ABSTRACT
BACKGROUND: The resurfacing of large abdominal and perineal defects is a major concern, and it poses a great challenge to the reconstructive surgeon. The main target in the reconstruction of the abdomen is to ensure a stable soft-tissue cover, and a strong and reliable fascia to prevent hernia recurrence and fecal contamination. The pedicled anterolateral thigh flap (ALT) either in the myocutaneous or fasciocutaneous form is a work-horse for the closure of abdominal and perineal defects. AIM: There is a paucity of studies on the use of the anterolateral thigh flap among black Africans especially in Nigeria; hence, we present our experience with the use of this flap for extensive abdominal and perineal defects. PATIENTS AND METHODS: The folders of all patients who had pedicled anterolateral thigh flap between January 2019 and July 2022 in our institution were reviewed. The patients' demographic data and the available details about the flap reconstruction were extracted from the folders. RESULTS: There were three males and two females, and the age range was between 22 and 48 years. Four cases resulted from tumor extirpation, while one was following extensive necrotizing fasciitis of the lower anterior abdominal wall. No gross anatomical variations were encountered intraoperatively. Four flaps had full survival, while one had marginal flap tip loss. CONCLUSION: The pedicled anterolateral thigh flap is an excellent reconstructive tool for the coverage of extensive abdominal and perineal defects.
Subject(s)
Fasciitis, Necrotizing , Plastic Surgery Procedures , Male , Female , Humans , Animals , Horses , Young Adult , Adult , Middle Aged , Thigh/surgery , Surgical Flaps , Abdomen/surgeryABSTRACT
The objective of our study was to evaluate the medico-surgical management of Buruli ulcer (BU) in the BU Screening and Treatment Center (CDTUB) of Allada in Benin. This retrospective and descriptive study retrospectively reviewed records of patients seen from 2010 to 2014 at the CDTUB of Allada. It included patients diagnosed with BU according to WHO epidemiological and clinical criteria as well as laboratory results and who were treated according to WHO medical and surgical recommendations. In all, 274 patients were diagnosed and treated, 57.7% of them children younger than 15 years. Ulcerative lesions (189, 69%) and WHO category II lesions (144, 52.5%) predominated. All patients received dual antibiotic therapy and 43.4% (119) underwent surgery as well. Category III lesions and multifocal lesions required more surgery, whereas most category I lesions healed under medical treatment. The overall rate of healing was 92%: 53.3% for patients who received only antibiotic therapy and 38.7% for those who also had surgery. The median healing time was 13 weeks and ranged from 4 to 56 weeks. In the CDTUB of Allada, between 2010 and 2014, most patients were treated with antibiotic therapy alone, but a significant number still received surgery.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Buruli Ulcer/drug therapy , Buruli Ulcer/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Benin , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Time Factors , Young AdultABSTRACT
Background and Objectives: Tardive dyskinesia (TD) is a frequent and incapacitating side effect of first-generation antipsychotics. Although second-generation antipsychotics (SGAs) seem to be associated with a decreased risk of TD, it remains a severe, unresolved iatrogenic condition. Moreover, there is no commonly accepted effective treatment for TD. We conducted a systematic review of the literature to assess evidence regarding the effectiveness of different therapeutic interventions for TD. Methods: We performed a systematic review focussing exclusively on randomised controlled trials (RCTs). We searched the MEDLINE database (1997 to 2011) using the keyword "tardive dyskinesia" within the "title" search field. Twenty-six RCTs were included. Based on the evidence from RCTs, we built a decision tree that healthcare professionals can use to choose an effective therapeutic intervention for TD. Results: Four therapeutic interventions were found to be effective in TD (vitamin B6, ginkgo biloba, branched-chain amino acids, and piracetam). Conclusions: Patients with TD could benefit from the therapeutic interventions supported by the data accumulated from RCTs (AU)
Subject(s)
Humans , Dyskinesia, Drug-Induced/epidemiology , Antipsychotic Agents/adverse effects , Mental Disorders/complications , Risk FactorsABSTRACT
In a prospective randomized study, the clinical effectiveness of ciprofloxacin at a single dose of 250 mg p.o. was compared with that of two oral doses of 250 mg bid administered for two days in women with urinary tract infection following gynecological procedures. A healing rate of 95% was achieved with both single-dose (n = 62) and two-day treatment (n = 65). In a further prospective randomized multicenter study, single-dose therapy with 250 mg of oral ciprofloxacin in women with uncomplicated urinary tract infection was compared with three days of ambulatory treatment with 2 x 250 mg/day. In the case of these patients, the diagnosis was made and treatment applied in the doctor's office by one of seven specialist gynecologists practicing in the city area of Essen. The healing rate of 78% (n = 46) achieved with single-dose treatment was significantly inferior to the 91% seen with the three-day regimen (n = 53, p < 0.05).
Subject(s)
Ciprofloxacin/administration & dosage , Urinary Tract Infections/drug therapy , Adult , Drug Administration Schedule , Female , Humans , Hysterectomy , Middle Aged , Postoperative Complications/drug therapy , Prospective Studies , Urinary CatheterizationABSTRACT
In a prospective randomized multicenter study Roxithromycin 150 mg or Doxycycline 100 mg was given b.i.d. p.o. for ten days to women with clinically diagnosed cervicitis. All women were seen as outpatients by one of eight licensed gynecologists in their private office in the Essen city area. With a cure and improvement rate of 100% in those women who completed therapy, Roxithromycin (n = 106) was as effective as Doxycycline (n = 104; 98%). At 90% Roxithromycin was as well tolerated as Doxycycline at 93%. Both drugs were clinically and microbiologically effective in eradicating Chlamydia trachomatis.
