Subject(s)
Debridement , Leg Injuries/surgery , Leg Ulcer/surgery , Occlusive Dressings , Skin Transplantation , Varicose Ulcer/surgery , Aged , Aged, 80 and over , Combined Modality Therapy , Female , Humans , Leg Injuries/etiology , Middle Aged , Necrosis , Postoperative Care , Vacuum , Wound Healing/physiologyABSTRACT
BACKGROUND: The article presents a comprehensive long-term analysis of the modem hypospadias repair based on preservation and use of the urethral plate. METHODS AND RESULTS: In years 1987 to 2004, 476 patients (aged 8 months to 45 years) were operated using a praeputial (mostly) flap. 81% were indicated for reconstruction of a proximal form of hypospadias, mostly penile. In years 1986 to 1991, a tubularized flap was performed in 31 patients. Since 1992, an onlay island flap in 394 patients, inlay-onlay flap in 43 patients and onlay-tube-onlay flap in 8 patients have been used. In years 2000 to 2004, 112 patients (aged 13 months do 17 years) were operated using tubularized incised plate (TIP) repair, mostly because of distal form of hypospadias. To cover the neourethra, a dartos flap was used in 72 and spongioplasty in 37 patients. We achieved the primary healing in 89% and 91%, resp., of patients after onlay and onlay-inlay island flap repairs with an average follow-up of 6,7 and 5,7 years, respectively. The most frequent complications were fistula or dehiscence of the glans. After the TIP repair combined with a dartos flap, 89% of the first operated patients healed without complications with an average follow-up of 2.3 years. A higher complication rate (40%) was found after a spongioplasty with foreskin preservation. Secondary repairs were also associated with more complications. CONCLUSIONS: Using onlay and inlay-onlay one-stage repairs, or using TIP one-stage repair combined with a dartos flap, a successful primary hypospadias repair was achieved in 90% of patients. The definite repair should be completed during early childhood.
Subject(s)
Hypospadias/surgery , Surgical Flaps , Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Male , Middle Aged , Plastic Surgery Procedures/methods , Surgical Flaps/blood supply , Urethra/surgeryABSTRACT
The author investigated in an open clinical study the neuroleptic and antidepressive action of Eglonyl in 17 patients who met the criteria (diagnosis of psychoaffective psychosis, symptoms in the sphere of schizophrenia, depressive pathic moods). Eglonyl was administered by injection during the first four days and in tablet form on the subsequent 24 days in individual daily doses of 300-800 mg. At the onset and after 7-day intervals the patients were followed up, by clinical and psychiatric tests, along with the evaluation of the therapeutic effect by means of the clinical global impression scale, CGI, by the BPRS scale, and side-effects by means of the SARS scale. For statistical analysis Wilcoxon's test was used. The expected neuroleptic and antidepressive action of Eglonyl was confirmed in the clinical trials in patients with schizoaffective psychosis--depressive type: marked improvement was recorded in 58.9% of patients, medium improvement in 29.4% and slight improvement in 11.7% of patients. The decline of the global score in BPRS is highly significant (T1 - Tpop = 76.5, P less than 1%).
Subject(s)
Psychotic Disorders/drug therapy , Sulpiride/therapeutic use , Adult , Female , Humans , Middle AgedABSTRACT
The authors analyzed the case-sheets of 45 minors examined and treated in departments for adults at the Psychiatric Clinic, Medical Faculty Comenius University, Bratislava in 1974-1980. The patients comprised 21 girls and 24 boys. Sixty-two case-sheets were analyzed because of repeated hospital admissions. Forty-three hospitalizations concerned adolescents aged 16-17 years. During the last two years of the observation an increase of enforced hospital admissions associated with suicidal attempts and drug dependence was observed. Suicidal attempts occurred in 23.2% of the cases and were demonstrative, affective and seriously meant according to A. E. Licek's classification. All hospital admissions were necessary, frequently urgent and life saving. Hospitalization of adolescents in departments for adults is not an optimal variant of specialized care of youth.
