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TITLE: Sindrome de vasoconstriccion cerebral reversible secundario a un paraganglioma yugular secretor de metanefrinas.
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Transtornos Cerebrovasculares/etiologia , Cefaleia/etiologia , Veias Jugulares , Paraganglioma/complicações , Neoplasias Vasculares/complicações , Vasoconstrição , Secreções Corporais , Feminino , Humanos , Pessoa de Meia-Idade , Paraganglioma/metabolismo , Síndrome , Neoplasias Vasculares/metabolismoRESUMO
[This corrects the article DOI: 10.1186/s13017-017-0141-6.].
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[This corrects the article DOI: 10.1186/s13017-016-0089-y.].
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PURPOSE: The outcomes of open incisional hernia repair from the patients' point of view have variations over time, and only continuous follow-up would reflect the real outcomes. The purpose of this study is to validate a standard measurement instrument in the form of a questionnaire to report the evolutionary outcomes of a specific open technique to repair incisional hernias. METHODS: Prospective study follows up a cohort of 82 consecutive patients submitted to elective intraperitoneal open hernioplasty of midline incisional hernias. The follow-up consisted in an interview and physical examination 30 days after surgery, at 6 months, 1 year, 2 years, 3 years, and 4 years. Primary outcome measure was reporting the outcomes of hernia repair according to a standardized scale obtained from a questionnaire. RESULTS: There was no correlation between complications suffered by patients and score results (p = 0.722). The length of hospital stay was 6.5 ± 4.3 days, and a prolonged hospital stay was related to complications (p = 0.002) and did not influence the score results (p = 0.365). The final score demonstrated that patients had a very good impression on this procedure 1 month after surgery (p = 0.003). This impression shifted to an excellent perception 1 year after surgery remaining similar until the last control (p < 0.0001). CONCLUSIONS: In this series, the intraperitoneal hernioplasty was a procedure associated with minor morbidity and without recurrences 4 years after the operation. The outcomes from the patients' point of view were excellent 1 year after the procedure with a tendency to improve in the long term.
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Parede Abdominal/cirurgia , Hérnia Abdominal/cirurgia , Herniorrafia/métodos , Satisfação do Paciente , Complicações Pós-Operatórias/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Herniorrafia/efeitos adversos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Estudos Prospectivos , Telas Cirúrgicas , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND: Intestinal obstruction (IO) leads to increased intra-abdominal pressure and abdominal compartment syndrome. The purpose of this study was to investigate the characteristics of abdominal compartment syndrome in patients with IO secondary to strangulated hernia. METHODS: We studied 81 consecutive unselected patients presenting complicated hernias and IO. We measured intra-abdominal pressure using the intra-vesicular pressure method. RESULTS: Preoperative (15 min) intra-abdominal pressure was higher in patients with strangulated hernias. Postoperative (15 min) intra-abdominal pressure in both groups decreased to similar values. Intra-abdominal pressure was measured during the preoperative period in patients with strangulated hernias and during the postoperative period at 15 min (13.8 +/- 6.4 mmHg), 24 h (9.8 +/- 3.2 mmHg) and 48 h (7.4 +/- 2.4 mmHg). Abdominal compartment syndrome developed in 47% cases with strangulated hernias with a mortality of five patients. CONCLUSIONS: Serial measurements of intra-abdominal pressure evidenced the clinical severity of strangulated hernia. Intra-abdominal pressure measurement may be used as a predictor of intestinal strangulation in patients presenting acute abdominal compartment syndrome secondary to complicated hernia.
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Abdome , Síndromes Compartimentais/etiologia , Hérnia Abdominal/complicações , Obstrução Intestinal/complicações , Idoso , Síndromes Compartimentais/classificação , Feminino , Hérnia Abdominal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , PressãoRESUMO
Real outcomes for the inguinal tension-free Lichtenstein hernioplasty are not reflected by the usual parameters by which they are measured and habitually reported. It is possible to measure these outcomes from the point of view of the surgeon, as well as from the patient's, using an instrument specifically designed for that purpose. The aim of this study was to analyze the outcomes of the tension-free hernioplasty in 236 patients. Based upon the concept of quality-of-life, we designed a structured questionnaire in the form of a qualitative-and-quantitative measurement instrument. The study had two phases. First, we analyzed retrospectively the clinical records. Second, we interviewed the patients applying the instrument. The score demonstrated that 83% of the patients feel that the outcomes of their surgery are excellent, 9.7% feel that they are very good, and 3.8% feel that they are bad or very bad. Outcomes of the Lichtenstein hernioplasty should not only reflect the technological progress of hernia surgery but also the more intimate aspects of the patient's experience. It is possible to measure the outcomes of this common surgical procedure in a more complete way using a simple measurement instrument.
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Hérnia Inguinal/cirurgia , Avaliação de Resultados em Cuidados de Saúde/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Qualidade de Vida , Recidiva , Inquéritos e QuestionáriosRESUMO
1,200 cases of bone tumors were reviewed from the Orthopedic Hospital "Magdalena de las Salinas" between 1982 and 1989. 66.7% of them were benign tumors, 14.3% pseudotumoral lesions, 10.1% metastatic tumors, 8.6% primary malignant tumors, and 0.3% were malignant invasive tumors to bone. The most frequently found benign tumors were: osteochondroma, enchondroma and giant cell tumor; the most frequent pseudotumoral lesions were metaphyseal fibrous defects, solitary bone cysts and fibrous dysplasia; the most frequent primary malignant tumor was osteosarcoma. Prevalence, frequency, distribution, sex, most frequent ages, affected bones, multicentricity, and aggregated fractures, as well as the site of the primary lesion in metastatic and invading tumors, were similar to those reported in the classical series.