ABSTRACT
We hereby report the case of a 66-year-old obese patient (BMI 30) with type 2 diabetes, who presented a chronic vulvar lesion on the left labia majora following surgical drainage of an abscess. After multiple unsuccessful treatments by antibiotics and local wound care, we proposed a trial of hyperbaric oxygen therapy (HBOT). The patient fully recovered after 54 sessions at 2.5 ATA, 95 minutes each. HBOT has been studied for perineal lesion such as skin atrophy or necrosis caused by irradiation but not for vulvar nonhealing chronic lesions in the case of impaired vascularization caused by diabetes. This case is, to our knowledge, one of the first publications about the healing boost of HBOT in chronic vulvar wounds due to vascular impairment.
ABSTRACT
OBJECTIVES: To determine the incidence of popliteal vein compression in supine patients, who are under general anaesthesia and using heel elevators. DESIGN: A prospective cohort study. METHODS: The popliteal veins of 50 patients, lying supine under general anaesthesia, were insonated using duplex ultrasonography to determine the incidence of popliteal vein compression when the knees were flexed and extended. RESULT: There was a statistically significant reduction in popliteal vein diameter in extension compared with the diameter in flexion (median diameter: flexed 7.6mm, extended 2.1mm, p<0.001, Wilcoxon test). In extension, 43% of veins occluded, and a further 21% was compressed by >or=50%. There was a significant relationship to body mass index (BMI) but not to height, gender or age; all patients with BMI >or=30 displayed narrowing at least one vein by >or=50%. The relative risk of vein narrowing >or=50% or occlusion was 1.55 for BMI >or=25 versus <25, and 1.67 for BMI >or=30 versus <25. CONCLUSION: Knee hyperextension in supine patients during general anaesthesia leads to popliteal vein compression or occlusion. The likelihood of compression increases with higher BMIs.
Subject(s)
Anesthesia, General/adverse effects , Popliteal Vein/diagnostic imaging , Supine Position/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Constriction, Pathologic/etiology , Constriction, Pathologic/physiopathology , Female , Humans , Male , Middle Aged , Prospective Studies , Regression Analysis , Ultrasonography, Doppler, Duplex , Young AdultABSTRACT
Responding optimally with unknown sources of evidence (ROUSE) is a theory of short-term priming applied to associative, orthographic-phonemic, and repetition priming. In our studies, perceptual identification is measured with two-alternative forced-choice testing. ROUSE assumes features activated by primes are confused with those activated by the target. A near-optimal decision discounts evidence arising from such shared features. Too little discounting explains the finding that primed words were preferred after passive viewing of primes. Too much discounting explains the findings of reverse preference after active processing of primes. These preference changes highlight the need to use paradigms (like the present ones) capable of separating preferential and perceptual components of priming. Evidence of enhanced perception was found only with associative priming and was very small in magnitude compared with preference effects.
Subject(s)
Choice Behavior , Models, Psychological , Visual Perception , Analysis of Variance , Humans , Likelihood Functions , Reaction Time , Signal Detection, PsychologicalABSTRACT
In most recognition models a decision is based on a global measure often termed familiarity. However, a response criterion is free to vary across lists varying in length and strength, making familiarity changes immeasurable. We presented a single list with a mixture of exemplars from many categories, so that the criterion would be unlikely to vary with length or strength of the category of the test item. False alarms rose with category length but not category strength, suggesting that familiarity does not change much with changes in strength of other items but grows when additional items are studied. The results were well fit by an extension of the search of associative memory (SAM) model presented by R. M. Shiffrin, R. Ratcliff, and S. E. Clark (1990).
Subject(s)
Attention , Mental Recall , Verbal Learning , Adult , Association Learning , Female , Humans , Male , Phonetics , Psycholinguistics , SemanticsABSTRACT
A case of splenic pregnancy is reported. The patient was treated surgically with a satisfactory result. The problem of preservation of the spleen in the presence of a spontaneous rupture is highlighted.
