target mitigation measures to improve local air quality.

Laparoscopic deroofing of a ruptured hepatic cyst presenting as an acute abdomen.

The rupture of a nonparasitic hepatic cyst is a rare complication for which there is no optimal treatment strategy yet. Laparoscopic deroofing is the standard approach for the elective treatment of symptomatic NHCs but it has seldom been described as an option for a ruptured hepatic cyst. The authors report a case of a male patient presenting to the emergency room with an acute abdomen caused by the rupture of a hepatic cyst. The patient was successfully treated by urgent laparoscopic deroofing of the cyst. Laparoscopic surgery can be a valid option for treating urgent cases presenting the same efficacy and less morbidity than open surgery.

Cavernous hemangioma of small bowel: a rare cause of digestive hemorrhage / Hemangioma cavernoso del intestino delgado: una causa rara de hemorragia digestiva

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Integration of biomonitoring and instrumental techniques to assess the air quality in an industrial area located in the coastal of central Asturias, Spain.

Throughout the world, epidemiological studies were established to examine the relationship between air pollution and mortality rates and adverse respiratory health effects. However, despite the years of discussion the correlation between adverse health effects and atmospheric pollution remains controversial, partly because these studies are frequently restricted to small and well-monitored areas. Monitoring air pollution is complex due to the large spatial and temporal variations of pollution phenomena, the high costs of recording instruments, and the low sampling density of a purely instrumental approach. Therefore, together with the traditional instrumental monitoring, bioindication techniques allow for the mapping of pollution effects over wide areas with a high sampling density. In this study, instrumental and biomonitoring techniques were integrated to support an epidemiological study that will be developed in an industrial area located in Gijon in the coastal of central Asturias, Spain. Three main objectives were proposed to (i) analyze temporal patterns of PM10 concentrations in order to apportion emissions sources, (ii) investigate spatial patterns of lichen conductivity to identify the impact of the studied industrial area in air quality, and (iii) establish relationships amongst lichen conductivity with some site-specific characteristics. Samples of the epiphytic lichen Parmelia sulcata were transplanted in a grid of 18 by 20 km with an industrial area in the center. Lichens were exposed for a 5-mo period starting in April 2010. After exposure, lichen samples were soaked in 18-MΩ water aimed at determination of water electrical conductivity and, consequently, lichen vitality and cell damage. A marked decreasing gradient of lichens conductivity relative to distance from the emitting sources was observed. Transplants from a sampling site proximal to the industrial area reached values 10-fold higher than levels far from it. This finding showed that lichens reacted physiologically in the polluted industrial area as evidenced by increased conductivity correlated to contamination level. The integration of temporal PM10 measurements and analysis of wind direction corroborated the importance of this industrialized region for air quality measurements and identified the relevance of traffic for the urban area.