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At least 1,207 records · Page 67Linked to original sources
PubMed2000

Spleen laceration, a rare complication of laparoscopy.

A 31-year-old woman had secondary infertility of 4 years' duration. Hysterosalpingography revealed bilateral distal tubal occlusion with bilateral hydrosalpinx-like appearance. At laparoscopy, both oviducts were occluded with marked hydropic change. Salpingoplasty was performed to correct bilateral hydrosalpinges and reform the fimbriated tubal ends. The procedure was performed uneventfully by an experienced surgeon in 45 minutes. Nine hours after the operation an emergency exploratory laparotomy was performed due to massive intraabdominal bleeding. The cause was a small tear, 3 cm long and 1 cm deep, with active bleeding in the inferior splenic tail. The laceration was repaired successfully with 1-0 chromic suture. The etiology of splenic laceration during laparoscopic surgery is uncertain. Many complications of laparoscopy are physiologic, and this one might have occurred while establishing pneumoperitoneum. Distortion and stretching of small vascular adhesions of the spleen with the abdominal wall also may have played a role. Gynecologists must be aware of the physiologic insult to patients during laparoscopy.

Adult↗
PubMed2000

Litigation of laparoscopic major vessel injuries in Canada.

This study is a review of conditions and circumstances associated with 15 injuries to great vessels during laparoscopic surgery. Thirteen cases were litigated in Canada and two occurred in the author's operating room. Body habitus may have been an underlying factor in the injuries. Most injuries were entry related and independent on complexity of surgery. One was caused by the Veress needle and one by a secondary trocar, and three occurred during dissection of adhesions. Ten were primary trocar injuries, 9 after pneumoperitoneum and 1 at direct trocar insertion. Of these, five were caused by reusable and five by disposable trocars with so-called safety shields. In 6 of 15 cases recognition of the injury was delayed; 5 in the recovery room. Eleven women had uncomplicated recovery. Of 13 litigated cases, 8 (62%) resulted in settlement.

Adult↗
PubMed2002

Pathologic interactions in pulpal and periodontal tissues.

Both endodontic and periodontal disease are caused by a mixed anaerobic infection. The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. This article is an attempt to provide a rational approach to the perio-endo/endo-perio question based on a review of the relevant literature. In the light of evidence, clinical concepts for the diagnosis and treatment of lesions involving both periodontal and pulpal tissues are discussed.

Bacteria, Anaerobic↗
PubMed1975

[Juvenile spongy dystrophy of CNS with necrosis of the medulla. A. complication of hydroxyquinoline therapy (author's transl)].

A girl of 10-5/12 years is described, who had diabetes mellitus from the age of 5 years on and who developed bilateral ptosis, pigment degeneration of the retina and bilateral impairment of hearing at the age of nine years. A few weeks before death she suffered from an acute gastrointestinal infection which was successfully treated by a hydroxyquinoline derivative. In the days following a severe encephalopathy and signs of cardiac involvement appeared. A month later the girl died of bulbar paralysis and acute heart failure. Histology showed remnants of a granulomatous inflammation in the heart, the kidneys, the pancreas and the skeletal muscles. Furthermore there was a widespread spongiosis in the white substance of the brain, with large astrocytes, and partly also in the basal ganglia, the brain stem and the cerebellum. Foci of sudanophilic tissue necrosis resembling Wernicke's Encephalopathy were found in the medulla oblongata and the spinal cord. The peripheral nerves appeared partially demyelinated and showed axonal lesions. This case is classified as a Juvenile Type of so-called Canavan's Disease. It shows some resemblence to the "Progressive Chronic Ophthalmoplegia with Spongiform Encephalopathy described by Daroff, Kearn and Sayre. The possible neurotoxical effects of the hydroxyquinoline therapy are discussed.

Brain↗
PubMed1980

[Conservative treatment of ureteral lesions caused by gynecological surgery (author's transl)].

Conservative treatment with long lasting success is possible in many cases of ureteral lesions of different etiology, esp. after complications with gynecological surgery. Both fistulas and stenoses of the ureter can be treated conservatively by placing long term indwelling PVC ureteral splints ("endoprothesis") of FR 8 or 10 with smooth surface and without hooks or the like to keep them place. In a considerable number of cases such treatment is a true and even superior alternative to open surgery with its consecutive longer lasting hospitalization, because it can be done as outpatient-care and, of course, has a lower rate of complications.

Adult↗
PubMed1993

Infertility, infection, and iatrogenesis in Egypt: the anthropological epidemiology of blocked tubes.

In this article, we integrate medical anthropological and analytical epidemiological methods, forms of data analysis, and interpretive insights to examine the culture-specific behavioral factors that place poor, urban Egyptian women at risk of tubal-factor infertility (TFI). Such risk factors include biomedically and ethnomedically produced iatrogenesis, including the consequences of the practice of female circumcision, and male sexual behavior leading to sterilizing sexually transmitted diseases (STDs) in their female sexual partners. We examine the socio-cultural and political-economic context in which infertility-producing behavioral risk factors are maintained, and we explore the ways in which these risk factors are perceived by biomedically trained Egyptian gynecologists.

Adolescent↗
PubMedDate not supplied

Arthritis in disease due to Neisseria meningitidis.

