Acute abdomen as complication of a knee arthroscopy: A case report

A knee arthroscopy in spinal anaesthesia was performed on a 67 years old male patient. During the procedure the patient was hemodynamically stable, until he suddenly turned pale and started complaining of severe pain in lower abdomen with signs of guarding. The procedure was finished as urgently as possible and after releasing the tourniquet we noticed significant difference in volume of the leg, with redness distal to tourniquet. Urgent lab results were essentially unremarkable and the patient was sent for the urgent radiological diagnostics. CD of the left leg described fluid in the soft tissues of the thigh, scrotum, and abdomen; and the unenhanced CT of the abdomen showed free fluid along the entire femoral shaft of the left thigh, extending towards pelvis and abdomen to perihepatic and perisplenic space, and retroperitoneum, with gas bubbles tracking along anterior aspect of the left thigh into the left retroperitoneum. He was admitted to the ICU, and within few hours all symptoms have resolved and his further recovery was without complications.

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The clinical efficacy of arthroscopic therapy with knee infrapatellar fat pad cell concentrates in treating knee cartilage lesion: a prospective, randomized, and controlled study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02224-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yiqin Zhou ◽

Haobo Li ◽

Dong Xiang ◽

Jiahua Shao ◽

Qiwei Fu ◽

...

Keyword(s):

Clinical Efficacy ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Knee Arthroscopy ◽

Infrapatellar Fat Pad ◽

Control Group ◽

Knee Cartilage ◽

Fat Pad ◽

Group 12 ◽

Significant Difference

Abstract Introduction To evaluate the clinical efficacy of arthroscopic therapy with infrapatellar fat pad cell concentrates in treating knee cartilage lesions, we conducted a prospective randomized single-blind clinical study of controlled method. Methods Sixty cases from Shanghai Changzheng Hospital from April 2018 to December 2019 were chosen and randomly divided into 2 groups equally. Patients in the experiment group were treated through knee arthroscopy with knee infrapatellar fat pad cell concentrates containing mesenchymal stromal cells, while patients in the control group were treated through regular knee arthroscopic therapy. VAS and WOMAC scores were assessed at pre-operation, and 6 weeks, 12 weeks, 6 months, and 12 months after intervention. MORCART scores were assessed at pre-operation and 12 months after intervention. Results Twenty-nine cases in the experiment group and 28 cases in the control group were followed up. No significant difference in VAS, WOMAC, and MOCART scores were found between the two groups before surgery (P > 0.05). The WOMAC total and WOMAC function scores of the experiment group were significantly lower than those of the control group 6 months and 12 months after surgery (P < 0.05). The VAS rest and VAS motion scores of the experiment group were found significantly lower than those of the control group 12 months after surgery (P < 0.05). The MOCART scores of the experiment group were found significantly higher compared with the control group 12 months after surgery (P < 0.05). No significant difference in WOMAC stiffness scores were found between the two groups. Conclusions The short-term results of our study are encouraging and demonstrate that knee arthroscopy with infrapatellar fat pad cell concentrates containing mesenchymal stromal cells is safe and provides assistance in reducing pain and improving function in patients with knee cartilage lesions. Trial registration ChiCTR1800015379. Registered on 27 March 2018, http://www.chictr.org.cn/showproj.aspx?proj=25901.

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The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity

Pain Research and Management ◽

10.1155/2018/9819402 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Mefkure Eraslan Sahin ◽

Erdem Sahin ◽

Yusuf Madendag ◽

Ilknur Col Madendag ◽

Ahter Tanay Tayyar ◽

...

Keyword(s):

Disease Severity ◽

Severe Pain ◽

Longitudinal Axis ◽

Primary Dysmenorrhea ◽

Uterine Corpus ◽

Significant Family History ◽

Significant Difference ◽

History Of ◽

Secondary Dysmenorrhea ◽

The Mean

Background. Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods. A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results. Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P<0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P<0.001). Conclusion. Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.

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Comparison of patient and surgeon satisfaction in patients undergoing knee arthroscopy with peripheral nerve block versus spinal anesthesia

Journal of Clinical and Investigative Surgery ◽

10.25083/2559.5555/6.2.10 ◽

2021 ◽

Vol 6 (2) ◽

pp. 148-152

Author(s):

Seray Turkmen ◽

◽

Mehmet Mutlu

Keyword(s):

Peripheral Nerve ◽

Spinal Anesthesia ◽

Nerve Block ◽

Knee Arthroscopy ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Rescue Analgesia ◽

