Congenital diaphragmatic hernia (CDH) is a rare and complex developmental disorder characterized by diaphragmatic defects, pulmonary hypoplasia, and persistent pulmonary hypertension, leading to significant neonatal morbidity and mortality. This review summarizes current knowledge on the pathogenesis, genetic background, clinical features, and risk stratification of CDH. The etiology is multifactorial, involving genetic mutations, chromosomal abnormalities, and environmental influences, with key molecular pathways including the retinoic acid and Sonic Hedgehog signaling pathways. Advances in pre-natal diagnosis, particularly the ultrasound-based lung-to-head ratio and magnetic resonance imaging-derived total fetal lung volume, have improved prognostic assessment. Post-natal risk stratification using clinical parameters and scoring systems further guides management and predicts outcomes. Despite improvements in neonatal intensive care and surgical techniques, long-term morbidity remains a major concern. A comprehensive understanding of CDH pathophysiology and the integration of pre-natal and post-natal risk assessment are essential for optimizing individualized management strategies and improving survival and long-term outcomes.
Trauma from explosions is among the most serious injuries faced by healthcare professionals. There are few studies that describe the risk factors for mortality, or the patterns of blast injuries in the civilian compared to the military population. Review of articles extracted from Medline, PubMed, and Scopus published (01/2014-03/2024). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Data on mortality and injury patterns were extracted from the articles that met the inclusion criteria to describe the type of injuries and to identify risk factors for mortality. Sixteen articles were included. Average age of civilians was 40.0 years ± 3.7, with men representing 79.4% compared to a mean age of 24.5 ± 1.4 and 79.0% for the military patients. While there was no difference in the distribution of injuries by body regions, the civilian population was more likely to sustain severe cranial and thoracic injuries (31.9% and 20.4% vs. 18.1% and 9.9%, respectively). Civilian population had a non-statistically significant lower risk of death (odds ratio = 0.96; 95% confidence interval = 0.82, 1.13). The findings of this review indicate that clinical experience derived from explosions occurring in one setting may not be fully generalizable to explosions occurring in other contexts, as demographic, environmental, and contextual factors contribute to distinct injury patterns.
Objetivo: Evaluar la correlación de las mediciones de unidades Hounsfield (HU) en la tomografía computarizada (bidimensional y volumétrica) y los T-scores de absorciometría de rayos X de energía dual (DXA), analizando su intercambiabilidad para la detección oportunista de osteoporosis (OP). Métodos: Se incluyeron 97 pacientes (15 hombres y 82 mujeres, edad media 66.48 ± 9.97 años) con TC lumbar y DXA en un intervalo de 7 meses. Se midieron los valores HU bidimensionales en imágenes axiales (L1-L4) y los valores volumétricos mediante segmentación 3D. Se analizaron las correlaciones con DXA y la concordancia entre métodos mediante Bland-Altman y coeficiente de correlación intraclase (CCI). Resultados: Ambas mediciones se correlacionaron significativamente con los T-scores de DXA (p < 0.001), con una correlación más fuerte en HU volumétrico (r = 0.572 vs. r = 0.532). Los pacientes con osteoporosis mostraron valores HU más bajos, con mejor diferenciación en HU volumétrico. Bland-Altman indicó un sesgo sistemático con subestimación en HU bidimensional. El CCI mostró alta concordancia, con mejor fiabilidad en HU volumétrico (CCI = 0.963 vs. CCI = 0.918). Conclusiones: Las mediciones volumétricas de HU ofrecen una evaluación más fiable y sensible de la densidad ósea trabecular, siendo un método superior para la detección de osteoporosis y el seguimiento de su tratamiento.
