RESUMO
Lasers and light-based devices are indispensable to an aesthetic dermatology practice. The growing popularity of lasers has been matched by a sharp increase in the incidence of complications. The Indian skin with its high melanin content is more prone to injury and careful setting of laser parameters, early detection of complications and immediate therapy are vital to avoiding permanent sequelae. We review the various complications that occur during laser procedures and their management.
Assuntos
Terapia a Laser/efeitos adversos , Fototerapia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Pigmentação da Pele , Vesícula/diagnóstico , Vesícula/etiologia , Vesícula/prevenção & controle , Edema/diagnóstico , Edema/etiologia , Edema/prevenção & controle , Humanos , Terapia a Laser/tendências , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/tendências , Fototerapia/tendências , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controleRESUMO
We have described the epidemiology of complications after surgical treatment of ankle fractures and assessed which factors are associated with the most frequent complications. We conducted a retrospective cohort study at 2 level 2 and 1 level 1 trauma center in a single trauma region in the Netherlands. The study variables were collected from the electronic medical patient records; all ankle fractures were classified using the Lauge-Hansen classification, and the complications were recorded. A total of 989 patients were included from 3 hospitals, with 173 complications in 156 patients (15.8%). The most frequent complication was wound related, occurring in 101 patients (10.2%). Implant-related complications occurred in 44 patients (4.4%). Other complications, such as cast pressure spots, posttraumatic dystrophy, nonunion, impingement, and pneumonia occurred in 28 patients (2.8%). The 2 most important complications were further analyzed for risk factors. Multivariate analysis showed the risk factors for wound-related complications were advanced age, increased American Society of Anesthesiologists classification, smoking, right side symptomatic, open fracture, and initial external fixation. Most implant-related complications were caused by malreduction (n = 22) or untreated syndesmotic injury (n = 19). Malreduction was associated with supination eversion fractures (p = .059), and untreated syndesmotic injury occurred more often with pronation external rotation fractures (p < .001). The most frequent complications after ankle fracture surgery were wound- and implant-related complications. Postoperative wound-related complications were multifactorial and dependent on a combination of trauma-, patient-, and treatment-related factors. In contrast, implant-related complications resulted from the interaction between the fracture type and subsequent surgical treatment.
Assuntos
Fraturas do Tornozelo/cirurgia , Fixação Interna de Fraturas/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Fraturas do Tornozelo/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Complicações Pós-Operatórias/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Centros de TraumatologiaAssuntos
Ciclosporina/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/tratamento farmacológico , Pioderma Gangrenoso/diagnóstico , Pioderma Gangrenoso/tratamento farmacológico , Administração Oral , Idoso , Humanos , Masculino , Resultado do TratamentoRESUMO
Leprosy is still a public health concern in Brazil, where more than 30,000 new cases are detected every year. There are few reports of this mycobacteriosis in immunosuppressed patients, despite the increasing number of solid organ transplantation and the use of post-transplant drugs in this country. The authors describe a case of multibacillary leprosy in a renal transplant recipient, detected 12 years after the procedure, and discuss the therapy, adverse effects and management of leprosy reactions in patients immunosuppressed by drugs.
Assuntos
Transplante de Rim , Hanseníase Multibacilar , Complicações Pós-Operatórias , Adulto , Humanos , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/terapia , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapiaRESUMO
O Brasil é um país onde a hanseníase ainda é um problema de saúde pública, apresentando mais de 30.000 novos casos por ano nos últimos anos. Apesar do crescente número de transplante de órgãos sólidos realizados no país, sobretudo o transplante renal, não são frequentes os relatos dessa micobacteriose em pacientes imunossuprimidos pelas medicações póstransplante. Os autores relatam um caso de hanseníase multibacilar manifestada 12 anos depois do transplante renal, acompanhado desde o diagnóstico, durante a poliquimioterapia, tratamento e seguimento do eritema nodoso hansênico.
Leprosy is still a public health concern in Brazil, where more than 30,000 new cases are detected every year. There are few reports of this mycobacteriosis in imunossupressed pacients, despite the increasing number of solid organ transplantation and the use of post-transplant drugs in this country. The autors describe a case of multibacillary leprosy in a renal transplant recipient, detected 12 years after the procedure, and discuss the therapy, adverse effects and management of leprosy reactions in pacients imunosupressed by drugs.