Three clinical types of arthritis in meningococcal disease are presented; their classification is based on a review of the literature from 1887 and on experience with pediatric patients treated in Dallas, Texas. The most common type is arthritis complicating acute meningococcal disease; it occurred in 1,180 of the patients reviewed or approximately 5% of children and 11% of adults with meningococcal disease. Septic or allergic pathogenesis was documented in fewer than 5% of these, 1,180 patients. However, the search for an immunologic basis, conducted in a small number of patients, produced results suggesting that immune complexes are involved in many patients with sterile effusions. Large joints, especially the knee, were involved in 95% of the cases, and almost half the patients had polyarthritis. Chronic meningococcemia, an infrequently reported clinical entity, was accompanied more often by arthralgia than arthritis. Primary meningococcal arthritis, which is a rare form of acute septic arthritis, affected large joints almost exclusively and was polyarthritic in about one-third of cases. The management was the same for all types of meningococcal arthritis and consisted primarily of specific antimeningococcal chemotherapy. Evacuation of pus is recommended, since this treatment may be expected to shorten the relatively long symptomatic course. The prognosis for patients with meningococcal arthritis is excellent, and joint residua are rare.

Adult↗
PubMedDate not supplied

Invasive aspergillosis.

Invasive fungal disease of humans caused by species of the genus Aspergillus Micheli ex Linnaeus has become a significant and prevalent problem in contemporary medicine, particularly with regard to the compromised host. This review addresses the current status of invasive aspergillosis, including microbiological, clinical, and pathologic aspects. Diagnostic and therapeutic considerations are discussed with a view toward early and aggressive intervention in order to prevent the high mortality rate associated with aspergillosis.

Antifungal Agents↗
PubMed2003

Total thyroidectomy for benign thyroid disease.

OBJECTIVES/HYPOTHESIS: The use of total thyroidectomy in thyroid cancer treatment is not unanimous, and it is even more controversial when this procedure is advocated for benign diseases. On the other hand, the complication risk may have an increase up to 20 times in repeat operations for recurrence. The objective of the study was to evaluate the use of total thyroidectomy in benign diseases, multinodular goiter, and Graves disease to justify the authors' preference. STUDY DESIGN: Retrospective study of use of total thyroidectomy in benign diseases. METHODS: Retrospective study of 1789 patients who underwent thyroidectomies from June 1990 to December 2000. Indication, extension of thyroidectomy, cancer incidence, and complications were analyzed. RESULTS: Total thyroidectomy was performed in 81.19% of 456 patients with nontoxic multinodular goiter, 93.93% of 33 with toxic multinodular goiter, 93.93% of 66 with recurrent multinodular goiter, and 49.18% of 122 with Graves disease. Thyroid cancer was found in 16.62%, 9.09%, 3.03% and 5.73% of patients, respectively. Transitory and permanent hypoparathyroidism, hematoma requiring surgical intervention, and transitory and permanent recurrent laryngeal nerve injury occurred in 12.27%, 1.61%, 0.26%, 1.88%, and 0.35% of the patients undergoing total thyroidectomy, respectively. Permanent complications of total thyroidectomy for nontoxic multinodular goiter and Graves disease were similar to nontotal thyroidectomy. Use of total thyroidectomy for nontoxic multinodular goiter increased from 53.33% of the patient to 81.19%, on average, with a concomitant increase of cancer diagnosis from 11.11% to 16,62%. The authors performed total thyroidectomy for all patients with Graves disease. CONCLUSION: Total thyroidectomy is the treatment of choice for multinodular goiter and thyroiditis, when there is bilateral gland involvement posterior to middle thyroid veins, and for Graves disease because it decreases the likelihood of future repeat operations for recurrent disease and thus the associated risks, when performed safely.

Goiter, Nodular↗
PubMed1996

Quadriplegia after lumbar disc surgery. A case report.

STUDY DESIGN: Case report. OBJECTIVE: To report a case of quadriplegia after surgery in the prone position for a herniated lumbar disc. SUMMARY OF BACKGROUND DATA: Ischemia in the vascular territories of the vertebral arteries after back surgery in the prone position is rare. Degenerative changes of the cervical spine or decreased blood flow to the head with mechanical vessel obstruction during extreme neck movements, systemic hypotension, and thromboembolism have mostly been implicated in the pathogenesis. METHODS: The case of a 33-year-old man undergoing surgery for an unilateral single level disc herniation at L4-L5 is presented. Within a few hours after surgery he developed quadriplegia and signs of occipital lobe dysfunction. He underwent magnetic resonance imaging investigation. Therapy included arterial blood pressure control, low molecular dextran, dexamethasone, bladder catheterization, and physiotherapy. RESULTS: Magnetic resonance imaging demonstrated intramedullary ischemic changes in the cervical spinal cord and at the borderline between anterior and posterior circulation. Outcome after 2 years is fair regarding the severe initial deficit-the patient walks alone with a cane and bladder function is under control. He is employed in a sedentary job. CONCLUSIONS: The authors believe that a temporary mechanical occlusion of a vertebral artery led to stasis, formation of thrombi, and subsequent embolism in the vertebrobasilar vascular territory. Extreme head rotation and neck extension is to be avoided in the prone position.

Adult↗
PubMed1981

Adeno-viral kerato conjunctivitis.

In summer, 1976 an epidemic of Kerato Conjunctivitis commenced in Melbourne, Australia. A total of 422 patients was studied in the adeno-viral clinic at the Royal Victorian Eye and Ear Hospital, Melbourne, from 1976 to 1979. Most patients were referred from the Casualty Department of the hospital, but others came from private practice. A total of 72 cases were adeno-viral with positive cultures. Types 8 and 19 predominated, but sporadic cases of types 1, 3, 4 and 7 were also isolated. Herpes Simplex type 1 was positive in 13 patients. The hospital staff were involved in spread of adeno-virus type 8. Six patients contracted Kerato-Conjunctivitis following removal of corneal foreign bodies from the casualty ward, and several patients contracted epidemic Kerato-Conjunctivitis after beta-irradiation post-pterygium surgery. These latter two methods of infection have not been reported before. Treatment and prevention is discussed.

Adenoviridae Infections↗