Femoral artery blowout syndrome following radical vulvectomy and radiation therapy.

Arterial blowout syndrome has mostly been described in carotid arteries and has been attributed to factors associated with head and neck neoplasia, radical resection, and a history of irradiation. Only sporadic cases have been described in other arteries. Herein we present a case of the femoral artery blowout syndrome, six months after radical surgery of the vulva and radiation therapy.

AIRWAY MANAGEMENT IN LAPAROSCOPIC CHOLECYSTECTOMY - A COMPARATIVE ANALYSIS.

In this study, we aimed to compare supraglottic airway devices (Supreme and i-gel laryngeal mask) with tracheal tube with respect to airway control and efficiency in ventilation and oxygenation. The study included 325 patients of ASA I-II who underwent laparoscopic cholecystectomy. In group 1, the airway was secured using endotracheal intubation (115 patients). In group 2 (103 patients), LMA Supreme was applied, whereas i-gel mask was used for airway management in group 3 (107 patients). Monitoring parameters were recorded and compared using t-test, analysis of variance (ANOVA), Tukey's test and χ2-test. The following parameters were monitored: insertion time, number of attempts for device placement, oropharyngeal seal pressure, etc. Insertion time was longest in group 1 (14.7±1.65 s) as compared to group 2 (15.5±1.05 s) and group 3 (14.1±1.27 s); ANOVA test yielded a statistically significant difference (p<0.01). Insertion success rate was almost identical in all three groups (p=0.907, χ2-test). Comparison of oropharyngeal seal pressure between group 2 (35.95±2.92 cm H2O) and group 3 (36.47±1.43 cm H2O) yielded no statistical difference (p=0.314, t-test). Endotracheal tube, Supreme and i-gel laryngeal masks were shown to be equally efficient in airway management in laparoscopic cholecystectomy. All three devices enabled efficient ventilation and oxygenation despite certain pathophysiological changes associated with laparoscopy.

Effectiveness of an intraoral thermoformed splint with magnet device in patients with xerostomia and hyposalivation: A pilot study.

AIM: The aim of the study was to examine the effectiveness of intraoral thermoformed splint with a magnet device over a period of 3 months, that is, to assess acceptability of this method of treatment using both objective and self-reported measures. MATERIALS AND METHODS: This study was designed as a prospective clinical pilot trial. 22 patients with xerostomia and hyposalivation were included. Xerostomia was assessed using a 4-question xerostomia questionnaire score and a test for unstimulated salivary flow rates. Evaluations were performed before the treatment and 3 months after the treatment using a thermoformed splint with a magnet device. RESULTS: There was a significant reduction in subjective symptoms after using a thermoformed splint with a magnet device for 3 months. For all 4 scored items, there was a statistically significant difference (P < .001) in median VAS scores before and 3 months after treatment. There was also a statistically significant difference in USFR before (0,15 ± 0,04 ml/min) and after treatment (0,24 ± 0,03 mL/min). CONCLUSION: Our findings indicate that the use of this device alleviated oral dryness and stimulated the function of the submandibular salivary gland. An intraoral thermoformed splint with a magnet device is safe, physiologically indifferent, useful, and effective in treating xerostomia and hyposalivation.

Primary hydatid disease of the transverse abdominal muscle A case report.

INTRODUCTION: Echinococcus is a parasitic disease that affects all organs and tissues. The most commonly affected are liver (70-80%) and lungs (10-25%), while very rarely, in about 5% of cases, it can be found in the spleen, kidneys, brain, heart, pancreas, muscles and skeleton. CASE REPORT: Although localization of hydatid cyst in muscle is rare, it is important to consideredPORT it in the differential diagnosis of a cystic mass in the muscle. Clinical diagnosis of cystic echinococcosis is based on general ultrasound imaging, CT, MRI, differentiation of Echinococcus-Ag, ELISA testing, immunoelectrophoresis (IEP), counterimmunoelectrophoresis (CIE). DISCUSSION: Surgery is the primary treatment for muscle hydatidosis. We present our experience in treating the case of an infected hydatid cyst on transverse abdominal muscle, with infection extending to the right diaphragm and subcutaneous tissue of abdomen and thorax between the transverse abdominal and internal sternal abdominal muscles. CONCLUSION: The goal of the surgical treatment is total evacuation of the parasite, "sterilization" of the residual cavity and handling of intraoperartive complications. The post-operative course was normal and the patient was discharged to home care ten days after surgery in good general and local condition. KEY WORDS: Abscess, Echinococcus, Infection, Muscle.

Severe Anaphylactic Reaction to Diclofenac during Intravenous Anesthesia for In Vitro Fertilization.

We present a case of a severe anaphylactic reaction to diclofenac, administered as an intravenous infusion in a 45-year-old patient, during intravenous anesthesia for in vitro fertilization. During the preoperative clinical examination and obtaining of anamnestic data, the patient denied symptoms of allergies to medicines and other substances. The dominant clinical manifestations of anaphylactic reaction were: hypotension, tachycardia, angioedema, bronchospasm, and delayed awakening following anesthesia. No visible changes in the appearance of the skin, such as erythema or urticaria have been observed. Proper clinical observation and adequate intraoperative monitoring led to rapid diagnosis and significantly reduced the time interval from the onset of anaphylaxis to the beginning of treatment and reanimation procedures.

Effectiveness of Augmented Reality Mobile Simulator in Teaching Local Anesthesia of Inferior Alveolar Nerve Block.

The aim of this study was to evaluate the effectiveness of a mobile augmented reality simulator for local anesthesia training with dental students who are administering inferior alveolar nerve block (IANB) for the first time. Participants in this prospective study conducted in 2016 were 41 fourth- and fifth-year students randomly divided into two groups: a control group with 19 students and an experimental group with 22 students. In addition to theoretical instruction and exercises, students in the experimental group used the mobile augmented reality simulator in a dental office 2h weekly for four weeks. The Sony SmartBand-2 was used to measure all students' heart rate five minutes before and during anesthesia administration. After anesthesia, students in both groups completed a post-clinical questionnaire evaluating their knowledge and skills. The experimental group had a higher average score and/or a more limited range of responses on each item of the questionnaire than the control group. The average time for performing IANB in the experimental group was 50.0±14.3 seconds, while the control group's average was 68.4±25.5 seconds. In addition, the group that used the augmented reality simulator had an anesthesia success rate of 90.9% compared to 73.7% for the control group. Students in both groups had a statistically significant increase in heart rate while performing anesthesia. Overall, the students who used the mobile simulator in addition to their education in augmented reality carried out anesthetic procedures for IANB in a shorter period of time and had greater success than the students who used only the conventional educational methods.