ABSTRACT
INTRODUCTION: Bariatric restrictive interventions, as sleeve gastrectomy or gastric banding can cause metabolic complications, especially when vomiting is present, such as thiamine deficiency that can lead to Wernicke's encephalopathy. CASE REPORT: A 31-year-old man with a 47kg/m(2) body mass index presented with Wernicke's encephalopathy, with ophtalmoplegia, nystagmus, ataxia and confusion, followed by a Korsakoff syndrome, occurring two months after a sleeve gastrectomy. MRI showed hyperintense signals on T2 and FLAIR image in both thalamus, periaqueducal area and mamillary bodies. CONCLUSION: A close clinical and biological monitoring is required in the first year after surgery, especially if vomiting occurs. Early diagnostic and treatment are needed to avoid severe sequelae.
Subject(s)
Gastrectomy/adverse effects , Obesity, Morbid/surgery , Wernicke Encephalopathy/etiology , Adult , Gastrectomy/methods , Humans , Male , Thiamine Deficiency/complications , Thiamine Deficiency/etiologyABSTRACT
Percutaneous transluminal angioplasty (PTA) of the lower abdominal aorta was performed in 14 patients aged 29-66 years (mean, 50). The disease was largely isolated to the distal aorta in this group. There were 13 women and 1 man; all were heavy smokers. Initial success, defined as improved or subsided clinical symptoms, improved ankle/arm indices, and improved angiogram, was achieved in all but one patient who thrombosed at the puncture site. At a mean follow-up period of 16 months (range, 1-58), a persistent beneficial effect was maintained in all patients. These results suggest that PTA is a safe alternative to surgery in patients with signs and symptoms of aortoiliac disease secondary to a significant but short stenotic segment of the lower abdominal aorta.
Subject(s)
Angioplasty, Balloon , Aortic Valve Stenosis/therapy , Adult , Aged , Aorta, Abdominal , Female , Humans , Male , Middle AgedABSTRACT
A prospective study of 100 consecutive outpatient angiograms with catheters on rapid changers was undertaken to ascertain the safety of this protocol. Ninety-four patients could be discharged after a 4 hr surveillance and were still well 1 week later; six patients had to be observed up to 24 hr for minor problems and one was hospitalized the night after his angiogram, for a renal complication. This approach to angiography, emphasizing the outpatient status, seems to be safe and should deserve widespread acceptance.
Subject(s)
Accident Prevention , Ambulatory Care/standards , Angiography/standards , Safety , Adult , Canada , Catheterization , Female , Hospitals , Humans , Male , Prospective Studies , RiskABSTRACT
Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students.
Subject(s)
Education, Medical , Radiography/education , Curriculum , Internship and Residency , Programmed Instructions as Topic , QuebecABSTRACT
Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students (Au)
Subject(s)
Education, Medical , Radiography/educationABSTRACT
Debido a los problemas metodologicos y de organizacion y evaluacion que confrontaban los departamentos de radiologias de los hospitales universitarios afiliados a la Universidad de Montreal, los estudiantes de medicina y la propia Universidad, en relacion con una pasantia optativa en radiologia que se ofrecia en el quinto ano de medicina, se constituyo un comite para reorganizar el plan de estudios. En este conciso articulo los autores describen esta y otras medidas tomadas por la Universidad para vencer los obstaculos mencionados. El interes fundamental del comite era reestructurar la pasantia, que se hizo obligatoria, a fin de que el futuro medico estuviera bien preparado para utilizar los recursos de la radiologia diagnostica y la medicina nuclear. Con ese fin, el comite formulo los objetivos, el contenido y el sistema de evaluacion que habrian de emplearse en esos cursos, asi como los medios pedagogicos. Los 25 modulos de autoaprendizaje que se concibieron, unidos a la observacion e interpretacion practica de sesiones radiologicas, fueron de gran utilidad para resolver los problemas iniciales y resultaron especialmente interesantes para los estudiantes
Subject(s)
Education, Medical , Internship and Residency , RadiologyABSTRACT
At the Université de Montréal, a four-week rotation in radiology is part of the core curriculum for students in their fifth and final year of medicine. The objective of this undergraduate radiology clerkship is to prepare the future physician to use efficiently the resources of radiology and nuclear medicine in patient care. Specific goals and methods used to achieve them are described and analysed.
