Benign pulmonary nodules excised for suspicion of malignancy. Experience in 140 patients Background: The management of incidental pulmonary nodules discovered during imaging studies may range from clinical observation, percutaneous needle aspiration to open surgery. The predictive value for malignancy of imaging studies is low. Aim: To report our experience with nodular pulmonary lesions suggestive of lung cancer and subsequently proven benign on histological examination. Material and Methods: A retrospective analysis of the medical records of 140 patients aged 59 ± 15 years (107 males) in whom a focal pulmonary lesion was excised at our institution from October 1984 to august 2007. Computed tomography and pathology reports were reviewed for all patients. Fluorine-18-flurodeoxyglucose positron emission tomography studies were performed on 43 patients. Lesions were excised by thoracotomy and video-assisted thoracoscopy, and sternotomy. All lesions were diagnosed as benign on pathology. Results: One patient died in the postoperative period. Pathologic diagnoses of the surgical pieces were granulomatous inflammation in 65%, hamartomas in 12%, pneumonia or pneumonitis in 10%, fibrosis in 4% and other in 9%. Fluorine-18fluorodeoxyglucose positron emission tomography imaging suggested malignancy in 22 of 43 patients. Conclusions: Despite thorough clinical assessment, advanced imaging technology, and needle biopsy, many patients continue to undergo surgery for benign diseases. Aggressive attempts to diagnose and treat early stage lung cancer must be tempered with understanding.

Objective: To compare the outcomes of thoracotomy and video-assisted thoracoscopic surgery (VATS) in the treatment of recurrence of primary spontaneous pneumothorax. Methods: Medical records of patients presenting recurrence of primary spontaneous pneumothorax were retrospectively reviewed. Patients were divided into two groups: those who underwent conservative thoracotomy (n = 53, thoracotomy group); and those who underwent VATS (n = 47, VATS group). Results: Although there were no deaths in either group and the length of hospital stays was similar between the two, there was greater morbidity in the thoracotomy group. Patients in the thoracotomy group required more pain medication for longer periods than did those in the VATS group (p < 0.05). In the thoracotomy group, the rate of recurrence was 3%. Pain was classified as insignificant at one month after the operation by 68% of patients in the VATS group and by only 21% of those in the thoracotomy group (p < 0.05). At three years after the surgical procedure, 97% of the VATS group patients considered themselves completely recovered from the operation, compared with only 79% in the thoracotomy group (p < 0.05). Chronic or intermittent pain, requiring the use of analgesics more than once a month, was experienced by 90% of the thoracotomy group patients and 3% of the VATS group patients. In addition, 13% of the thoracotomy group patients required clinical pain management. Conclusions: We recommend VATS as the first-line surgical treatment for patients with recurrent primary spontaneous pneumothorax.Keywords: Thoracoscopy; Thoracic surgery, video-assisted; Recurrence; Pneumothorax. ResumenObjetivo: Comparar los resultados de la toracotomía con la video-assisted thoracoscopic surgery (VATS, cirugía torácica video-asistida) en el tratamiento de las recurrencias del neumotórax espontáneo primario. Métodos: Se revisaron los expedientes clínicos de los pacientes con neumotórax primario recurrente dividiéndose en dos grupos: pacientes sometidos a toracotomía (n = 53, grupo toracotomía) y pacientes sometidos a VATS (n = 47, grupo VATS). Resultados: La morbilidad fue mayor en el grupo A. Sin mortalidad en ninguno de los dos grupos. La duración de la hospitalización fue similar. Los pacientes del grupo toracotomía necesitaron más dosis de narcóticos durante períodos más largos de tiempo que los del grupo VATS (p < 0.05). Se presentó una recurrencia en el grupo toracotomía (3%). El 68% de los pacientes del grupo VATS y el 21% del grupo toracotomía clasificaron su dolor como insignificante transcurrido un mes de la cirugía (p < 0.05). A los tres años, el 97% de los sometidos a VATS se consideraron totalmente recuperados comparado con el 79% del grupo de toracotomía (p < 0.05). El 90% del grupo toracotomía y el 3% del grupo VATS se quejaban de dolor necesitando analgésicos por más de una vez al mes, 13% de los sometidos a toracotomía requirieron la asistencia de la clínica del dolor. Conclusiones: La VATS es la primera elección en el tratamiento de la recidiva del neum...

Objetivo: El objetivo de este estudio fue validar un instrumento de uso masivo para evaluar la ansiedad dental, mediante la dicotomización de una variable continua del Instrumento de versión corta del Inventario de Ansiedad Dental (SDAI) a una variable binaria del instrumento EQ-SDAI. Material y métodos: Se utilizó una población de edad > 18 años en el análisis. El SDAI se adaptó interculturalmente al español y se llamó EQ-SDAI; luego se calculó la sensibilidad y la especificidad. También se utilizó la curva ROC para evaluar la confiabilidad del nuevo cuestionario. Se calculó el coeficiente de correlación biserial puntual. Para el análisis de consistencia interna se utilizó el coeficiente Kuder Richardson (KR-20). Resultados: Se obtuvo una alta sensibilidad (Sen = 0,93) y una especificidad aceptable (Esp = 0,60). A través del punto de coeficiente de correlación biserial, se obtuvo una buena correlación (R> 0,70), en ocho de las nueve preguntas de la escala SDAI. Conclusiones: Los resultados indican que existe un buen coeficiente de correlación. La consistencia interna (KR-20) fue 0,866.

This study aims to model and evaluate the energy performance of a supermarket located in Guayaquil, Ecuador. For this purpose, we modeled the baseline of the supermarket using EnergyPlus software. All input parameters used in the simulations were provided by the supermarket staff. Air-conditioners and refrigerated cases were modeled using the default templates in EnergyPlus but replacing the specifications of the site systems. The baseline model predicted, within ±10%, the energy consumption of the case study when compared to the real electricity bills of the building. Then, we incorporated a desiccant wheel for each of the air-conditioner units that supply the frozen food area. Results showed relevant reductions of about 52% in cooling energy by decreasing the humidity level from 70% to 40% with the use of desiccant systems. However, the introduction of these systems increased the total building energy consumption by about 3% due to the regeneration process.

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