RESUMO
The authors report a case of septo-optic dysplasia discovered during the pregnancy without another abnormality. It's a rare cerebral abnormality that is characterized by an absence of septum pellucidum associated to a hypoplasia of ways and optic chiasm to variable degrees. Discovery is often made for adulthood. Future is extremely wide. It is determined with the arisen to different degrees of incapacity of Pituitary gland, psychomotor delay of variable intensity with mental deficiency, a visual confusion, and a confusion of the regulation of the temperature.
Assuntos
Displasia Septo-Óptica/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Algoritmos , Feminino , Humanos , Gravidez , Displasia Septo-Óptica/diagnósticoRESUMO
OBJECTIVE: The purpose of this study was to assess the value of hand disinfection by rubbing with alcohol in terms of prevention of surgical site infection (SSI) and cost in a tropical setting. MATERIAL AND METHOD: This prospective cohort study carried out in the Gynecology Obstetrics Department of the Yopougon University Teaching Hospital from May to September 2005 was designed to compare two different methods of hand disinfection, i.e., traditional 3-step hand scrubbing using an antiseptic preparation versus handwashing without an antiseptic preparation followed by two applications of an aqueous alcohol solution. RESULTS: The study population included 318 patients who underwent surgery during the study period. The SSI rate was 13.2% in patients operated on after traditional hand scrubbing and 11.5% after handwashing followed by rubbing with alcohol (not significantly different). Hand disinfection by rubbing with alcohol did not increase the risk of SSI and was considered as easier than traditional hand scrubbing by 90% of users. Skin tolerance was deemed good by 52% of users. Most users (69%) wished both hand disinfection methods to be available. Hand disinfection by rubbing with alcohol was much more cost-effective than traditional hand scrubbing both with regard to initial investment and to consumable costs (50% lower). CONCLUSION: This study shows that hand disinfection by rubbing with an alcoholic solution is not only as effective as traditional hand scrubbing for prevention of SSI but also more cost-effective. These findings indicate that rubbing with alcohol is a suitable alternative to traditional scrubbing for hand disinfection prior to surgery in our tropical setting.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Desinfecção/métodos , Etanol/administração & dosagem , Desinfecção das Mãos , Período Pré-Operatório , Análise Custo-Benefício , Humanos , Estudos Prospectivos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Clima Tropical , Medicina Tropical , Raios UltravioletaRESUMO
OBJECTIVES: Assess the efficiency of internal iliac arteries ligation in intractable obstetrical hemorrhage and ascertain success or failure factors. PATIENTS AND METHODS: It was a retrospective study which concerned 159 patients who underwent internal iliac arteries ligation for persistent and severe obstetrical hemorrhage from March 1992 to February 2007. Arrest of hemorrhage after ligation with survival of the patient was considered as successful; was considered as failure, persistence of hemorrhage in spite of the ligation or patient death. RESULTS: Internal iliac arteries ligation allowed hemorrhage control in 84.3% of cases. Main etiology of hemorrhage were: uterine atony (42.8%), abruptio placentae (31.4%). Coagulation disorders and hypovolemic shock, consequences of long delay of management were identified as bad prognosis factors. Blood transfusion was also singled out as a factor likely to ameliorate prognosis, especially in hemodynamic precarious situations. Surgical complications incidence was 1.89%, represented by two internal iliac vein lesions and one ureteral section successfully repaired. DISCUSSION AND CONCLUSION: Internal iliac arteries ligation is a prerequisite treatment of severe postpartum hemorrhage. The outcome is better when it is performed precociously (p=0.0000003) before the happening of disseminated intra vascular coagulation (p=0.006), hemodynamic troubles (p=0.0099) and acute severe anemia (p=0.02). It is a good alternative to arterial embolization in Africa.
Assuntos
Hemostasia Cirúrgica/métodos , Artéria Ilíaca/cirurgia , Hemorragia Pós-Parto/cirurgia , Útero/irrigação sanguínea , Adolescente , Adulto , África , Feminino , Humanos , Ligadura , Paridade , Complicações Pós-Operatórias , Hemorragia Pós-Parto/mortalidade , Gravidez , Hemorragia Uterina/mortalidade , Hemorragia Uterina/cirurgia , Adulto JovemRESUMO
Lobar congenital emphysema is a rare pulmonary malformation corresponding to progressive overinflation of a pulmonary lobe secondary to partial bronchial obstruction. Prenatal diagnosis is mainly based on lung hyperechoic area. Sonographic features are not specific highlighting the interest of fetal MRI or postnatal tomodensitometry. This case report describes prenatal detection including pitfalls and postnatal management.
Assuntos
Doenças Fetais/diagnóstico , Diagnóstico Pré-Natal/métodos , Enfisema Pulmonar/diagnóstico , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Pneumonectomia , Gravidez , Resultado da GravidezRESUMO
The authors report a care management of a patient presenting a severe alloimmunisation treated by spectrophotometry, a very efficient method but difficult of access in developing countries. Beyond the restrictive paraclinical exams which do not allow an efficient monitoring of this pathology, the lack of alloimmunisation prevention during illegal abortions and the lack of information about patients'medical files are highly responsible for the difficult management of Rhesus- negative patients. However the authors remind that only the scan at best combined with the Doppler, are effective exams helping to avoid the constraints of spectrophotometry. Although quite well-known this pathology induces very severe foetal consequences and may involve the obstetric prognosis of young women. The caesarian section will still remain for a long time the only means to prevent foetus from alloimmunisation complications in developing countries.