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Maroua Eid, Olivier Fouquet, Cédric Darreau, Marc Pierrot, Achille Kouatchet, Alain Mercat, Christophe Baufreton
INTRODUCTION: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. METHODS: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure...
March 2018: International Journal of Artificial Organs
Zhongkui Wang, Masamitsu Kido, Kan Imai, Kazuya Ikoma, Shinichi Hirai
Clinically in medializing calcaneal osteotomy (MCO), foot and ankle surgeons are facing difficulties in choosing appropriate surgical parameters due to the individual differences in deformities among flatfoot patients. Traditional cadaveric studies have provided important information regarding the biomechanical effects of tendons, ligaments, and plantar fascia, but limitations have been reached when dealing with individual differences and tailoring patient-specific surgeries. Therefore, this study aimed at implementing the finite element (FE) method to investigate the effect of different MCO parameters to help foot and ankle surgeons performing patient-specific surgeries...
March 15, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Sanjay Mhalasakant Khaladkar, Kunaal Mahesh Jain, Rajesh Kuber, Sidappa Gandage
Emphysematous pyelonephritis is a life-threatening severe form of pyelonephritis usually occurring in patients with diabetes mellitus with or without obstructive uropathies in whom there is necrotizing infection leading to the gas production of an unclear mechanism involving the renal parenchyma and the collecting system. Necrotizing fasciitis is characterized by progressive necrosis of fat and fascia due to deep-seated infection of subcutaneous tissue. It has a fulminant course with considerable mortality...
2018: Journal of Clinical Imaging Science
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
David K Tso, Ajay K Singh
OBJECTIVE: The purpose of this article is to review the imaging findings of necrotizing fasciitis as seen on radiograph, ultrasound, CT, and MRI, and to recognize the early findings in this potentially fatal disease. CONCLUSION: Although classically a clinical diagnosis, imaging is a powerful adjunct to facilitate early diagnosis in equivocal cases. Compared to plain radiography, US, CT and MR provide higher sensitivity and specificity for the diagnosis of necrotizing fasciitis...
March 14, 2018: British Journal of Radiology
Liselotte Hansen, Thøger Persson Krogh, Torkell Ellingsen, Lars Bolvig, Ulrich Fredberg
Background: Plantar fasciitis (PF) affects 7% to 10% of the population. The long-term prognosis is unknown. Purpose: Our study had 4 aims: (1) to assess the long-term prognosis of PF, (2) to evaluate whether baseline characteristics (sex, body mass index, age, smoking status, physical work, exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad...
March 2018: Orthopaedic Journal of Sports Medicine
Jessica T Servey, Christopher Jonas
Plantar fascia rupture in the absence of previous diagnosis of plantar fasciitis, corticosteroid injection, or injury is a rare occurrence with only 7 case reports in the literature since 1978. This is a case of spontaneous plantar fascia rupture in a 38-year-old active-duty US military member with current considerations in musculoskeletal ultrasound, other radiologic imaging, treatment, and followup of this diagnosis.
March 2018: Journal of the American Board of Family Medicine: JABFM
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue includes several excellent observational studies prompted by physicians' clinical questions. Many people use lots of menthol cough drops-does the menthol overall lengthen the cough duration? When should we intensify treatment of older individuals with diabetes? Do occipital nerve blocks work for acute migraine headaches? Did you know that the plantar fascia can rupture? What happens to those patients with chest pain but low pretest probability for serious cardiac disease who are admitted to the hospital? Acupuncture can work well-for the patients-but how can we incorporate it into the usual pace of the family medicine office? Is it a win-lose situation when medical assistant roles are expanded? How many practice sites do physicians have and does that make a difference in the number or type of health personnel shortage areas? What would you guess on the presence of humor in the medical office-more or less than half of the visits; introduced by doctors or patients; primary care or specialty doctors?...
March 2018: Journal of the American Board of Family Medicine: JABFM
X J Lyu, L Li, R Kong, B Sun
The retroperitoneum space comprises anterior pararenal space, perirenal space and posterior pararenal space. Pancreas is a retroperitoneal organ and located in the anterior pararenal space of the retroperitoneum. Left and right sides anterior pararenal space are potentially communicated, which contains many adipose tissues and a little connective tissues. The exacerbation of acute pancreatitis results in the lesion spreading into adjacent area of pancreas in the retroperitoneal space. In addition, the lesion could spread into bare area of stomach, posterior colonic region, subperitoneal space and pelvic retroperitoneal space through the same anatomical space or communicating space...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Doh Young Lee, Young Ho Kim
OBJECTIVE: This study reviewed available literature to evaluate the success rate of fat myringoplasty compared with methods using other graft materials and suggests proper indications for this procedure. DATA SOURCES: Studies reporting the success rate of fat myringoplasty were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2017. STUDY SELECTION: The following terms were used for the literature search: ("Fat" OR "Adipose") and ("Myringoplasty" OR "Tympanoplasty")...
