RESUMO
In 2013-2014 we undertook a randomised controlled trial (RCT) to determine whether the daily ingestion of dark chocolate during pregnancy could reduce the incidence of pre-eclampsia in primigravidae. However, after two years we had not succeeded in recruiting more than 3.5% of the number of participants required to answer the research question, and the trial was halted. We also reviewed the literature on this topic and found it to be limited. We report here our findings and discuss the difficulties facing researchers in this area.
Assuntos
Chocolate , Seleção de Pacientes , Pré-Eclâmpsia/dietoterapia , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de PesquisaRESUMO
BACKGROUND: Scuba diving-related otological injuries comprise the majority of diving-related incidents that present to general practitioners (GPs). Correct diagnosis and management are key to prevent permanent hearing loss and vertigo. OBJECTIVE: The aim of this article is to increase awareness of the pathophysiology of otological diving injuries and provide an approach to initial assessment and treatment, as well as to highlight particular circumstances in which onward referral is required. DISCUSSION: Accurate diagnosis and treatment of diving-related otological injuries by GPs can have profound positive effects on a patient's long-term outcomes. Complete otolaryngological assessment in those who have previously had a dive-related injury is critical to ensure patient safety prior to recommencing scuba diving.
Assuntos
Mergulho/lesões , Gerenciamento Clínico , Mergulho/efeitos adversos , Orelha/anatomia & histologia , Orelha/lesões , Orelha/fisiopatologia , Perda Auditiva/fisiopatologia , Perda Auditiva/prevenção & controle , Humanos , Exame FísicoRESUMO
INTRODUCTION: Abdominoplasty and abdominal hernia repair are often carried out in two-stage procedures, and those describing single-stage surgery require careful dissection to preserve often only partial blood supply to the umbilicus to maintain its viability. This paper aims to describe the surgical method of laparoscopic umbilical hernia repair in association with abdominoplasty. CASE PRESENTATION: A patient presents with an incisional hernia at a previous periumbilical port site of size 14 x 9 mm observed on ultrasound as well as a recurrent left inguinal hernia from previous bilateral laparoscopic inguinal hernia repair, oophorectomy, and laparoscopic cholecystectomy. A laparoscopic mesh repair of the hernia defect followed by abdominoplasty was performed. The patient made an uncomplicated recovery and was discharged home on day 5 post operation. There was complete healing of the umbilicus and remainder of the wounds. At 24-month follow-up, there was no recurrence of hernia. CONCLUSION: Previously documented methods of concomitant abdominoplasty and hernia repair use an open technique to repair the hernia. A laparoscopic approach is faster, but it poses a significant risk to the vascular supply to the umbilicus. This not only increases positive aesthetic outcomes and patient satisfaction but also reduces rates of postoperative complications and recovery time.
Assuntos
Produtos Pesqueiros/efeitos adversos , Corpos Estranhos/cirurgia , Veias Jugulares/patologia , Tromboflebite/etiologia , Administração Intravenosa , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Osso e Ossos , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Síndrome de Lemierre/prevenção & controle , Pessoa de Meia-Idade , Tromboflebite/tratamento farmacológico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia/métodosRESUMO
A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion. Data extraction was conducted by both reviewers and entered and analyzed in Microsoft Excel. The search identified 784 articles and 78 of these were suitable for inclusion in the review. A total of 14,232 patients underwent a stapled hemorrhoidopexy in this review. Overall complication rates of stapled hemorrhoidopexy ranged from 3.3%-81% with 5 mortalities documented. Early and late complications were defined individually with overall data suggesting that early complications ranged from 2.3%-58.9% and late complications ranged from 2.5%-80%. Complications unique to the procedure were identified and rates recorded. Both early and late complications unique to stapled hemorrhoidopexy were identified and assessed.