Surgical treatment of acute abscesses and gangrene of the lungs

1982 ◽  
Vol 63 (1) ◽  
pp. 28-31
Author(s):  
E. A. Wagner ◽  
V. M. Subbotin ◽  
V. D. Firsov ◽  
V. A. Cherkasov ◽  
V. I. Ilchishin ◽  
...  

Abstract. The experience of treating 263 patients with acute abscesses and lung gangrene is generalized. Acute abscesses are mainly subject to conservative treatment; surgical interventions were performed in 13%. With gangrene of the lung, conservative treatment and palliative operations are futile. Preference is given to early radical operations performed before dangerous complications occur. Possible ways to reduce mortality in acute pulmonary suppuration are indicated.

2016 ◽  
Vol 69 (9-10) ◽  
pp. 305-311
Author(s):  
Ivana Spasojevic ◽  
Danica Hajdukovic ◽  
Milena Komarcevic ◽  
Stanislava Petrovic ◽  
Jelena Jovanovic ◽  
...  

Introduction. Myasthenia gravis is an autoimmune disease caused by antibodies leading to the destruction of nicotinic acetylcholine receptors on the neuromuscular junction. It is characterized by muscle weakness that gets aggravated with physical activity and improves at rest. Myasthenia Gravis Foundation of America made the clinical classification of Myasthenia gravis which is still in use today. ?Tensilon test? is still the gold standard for the diagnosis of Myasthenia gravis. In addition to this test repeated muscular stimulation can be used as well as the analysis of specific autoantibodies. Treatment of Myasthenia Gravis. In conservative treatment of Mysthenia gravis anticholinesterases, immunosuppressants and plasmapheresis can be used. If conservative treatment does not lead to the desired remission, surgical treatment is indicated. The most accepted indication for thymectomy is the presence of thymoma with generalized form of Myasthenia gravis in adults. How to Distinguish Myasthenic From Cholinergic Crisis. The following is important to make a difference between these two crises: knowledge of the events that preceded the crisis, the size of pupils as well as the presence of muscarinic signs and tensilon test. Specific Features of Anesthesia in Patients with Myasthenia Gravis. Mechanism of the disease development is the reason for the increased sensitivity or resistance of these patients to certain types of drugs used in anesthesia. Protocol of Perioperative Anesthesia in Patients with Myasthenia Gravis. Based on 35 years of experience in the surgical treatment of patients with Myasthenia gravis anesthesiologists at the Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, made the protocol of anesthesia and perioperative treatment for these patients. Conclusion. Anesthesiologists may have to deal with a patient with myasthenia gravis in different types of surgical interventions. The protocol for anesthesia and perioperative management of these patients herewith presented may greatly help them in their clinical practice.


2018 ◽  
Vol 69 (10) ◽  
pp. 2722-2724
Author(s):  
Teodora Ioana Ghindea ◽  
Alexandru Dumitras Meius ◽  
Dragos Cristian Stefanescu ◽  
Catalina Pietrosanu ◽  
Irina Ionita ◽  
...  

The pharyngeal tonsil is a lymphatic tissue mass located in the roof of the nasopharynx. The function of the pharyngeal tonsil is to prevent infections with the help of antibodies. Chronic inflammation and allergies lead to hyperplasia of the adenoids that is found almost exclusively in children. The treatment of choice is surgical treatment; conservative treatment is only indicated preoperatively or if surgery is contraindicated. In this paper, we will present a new surgical method for adenoidectomy performed trans-orally with coblation, under endoscopic control.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Luis M. Marti-Martinez ◽  
Rubén Lorca-Gutierrez ◽  
Salvador Pedro Sánchez-Pérez ◽  
Jonatan Garcia-Campos ◽  
Nadia Fernández Ehrling ◽  
...  

Abstract Background Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. Methods This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. Results At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p <  0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. Conclusions Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.