Significant Difference ◽

Duration Of Surgery ◽

Surgeon Satisfaction

Objective. This study aims to compare two different methods of regional anesthesia applied for knee arthroscopy in terms of patient and surgeon satisfaction. Materials and Methods. Eighty patients who underwent knee arthroscopy either with spinal anesthesia (SA) or unilateral sciatic and femoral nerve block (SFNB) were included in the study. A nurse conducted a blind study questionnaire to assess the surgeon and patient satisfaction from anesthesia performed at the end of the surgery. Pain score, demographical data, duration of surgery, motor and sensory block duration, time of first rescue analgesia were recorded and analyzed statistically. Results. A statistically significant difference was found between the patient (p = 0.001; p <0.01) and surgeon (p = 0.022; p <0.05) satisfaction rates, these being lower in the group with SFNB comparable to patients with spinal anesthesia. There was a statistically significant difference between the first analgesic requirements of the patients according to the groups (p = 0.001; p <0.01). The first analgesic requirement of the patients who received SFNB was later than in the case of patients who received spinal anesthesia. Conclusions. Patient and surgeon satisfaction with SA was significantly higher than SFNB. The peripheral nerve blocks are inadequate for patient and surgeon satisfaction for knee arthroscopy compared to SA.

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To casuistry foreign bodies of the female urinary bladder

Journal of obstetrics and women s diseases ◽

10.17816/jowd5130-33 ◽

2020 ◽

Vol 5 (1) ◽

pp. 30-33

Author(s):

I. Tyshko

Keyword(s):

Urinary Incontinence ◽

Urinary Bladder ◽

Severe Pain ◽

Foreign Bodies ◽

Lower Abdomen ◽

Lower Back ◽

External Genital Organs

Alexandra Ermolaeva, a peasant woman from the Smolensk district, Spasskaya volost, 22 years old, was admitted to the Smolensk Provincial Zemsky Hospital on February 2, 1890, complaining of complete urinary incontinence, severe pain in the lower abdomen, in the lower back, and external genital organs, constipation and pain.

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Foreign body of the esophagus, complicated by retropharyngeal abscess and mediastinitis

Kazan medical journal ◽

10.17816/kazmj84146 ◽

1981 ◽

Vol 62 (5) ◽

pp. 64-65

Author(s):

V. V. Baityakov ◽

V. V. Fedotov ◽

A. I. Bocharov

Keyword(s):

Foreign Body ◽

Sore Throat ◽

General Condition ◽

Severe Pain ◽

Soft Tissues ◽

Fish Bone ◽

Retropharyngeal Abscess ◽

Anterior Surface ◽

Interscapular Region

T., 55 years old, choked on a fish bone while eating. After 2 days, she was admitted to the ENT clinic with complaints of sore throat, hoarseness, sharp difficulty in swallowing and breathing. The general condition of the patient is severe, the neck is enlarged due to edema of soft tissues, the skin is pale, on the anterior surface of the chest there are massive subcutaneous hemorrhages. The patient retains a forced position, cannot lie on the couch on her own. Palpation of the neck and interscapular region causes severe pain. Temperature 39.3 .

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Mesenchymal Chondrosarcoma: A Rare Aggressive Variant of Chondrosarcoma

Nepalese Medical Journal ◽

10.3126/nmj.v3i2.35048 ◽

2020 ◽

Vol 3 (2) ◽

pp. 388-391

Author(s):

Adarsh Kumar Jhunjhunwala ◽

Arnab Ghosh ◽

Manish Kiran Shrestha ◽

Dilasma Ghartimagar ◽

Sushma Thapa ◽

...

Keyword(s):

Soft Tissue ◽

Femoral Head ◽

Head And Neck ◽

Left Thigh ◽

Mesenchymal Chondrosarcoma ◽

Post Contrast ◽

Sclerotic Lesion ◽

Anterior Aspect ◽

Intensity Lesion ◽

Cortical Irregularity

A 15-year-old boy reported a 2-month history of severe left thigh pain Physical examination revealed left thigh swelling measuring 6x5 cm. X-ray of the region showed mixed lytic and sclerotic lesion involving the femoral head and neck. A Computed Tomography scan showed mixed lytic and sclerotic lesion involving the femoral head and neck with cortical irregularity and mild periosteal reaction with associated soft tissue in the anterior aspect. Magnetic resonance imaging demonstrated heterogeneous signal intensity lesion with areas of sclerosis involving the femoral head and neck. The large associated soft tissue in the anterior aspect appears predominantly hyperintense on T2W images. On post-contrast axial and sagittal images, heterogeneous enhancement with areas of necrosis involving soft tissue was seen. A presumptive radiological differential diagnosis of Ewing Sarcoma and Osteosarcoma was made. However, on histopathology, it was a case of mesenchymal chondrosarcoma.

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Butterfly Fragment in the Femoral Shaft Fractures Treated by Intramedullary Nail: Do We Need to Reduce It or Not?

