SURGICAL RECONSTRUCTION (UTEROVAGINAL ANASTOMOSIS) USING AUTOLOGOUS PERITONEUM (DAVYDOV’S PROCEDURE) IN A CASE OF CERVICAL AGENESIS

2021 ◽  
pp. 19-20
Author(s):  
Dhvani Shah ◽  
Apoorva Kulkarni ◽  
Abhaya Gupta ◽  
Paras Kothari ◽  
Manajitsinh Jadhav
Keyword(s):  
Surgical Reconstruction ◽  
Conservative Approach ◽  
The Past ◽  
Mullerian Anomaly

Cervical agenesis is a rare Mullerian anomaly requiring surgical reconstruction to restore the uterovaginal canal and thus menstruation in such patients. In the past, treatment in such patients was hysterectomy which has now developed into more conservative approach. We describe a successful canalization of the uterovaginal canal using autologous peritoneum in a case of cervical agenesis

Complete distal deltoid muscle detachment: a case report

2020 ◽  
Author(s):  
Naji S. Madi ◽  
Rayane Issa ◽  
Youssef Koaik ◽  
Muhyeddine Al-Taki
Keyword(s):  
Traumatic Injury ◽  
Deltoid Muscle ◽  
Shoulder Function ◽  
Young Female ◽  
Surgical Reconstruction ◽  
Conservative Approach ◽  
Successful Management ◽  
First Case ◽  
Basic Functions ◽  
Musculoskeletal Examination

Abstract Background The deltoid is a large triangular muscle at the shoulder. It attaches proximally to the clavicle, acromion and scapula, while distally it attaches to the lateral deltoid tuberosity. Ruptures are rare, and the literature only reports cases of proximal detachment. In this article, we report the first case of distal traumatic deltoid muscle detachment and its successful management. Case A young female sustained a traumatic injury following a Jet Ski accident with loss of consciousness. A complete distal rupture of the deltoid muscle was diagnosed after the basic functions were regained and a thorough musculoskeletal examination could be conducted. A conservative approach helped her to regain an acceptable shoulder function, but there was persistent pain upon activity and cosmetic scarring. The patient underwent surgical reconstruction. Postoperatively, she recovered satisfactorily. Discussion Distal detachment of the deltoid muscle is rare. The choice for surgical treatment may be undertaken based on several factors including functional status and patient-based assessment.

scholarly journals Primary Infertility secondary to Testicular Microlithiasis

2017 ◽  
Vol 16 (1) ◽  
pp. 178-180
Author(s):  
Imtiaz Shah ◽  
Fayaz Khan ◽  
Mohammad Zaieem ◽  
Farhan Khan ◽  
Suhail Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ultrasound Examination ◽  
Medical Science ◽  
Chromosomal Anomalies ◽  
Conservative Approach ◽  
Adult Males ◽  
Testicular Microlithiasis ◽  
Testicular Tumors ◽  
The Past ◽  
High Risk Factors

Testicular microlithiasis is an uncommon entity among adult males, resulting from tubular calcification. Reported incidence of testicular microlithiasis has been highly variable in the past decade due to increasing frequency of ultrasound examination of scrotal and testicular conditions. Testicular microlithiasis is associated with many benign and malignant conditions of testes. It is believed that in patients with Testicular microlithiasis conservative approach is warranted in absence of high risk factors, like contralateral testicular tumors, chromosomal anomalies and gonadal dysgenesis.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.178-180

Playing it safe

2020 ◽  
Vol 12 (3) ◽  
pp. 303-319
Author(s):  
Mark Mullen
Keyword(s):  
Video Game ◽  
Subject Matter ◽  
Digital Games ◽  
Conservative Approach ◽  
Art Galleries ◽  
Ethical Problems ◽  
The Past ◽  
Videogame Industry ◽  
Stated Purpose

For the past 30 years museums and art galleries on both sides of the Atlantic have been resistant to exhibiting digital games as art and have instead embedded them in exhibitions and displays that have portrayed them as exemplars of design. This conservative approach has largely failed to achieve the stated purpose of many of these exhibitions: to foster a wider public appreciation for games and encourage more sophisticated conversations about gaming. This article argues that curators for video game exhibitions have been co-opted by the ideological norms of the tech sector which has produced a reluctance to engage critically with their subject matter and a willingness to overlook ethical problems within the videogame industry.

