RESUMO
Acupuncture is a well-known form of complementary medicine that is increasingly being used worldwide. Despite being rare, pneumothorax is the most common serious complication described in acupuncture. A 79-year-old woman was admitted to the emergency department with a pneumothorax. Two days before, she had undergone an acupuncture treatment for chronic back pain. She felt a sharp right shoulder pain as needles were inserted in the interscapular area. As the pain did not resolve, she consulted her general practitioner and had a chest radiography done, revealing a right-sided pneumothorax. At the hospital, a right chest tube was inserted with relief of the symptoms and lung expansion. The chest tube was removed on the second day of admission, and she was discharged on the third day. Both acupuncturists and clinicians need to be aware of the possibility of adverse events following acupuncture, especially in those who develop symptoms.
Assuntos
Terapia por Acupuntura/efeitos adversos , Pneumotórax/etiologia , Idoso , Feminino , HumanosRESUMO
Sclerosing mesenteritis is a rare disease of the mesentery. Associations with surgery, trauma, autoimmunity and paraneoplastic syndrome have been suggested, but most of the cases remain idiopathic. Diagnosis is often incidental, based upon the finding of a single or multiple mesenteric lesions on abdominal CT and histopathological confirmation. Optimal treatment is still controversial, but most of the cases reported have a favourable prognosis. We present a case of a 54-year-old male with long-standing abdominal pain and nausea, whose CT revealed the presence of a large mesenteric mass. A biopsy was performed, revealing benign chronic inflammation, fibrosis and IgG4-positive plasmocytes consistent with sclerosing mesenteritis. Clinical remission was achieved with corticosteroids and follow-up CTs at six and twelve months documented stability of the lesion. Furthermore, we review the current literature on the diagnosis and treatment options for this rare disease.
Assuntos
Dor Abdominal/etiologia , Mesentério/patologia , Paniculite Peritoneal/diagnóstico , Corticosteroides/uso terapêutico , Biópsia , Seguimentos , Humanos , Masculino , Mesentério/diagnóstico por imagem , Pessoa de Meia-Idade , Paniculite Peritoneal/tratamento farmacológico , Paniculite Peritoneal/patologia , Prognóstico , Tomografia Computadorizada por Raios XRESUMO
During 16 years 202 patients with leg ulcer have been studied prospectively. Whenever possible, cure has been obtained in ambulatory, which was the main objective. Surgery was preferentially made after the cure of the ulcer. From the 202 patients, 166 have made a prolonged follow-up. Cure in ambulatory has been obtained in 91% of the patients. We stress the importance of the direct control of all the treatment by the responsible doctor.
Assuntos
Úlcera da Perna/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Colorectal cancer patients with regional invasion or metastatic disease present low life expectancy. Radical surgical treatment is the only potentially curative procedure, with significant good results being reported. Thirty two patients with either regional invasion or metastatic disease were submitted to surgery with good survival rate.
Assuntos
Neoplasias Abdominais/secundário , Neoplasias Colorretais/cirurgia , Exenteração Pélvica , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The end results of surgery for pancreatic tumors remains very poor. In patients with locally invasive tumors a by-pass type of surgery is usually performed with low survival and poor life quality. Seven patients with locally invasive pancreatic tumors were operated by the authors and extensive radical surgery was done with good results. An original revascularization technique of the hepatic artery is described.