RESUMO
Breast cancer is the most frequent malignancy in women accounting for approximately 32% of all cancers, with a lifetime risk of 1 in 10. It causes considerable morbidity and mortality. Recently, the survival rate has dramatically increased due to early detection of the disease and improvement in the treatment measures. However, more than 30% of the patients develop metastatic diseases following surgical treatment, radiotherapy, hormonal therapy, or chemotherapy. Distant spread is usually found in bones, lungs, liver, brain and skin. Rarely, it spreads to bowel, spleen, gallbladder, pancreas, urinary bladder, and eyes. Breast cancer is the second commonest primary tumour responsible for gastrointestinal metastases after malignant melanoma. We report a case of a Caucasian female who developed an intestinal obstruction secondary to metastatic deposits to the small bowel and later to the rectum from breast lobular carcinoma 2 years after mastectomy, axillary clearance, radiotherapy, hormonal therapy, and transverse rectus abdominis myocutaneous (TRAM) flap for reconstruction.
RESUMO
A hitherto unpublished means of testing the patency across an end-to-side venous anastomosis is described. It relies on the elasticity of the venous walls to produce ballooning when the appropriate segments of the veins are occluded and blood is flowing unimpeded across the end-to-side anastomosis. It is foolproof, easy to perform and has no ambiguity in its interpretation.
Assuntos
Anastomose Cirúrgica/métodos , Prótese Vascular , Veias/cirurgia , Humanos , Grau de Desobstrução Vascular/fisiologiaRESUMO
This is a comparative study of a hydrocellular foam (Allevyn, Smith and Nephew) and a calcium alginate (Kaltostat, ConvaTec) in dressing split-thickness skin-graft donor sites. The dressing materials were used in equal halves of each donor site in 20 patients undergoing skin-graft harvest. The donor sites dressed with Allevyn showed a tendency to earlier healing, but this was not confirmed statistically. However, Allevyn was found to be more comfortable than Kaltostat and this difference was statistically significant. Due to its increased patient comfort, cheaper cost and comparable time to healing with Kaltostat, the authors recommend the use of Allevyn as a dressing for split-thickness skin-graft donor sites.
Assuntos
Alginatos/uso terapêutico , Bandagens/normas , Poliuretanos/uso terapêutico , Transplante de Pele/efeitos adversos , Cicatrização , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alginatos/economia , Alginatos/farmacologia , Bandagens/economia , Criança , Análise Custo-Benefício , Custos de Medicamentos , Feminino , Ácido Glucurônico , Ácidos Hexurônicos , Humanos , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Poliuretanos/economia , Poliuretanos/farmacologia , Cuidados Pós-Operatórios/economia , Cuidados Pós-Operatórios/métodos , Higiene da Pele/economia , Higiene da Pele/métodos , Fatores de Tempo , Cicatrização/efeitos dos fármacosRESUMO
We describe a 21-year-old female who presented with four agminate Spitz naevi close to the scar from a previously excised solitary Spitz naevus, and review the literature since 1987 on widespread and agminate Spitz naevi. Spitz naevi usually present as solitary firm red or brown papular lesions. Agminate Spitz naevi are unusual and they have been reported mainly in children. It is uncommon for Spitz naevi to recur after surgery and far more unusual for a recurrence to occur in an agminate form. Such lesions may mimic multiple satellite and in-transit metastases which can occur in malignant melanoma, and close follow up of any new lesions occurring in this case is intended.