Objetivo: Determinar la validez de la biopsia de ganglio centinela (BGC) en mujeres con cáncer cervicouterino (CaCu) en etapa temprana. Métodos: Se realizó un estudio de 46 pacientes con CaCu en etapas FIGO IA1c-IB2 tratada con cirugía radical uterina. La técnica para la identificación de la BGC fue con colorante azul patente y tecnecio-99m. Para su validación se realizó linfadenectomía pélvica bilateral (LPB) y a todos los ganglios centinela se les realizó ultraestadificación patológica. Se determinaron las tasas de detección de BGC, la bilateralidad, la sensibilidad, la especificidad y los valores predictivos negativo y positivo. Resultados: La sensibilidad de la BGC fue del 100%, la especificidad del 95%, el valor predictivo positivo del 75% y el valor predictivo negativo del 100%, con una precisión diagnóstica del 93% y una tasa de falsos negativos del 0%. Conclusiones: La técnica de BGC en pacientes con CaCu en etapa temprana que son sometidas a histerectomía radical es un método factible y seguro en el Instituto Nacional de Cancerología. La importancia de este método es que puede obviarse la LPB cuando migra de forma bilateral, disminuyendo la morbilidad del procedimiento.
Objetivos: Determinar si los tumores paratiroideos atípicos (TPA) pueden diferenciarse de los adenomas paratiroideos (AP) en el periodo preoperatorio, y comparar sus características bioquímicas, complicaciones posoperatorias y evolución a largo plazo. Métodos: Se realizó un análisis retrospectivo de pacientes sometidos a paratiroidectomía entre 2010 y 2022. Se incluyeron 50 pacientes con TPA y 100 con AP como grupo control. Se compararon datos demográficos, parámetros bioquímicos, complicaciones quirúrgicas y resultados del seguimiento. Resultados: Los niveles preoperatorios de calcio sérico y hormona paratiroidea (PTH) fueron significativamente más elevados en los pacientes con TPA. El análisis ROC identificó calcio > 11.5 mg/dl y PTH > 180 pg/ml como puntos de corte útiles para distinguir los TPA. El análisis multivariado confirmó estos valores como predictores independientes. Los pacientes con TPA presentaron mayor frecuencia de cirugía tiroidea concomitante y complicaciones como lesión nerviosa transitoria y síndrome del hueso hambriento. No se observaron diferencias significativas en enfermedad persistente ni en recurrencia tras un seguimiento promedio de 4.8 años. Conclusiones: Los niveles elevados de calcio y PTH preoperatorios pueden contribuir al diagnóstico diferencial de TPA. Se debe informar a los pacientes sobre el mayor riesgo quirúrgico y considerar estrategias preventivas.
Objetivo: La anquiloglosia, conocida como frenillo lingual, es una malformación congénita común que restringe el movimiento de la lengua. Se observa en el 4.8% de los recién nacidos y es más frecuente en los hombres que en las mujeres. El objetivo de este estudio es evaluar el conocimiento y las actitudes de los dentistas en Turquía con respecto a la anquiloglosia. Métodos: Se realizó una encuesta en línea a dentistas de Turquía que examinan y tratan a pacientes. Los datos se analizaron utilizando el software IBM SPSS V.21. Se examinaron las distribuciones de frecuencia y los porcentajes, y las relaciones entre variables nominales se evaluaron utilizando la prueba χ2. Se consideró como nivel de significancia p < 0.05. Resultados: El 76.14% de los participantes podían reconocer la anquiloglosia en los niños y el 87.14% creían que era una anomalía congénita. Además, el 91.49% de los participantes pensaba que la anquiloglosia afecta negativamente la lactancia materna y el 98.34% que podría causar trastornos del habla. Conclusiones: Este estudio enfatiza la importancia de aumentar la conciencia sobre la anquiloglosia y la importancia del diagnóstico y el tratamiento tempranos.
This paper examines the reception of American literature in Iran during the period between the Persian Constitutional Revolution (1905–1911) and the Iranian Revolution of 1979. Divided into four distinct phases (1905–1922, 1922–1941, 1941–1953, and 1953–1979), this study explores how political and ideological dynamics shaped the interpretation and translation of American literary works. Central to this reception was its inherently political nature, driven by the dominance of leftist ideologies within Iran’s intellectual landscape. The influence of the Tūdih Party and other leftist movements profoundly impacted the ways American literature, particularly the works of Walt Whitman, was translated, interpreted, and disseminated. By situating these translations within the broader socio-political context, the paper highlights how American literature became a vehicle for intellectual discourse and ideological contestation in twentieth-century Iran.
