ABSTRACT
A consecutive series of 65 adult patients with chronic subdural haematoma was reviewed to ascertain the efficacy of twist-drill craniostomy and closed-system catheter drainage. In all patients but two the percutaneous evacuation of the haematoma alone was enough to bring about their recovery. Infections or neurological complications were never observed. Pneumocephalus was likewise absent in all patients. Therefore this technique should be recommended as the "first intention" management of the disease, particularly in elderly patients.
Subject(s)
Craniotomy/instrumentation , Drainage/instrumentation , Hematoma, Subdural/surgery , Trephining/instrumentation , Aged , Chronic Disease , Female , Hematoma, Subdural/diagnosis , Humans , Male , Middle Aged , Neurologic Examination , Postoperative Complications/diagnosis , Subdural Effusion/diagnosis , Subdural Effusion/surgery , Tomography, X-Ray ComputedABSTRACT
The authors illustrate the cases of spontaneous pneumothorax observed in their institute along with the diagnostic and therapeutic aspects. In accord with the experience of others as reported in the literature, they stress the importance of a precise, immediate diagnosis for the purposes of adopting the treatment of choice: in the presence of closed, partial forms a conservative approach is to be preferred, whereas in open and/or hypertensive cases an aspirative thoracic drainage must be provided without delay. Aggressive surgical treatment, with resection of the bullous lesions responsible for bronchopleural fistulas, will resolve the condition and should be implemented after a reasonable waiting period with aspirative drainage, or even, electively, in the first instance, in the presence of multiple relapses. In any event, the authors stress the need to avoid uncertainty and delay in view of the youthful age of most of the subjects affected and the potential danger of the complications of this apparently banal disease.
Subject(s)
Pneumothorax/surgery , Age Factors , Drainage/methods , Female , Humans , Male , Pneumothorax/etiologySubject(s)
Fetal Alcohol Spectrum Disorders/complications , Child , Child, Preschool , Congenital Abnormalities/complications , Female , Fetal Alcohol Spectrum Disorders/immunology , Fetal Alcohol Spectrum Disorders/metabolism , Follow-Up Studies , Humans , Immunologic Deficiency Syndromes/complications , Infant , Infant, Newborn , Male , Pregnancy , Proteins/metabolism , Time FactorsABSTRACT
The authors considered the possibility, for purposes of total parenteral nutrition, to use lyophilized amino-acids as an alternative to the traditional amino-acid solutions, and resolved to check their nutritional and metabolic effectiveness. For this purpose, they appraised some parameters concerning the proteic metabolism in two homogeneous groups of surgical patients, subjected to T.P.N., one with crystallized amino-acids in solution and the other with lyophilized amino-acids. The supply in glucides and in lipides was identic in both groups. It appears evident from the results that the lyophilized amino-acids not only show the advantage of being administrable in nutritional mixtures with reduced volume, but also represent a valid plastic source, and can surely replace the traditional commercial amino-acid solutions.
Subject(s)
Amino Acids/therapeutic use , Nutrition Disorders/therapy , Parenteral Nutrition, Total , Postoperative Complications/therapy , Adult , Aged , Amino Acids/metabolism , Crystallization , Drug Evaluation , Female , Freeze Drying , Humans , Male , Middle Aged , SolutionsSubject(s)
Adenoma/pathology , Adrenal Gland Neoplasms/pathology , Carcinoma/pathology , Cushing Syndrome/complications , Pheochromocytoma/pathology , Adenoma/diagnosis , Adrenal Gland Neoplasms/diagnosis , Adrenal Glands/pathology , Adult , Carcinoma/diagnosis , Cushing Syndrome/pathology , Diagnosis, Differential , Female , Humans , Hyperplasia/diagnosis , Hyperplasia/pathology , Male , Middle Aged , Pheochromocytoma/diagnosis , Retrospective StudiesABSTRACT
Mucociliary transport and ultrastructure of nasal cilia in a 13 year old boy with Kartagener's triad, were investigated. Mucociliary transport was significantly delayed (greater than 30 minutes). Electron microscopy showed cilia lacking radial spokes, eccentric central tubules, and a dislocation of one the outer doublets. Dynein arms were present. We consider the radial spoke defect as a distinct congenital anomaly which contributes to the pathogenesis of the "immotile cilia syndrome".
