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A Munro, D McKeen, J Coolen
A 70 kg, 34-year-old woman at 29 weeks-of-gestation required intrauterine transfusion for Rh (D) alloimmunization. In the ambulatory treatment clinic, 19 mg of rocuronium was administered intramuscularly in split doses into the fetal buttock. The fetus moved and inadvertent maternal neuromuscular blockade occurred, leading to respiratory distress. The patient was transferred to the operating room where she had poor muscle tone, worsening dyspnea and dysphonia. Sugammadex 100 mg was administered intravenously and complete resolution of neuromuscular blockade was demonstrated using a Neuromuscular Transmission™ monitor...
January 8, 2019: International Journal of Obstetric Anesthesia
Monika Kusz, Beata Bieniaś, Anna Wieczorkiewicz-Płaza, Agnieszka Brodzisz, Paweł Wieczorek, Przemysław Sikora
RATIONALE: Medullary sponge kidney (MSK) is a rare congenital abnormality characterized by cystic dilatation of the medullary collecting tubules. The disorder is likely to be complicated by nephrocalcinosis, urolithiasis, tubular dysfunctions, and urinary tract infections. In addition, it may be rarely associated with extrarenal anomalies. PATIENT CONCERN: We present a case of 17-year old girl who was referred for metabolic evaluation of bilateral nephrocalcinosis...
February 2019: Medicine (Baltimore)
Carine Mekoguem, Cécile Triboulet, Alexandre Gouveia
BACKGROUND: Mycetoma is a neglected infectious disease caused by a fungus (eumycetoma) or bacteria (actinomycetoma); it is characterized by chronic local inflammation with sinus formation and purulent discharge. Its course can be quite devastating because of the difficulty in diagnosing the infection and in eliminating the causative agent. Although endemic in many countries in the tropics and subtropics, the migration of Africans to Europe may increase the presence of this neglected disease in European countries...
February 12, 2019: Journal of Medical Case Reports
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Journal of Paediatrics and Child Health
Xin Lin Wong, Robert V Rawson, Deshan F Sebaratnam
No abstract text is available yet for this article.
February 2019: Journal of Paediatrics and Child Health
T B Pedersen, A F Juvik, S F Koren, P Gocht-Jensen, M F Klein
INTRODUCTION: Squamous cell carcinoma of the anus is a rare condition. First line treatment is combined chemo-radio therapy. As many as a third of patients undergoing chemo-radiotherapy will experience recurrence. These patients often undergo salvage surgery with an extended abdominoperineal excision. The aim of this study was to examine the quality of life in disease free survivors following salvage surgery for squamous cell carcinoma of the anus. MATERIAL AND METHODS: Patients undergoing salvage surgery for SCCA at Copenhagen University Hospital Herlev between 1st of January 2011 and 31st December 2016 were identified and quality of life was assessed with EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires...
February 1, 2019: European Journal of Surgical Oncology
Daiki Kitano, Takeo Osaki, Mika Nakasone, Tadashi Nomura, Kazunobu Hashikawa, Hiroto Terashi
INTRODUCTION: Diffuse plexiform neurofibroma (DPN) in patients with neurofibromatosis type 1 (NF1) causes motility dysfunction in severe cases. Transcatheter arterial embolisation (TAE) is an effective haemorrhage control method in vascular tumour surgery. PRESENTATION OF CASE: We performed debulking surgery for DPN in the buttock and posterior thigh of two NF1 patients. Preoperative TAE with gelatine particles to tumour feeder vessels was conducted in both cases...
January 29, 2019: International Journal of Surgery Case Reports
Marwan H Abboud, Saad A Dibo, Nicolas M Abboud
Background: A simple and reproducible surgical technique for large volume fat grafting. Objectives: The authors share their 7-year experience with their large volume fat transfer technique called power-assisted liposuction lipofilling (PALL). Methods: our hundred and seventeen patients who underwent PALL related surgeries involving the breast and buttock were evaluated in a retrospective study. Liposculpting and fat harvesting were performed with power-assisted liposuction...
February 4, 2019: Aesthetic Surgery Journal
Ji Eun Park
Neuromuscular choristomas are rare tumors with mature skeletal muscle elements admixed with neural elements. Follow-up results are limited, the natural history of neuromuscular choristomas is poorly understood. To date, 14 cases of sciatic nerve neuromuscular choristomas have been reported, but follow-up results were provided only for 10 cases (median duration: 2 years). The natural history of neuromuscular choristomas is therefore poorly understood due to lack of longitudinal data. We describe a case with long-term natural history for 17 years of the disease and provide a literature review of the reported cases...
January 5, 2019: Clinical Imaging
James Rainville, James V Bono, Eric B Laxer, David H Kim, John M Lavelle, Aage Indahl, David G Borenstein, Andy J Haig, Jeffrey N Katz
BACKGROUND: Leg pain associated with walking is sometimes incorrectly attributed to hip osteoarthritis (OA) or lumbar spinal stenosis (LSS). PURPOSE: This study compared physicians' values of signs and symptoms for diagnosing and differentiating hip OA and LSS to their clinical utility. STUDY DESIGN/SETTING: Musculoskeletal physicians were surveyed with online questionnaires. Patients were recruited from hip and spine specialty practices. PATIENT SAMPLE: Seventy-seven hip OA and 79 LSS patients...