10.21203/rs.3.rs-51108/v1 ◽

2020 ◽

Author(s):

Tayyar Kürşat Dabak ◽

Osman Ci̇van ◽

Hakan Özdemi̇r

Keyword(s):

Intramedullary Nail ◽

Fragment Size ◽

Femoral Shaft ◽

Shaft Fracture ◽

Variance Analysis ◽

Gap Size ◽

Femur Shaft Fracture ◽

Femoral Shaft Fractures ◽

Significant Difference ◽

Femur Shaft

Abstract Background: Limited data is available regarding the effect of gap size, fragment size and position of fragment on union in fragmented femur shaft fracture. The aim of the study is to analyze the effect of these parameters on union and determine cut-off values that necessitate reduction of fragment. Methods: Total of 59 patients with fragmented femur shaft fracture were reviewed and the effect of fragment size, gap size and fragment position on union were evaluated on 3rd, 6th and 12th month graphies from medical record of patients. Union rate was determined due to Radiographic Union Score of Femur. Patients were divided into small gap ( 10 mm) or large gap (10 mm), reverse fragment or non-reverse fragment and small fragment (50 mm) or large fragment (50mm) groups. Kruskal–Wallis Variance Analysis and Mann Whitney U test was used for comparisons among groups. The post-hoc Mann Whitney U-Test with Bonferroni Correction was used when the Kruskal Wallis Variance Analysis determined a significant difference.Results: In comparison of union scores of groups in regarding gap size and fragment size, there was not significant difference between groups at 3rd, 6th and 12th months. Union scores in the 3rd month (p=0,011) and 6th month (p=0,039) were lower in the reverse group than non-reverse group. But there was not statistically significant difference between two groups at 12th month (p=0.819). There was no significant difference in union rates in respect to intramedullary nail types. There was an indirect correlation between age and mean union score at 12th month. Conclusions: we could not determine any cutoff value regarding gap width and fragment size in the treatment of the femoral shaft fractures by IMN. Although there was a tendency to decrease in union scores due to the increase in the gap size, any significant difference was not determined. Only the reverse position of fragment had an adverse effect on the union until 6th months but the union score of reverse group reached the result of the non-reverse group by 12th months.

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Perbedaan Penyembuhan Luka Pasca Ekstraksi Gigi Antara Pasien Perokok Dengan Bukan Perokok Di RSGM Unsrat

e-GIGI ◽

10.35790/eg.7.2.2019.25141 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

Lidia A. Kewo ◽

Damajanty H.C. Pangemanan ◽

Aurelia Supit

Keyword(s):

Wound Healing ◽

Tooth Extraction ◽

Soft Tissues ◽

P Value ◽

Eligibility Criteria ◽

Cross Sectional ◽

Inflammatory Phase ◽

Significant Difference ◽

The Difference ◽

Cross Sectional Design

Abstract: To date, there are lots of documentations about the adverse effects of smoking on the oral cavity. Albeit, smoking is still considered as a casual thing in our community. Chemicals contained in the cigarette smoke can irritate the gums and soft tissues of the mouth, thus inhibiting wound healing after tooth extraction. This study was aimed to determine the difference in post-extraction dental wound healing between smokers and non-smokers. This was a comparative analytical study with a cross sectional design. Samples were obtained by using total sampling method. Subjects consisted of 16 smokers and 16 non-smokers that fulfilled the study eligibility criteria. Their oral cavities were examined to check the signs of inflammation (calor, dolor, rubor, tumor, and functio laesa). The results showed that there was a difference in post-extraction wound healing in inflammatory phase between smokers and non-smokers. As many as 9.4% of smoker patients and 34.4% of non-smoker patients recovered at 7 days post extraction. The Mann Whitney U test showed a p-value of 0.005. In conclusion, there was a significant difference in post-extraction wound healing between smokers and non-smokers.Keywords: smokers, non-smokers tooth extraction, wound healing Abstrak: Kebiasaan merokok bukan merupakan hal asing di masyarakat walaupun banyak dokumentasi mengenai akibat buruk dari merokok terhadap rongga mulut. Bahan kimia yang terdapat dalam asap rokok dapat mengiritasi gusi dan jaringan lunak mulut sehingga menghambat penyembuhan luka pasca ekstraksi gigi. Penelitian ini bertujuan untuk mengetahui perbedaan penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan bukan perokok. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Pengambilan sampel menggunakan total sampling yang memenuhi kriteria penelitian. Terdapat sebanyak 16 orang perokok dan 16 orang bukan perokok sebagai subyek penelitian. Pemeriksaan rongga mulut dilakukan untuk melihat tanda-tanda inflamasi (kalor, dolor, rubor, tumor, dan fungsio laesa). Hasil penelitian menunjukkan terdapat perbedaan penyembuhan luka 7 hari pasca ekstraksi gigi pada fase inflamasi antara pasien perokok dengan yang bukan perokok; sebanyak 9,4% pasien perokok dan 34,4% pasien bukan perokok yang sudah sembuh. Hasil uji Mann Whitney U mendapatkan nilai p=0,005. Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan yang bukan perokokKata kunci: perokok, bukan perokok, ekstraksi gigi, penyembuhan luka

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Survival outcomes in primary head and neck adult sarcoma: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6055 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6055-6055

Author(s):

Sondos Zayed ◽

Cindy Lin ◽

Gabriel Boldt ◽

Pencilla Lang ◽

Nancy Read ◽

...

