[COMPLICATIONS OF VIDEOTHORACOSCOPIC BIOPSY OF INTRATHORACIC LYMPH NODES AND METHODS OF THEIR PROPHYLAXIS].

Videothoracoscopy constitute a secure miniinvasive method of diagnosis of intrathoracic lymphadenopathy syndrome. Pulmonary hemorrhage and injury constitute intraoperative videothoracoscopic complications, and pulmonary collapse, hemorrhage, purulent complications ­ postoperative complications. Satisfactory intraoperative visualization, guaranteeing optimal position of the patient's body on operative table and sufficient pulmonary collapse on the intervention side, application of medical аlpha­cyanacrylate adhesive with hemostatic sponge for hemostasis in a biopsy zone, systemic application of antibiotics constitute the main prophylactic methods for videothoracoscopic complications and optimization of conditions for videothoracoscopic biopsy of intrathoracic lymphatic nodes. Application of the methods proposed have permitted to reduce the intraoperative complications rate from 19.2 tо 2.8%, and a postoperative one ­ from 23 tо 2.8%.

[Optimization of intraoperative conditions in endoscopic biopsy of intrathoracic lymph nodes].

Conducted a retrospective analysis of the results transpleural (videothoracoscopic and videoassisted) biopsy of intrathoracic lymph nodes (ITLN) performed in 91 patients with hilar lymphadenopathy syndrome of various etiologiy for the period from 2003 to 2014. Endoscopic ITLN biopsy performed in the mediastinum in the high risk zone, so patients need to create adequate and safe intraoperative comfort, in particular, the position of lying on side, imposing artificial pneumothorax before surgery, one-lung ventilation, lifting the head end of the operating table at 300. These measures provide optimal con- ditions for handling and minimizing the frequency of intraoperative complications or prevention after surgery.

Surgical practice in a maximum security prison - unique and perplexing problems.

The practice of general surgery in a prison population differs considerably from that in a general surgical practice. We audited surgical consultations at the Mangaung Correctional Centre from December 2003 to April 2009. We found a high incidence of foreign object ingestion and anal pathology. Understanding the medical and social aspects of prison life facilitates the treatment of inmates with surgical problems.

Trastornos cutáneos y no cutáneos tratadoscon fotoféresis extracorpórea / Cutaneous and noncutaneous disorders treated with extracorporeal photopheresis

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Surgical indications for HIV-infected patients.

We proposed surgical indications for major operations on HIV-infected patients. According to our criteria, major surgery could be performed for HIV-infected patients as long as the surgical approach is preferred and surgery is not likely to exacerbate the subject's quality of life during the course of the disease.

[Emergencies in human immunodeficiency virus infection]. / Urgences au cours de l'infection par le virus de l'immunodéficience humaine.

Emergencies during HIV infection consist mainly in opportunistic infections. They are varied and the physician should keep an "internist's eye" on the condition; they also require emergency complementary examinations for confirmation of diagnosis. If such diagnostic tests cannot be rapidly made, treatment should be started on the basis of presumption and frequency. In France, the most frequently observed opportunistic infections are: pneumocystosis, cerebral toxoplasmosis and candidiasis. Tuberculosis is a major concern of those responsible for public health care. Surgical complications following infections or opportunistic tumours, are rare and of poor prognosis. Iatrogenic complications (haematologic, cutaneous and infectious) are also reasons for emergency care.

Benign lymphoepithelial lesions of the parotid.

Persistent generalized lymphadenopathy has been well described in patients with seropositivity to the human immunodeficiency virus (HIV). Moreover, isolated enlargement of the parotid gland and parotid lymphadenopathy have been noted much more frequently over the past few years. Histologically, these lesions demonstrate follicular hyperplasia, cystic dilatation of the ducts lined by pseudo-stratified squamous epithelium, and lymphocytic infiltrates. They are generally considered to be benign lymphoepithelial lesions of the parotid or hyperplastic periparotid lymph nodes. The relationship of this entity to the AIDS-related complex (ARC) and the subsequent development of AIDS is not clear. Over the past 7 years, we have seen 50 patients with parotid enlargement in whom the diagnosis of benign lymphoepithelial lesion was made. Fine-needle aspiration was performed in 32 patients. Although not conclusively diagnostic, needle aspirates ruled out primary salivary glandular pathology. Most patients gave a history of intravenous drug abuse. HIV tests have been performed on a routine basis only in the last 2 years, and these were positive in the majority of the patients. Thirty-five patients underwent surgical excision. In the initial 20 patients, we routinely performed parotid exploration, identification of the facial nerve, and superficial parotidectomy. In the last 15 patients, we changed our surgical approach to parotid exploration and excision of the mass in the tail of the parotid. The exposure of the posterior belly of the digastric muscle, with identification and removal of the deep jugular node, has become routine. In each case, we found an enlarged lymph node in the deep jugular region, which was not clinically palpable preoperatively. The rate of surgical complications was minimal, and, after resection of the mass, patients improved symptomatically. If the patient shows obvious signs of AIDS, a nonsurgical approach with repeated aspirations should be considered, and treatment with zidovudine offered.