Background Oxidative stress and the inflammatory process are involved in ischemia–reperfusion (I/R) injury. Juglans mollis has been reported as having antioxidant activity, which could attenuate the damage caused by I/R. We evaluated whether a methanolic extract of Juglans mollis (JM) exhibits nephroprotective activity in a Wistar rat model of I/R injury. Methods Four groups of six rats were used: Sham, I/R, JM, and JM + I/R. Two groups were dosed with JM (300 mg/kg) for 7 days before I/R. I/R injury was induced by clamping the renal hilums for 45 min and then reperfusing the kidneys for 15 h. Blood samples were taken to evaluate the levels of alanine aminotransferase (ALT), blood urea nitrogen, creatinine, superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α). Results The levels of creatinine, ALT, MDA, IL-1β, IL-6, and TNF-α were lower in JM + I/R than in I/R rats, whereas SOD level only was higher in JM + I/R than in Sham rats. No biochemical or histological damage was observed in JM rats compared with Sham rats; however, less histological damage was observed in JM + I/R rats compared with I/R rats. Conclusions To our knowledge, this is the first report of nephroprotective activity of J. mollis against damage induced by I/R. This activity may be related to decreased levels of proinflammatory cytokines (IL-1β, IL-6, and TNF-α) and modulation of oxidative stress markers (SOD and MDA) observed in the present study.

Primary hyperparathyroidism is caused by increased secretion of parathyroid hormone and was first described in 1930. Eighty percent are caused by a benign parathyroid adenoma, about 16% may present as ectopic. A 39-year-old female with multiple urinary tract infections, urolithiasis, hypercalcemia and increased parathyroid hormone. Gammagram showed ectopic parathyroid adenoma in superior mediastinum, by transverse cervicotomy, median sternotomy and gamma probe, the lesion was resected without eventualities.

Traumatic diaphragmatic hernias were first described by Ambroise Paré in 1579, who reported the case of an artillery captain, that presented an intestinal perforation that had caused a diaphragmatic hernia 1. The timely diagnosis of a traumatic diaphragmatic hernia can be a challenge , which requires extensive knowledge of the kinematics of trauma, as well as clinical and radiological evidence 2. We present the case of a 60-year-old male who presented blunt abdominal trauma due to a traffic accident, causing an undetected diaphragmatic hernia in his initial evaluation; months after de incident goes to the emergency room (ER) with hemodynamic instability and septic shock. A diagnosis of complicated diaphragmatic hernia and fecopneumothorax is made, for which he undergoes surgery.

Introduction: Penetrating cardiac injuries are very rare, an approximate incidence of 0.16% has been described. They have a high mortality rate, most of them die at the site of the accident. PCI should be suspected in any penetrating wound over Ziedler's area. Case report: An 18-year-old male with no known history was taken by paramedics to the emergency department for having suffered a stab wound to the left hemithorax 45 minutes before. On arrival he was in shock (hypotensive, tachycardic, tachypnea, hypoxemic) and beck's triad. Due to the suspicion of cardiac injury, he was admitted to the operating room, where a left anterolateral thoracotomy was performed, identifying a 1 cm wound in the right ventricle, corresponding to AAST grade IV. Vascular control and suture with monofilament was performed, and an endopleural probe was placed at the end. With an adequate postoperative period, the patient was discharged on the fourth day without eventualities. Conclusion: It is important to keep in mind this type of lesion due to its high mortality rate, and immediate action should be taken upon suspicion. This case is an example, where if approached in a timely manner, the prognosis is good despite the high mortality.