RESUMO
No abstract available.
Assuntos
Herpesvirus Humano 4 , Transtornos Linfoproliferativos , Mielofibrose PrimáriaRESUMO
STUDY DESIGN: Prospective, randomised controlled, single centre study of 45 patients posted for two level lumbar fixation surgery in the prone position. PURPOSE: To compare intra-abdominal pressure (IAP), mean airway pressure mean airway pressure and blood loss during the spine surgery in prone position using three different positioning systems. OVERVIEW OF LITERATURE: Studies have correlated IAP with the amount of perioperative bleeding. However, IAP and airway pressures while assessing the bleeding comparing two or more prone positioning systems are unclear. METHODS: This prospective study was conducted on a cohort of 45 patients scheduled for two-level lumbar fixation. Patients were randomly allocated to a spine table, Wilson's frame, and thermomodulated pads. Bladder pressure as an indicator of IAP, mean and peak airway pressures, and blood loss were monitored. RESULTS: IAP increased whenever patient position was changed to prone .The increase in pressure was more in the Wilson's frame group but was statistically significant only on prolonged positioning. Adopting the prone position always increased the mean airway pressure, but the increased was significant only in the Wilson's frame group. Mean airway pressure decreased in the spine table group and was statistically significant. The blood loss in the spine table group was significantly less as compared to the other groups. CONCLUSIONS: Positioning on a spine table results in less blood loss and low mean airway pressure. The Wilson's frame results in high IAP, increased mean airway pressure, and more blood loss. The thermomodulated frame increases mean airway pressure and produces a moderate increase in IAP and airway pressure.
Assuntos
Humanos , Estudos de Coortes , Hemorragia , Decúbito Ventral , Estudos Prospectivos , Coluna Vertebral , Bexiga UrináriaRESUMO
STUDY DESIGN: Prospective, randomised controlled, single centre study of 45 patients posted for two level lumbar fixation surgery in the prone position. PURPOSE: To compare intra-abdominal pressure (IAP), mean airway pressure mean airway pressure and blood loss during the spine surgery in prone position using three different positioning systems. OVERVIEW OF LITERATURE: Studies have correlated IAP with the amount of perioperative bleeding. However, IAP and airway pressures while assessing the bleeding comparing two or more prone positioning systems are unclear. METHODS: This prospective study was conducted on a cohort of 45 patients scheduled for two-level lumbar fixation. Patients were randomly allocated to a spine table, Wilson's frame, and thermomodulated pads. Bladder pressure as an indicator of IAP, mean and peak airway pressures, and blood loss were monitored. RESULTS: IAP increased whenever patient position was changed to prone .The increase in pressure was more in the Wilson's frame group but was statistically significant only on prolonged positioning. Adopting the prone position always increased the mean airway pressure, but the increased was significant only in the Wilson's frame group. Mean airway pressure decreased in the spine table group and was statistically significant. The blood loss in the spine table group was significantly less as compared to the other groups. CONCLUSIONS: Positioning on a spine table results in less blood loss and low mean airway pressure. The Wilson's frame results in high IAP, increased mean airway pressure, and more blood loss. The thermomodulated frame increases mean airway pressure and produces a moderate increase in IAP and airway pressure.
Assuntos
Humanos , Estudos de Coortes , Hemorragia , Decúbito Ventral , Estudos Prospectivos , Coluna Vertebral , Bexiga UrináriaRESUMO
Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Assuntos
Humanos , Masculino , Adulto Jovem , Acidentes de Trânsito , Articulação do Cotovelo , Ferimentos e Lesões , Luxação do Quadril , Patologia , Luxações Articulares , Lesões dos Tecidos MolesRESUMO
A biliary fistula from the gallbladder can develop as a result of the erosion of stones into the surrounding viscera. An 82-year-old woman with multiple comorbid diseases presented with a persisting discharge from what was thought to be an abscess in the right hypochondrium, which had previously been drained. Sinogram confirmed fistulous communication with the gallbladder and gastric antrum. The fistulous tract was excised together with the gallbladder, and the gastric defect was repaired. The patient made an uneventful recovery.