Children who swallowed multiple magnetic foreign bodies.Gastrointestinal perforation and intestinal obstruction. The magnetic foreign bodies caused local bowel wall tissue ischemia necrosis and perforation as well as other complications associated with fistula formation. The magnets were finally removed by laparotomy surgery.

Πέμπτη, 22 Ιουνίου 2017

Children who swallowed multiple magnetic foreign bodies.Gastrointestinal perforation and intestinal obstruction. The magnetic foreign bodies caused local bowel wall tissue ischemia necrosis and perforation as well as other complications associated with fistula formation. The magnets were finally removed by laparotomy surgery.

Clinical experience in the treatment of children who swallowed multiple magnetic foreign bodies: A report of five cases: 

Abstract

Background

Several clinical reports have been published on complications resulting from swallowing multiple magnetic foreign bodies. This study aimed to summarize the clinical experience of managing children who swallowed multiple magnetic foreign bodies.

Methods

We reviewed the clinical records of five children who swallowed multiple magnetic foreign bodies and were admitted to our hospital during June 2012 to June 2014. Details of the patients' presentation, imaging studies, complications and treatment were recorded.

Results

All five children suffered from gastrointestinal perforation and intestinal obstruction. The magnetic foreign bodies caused local bowel wall tissue ischemia necrosis and perforation as well as other complications associated with fistula formation. The magnets were finally removed by laparotomy surgery.

Conclusion

If magnetic foreign bodies cannot be removed by endoscopy, an operation is suggested as soon as possible to avoid serious complications.

Αναρτήθηκε από 

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

What is global surgery?.

No abstract available

http://ift.tt/2sHXEtA

3D Printing: current use in facial plastic and reconstructive surgery.

Purpose of review: To review the use of three-dimensional (3D) printing in facial plastic and reconstructive surgery, with a focus on current uses in surgical training, surgical planning, clinical outcomes, and biomedical research. To evaluate the limitations and future implications of 3D printing in facial plastic and reconstructive surgery. Recent findings: Studies reviewed demonstrated 3D printing applications in surgical planning including accurate anatomic biomodels, surgical cutting guides in reconstruction, and patient-specific implants fabrication. 3D printing technology also offers access to well tolerated, reproducible, and high-fidelity/patient-specific models for surgical training. Emerging research in 3D biomaterial printing have led to the development of biocompatible scaffolds with potential for tissue regeneration in reconstruction cases involving significant tissue absence or loss. Major limitations of utilizing 3D printing technology include time and cost, which may be offset by decreased operating times and collaboration between departments to diffuse in-house printing costs Summary: The current state of the literature shows promising results, but has not yet been validated by large studies or randomized controlled trials. Ultimately, further research and advancements in 3D printing technology should be supported as there is potential to improve resident training, patient care, and surgical outcomes. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rXRus0

Barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitisation

Πέμπτη, 22 Ιουνίου 2017

Barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitisation

A randomised trial of a barrier lipid replacement strategy for the prevention of atopic dermatitis and allergic sensitisation: The PEBBLES Pilot Study: 

Abstract

It is hypothesised that the impaired skin barrier in atopic dermatitis (AD) allows the immune system to be exposed to environmental allergens, resulting in sensitisation and allergic disease[1]. Two small trials recently found that routine use of emollients reduced the incidence of AD during the active treatment period by approximately half [2, 3]. It remains unknown if prophylactic use of emollients can prevent the development of AD beyond the treatment period (as opposed to simply delay its onset) or if this reduction in AD leads to a reduced risk of allergic sensitisation.

This article is protected by copyright. All rights reserved.

Αναρτήθηκε από 

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Predictive factors for short- and long-term hearing preservation in cochlear implantation with conventional-length electrodes

Objectives/Hypothesis

The aims of this study were to investigate short- and long-term rates of hearing preservation after cochlear implantation and identify factors that impact hearing preservation.

Study Design

Retrospective review.

Methods

Patients undergoing cochlear implantation with conventional-length electrodes and air-conduction thresholds ≤80 dB HL at 250 Hz preoperatively were included. Hearing preservation was defined as air-conduction thresholds ≤80 dB HL at 250 Hz.

Results

The sample included 196 patients (225 implants). Overall, the rate of short-term hearing preservation was 38% (84/225), with 18% (33/188) of patients preserving hearing long term. Multivariate analysis showed better preoperative hearing was predictive of hearing preservation at short (odds ratio [OR]: 0.93, 95% confidence interval [CI]: 0.91-0.95, P < .001) and long-term follow-up (OR: 0.94, 95% CI: 0.91-0.97, P < .001). Lateral wall electrodes and mid-scala electrodes had 3.4 (95% CI: 1.4-8.6, P = .009) and 5.6-times (95% CI: 1.8-17.3, P = .003) higher odds of hearing preservation than perimodiolar arrays at short-term follow-up, respectively. Long-term data revealed better hearing preservation for lateral wall (OR: 7.6, 95% CI: 1.6-36.1, P = .01), but not mid-scala (OR: 3.1, 95% CI: 0.4-23.1, P = .28), when compared to perimodiolar electrodes. Round window/extended round window (RW/ERW) approaches were associated with higher rates of long-term hearing preservation (21%) than cochleostomy approaches (0%) (P = 0.002) on univariate analysis.

Conclusions

Better preoperative residual hearing, lateral wall electrodes, and RW/ERW approaches are predictive of higher rates of long-term functional hearing preservation.

Level of Evidence

4 Laryngoscope, 2017

http://ift.tt/2tUQK3G

Against fields

Abstract

Using the example of classical electrodynamics, I argue that the concept of fields as mediators of particle interactions is fundamentally flawed and reflects a misguided attempt to retrieve Newtonian concepts in relativistic theories. This leads to various physical and metaphysical problems that are discussed in detail. In particular, I emphasize that physics has not found a satisfying solution to the self-interaction problem in the context of the classical field theory. To demonstrate the superiority of a pure particle ontology, I defend the direct interaction theory of Wheeler and Feynman against recent criticism and argue that it provides the most cogent formulation of classical electrodynamics.

http://ift.tt/2s1Qv5z

Anterior abdominal wall extraosseous osteosarcoma, occurring 40 years after para-aortic irradiation

Extraskeletal osteosarcomas (OSs) are highly malignant soft tissue tumours associated with a poor prognosis. Only a few records of these rare aggressive neoplasms have been reported in the literature.

We describe the case of a 49-year-old man, who presented to our tertiary care centre with a painful isolated lump around the umbilicus. After surgical biopsy, imaging and subsequent pathological analysis, the swelling was diagnosed to be a localised extraskeletal OS. He received previous radiation as treatment for testicular seminoma 40 years ago, which has been in remission ever since. He also happens to have testicular hydrocele since 10 years. He was subjected to resection and free flap reconstruction complicated by lower anterior abdominal wall haematoma and large pseudoaneurysm of the left femoral artery. Patient completed 60 Gy of adjuvant electron beam irradiation for close margins and is scheduled for adjuvant chemotherapy. We describe a brief account of his illness.

http://ift.tt/2rIRS9R