An unusual case of a tension pneumothorax

A total intra-thoracic stomach describes the case of a complete herniation of the stomach into the thoracic cavity. Symptoms may vary from mild to an acute life-threatening situation in case of perforation or bleeding, requiring emergency surgery. Here we describe the case of a gastric perforation leading to a tension pneumothorax and concomitant pleural empyema due to a giant hiatal recurrence after previous surgery. Multidisciplinary management involving thoracic surgeons helped in achieving the best clinical outcome for the patient.

Short-Term Anomia Training and Electrical Brain Stimulation

Background and Purpose—

Language training success in chronic aphasia remains only moderate. Electric brain stimulation may be a viable way to enhance treatment efficacy.

Methods—

In a randomized, double-blind, sham-controlled crossover trial, we assessed if anodal transcranial direct current stimulation compared to cathodal transcranial direct current stimulation and sham stimulation over the right temporo-parietal cortex would improve the success of short-term high-frequency anomia training. Twelve chronic poststroke aphasia patients were studied. Naming outcome was assessed after training and 2 weeks later.

Results—

All training conditions led to a significant increase in naming ability, which was retained for at least 2 weeks after the end of the training. Application of anodal transcranial direct current stimulation significantly enhanced the overall training effect compared to sham stimulation. Baseline naming ability significantly predicted anodal transcranial direct current stimulation effects.

Conclusions—

Anodal transcranial direct current stimulation applied over the nonlanguage dominant hemisphere can enhance language training outcome in chronic aphasia.

Clinical Trial Registration—

URL: www.clinicaltrials.gov/ . Unique identifier: NCT00822068.