ABSTRACT
The authors describe their surgical technique for pilonidal sinus outpatient total excision with local anaesthesia and primary repair of surgical wound. The results for recurrences and off work short time are good. Fewer complications and recurrences are observed in comparison to patients treated with general anaesthesia. For decreasing recurrence rate, the Authors stress the importance of body weight control and correct local hygiene. Local anaesthesia is safe e cost-effectiveness for outpatient treatment of the pilonidal sinus.
Subject(s)
Ambulatory Surgical Procedures , Pilonidal Sinus/surgery , Adolescent , Adult , Anesthesia, Local , Cost-Benefit Analysis , Female , Follow-Up Studies , Humans , Male , Recurrence , Treatment OutcomeABSTRACT
The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.
Subject(s)
Ambulatory Surgical Procedures , Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Lidocaine/administration & dosage , Adult , Anesthesia, Local/adverse effects , Bicarbonates/administration & dosage , Epinephrine/administration & dosage , Female , Humans , Male , Middle Aged , Patient Satisfaction , Reproducibility of Results , Retrospective StudiesABSTRACT
The Authors present a rare association of gastric adenocarcinoma and somatostatin-producing duodenal carcinoid. The pre-operative abdominal CT scan revealed the gastric lesions and a duodenal polypoid lesion, giving an important indication to perform a subtotal gastrectomy and a duodenal resection. The definitive diagnosis was possible with histological examination.
Subject(s)
Adenocarcinoma , Duodenal Neoplasms , Neoplasms, Multiple Primary , Somatostatinoma , Stomach Neoplasms , Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Aged , Duodenal Neoplasms/diagnosis , Duodenal Neoplasms/surgery , Humans , Male , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/surgery , Somatostatinoma/diagnosis , Somatostatinoma/surgery , Stomach Neoplasms/diagnosis , Stomach Neoplasms/surgeryABSTRACT
By clinical observation and surgical treatment of a patient with cutaneous B-cell non-Hodgkin lymphoma, the Authors describe the nosological approach, the correct diagnosis and the surgical treatment in this disease.
Subject(s)
Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/surgery , Skin Neoplasms/diagnosis , Skin Neoplasms/surgery , Humans , Male , Treatment OutcomeABSTRACT
The Authors present a singular case of seroma which developed in residual fibrous capsule after explantation of breast prostheses without replacement. Mammographic and sonographic findings of the seroma make difficult the diagnosis: mammograms revealed a radiopaque, well-circumscribed mass anterior to the pectoralis major muscle in the region of the prior sub-glandular implant, that was initially misinterpreted as breast implant radiographic feature. It is particularly important review and carefully correlate mammographic and sonographic findings with patient's surgical history for a correct diagnosis.
Subject(s)
Breast Diseases/diagnosis , Breast Diseases/etiology , Breast Implants/adverse effects , Device Removal/adverse effects , Seroma/diagnosis , Seroma/etiology , Breast Diseases/diagnostic imaging , Female , Humans , Mammaplasty/methods , Mammography , Middle Aged , Reoperation , Seroma/diagnostic imaging , Silicone Gels/adverse effects , Treatment Outcome , Ultrasonography, MammaryABSTRACT
Authors review their outpatient lymph node biopsies in order to verify safety and diagnostic accuracy. They didn't observe any complication and in every case, the procedure provided the correct diagnosis. Lymph node biopsy is the procedure of choice to study the pharmacologic therapy non responsive lymph node pathology that is not surely defined by fine needle aspiration, as almost always in lymphomas.
Subject(s)
Ambulatory Care , Biopsy, Fine-Needle/methods , Lymph Nodes/pathology , Lymphoma/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Lymphoma/diagnosis , Lymphoma, Non-Hodgkin/pathology , Male , Middle Aged , Predictive Value of Tests , Prognosis , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Multiple and ripetitive mammary fibroadenomas represent a rare disease. The etiology is uncertain. The diagnostic radiology is able to allow a correct diagnosis. The authors report a case of a woman 22 years old undergone a surgical treatment many times to remove multiple and ripetitive mammary fibroadenomas. The proposed management provides for periodic radiological exams; the surgical treatment is proposed only for the lesions with a rapid growth.
Subject(s)
Breast Neoplasms/surgery , Fibroadenoma/surgery , Neoplasms, Multiple Primary/surgery , Adult , Female , HumansABSTRACT
Data from a large series of acutely injured patients revealed the Glasgow Coma Score was acquired in less than one half of those for whom it should have been documented. To improve these statistics, a five-part educational intervention based on an application of the PRECEDE-PROCEED model was developed. The study populations consisted of hospital-based nurse-managers and their emergency department nursing staff. Evaluation of the educational intervention's effectiveness suggested (1) simply conveying benefits of a particular patient care practice is insufficient to bring about immediate and permanent changes and (2) the most significant changes occurred in settings in which a formal policy and formal data collection procedures were established to accompany and reinforce the educational intervention. On-site advocacy and physician support are essential if changes in nursing practice are to occur in hospital emergency departments.
