ABSTRACT
Spinal anaesthesia (SA) is an important form of anaesthesia in tropical countries. It is considered to have few long-term complications or sequelae, although this hypothesis has not been proven in a rural tropical setting. In a case control study we found SA to he a significant risk factor for lower back pain, reflex abnormalities and muscular atrophy and mild impairment of muscle power in patients examined between 3 months and 4 years after SA. These long-term sequelae need to be confirmed in a larger prospective study employing all possible neurophysiological and neuroimaging techniques.
Subject(s)
Anesthesia, Spinal/adverse effects , Low Back Pain/etiology , Muscular Atrophy/etiology , Adult , Aged , Case-Control Studies , Female , Humans , Incidence , Male , Middle Aged , Postoperative Complications/epidemiology , Reflex, Abnormal , Risk Factors , Rural Population , Surveys and Questionnaires , Tanzania/epidemiology , Tropical ClimateABSTRACT
The DTC promotes access to surgical care facilities of acceptable medical quality for all people in third world countries. To achieve this goal following concepts and activities are persued: Establishment of a 2-year training programme district surgery Postgraduate surgical training in Germany Workshops and annual scientific meetings Development of adapted surgical technologies Cooperation with national and international organisations Promotion of north-south partnerships between colleagues and hospitals.
Subject(s)
Developing Countries , Education, Medical, Graduate/trends , General Surgery/education , Tropical Medicine/education , Curriculum/trends , Forecasting , Germany , Humans , Specialization/trendsABSTRACT
Hydatid disease is caused by the parasitic tapeworm Echinococcus. The larval stage of this parasite can thrive in many parts of the body, most frequently in the liver. Primary bone location is very rare, accounting for less than 2% of all hydatid lesions. We report on a case of left-sided extended pelvic infestation. The destruction of the hip joint, os pubis, large parts of the ileum and the femoral head made pelvic resection and prosthetic replacement necessary. Recurrence of a hydatid cyst 5 years later in the left groin originating from the proximal femur was treated with second femoral resection and new total hip replacement. Because of instability, the primarily inserted polyacetal pelvic replacement had to be exchanged for a custom-made device fabricated with the aid of computer-aided design (CAD) techniques. This surgical procedure was combined with chemotherapy (mebendazole). The necessity of radical resection in osseus hydatid disease is discussed.
Subject(s)
Bone Diseases/surgery , Echinococcosis/surgery , Femur/surgery , Hip Joint/surgery , Hip Prosthesis , Pelvic Bones/surgery , Postoperative Complications/surgery , Antinematodal Agents/administration & dosage , Combined Modality Therapy , Humans , Male , Mebendazole/administration & dosage , Middle Aged , Prosthesis Design , Prosthesis Fitting , ReoperationABSTRACT
We report a case of left-sided extended pelvic infestation of hydatid disease. The destruction of the hip joint, os pubis, larger parts of os ileum and the femoral head made pelvic resection and prosthetic replacement necessary. Recurrence of a hydatid cyst 5 years later in the left groin originating in the femur was treated with a second femoral resection and total hip replacement. Because of instability, the pelvic replacement also had to be changed to a custom-made CAD replacement. This surgical procedure was combined with chemotherapy by mebendazole. The need for radical resection in osseal hydatid disease is discussed.
