Several methods have been exercised during the past years, thus offering the surgeon the possibility to choose when planning reconstructive surgery. Among these methods, we recall: the dislocation of a large surface of skin and fasciocutaneous flaps, the transposition of the muscle and its covering with a simple cutaneous flap or a cutaneo-adipose flap, musculocutaneous pediculate flaps, neurovascular flaps. The study was conducted on 292 patients with 3rd and 4th degree decubitus lesions admitted into and operated at the Plastic Surgery and Reconstructive Microsurgery ward during 10 years. Pediculated flaps on septofasciocutaneous perforating arteries or on musculocutaneous perforating arteries are more difficult to harvest (they require a precise knowledge about the localization of the perforating artery) but provide a better post-op result.
We present a report of a unique surgical entity: acute cholecystitis caused by the gallbladder strangulation within a recurrent right upper quadrant incisional hernia. A previously healthy 39 year-old male patient presented to our Emergency Department with abdominal pain, nausea, vomiting, and a tender mass in the right upper quadrant of the abdomen, where an incisional hernia was palpable. He had a history of a gunshot wound to the right upper quadrant and multiple operations to include repairing mesh of the incisional hernia in that area. Abdominal computed tomography demonstrated an acutely inflamed gallbladder within the recurrent hernia. Open cholecystectomy and primary hernia repair were performed. Intraoperatively, the gallbladder appeared being strangled within the hernia. The patient recovered uneventfully and no cholelithiasis was observed on gross examination of the gallbladder. Though there have been a few reports of gallbladder strangulation within primary incisional hernia, ours is the first to describe this phenomenon in a recurrent hernia.
The spring of 2014 has brought a new calamity, the exotic infectious disease: Ebola Hemorrhagic Fever, which is caused by a highly contagious and pathogenic virus, transmitted directly by interpersonal contact or indirectly by common usage of objects. The epidemic which occurred in Guinea tended to expand to neighboring countries; 83 deaths have been reported on April 1st 2014. Genetic analysis have revealed that the virus that causes this epidemic is similar in a proportion of 98% to Ebolavirus Zaire (EBOV) species that were responsible for the epidemic in Democratic Republic of Congo, in 2008. The Ebola virus belongs to the Filoviridae family, Ebolavirus genus and causes Ebola Hemorrhagic Fever, with a rate of fatality of up to 90% in humans. There are five distinct species: Bundibugyo Ebolavirus (BDBV), Ebolavirus Zaire (EBOV), Reston Ebolavirus (RESTV), Sudan Ebolavirus (SUDV) and Taï Forest Ebolavirus (TAFV).
Chronic pancreatitis is characterised by progressive and irreversible damage of the pancreatic parenchyma and ductal system, which leads to chronic pain, loss of endocrine and exocrine functions. Clinically, pancreatic exocrine insufficiency becomes apparent only after 90% of the parenchima has been lost. Despite the simple definition, diagnosing chronic pancreatitis remains a challenge, especially for early stage disease. Because pancreatic function tests can be normal until late stages and have significant limitations, there is an incresing interest in the role of imaging techniques for the diagnosis of chronic pancreatitis. In this article we review the utility and accuracy of different imaging methods in the diagnosis of chronic pancreatitis, focusing on the role of advanced imaging (magnetic resonance imaging, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound).
Introduction: Cisplatin is a well known platinum-based chemotherapeutic agent used for the treatment of diverse malignant tumours. A frequent side effect of cisplatin therapy is ototoxicity. Material and methods: Experimental, clinical studies and reviews from the English language medical literature concerning ototoxicity were selected either from PubMed or printed medical journals, pointing out cisplatin-induced ototoxicity. Molecular mechanisms, clinical audiological and histological marks of cisplatin-induced ototoxicity as well as current experimental and clinical strategies for prevention or treatment of hearing loss were reviewed. Results and discussion: A wide range of otoprotective molecules and efficient strategies against cisplatin-induced hearing loss proved to be helpful in experimental studies whereas only dexamethasone settled a slight otoprotective effect in a clinical study. Conclusion: There is no currently available treatment for cisplatin associated hearing loss and further research is required for future therapeutic options.
The article presents the main aspects of sectional anatomy, lymph nodes and adjacent structures as well as MRI examination standard protocol for prostate cancer diagnosis. Using MRI multiparametric examination we succeed in classifying efficiently the malignant prostatic tumors using PI- RADS system. Also, using MRI multiparametric examination we can evaluate the effectiveness of prostate cancer treatment.
Bio-terrorism involves using biological agents/toxins with the intent to intimidate or coerce a government or civilian population to further political or social objectives, usually leading to deaths or illnesses of humans but also of plants/animals. Their use would probably initially be considered as a natural or unintentional event, especially in case of live biological agents. Moreover, a natural occurring disease outbreak could have the same destructive outcome as an efficient biological weapon. There is a need for proper differentiation between natural and intentional events although in the first stages the medical response should be similar; however, the course of incident management would take different paths later on. Biological agents’ investigation of dangerous pathogens, from natural unusual outbreaks or bio- terrorist attacks/other intentional use, imply the collaboration of different institutions with responsibilities in public health but also in national security and defense. The National Security and the Defense System institutions think mainly in security terms while national health care system institutions think principally` in medical care/prevention terms. These two ways of acting have to be combined in order to deal properly with hazardous biological agents.