Keyword(s):

Systematic Review ◽

Head And Neck ◽

Soft Tissues ◽

Treatment Approach ◽

Meta Analysis ◽

Multimodality Treatment ◽

Cochrane Library ◽

Size Analysis ◽

Survival Outcomes ◽

Significant Difference

6055 Background: Head and neck sarcomas (HNS) are rare entities and confer substantial morbidity and mortality. Yet, the optimal management of HNS remains unclear. This study aimed to describe the epidemiology of HNS and to identify the most favorable treatment approach. Methods: We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using the PubMed (Medline), EMBASE, and Cochrane Library databases, queried from 1990 until present. Articles in the English language reporting on survival outcomes of adult primary HNS patients treated with curative-intent were included. All estimates were weighted based on sample size. Analysis of variance (ANOVA) and two-sample t-tests were used as appropriate. Meta-analyses were performed using random effects models. This study was registered with PROSPERO, CRD42021220970. Results: A total of 3652 articles were identified, with 42 articles reporting on 21228 patients, meeting inclusion criteria. Mean ± SD age was 56.7 ± 14.6 years with 14170 (67.0%) men and 6991 (33.0%) women. The most common locations included skin and soft tissues (n = 12749, 63.3%), bones of skull and face (n = 2256, 11.2%), and oral cavity (n = 1775, 8.8%). The most common histologies included undifferentiated pleomorphic sarcoma (n = 5065, 24.8%), osteosarcoma (n = 2578, 12.6%), Kaposi sarcoma (n = 2316, 11.3%), chondrosarcoma (n = 2141, 10.5%), and hemangiosarcoma (n = 2072, 10.1%). 5459 patients had early stage I-II disease (76.9%) whereas 1643 had late stage III-IV disease (23.1%). Most received surgery alone (n = 10968, 61.0%), 3917 (21.8%) received surgery and radiotherapy (RT), 2173 (12.1%) received definitive RT/chemoradiotherapy (CRT), 811 (4.5%) received surgery and CRT, and 98 (0.5%) received surgery and chemotherapy. Negative margins were achieved in 6081 (76.5%). Mean ± SD follow-up was 55.3 ± 42.8 months. Weighted mean, 2-, 5-, and 10-year overall survival (OS) were 78.5 months, 75.9%, 63.2%, and 54.9% respectively. There was no significant difference in mean OS (P = 0.674) or 5-year OS (P = 0.965) between patients who received surgery alone, multimodality treatment with surgery and RT/CRT, or definitive RT/CRT. Mean ± SD 5-year OS was significantly higher with negative margins (62.7 ± 20.8%) compared with positive margins (22.7 ± 19.1%; P = 0.001). Mean ± SD local recurrence rate (LRR) was 32.0 ± 13.0%. LRRs were 41.8% for definitive RT/CRT, 39.3% for surgery and CRT, 33.6% for surgery alone, 24.7% for surgery and chemotherapy, and 20.1% for surgery and RT (P = 0.126). Conclusions: In the largest HNS study to date, negative margins were associated with an improvement in OS. Multimodality treatment did not confer an OS benefit. Definitive RT/CRT may be associated with a higher LRR. Randomized trials are needed to establish the optimal treatment approach for HNS.

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Does tranexamic acid improve intra-operative visualisation in endoscopic ear surgery? A double-blind, randomised, controlled trial

The Journal of Laryngology & Otology ◽

10.1017/s0022215119002317 ◽

2019 ◽

Vol 133 (12) ◽

pp. 1033-1037 ◽

Cited By ~ 2

Author(s):

A Das ◽

S Mitra ◽

D Ghosh ◽

S Kumar ◽

A Sengupta

Keyword(s):

Tranexamic Acid ◽

Middle Ear ◽

External Auditory Canal ◽

Soft Tissues ◽

Controlled Trial ◽

Control Group ◽

Endoscopic Ear Surgery ◽

Ear Surgery ◽

Significant Difference ◽

Surgical Field

AbstractObjectiveTo assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.MethodsFifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.ResultsThe Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.ConclusionTranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.

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