Osteomyelitis and Neuropathic Ulcers in Forefoot—Amputation Is the Only Surgical Intervention Resolving?

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 646-P
Author(s):  
DIMITRIOS SKOUTAS ◽  
FARES SAYEGH ◽  
SYMEON METALLIDIS ◽  
SOKRATIS SGOUTZAKOS ◽  
IOANNIS KATSANOS ◽  
...  
1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.


2019 ◽  
Vol 98 (4) ◽  
pp. 167-173

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.


2018 ◽  
Author(s):  
Louise Curtis ◽  
N Mathad ◽  
Aabir Chakraborty ◽  
Sarah Brewster ◽  
Kate Millar ◽  
...  

2012 ◽  
Vol 15 (5) ◽  
pp. 286
Author(s):  
Jan Droste ◽  
Heidar Zafarani Zadeh ◽  
Mohammed Arif ◽  
Ian Craig ◽  
A K Thakur

<p>A patient presented with recurrent syncope due to transient severe hypotension. The patient's history, physical examination, and initial baseline investigation did not suggest a cardiovascular cause. After fluid resuscitation, a raised jugular venous pulse was noted. Bedside transthoracic echocardiogram showed a pericardial effusion and a proximally dilated aorta. Computed tomography of the thorax confirmed these findings and also demonstrated an intramural hematoma of the proximal aortic wall.</p><p>The patient was transferred to a cardiothoracic center, where he was at first treated medically. He then developed sudden cardiogenic shock due to pericardial tamponade and was successfully operated on.</p><p>It is important to recognize an acute intramural hematoma of the proximal aortic wall as a cardiothoracic emergency. This condition can present atypically, but nevertheless warrants urgent surgical intervention, equal to type A aortic dissection. Echocardiography can help in making the diagnosis.</p>


2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.


2018 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Mochamad Targib Alatas

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible. 


Author(s):  
Priscilla Song

Thousands of people from more than eighty countries have traveled to China since 2001 to undergo fetal cell transplantation. Galvanized by the potential of stem and fetal cells to regenerate damaged neurons and restore lost bodily functions, people grappling with paralysis and neurodegenerative disorders have ignored the warnings of doctors and scientists back home in order to stake their futures on a Chinese experiment. This book looks at why and how these individuals have entrusted their lives to Chinese neurosurgeons operating at the forefront of experimental medicine, in a world where technologies and risks move faster than laws can keep pace. The book shows how cutting-edge medicine is not just about the latest advances in biomedical science but also encompasses transformations in online patient activism, surgical intervention, and borderline experiments in health care bureaucracy. The book opens up important theoretical and methodological horizons in the anthropology of science, technology, and medicine. It illuminates how poignant journeys in search of fetal cell cures become tangled in complex webs of digital mediation, the entrepreneurial logics of postsocialist medicine, and fraught debates about the ethics of clinical experimentation. Using innovative methods to track the border-crossing quests of Chinese clinicians and their patients from around the world, the book maps the transnational life of fetal cell therapies.


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