RESUMO
Subarachnoid haemorrhage can be a massively debilitating condition with long-term repercussions. The "classic" presentation of sudden-onset severe headache normally raises suspicions. However, if the presentation is atypical, the diagnosis may be missed. We report on a 52-year-old man who presented with a 1-day history of progressively worsening right-sided neck pain spreading to the chest with associated symptoms of autonomic dysfunction. After initial stabilisation, the patient's Glasgow Coma Scale (GCS) score declined, with subsequent CT scan showing an extensive subarachnoid haemorrhage.
Assuntos
Cervicalgia/etiologia , Hemorragia Subaracnóidea/complicações , Doença Aguda , Angiografia Cerebral , Diagnóstico Diferencial , Embolização Terapêutica , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/diagnóstico por imagem , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/terapia , Tomografia Computadorizada por Raios XRESUMO
A short cut review was carried out to establish whether primary split skin grafting is better than simple wound edge approximation at reducing time to healing in patients with pretibial flap lacerations. A total of 72 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.
Assuntos
Lacerações/cirurgia , Traumatismos da Perna/cirurgia , Transplante de Pele , Pele/lesões , Serviço Hospitalar de Emergência , Medicina Baseada em Evidências , Humanos , CicatrizaçãoRESUMO
BACKGROUND: There is little published information about postoperative infection rates in day-case hand surgery and the possible factors promoting infection. RESULTS: We report on infection rates observed in day-case hand surgery of 1035 cases over a 2-year period performed by two consultant surgeons. Infection rates of just over 1% were observed. CONCLUSION: We believe that this low infection rate reflects seniority of surgeon, operative technique and short duration of operation.
Assuntos
Mãos/cirurgia , Infecção da Ferida Cirúrgica/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Ambulatórios , Criança , Feminino , Humanos , Incidência , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecção da Ferida Cirúrgica/epidemiologiaRESUMO
A short cut review was carried out to establish whether nail removal and nail bed repair is better than simple trephining in patients with significant subungual haematoma. Altogether 312 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
