The endoscopic division of the pharyngeal pouch wall with a mechanical stapling device has become increasingly popular. When compared to open excision, the reduced operative time, early resumption of oral intake, and short in-patient stay with no early recurrence of symptoms, are the proposed advantages. Small pouches or thick walled pouches are not suitable for stapling. From December 1996 to December 1999, 32 patients were admitted to the Aberdeen Royal Infirmary for endoscopic stapling of a pharyngeal pouch. Five patients were unsuitable for stapling. In addition, three patients were treated for pouch recurrence after an external approach. Two patients required repeat stapling at a later date. Our results are encouraging in terms of short operation time and hospital admission, improvement of symptoms and minimal complication rate. Fifteen patients were assessed 24 months after the procedure with satisfaction surveys and contrast swallow X-rays. Subjective improvement was sustained throughout this period, despite radiological evidence of persistence of the pharyngeal pouch.

Background This paper reports a case series of three elderly patients who were regularly attending ENT clinic every four to six weeks for ear canal care to address chronic otitis externa. All three patients had been taking bisphosphonate alendronic acid for years, and it is suspected that this drug was partly to blame for the progression of their chronic ear conditions. Results Some improvements were noted when the bisphosphonate was discontinued. The regular microsuctioning, and application of topical antibiotics with steroids, provided temporary relief of symptoms. The present pandemic shut down the routine clinic and the patients were not seen for four to five months. On latest review, it was a surprise to see that their ears seemed to have significantly improved, with healthy re-epithelialisation. Conclusion It is thus believed that excessive and repeated microsuctioning in bisphosphonate-induced osteonecrosis of that external ear canal can delay re-epithelialisation, and gradually prolonging the intervals between microsuctioning could help in overall resolution of the disease.

The high flame-retardant loading required for ethylene-vinyl acetate copolymer blends with polyethylene (EVA-PE) employed for insulation and sheathing of electric cables represents a significant limitation in processability and final mechanical properties. In this work, melamine triazine (TRZ) and modified bentonite clay have been investigated in combination with aluminum trihydroxide (ATH) for the production of EVA-PE composites with excellent fire safety and improved mechanical properties. Optimized formulations with only 120 parts per hundred resin (phr) of ATH can achieve self-extinguishing behavior according to the UL94 classification (V0 rating), as well as reduced combustion kinetics and smoke production. Mechanical property evaluation shows reduced stiffness and improved elongation at break with respect to commonly employed EVA-PE/ATH composites. The reduction in filler content also provides improved processability and cost reductions. The results presented here allow for a viable and halogen-free strategy for the preparation of high performing EVA-PE composites.

El 85% a 90% de los cálculos de la vía biliar son manejados de forma exitosa con la técnica endoscópica es- tándar, que incluye esfinterotomía endoscópica combinada con canastilla y/o catéter con balón. Sin embargo, cuando los cálculos son múltiples, de gran tamaño, de localización o forma inusual, o existen alteraciones anatómicas de la vía biliar se hacen refractarios al manejo estándar, lo que obliga la realización de otras modalidades terapéuticas. Los cálculos de gran tamaño o impactados generalmente son manejados con técnicas de fragmentación como la litotripsia mecánica y en casos fallidos con litotripsia electrohidráulica (LEH) o litotripsia láser (LL) guiado por colangioscopia convencional o más recientemente por un sistema de colangioscopia directa llamado Spyglass®. También se puede usar el sistema de dilatación endoscópica papilar con balón grande, que ha demostrado ser útil en el manejo de cálculos grandes y múltiples. En casos con anatomía alterada con dificultad para acceder a la papila, el abordaje preferido para la técnica de frag- mentación es el percutáneo transhepático. En pacientes ancianos y con pobre estado general la colocación de una prótesis biliar es la técnica de elección definitiva mientras mejoran las condiciones del paciente para un tratamiento endoscópico posterior.

Background and Aims: Before the covid-19 pandemic, medicine was practice and taught almost entirely face-toface. The new normal, presented us with an opportunity to change the paradigm. Previously, live video transmission was only possible with the use of satellites, that were too expensive to be use regular bases. Now it is possible to broadcast live cases, from anywhere around de world, at a relative low cost. Methodology: This is a descriptive study to show the experience in transmissions of endoscopy live procedures from endoscopy rooms of different centers of Latin America ascribed to the Latin American Training Center (LAGE-TC) adapting virtual transmission technologies for a diagnostic and therapeutic endoscopy, to broadcast cases in real-time through the internet. Results: From April 2020 to July 31 th , 2020 we have made transmissions every week, for each center, being Tuesdays designated for transmissions from Manizales in Colombia from the Unión de Cirujanos SAS (Dr Lázaro Arango M), Wednesdays from San Borja Arriaran, in Santiago de Chile (fellows training center of Latin America and from where the LAGE-TC is born) (Drs.