2021 ◽  
Vol 65 (2) ◽  
pp. 140-156
Author(s):  
Eve-Riina Hyrkäs

AbstractIn the Finnish medical discussion during the middle decades of the twentieth century, the challenging differential diagnostics between hyperthyroidism and various neuroses was perceived to yield a risk of unnecessary surgical interventions of psychiatric patients. In 1963, the Finnish surgeon Erkki Saarenmaa claimed that ‘the most significant mark of a neurotic was a transverse scar on the neck’, a result of an unnecessary thyroid surgery. The utterance was connected to the complex nature of thyroid diseases, which seemed to be to ‘a great extent psychosomatic’. Setting forth from this statement, the article aims to decipher the connection between hyperthyroidism, unnecessary surgical treatment and the psychosomatic approach in Finnish medicine. Utilising a wide variety of published medical research and discussion in specialist journals, the article examines the theoretical debate around troublesome diagnostics of functional complaints. It focuses on the introduction of new medical ideas, namely the concepts of ‘psychosomatics’ and ‘stress’. In the process, the article aims to unveil a definition of psychosomatic illness that places it on a continuum between psychological and somatic illness. That psychosomatic approach creates a space with interpretative potential can be applied to the historiography of psychosomatic phenomena more generally. Further inquiry into the intersections of surgery and psychosomatics would enrich both historiographies. It is also argued that the historical study of psychosomatic syndromes may become skewed, if the term ‘psychosomatic’ is from the outset taken to signify something that is all in the mind.


2021 ◽  
Vol 19 (3) ◽  
pp. 47-54
Author(s):  
A. F. LAZAREV ◽  
◽  
E. I. SOLOD ◽  
YA. G. GUDUSHAURI ◽  
E. I. KALININ ◽  
...  

A surgical treatment of the joints of the pelvic ring, especially the pubic joint is a separate and complex problem. When using standard plates, which are applied in the treatment of patients with fresh injuries to stabilize old injuries of the pelvic ring, problems arise with fatigue fracture of plates, destabilization of the metal structure and the need for repeated surgical interventions. Therefore, in the case of old injuries, during surgical treatment, it is necessary to use other tactical approaches to fixing pelvic injuries and to search for adapted structures for such cases. The purpose — to study the features of fixation of old injuries of the pelvic ring and to determine the results of different methods of the anterior pelvis fixation in old cases. Materials and methods. A retrospective analysis of the performed surgical treatment was carried out. In 2000-2015, in the first department of National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, 117 patients underwent surgical treatment of old injuries of the anterior pelvic ring under our supervision using standard reconstructive plates applied in the surgical treatment of new injuries of the pelvic ring. Results. Of the 65 patients who underwent fixation of an old injury of the anterior semiring with AO reconstructive plates and AO pelvic plates, installed in a standard manner as in new injuries, 12 patients (10,2%) experienced migration or fracture of structures within 2 to 6 months from the operation. In 52 patients, fixation of the anterior section with two AO plates was applied, one of which was located in a standard way along the upper edge of the pubic bones, the second was implanted additionally along the anterior surface of the pelvic ring perpendicular to the first one. In this group, migration and destabilization of the structures was observed in 7 patients (13,4%) within a period from 2 weeks to 2 months from the date of the operation. Conclusion. The analysis of the study results suggests that surgical treatment of old injuries of the anterior pelvic ring requires a special approach to the choice of the surgical fixation method, which differs from the treatment of new injuries. Over time, in the absence of treatment for injuries and ruptures of the pelvic ring, cicatricial-fibrous adhesions of the pelvic ring occur, which does not always ensure the stability of the pelvic ring, but leads to rigid post-traumatic deformity of the pelvis. Taking into account the cases of destabilization in groups 1 — 10,2% and 2 — 13,4%, as well as the assessment of the long-term results according to the Majeed scale, the use of standard methods for fixing the anterior pelvic semiring can be considered ineffective in old pelvic injuries.


Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.


2015 ◽  
Vol 29 (3) ◽  
pp. 310-314 ◽  
Author(s):  
Yoshiro Musha ◽  
Keisuke Ito ◽  
Takahide Sunakawa ◽  
Hiromasa Nagahari ◽  
Hiroyasu Ikegami ◽  
...  

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.


2020 ◽  
Vol 14 (3) ◽  
pp. 297-300
Author(s):  
Mercedes Juncay ◽  
Rafael Sposeto ◽  
Alexandre Godoy-Santos ◽  
Túlio Fernandes

Tarsal coalition is an abnormal connection between tarsal bones, caused by an embryogenic failure. Its most common forms are calcaneonavicular and talocalcaneal coalition, which are present in 53% and 37% of the cases, respectively. The onset of symptoms is related to tarsal bone ossification, and mean age for this event is estimated at 16 years for calcaneonavicular coalition. Surgical treatment is indicated for patients who did not improve symptoms with conservative treatment. The aim of this study is to present a surgical technique as a treatment option for resection of calcaneonavicular coalition associated with abnormal cuboid-navicular joint. Level of Evidence V; Therapeutic Studies; Expert Opinion.


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