April 2018: Otology & Neurotology
Yue Pan, Xi-Xun Wang, Ji-Chao Hu, Cheng Jin, Yong Wei, Jun Lei, Guo-Qing Wang
OBJECTIVE: To investigate the clinical effect of repairing soft tissue defect after hand wound using reverse island skin flap of upper carpal cutaneous branches of ulnar artery. METHODS: From June 2010 to November 2016, 12 patients with hand soft tissue defects were repaired by reverse island skin flap of upper carpal cutaneous branches of ulnar artery, including 9 males and 3 females with an average age of (35.2±9.4) years old ranging from 22 to 58 years. The defect area varied from 7...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Bradley Wills, Sung Ro Lee, Parke William Hudson, Bahman SahraNavard, Cesar de Cesar Netto, Sameer Naranje, Ashish Shah
BACKGROUND: Calcaneal osteotomy is a commonly used surgical option for the correction of hindfoot malalignment. A previous cadaveric study described a neurological "safe zone" for calcaneal osteotomy. We performed a retrospective chart review to evaluate the presence of neurological injuries following calcaneal osteotomies and the location of the osteotomy in relation to the reported safe zone. METHODS: In this retrospective study, we reviewed charts of patients who underwent calcaneal osteotomy at our institution from 2011 to 2015...
March 1, 2018: Foot & Ankle Specialist
Andreas Lorenz, Pamela Kogler, Marcus Huth, Reinhold Kafka-Ritsch, Dietmar Öfner, Alexander Perathoner
PURPOSE: Resection of a long rectal stump after previous colectomy or Hartmann procedure often requires a combined transperitoneal and transperineal approach because of limited access through a perineal incision alone. Risks associated with this procedure include iatrogenic injury to bowels, nerves, ureters, vessels and sexual organs. This study reports on the feasibility and safety of perianal minimally invasive surgery (PAMIS) for the resection of long rectal stumps that would otherwise require a combined transperitoneal and perianal approach...
March 10, 2018: International Journal of Colorectal Disease
H Hande Aydinli, Colin Peirce, Erman Aytac, Feza H Remzi
INTRODUCTION: Abdominal wound closure is a challenge in patients undergoing colorectal surgery with a complex history of multiple abdominopelvic operations. Loss of domain of the abdominal fascia because of prior laparotomies precludes the use of simple, everyday abdominal wound closure techniques. Furthermore, ongoing intra-abdominal sepsis, with or without a concurrent entero- or colocutaneous fistula, increases the risk of postoperative morbidity and mortality in this patient population...
April 2018: Diseases of the Colon and Rectum
Daniele Marchioni, Angelo Musumeci, Cristoforo Fabbris, Stefano De Rossi, Davide Soloperto
BACKGROUND: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions. This is a preliminary report on patients treated endoscopically for clival lesions by the authors' Skull Base Team...
March 8, 2018: European Archives of Oto-rhino-laryngology
S Ozturk, H Cakin, K Karabulut, R Pasahan, M Kaplan
Lumboperitoneal shunts are widely used for the treatment of patients diagnosed with pseudotumor cerebri (PTC). Obesity is a risk factor for PTC. In particular, catheter migration out of the abdominal cavity is more commonly observed in morbidly obese patients. The aim of this study was to discuss the underlying mechanisms of catheter migration and treatment modalities in morbidly obese patients with PTC. The present study included four morbidly obese patients. All cases had undergone the previous laparotomy for insertion of a distal catheter into the abdominal cavity...
March 2018: Nigerian Journal of Clinical Practice
Takuya Tokunaga, Hitoshi Arimura, Hiroshi Mizuta, Yuji Hiraki, Chisa Shukunami
Tendons and ligaments are dense fibrous connective tissues mainly composed of type I collagen, aligned in highly ordered arrays along the axis of the tendon and ligament. The enthesis is defined as the attachment site of a tendon, ligament, joint capsule, or fascia to bone. During morphogenesis, the cell population co-expressing Scleraxis(Scx)and the SRY-box containing gene 9(Sox9)contributes to the formation of fibrocartilaginous entheses. Scx regulates tendon and ligament maturation, while Sox9 is a key regulatory factor for cartilage formation...
2018: Clinical Calcium
Si-Hyun Park, Hyung-Bo Sim
Background: During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods: This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015...
March 5, 2018: Archives of Plastic Surgery
Xuekang Yang, Hui Zhao, Mengdong Liu, Yue Zhang, Qiaohua Chen, Zhiqiang Li, Juntao Han, Dahai Hu
The aim of this study was to describe the scheme, surgical procedures, and clinical outcomes for the early repair of deep wounds of the posterior talocrural region in extensively burned patients with a method combining a superficial temporal fascia free flap with thin split-skin grafting.From January 2013 to February 2016, 9 extensively burned patients with deep tissue defects of the posterior talocrural region were treated in our department (2 patients had bilateral deep tissue defects of the posterior talocrural region)...
January 2018: Medicine (Baltimore)
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