January 29, 2019: Spine Journal: Official Journal of the North American Spine Society
Jun Nitta, Katsuyuki Hoshina, Toshihiko Isaji
This study aimed to compare the pelvic cavity vasculature before and after the interventional occlusion of a hypogastric artery (IOHA) and to reveal the protective mechanism of the collateral vessels against pelvic ischaemia.Sixty-nine patients with abdominal aortic or aortoiliac aneurysms who underwent endovascular aneurysm repair accompanied with IOHA were retrospectively analysed. Patients were divided into those who complained of buttock claudication (BC) group and asymptomatic patients (non-BC group).Two analyses were performed...
February 2019: Medicine (Baltimore)
Hana Kamal Almadani
Persistent sciatic artery (PSA) is a rare vascular anomaly with estimated incidence of 0.03%-0.06%. It has high incidence of complications including aneurysmal formation and ischaemia that may lead to amputation. During early embryonic development, the sciatic artery (which usually supply fetal lower buds and caudal part) disappears when the superficial femoral artery develops properly and the lower limbs grow. On clinical examination, usually a pulsating gluteal mass (the aneurysm) is appreciated with weak or absent femoral artery (Cowie's sign)...
January 29, 2019: BMJ Case Reports
Parisa Nejati, Afsaneh Safarcherati, Farshid Karimi
BACKGROUND: The sacroiliac joint dysfunction (SIJD) has been found to be the primary culprit for lower back pain (LBP), but it is still overlooked and treated as LBP. There are no guidelines or appropriate therapeutic protocols for SIJD. Thus, there is a need for an effective treatment strategy for SIJD. OBJECTIVE: To compare exercise therapy (ET), manipulation therapy (MT), and a combination of the 2 (EMT) in terms of their effectiveness in treating SIJD. STUDY DESIGN: A comparative, prospective, single-blind randomized controlled trial ...
January 2019: Pain Physician
Luis Fernández, Cynthia Ellman, Patricia Jackson
INTRODUCTION: Negative pressure wound therapy with instillation and dwell time (NPWTi-d) cleanses wounds with cyclic delivery, dwell, and removal of topical solutions to solubilize infectious materials and wound debris. OBJECTIVE: In this 2-patient case study, the authors report their experiences using NPWTi-d on 2 critically ill patients requiring management of large, complex wounds. MATERIALS AND METHODS: In both cases, normal saline was instilled with 10- to 20-minute dwell times, followed by 2 hours of negative pressure wound therapy (NPWT) at -125 mm Hg...
January 2019: Wounds: a Compendium of Clinical Research and Practice
Alvaro Luiz Cansancao, Alexandra Condé-Green, Joshua A David, Rafael A Vidigal
In recent years, gluteal fat augmentation has exhibited some of the most significant growth among all plastic surgery procedures. However, as the popularity of and media attention to gluteal fat augmentation continue to rise, reports of fatalities, largely attributed to fat embolism, have raised valid concerns. Many plastic surgeons inject fat in the intramuscular plane and claim better graft take in the muscles and the possibility of injecting more volume in the gluteal region. Because of the large caliber of vessels, subcutaneous fat augmentation has been a preference of many...
February 2019: Plastic and Reconstructive Surgery
Maximilian Zaussinger, Ines E Tinhofer, Ulrike Hamscha, Stefan Meng, Wolfgang J Weninger, Michael S Pollhammer, Georg M Huemer, Manfred Schmidt
BACKGROUND: Perforator flaps of the upper thigh or buttock provide a valuable secondary choice in autologous breast reconstruction. The purpose of this study was to compare the vascular territories and supplying vessels of the transverse myocutaneous gracilis flap, the profunda artery perforator flap, and the fasciocutaneous infragluteal flap. METHODS: In total, 26 lower limbs from 13 fresh specimens were investigated. All flap pedicles were selectively injected with methylene blue, eosin red, or green ink...
February 2019: Plastic and Reconstructive Surgery
Tarinee Rungjirajittranon, Weerapat Owattanapanich
BACKGROUND: Immune thrombocytopenia is an acquired autoimmune disease. Recently, there has been evidence of thrombotic risk in patients with immune thrombocytopenia, but the mechanism is still inconclusive. Intravenous immunoglobulin infusion therapy is considered an efficient treatment; however, it still is associated with adverse events of fever, chills, and hypotension, as well as serious complications such as thrombosis. We report a case a patient with relapsed immune thrombocytopenia who developed ischemic stroke after an intravenous immunoglobulin infusion...
January 28, 2019: Journal of Medical Case Reports
Jung Hwan Kim, Hea Kyeong Shin, Gyu Yong Jung, Dong Lark Lee
It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle...
January 2019: Archives of Plastic Surgery
Renée J H Richters, Natallia E Uzunbajakava, Nadya Timofeeva, Peter C M van de Kerkhof, Piet E J van Erp
BACKGROUND/AIMS: Aberrant skin barrier and intercorneocyte adhesion are potential contributors to the pathomechanism of sensitive skin (SS). Here we aimed to develop a novel and easy-to-apply method to analyze corneodesmosomes and to interrogate potential differences between corneocytes of subjects with SS and non-SS (NSS). METHODS: Corneocytes of the volar forearm and upper outer quadrant of the left buttock of SS (n = 10) and NSS (n = 8) subjects were extracted as a function of depth using adhesive tape and stained with anti-desmoglein 1 (DSG1) antibody...
January 23, 2019: Skin Pharmacology and Physiology
Hideki Kadota, Kenta Momii, Masuo Hanada, Kenichi Kamizono, Yusuke Inatomi, Kana Hisanaga, Sei Yoshida, Kippei Ogaki, Keijiro Kiyoshima
Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction...
January 21, 2019: Microsurgery
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