ABSTRACT
No disponible
Subject(s)
Aged, 80 and over , Aged , Female , Humans , Male , Middle Aged , Femoral Fractures/complications , Femoral Fractures/therapy , Femoral Fractures , Upper Extremity/injuries , Upper Extremity , Fracture Fixation, Internal/methods , Retrospective Studies , Comorbidity/trendsABSTRACT
The treatment of soft-tissue defects of the lower third of the leg and foot is often an awkward problem to tackle because of the frequent involvement of muscle, tendon, and bone, which is caused by the thinness and poor circulation of the skin covering them and by the small quantity of local tissue available for reconstruction. The authors present their experience with the use of sural flaps for the treatment of small- and medium-size defects of the distal region of the lower limb. The flap used was a distally based fasciocutaneous flap raised in the posterior region of the lower two thirds of the leg. Vascularization was ensured by the superficial sural artery, which accompanies the sural nerve together with the short saphenous vein. The authors treated 18 patients (12 men and 6 women) from May 1997 to August 1999 at the Division of Plastic Surgery, University of Turin, Italy. Superficial necrosis without involvement of the deep fascia (which was grafted 1 month later) occurred in 1 patient of the 18 treated. In another 2 patients, defects were found in the flap margins, but no additional surgical revision was necessary, and recovery occurred by secondary intention. In every patient the sural flaps provided good coverage of the defects, both from a functional and an aesthetic point of view. The major advantages of this flap are its easy and quick dissection. Because the major arterial axis is not sacrificed, this flap can be used in a traumatic leg with damaged major arteries.
Subject(s)
Foot Injuries/surgery , Leg Injuries/surgery , Surgical Flaps , Adult , Aged , Female , Humans , Male , Middle Aged , Postoperative Care , Postoperative Complications , Plastic Surgery Procedures/methods , Skin TransplantationABSTRACT
Pain is an unique symptom which may constitute minor ailment but also the main complaint of a severe disease. It is one of the main factors that limits quality of life in patients with chronic diseases, specially in those institutionalized in nursing homes (NH). The aim of our study was to determine the characteristics of pain complaints and analgesic treatment, as well as the satisfaction degree of patients with their treatment. To this goal, an observational cross-sectional drug utilization study was undertaken in a sample of 74 patients of a nursing home. All of them were consuming analgesic drugs at the moment of the study and their mean (+/-standard deviation) was 75.5 +/- 13.9 years. The study analyzed several pain characteristics (intensity, etiology, localization and duration) as well as analgesic treatment features (drug, route of administration, prescribed dose and therapeutic compliance). The satisfaction with the therapeutic regimen was also evaluated. Nearly a third (32.4%) of patients described that they suffered severe pain, mostly from peripheral joints (70.1%) and mainly located in legs. The duration of pain was longer than one month in 56.8%. Most of patients were following a chronic treatment with scheduled analgesics, being paracetamol (28.7%) the most consumed drug. However, daily doses were less than considered effective to treat pain. The preferred route of administration was oral. The satisfaction degree varied nong the units of NH, but it was scored as acceptable in most patients. It may be concluded that pain is a highly prevalent issue in NH and, in spite of the provided analgesic treatment, was evaluated as severe by a significant group of patients. Although drugs were prescribed at "by the clock" patterns, the daily dose was below the recommended one. In spite of high prevalence of severe pain, patients were satisfied with the analgesic treatment they were receiving.
Subject(s)
Analgesics , Pain/drug therapy , Adult , Aged , Aged, 80 and over , Community Health Centers , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pain/epidemiology , Pain/etiology , Patient Satisfaction , PrevalenceABSTRACT
Seven cases of neonatal systemic candidiasis are summarized. This means an incidence of 8.3% respect total amount of newborns admitted and 3.7% of babies admitted in the intensive care unit. Clinical presentation was not specific. Five blood cultures were positive and in two cases meningitis was recognized. Two cases died. Six cases were treated with amphotericin B and 5-fluorocytosine and in one case renal toxicity appear.
