Remarkable Recovery After Severe Gunshot Brain Injury: A Comprehensive Case Study of Functional Rehabilitation.

BACKGROUND Penetrating traumatic brain injury (TBI) caused by gunshots is a rare type of TBI that leads to poor outcomes and high mortality rates. Conducting a formal neuropsychological evaluation concerning a patient's neurologic status during the chronic recovery phase can be challenging. Furthermore, the clinical assessment of survivors of penetrating TBI has not been adequately documented in the available literature. Severe TBI in patients can provide valuable information about the functional significance of the damaged brain regions. This information can help inform our understanding of the brain's intricate neural network. CASE REPORT We present a case of a 29-year-old right-handed man who sustained a left-hemisphere TBI after a gunshot, causing extensive diffuse damage to the left cerebral and cerebellar hemispheres, mainly sparing the right hemisphere. The patient survived. The patient experienced spastic right-sided hemiplegia, facial hemiparesis, left hemiparesis, and right hemianopsia. Additionally, he had severe global aphasia, which caused difficulty comprehending verbal commands and recognizing printed letters or words within his visual field. However, his spontaneous facial expressions indicating emotions were preserved. The patient received a thorough neuropsychological assessment to evaluate his functional progress following a severe TBI and is deemed to have had a favorable outcome. CONCLUSIONS Research on cognitive function recovery following loss of the right cerebral hemisphere typically focuses on pediatric populations undergoing elective surgery to treat severe neurological disorders. In this rare instance of a favorable outcome, we assessed the capacity of the fully developed right hemisphere to sustain cognitive and emotional abilities, such as language.

Cocaine-Induced Chronic Bowel Ischemia Manifesting As Small Bowel Obstruction.

Cocaine represents one of the most frequently used recreational drugs worldwide. Cocaine-related disorders mostly affect the nervous and cardiovascular system, although gastrointestinal complications are not negligible and sometimes life-threatening. The most common gastrointestinal manifestations of cocaine abuse are ulceration, infarction, perforation, ischemic enterocolitis, and rarely hemorrhage, with mesenteric ischemia being the underlying pathophysiological mechanism. Herein, we report a rare case of cocaine-induced small bowel obstruction in a young female patient, caused by chronic mesenteric ischemia and excessive intestinal wall fibrosis.

Algorithms for the Motion of Randomly Positioned Hexagonal and Square Microparts on a "Smart Platform" with Electrostatic Forces and a New Method for Their Simultaneous Centralization and Alignment.

In this paper, an approach is proposed for the simultaneous manipulation of multiple hexagonal and square plastic-glass type microparts that are positioned randomly on a smart platform (SP) using electrostatic forces applied by the suitable activation of circular conductive electrodes. First, the statics analysis of a micropart on the SP is presented in detail and the forces and torques that are applied to and around the center of mass (COM) respectively due to the activation of a SP electrode are determined. The "single electrode activation" (SEA) and the "multiple electrodes activations" (MEA) algorithms are introduced to determine the feasible SP electrodes activations for the microparts manipulation considering their initial configuration. An algorithm for the simultaneous handling of multiple microparts is studied considering the collision avoidance with neighboring microparts. An approach is presented for the simultaneous centralization and alignment of the microparts preparing them for their batch parallel motion on the SP. The developed algorithms are applied to a simulated platform and the results are presented and discussed.

A Review of Percutaneous Transluminal Angioplasty in Hemodialysis Fistula.

The number of patients in dialysis increases every year. In this review, we will evaluate the role of percutaneous transluminal angioplasty (PTA) according to patency of arteriovenous fistula and grafts. The main indication of PΤΑ is stenosis > 50% or obstruction of the vascular lumen of an arteriovenous fistula and graft. It is usually performed under local anesthesia. The infection rate is as low as the number of complications. Fistula can be used in dialysis in the same day without the need for a central venous catheter. Primary patency is >50% in the first year while primary assisted patency is 80-90% in the same time period. Repeated PTA is as durable as the primary PTA. An early PTA carries a risk of new interventions. Cutting balloon can be used as a second-line method. Stents and covered stents are kept for the management of complications and central outflow venous stenosis. PTA is the treatment of choice for stenosis or obstruction of dialysis fistulas. Repeated PTA may be needed for better patency. Drug eluting balloon may become the future in PTA of dialysis fistula, but more trials are needed.

Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication.

BACKGROUND: Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. CASE REPORT: An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee. On the 5th postoperative day, he was diagnosed with right parotitis probably because of dehydration, general anesthesia, and immunocompromisation. A CT scan confirmed the diagnosis. He received treatment with antibiotics and fluids. His condition gradually improved, and he was finally discharged on 15th postoperative day. CONCLUSIONS: Postoperative parotitis can possibly occur after any type of surgery including vascular. Clinicians should be aware of this complication although it is rare. Several risk factors such as dehydration, general anesthesia, drugs, immunocompromisation, head tilt during surgery, and stones in Stensen's duct may predispose to postoperative parotitis. Treatment consists of antibiotics and hydration.

A Modified Cooperative A* Algorithm for the Simultaneous Motion of Multiple Microparts on a "Smart Platform" with Electrostatic Fields.

In this article, a method for microparts parallel manipulation with electrostatic forces, applied by conductive electrodes embedded on a Programmable "Smart Platform", is introduced. The design of the platform and the layout of the electrodes underneath the rectangular microparts with respect to the platform's geometry are presented. The electrostatic phenomena that result to the electrostatic forces applied to the microparts by the activated electrodes of the "Smart Platform" are studied in detail. Algorithms for the activation of the platform's electrodes for the motion of the rectangular microparts are introduced and their motion is simulated. The Configuration-Space (C-Space) of the microparts on the "Smart Platform" is defined taking into account the static obstacles that are placed on the platform and the rest of moving microparts. Considering the layout of the platform, the activation algorithms, the motion and the C-Space of the microparts, a modified A* algorithm is proposed and the best path for every moving rectangular micropart on the "Smart Platform", is computed with respect to time. Simulated experiments are presented to demonstrate the effectiveness of the proposed approach and the results are discussed.

Pulmonary Embolism in a Young Immunocompetent Adult Infected with Cytomegalovirus. Are Novel Oral Anticoagulants an Efficient Alternative?

BACKGROUND/AIM: Cytomegalovirus (CMV) infection is a common disease especially in young adults. Thromboembolism like deep vein thrombosis and pulmonary embolism is increased among patients with CMV infection. Most cases represent immunocompromised patients usually treated with low molecular weight heparin. CASE REPORT: Herein, we describe a 25-year-old immunocompetent male who presented at the emergency department with sudden onset of chest pain. One month prior to admission, he had developed persistent fever and cough and the diagnosis of CMV infection had been established. After extensive workup, the diagnosis of pulmonary embolism after CMV infection was set and he was treated with rivaroxaban. During the next six months the patient continued on the same anticoagulant therapy with no other episode of pulmonary embolism at 1-year follow-up. CONCLUSION: To our knowledge, this is the first case of CMV-associated pulmonary embolism treated with novel oral anticoagulants (NOACs). NOACs, such as rivaroxaban, seem to be safe and may represent an attractive alternative with promising results in this particular group of patients. Studies incorporating a greater cohort of patients are needed in order to draw safe conclusions regarding the relationship between NOACs and CMV infection.