Charcot foot

1989 ◽  
Vol 79 (5) ◽  
pp. 213-235 ◽  
Author(s):  
AS Banks ◽  
ED McGlamry
Keyword(s):  
Surgical Reconstruction ◽  
Charcot Foot ◽  
Successful Management ◽  
The Past ◽  
Recent Developments ◽  
Therapeutic Measures

Successful management of the Charcot foot is one of the most challenging undertakings faced by physicians. However, many times such patients undergo prolonged and attentive care only to develop further deformity, and in many cases succumb to amputation. Research in the past few years has yielded a new understanding of the Charcot process that should serve as the basis for improved therapeutic measures. The authors discuss these more recent developments and how this knowledge may be applied to better serve the patient. In addition, surgical reconstruction of the diabetic Charcot foot is introduced and discussed.

Reconsidering the Size and Structure of Casas Grandes, Chihuahua, Mexico

2010 ◽  
Vol 75 (3) ◽  
pp. 527-550 ◽  
Author(s):  
Michael E. Whalen ◽  
A. C. MacWilliams ◽  
Todd Pitezel
Keyword(s):  
Conservative Approach ◽  
Casas Grandes ◽  
The West ◽  
Regional Organization ◽  
The Past ◽  
Ritual Architecture ◽  
Size And Structure ◽  
Count Estimation

The site of Casas Grandes (or Paquimé) in northwest Chihuahua, Mexico, originally was estimated to contain some 2,300 rooms, placing it at the top of known prehispanic pueblo sizes. Its rooms were seen as arranged in blocks of as many as five stories, forming a vast, U-shaped pueblo. This room count and configuration are cited often in the past and present literature. We contend that Casas Grandes originally was interpreted in the most liberal terms. We reexamine it with a more conservative approach, and a different characterization emerges. The U-shaped configuration cannot be supported. Instead, we see a central, linear room block, a small part of which contained three stories. It was flanked on the west by well-known ritual architecture and surrounded on all sides by small, scattered, contemporary, one-story room units. The original room count estimation is reduced by about 50 percent, as is the concomitant estimate of nearly 5,000 residents. This has implications for extant models of the internal and regional organization of Casas Grandes.

Peripheral Nerve Healing: So Near and Yet So Far

2021 ◽  
Vol 35 (03) ◽  
pp. 204-210
Author(s):  
Aslan Baradaran ◽  
Hassan El-Hawary ◽  
Johnny Ionut Efanov ◽  
Liqin Xu
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerve Regeneration ◽  
Treatment Options ◽  
Surgical Reconstruction ◽  
Chronic Disability ◽  
The Past ◽  
Nerve Conduits ◽  
Acellular Nerve Allograft ◽  
Injury Treatment ◽  
Microsurgical Techniques

AbstractPeripheral nerve injuries represent a considerable portion of chronic disability that especially affects the younger population. Prerequisites of proper peripheral nerve injury treatment include in-depth knowledge of the anatomy, pathophysiology, and options in surgical reconstruction. Our greater appreciation of nerve healing mechanisms and the development of different microsurgical techniques have significantly refined the outcomes in treatment for the past four decades. This work reviews the peripheral nerve regeneration process after an injury, provides an overview of various coaptation methods, and compares other available treatments such as autologous nerve graft, acellular nerve allograft, and synthetic nerve conduits. Furthermore, the formation of neuromas as well as their latest treatment options are discussed.

scholarly journals Trends in the Rates of Pediatric Pyeloplasty for Ureteropelvic Junction Obstruction over 19 Years: A PHIS Database Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ardavan Akhavan ◽  
Paul A. Merguerian ◽  
Cindy Larison ◽  
Adam B. Goldin ◽  
Margarett Shnorhavorian
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Health Information System ◽  
Geographic Region ◽  
Ureteropelvic Junction ◽  
Surgical Reconstruction ◽  
Time Of Surgery ◽  
The Past ◽  
Time Period ◽  
Adjusted Rate ◽  
Primary Pyeloplasty

Background. Over the past 20 years, the management of ureteropelvic junction obstruction (UPJ) has shifted. While many urologists note a decrease in the number of pyeloplasties performed over time, the nature of the change in practice has yet to be defined. In the current study, we utilize a national, multi-institutional database of children’s hospitals to evaluate trends in patients undergoing pyeloplasty as well as the rate of surgical reconstruction over the past 20 years.Material/Methods. We queried the Pediatric Health Information System (PHIS) database for all children undergoing primary pyeloplasty between 1992 and 2011. Clinical variables, including age at time of surgery, gender, length of stay (LOS), and geographic region, were determined. Age-adjusted rate of repair was also calculated per 100,000 PHIS inpatients.Results. 6,013 patients were included in the study, of which 71.6% were male and 64.2% were under the age of 24 months at time of surgery. Over the study period, the median age at time of surgery increased from 2–4 months to 12–14 months (P<0.01). LOS decreased from a median of 5 days to 2 days (P<0.001). The rate of surgery increased by 10.6 pyeloplasties per 100,000 PHIS inpatients from 1992 to 2011 (P<0.01). The highest rate of pyeloplasty was in the northeast. The increase in pyeloplasties performed from 1992 to 1999 was specific to children aged greater than 24 months, while rates stayed the same in infants younger than 2 years during the same time period. In contrast, from 1999 to 2011, the rate of pyeloplasty decreased in patients less than 2 years of age, while the rate remained constant in patients over age 2.Conclusion. The rate of pyeloplasty increased in PHIS hospitals from 1992 to 2011. Trends are due to an increase in surgery in infants younger than 2 years from 1992 to 1999, followed by a progressive surgical rate decline, characterized by a shift towards patients older than 2 years of age.