The article traces the evolution of Milan Kundera's notion of world literature across his career, contextualizing his writings within major historical events, including the so-called liberalization of Czechoslovakia in the 1960s, the post-1989 transition of the former Soviet bloc, and the turn of the millennium. Throughout the years, but particularly after his own immigration to France in 1975, Kundera consistently tied the notion of world literature with that of Central Europe to emerge with a conceptual framework that enabled him to position (semi-)peripheral European literatures within the Western canon. In his influential 2005 essay "Die Weltliteratur," Kundera ultimately reframed the marginalization of small literatures in terms reminiscent of other late twentieth-century conceptualizations of world literature, notably that of Pascale Casanova. However, the article argues that, unlike Casanova, who critically analyzed small literatures in relation to Paris, Kundera, while acknowledging their marginalization, promoted them within a framework that reproduces Eurocentric literary hierarchies, and, finally, as a novelist, embodied the very structure examined by Casanova. In this sense, Kundera became not only a thinker of world literature but also an exemplary embodiment of the mechanisms of recognition that were seminally theorized by scholars such as Casanova.
The Vsemirnaia Literatura publishing house was founded in Petrograd by Maxim Gorky less than a year after the October Revolution. Aligned with the objectives of the new regime, its mission was to translate and publish a substantial body of European and Asian poetry and prose, thereby contributing to the broad cultural education of the emerging Soviet generations. These ambitions clearly reflect a key element of Gorky's conception of culture as well: for Gorky, culture in its broadest sense (encompassing literature, art, music, and science) had the potential to unite humanity under the ideals of peace and harmony. Within this new humanist vision, intellectuals were called upon to join forces in creating networks of associations devoted to the preservation and advancement of culture beyond national boundaries. This article aims to outline the central features of the conception at the origin of Vsemirnaia Literatura, with particular emphasis on the efforts to establish a bridge between Asia (then commonly referred to as the East) and Europe (the West) through Russia. The article compares Gorky's utopian vision to Enlightenment-era cultural ambitions of the French Encyclopedists and to Goethe's notion of Weltliteratur, as both Enlightenment and Goethean ideals significantly influenced the policies of Vsemirnaia Literatura, together with contemporary socialist and pacifist ideas. In this regard, special attention is given to the terminological shift from the Russian adjective vsemirnyi-intentionally chosen by Gorky for its connotations of universality-to mirovoi, which later became the standard term for world literature in Soviet academic discourse.
Erich Auerbach's essay on world literature, written in the early postwar period, has become central to our understanding of the field. This essay contextualizes Auerbach on world literature by approaching it through his larger project, which it thinks about in relation to scholars rarely considered in this context. These scholars are the French literary historians and critics Hippolyte Taine and Remy de Gourmont, and the German historical sociologist Alexander R & uuml;stow. To place Auerbach at an intersection of these very different figures turns out to be illuminating. It both enlarges our sense of him and helps us better understand why he turned to world literature in the early 1950s. In particular, the essay argues that world literature is, for Auerbach, as much a political as a literary category, with roots in both post-Nietzschean end-of-history thought and the Cold War stand-off between capitalism and communism.
This essay investigates how Zheng Zhenduo ((sic)(sic)(sic)1898-1958) developed a theory of world literature in response to threats to China both politically from without and culturally from within. Centered on an analysis of his 1922 article "A View on the Unification of Literature" ( (Wenxue de tongyiguan (sic)(sic)(sic)(sic)- ), the essay argues that although Zheng believed like many of his contemporaries in the transformative effects of reading world literature in translation, that does not constitute the entirety of his theorization of world literature. Instead, he accepted the first-move advantage of other national literatures in defining both world literary standards and literature itself, and used those definitions to redefine Chinese literature as a constituent of world literature. After a brief overview of Zheng and his moment, this essay attempts to extract his theory of world literature from the 1922 article. It then seeks to illustrate that theory in practice by examining his scholarship and translations, and concludes with a recent translation controversy that demonstrates the effects of Zheng's own first-move advantage in Chinese conceptions of world literature.