scholarly journals Assessing thrombocytopenia in the intensive care unit: the past, present, and future

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 660-666 ◽  
Author(s):  
Ryan Zarychanski ◽  
Donald S. Houston
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Course ◽  
Conservative Approach ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Hematologic Disorder ◽  
Extracellular Histones ◽  
Adamts13 Deficiency ◽  
Underlying Disorder

Abstract Thrombocytopenia is common among patients admitted to the intensive care unit (ICU). Multiple pathophysiological mechanisms may contribute, including thrombin-mediated platelet activation, dilution, hemophagocytosis, extracellular histones, ADAMTS13 deficiency, and complement activation. From the clinical perspective, the development of thrombocytopenia in the ICU usually indicates serious organ system derangement and physiologic decompensation rather than a primary hematologic disorder. Thrombocytopenia is associated with bleeding, transfusion, and adverse clinical outcomes including death, though few deaths are directly attributable to bleeding. The assessment of thrombocytopenia begins by looking back to the patient’s medical history and presenting illness. This past information, combined with careful observation of the platelet trajectory in the context of the patient’s clinical course, offers clues to the diagnosis and prognosis. Management is primarily directed at the underlying disorder and transfusion of platelets to prevent or treat clinical bleeding. Optimal platelet transfusion strategies are not defined, and a conservative approach is recommended.

Tracheal stenosis in infants and young children

1990 ◽  
Vol 104 (3) ◽  
pp. 229-235 ◽  
Author(s):  
M. R. Laing ◽  
D. M. Albert ◽  
R. E. Quinney ◽  
C. M. Bailey
Keyword(s):  
Young Children ◽  
Tracheal Stenosis ◽  
Conservative Management ◽  
Surgical Reconstruction ◽  
Current Management ◽  
The Past ◽  
Sick Children ◽  
Infants And Young Children

AbstractEight cases of intra-thoracic tracheal stenosis presenting to the ENT department at the Hospital for Sick Children, Great Ormond Street, over the past 10 years are reported. The varied aetiology and presentation of these cases is discussed and the frequency of associated cardio-pulmonary anomalies emphasized. Difficulties in diagnosis and investigation are outlined, in addition to an overview of current management. While the overall outlook for many of these children remains poor there is reason to believe that a balance of conservative management and surgical reconstruction in selected cases will result in improved survival figures.

Strictures and fistulas of the anterior urethra

1997 ◽  
Vol 64 (4) ◽  
pp. 400-404
Author(s):  
S. Ranno ◽  
R. Leonardi ◽  
G. Stracuzzi ◽  
G. Minaldi ◽  
P. Miria
Keyword(s):  
Gold Standard ◽  
Surgical Reconstruction ◽  
Reconstruction Technique ◽  
Free Graft ◽  
Spongy Tissue ◽  
Anterior Portion ◽  
The Past ◽  
Urethral Strictures ◽  
Free Grafts ◽  
Urethral Surgery

– The first documents of urethral surgery for urethral strictures date back to the 4th century BC. In the past, endoscopic surgery was the best solution for most urologists. Nowadays, literature shows that the approach to urethral strictures depends on the degree of involvement of the spongy body. The choice of surgical reconstruction technique depends on the anatomical differences in the anterior portion of the urethra, which is divided anatomically into navicular, penile and bulbar. The gold standard for urethroplasty of the navicular urethra is the free graft which can take root due to the presence of glandular tissue. Techniques using a preputial pedunculated graft are good for penile urethra, while a free graft of preputial origin, that has first been perforated and then tubularised, is suggested for very long strictures (> 5 cm). Epidermal or mucosal free grafts can be used for bulbous urethral strictures, due to the presence of thick spongy tissue. The urethra should be completely substituted with a neo-urethra formed by preputial pedunculated and tubularised graft only for wide strictures with associated fibrosis of the spongy portion. Recurrent strictures can be treated twice with surgery.

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