RESUMEN
Hyperhidrosis affects 2.8% of the population and has severe negative influence on life quality. The disease is represented in many specialties but can unfortunately be incorrectly treated or not treated at all. Primary hyperhidrosis is the most common form. Secondary hyperhidrosis is most often excluded by a few anamnestic data. Botulinum toxin and anticholinergics are adequate treatment options when aluminium chloride is insufficient. This article describes the disease from the physician's as well as the patient's perspective. Furthermore, examination procedures and treatment procedures are presented.
Asunto(s)
Hiperhidrosis , Toxinas Botulínicas Tipo A/administración & dosificación , Toxinas Botulínicas Tipo A/uso terapéutico , Antagonistas Colinérgicos/administración & dosificación , Antagonistas Colinérgicos/uso terapéutico , Humanos , Hiperhidrosis/diagnóstico , Hiperhidrosis/etiología , Hiperhidrosis/psicología , Hiperhidrosis/terapia , Neurotoxinas/administración & dosificación , Neurotoxinas/uso terapéutico , Calidad de Vida , Sudoración/fisiologíaRESUMEN
We report on two patients with fracture of a modular, tapered and distally fixed, uncemented titanium revision hip stem, not previously described. A failure analysis revealed that the cause of the fractures was the development of fatigue cracks in the mid-stem cobalt-chromium modular junction ending in corrosion-fatigue failure. No material defects or stress risers were found in any of the implants. The diameter of the mid-stem modular junction might be undersized for use in heavy and active patients. We also report a new way of detecting an undisplaced fracture at the modular junction, using the scout image from a computed tomography (CT) scan; a technique that can be used when plain radiographs are inconclusive.
Asunto(s)
Prótesis de Cadera/efectos adversos , Falla de Prótesis , Anciano , Artroplastia de Reemplazo de Cadera , Materiales Biocompatibles , Aleaciones de Cromo , Corrosión , Análisis de Falla de Equipo , Humanos , Masculino , Diseño de Prótesis , Reoperación , Estrés Mecánico , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Compare perioperative course and long-term mortality after liver resection for colorectal cancer (CRC) metastases between patients who had preoperative treatment with portal vein embolization (PVE) and chemotherapy or chemotherapy alone. METHODS: Among patients undergoing liver resection for CRC metastases following preoperative chemotherapy treatment, 17 patients who had received preoperative PVE (group A) were compared with 17 matched controls who had no PVE (group B). Perioperative course and long-term mortality were compared between groups A and B and between group A and the entire group of 75 cases with preoperative chemotherapy (group C). RESULTS: Baseline characteristics for the matched groups A and B were similar. Group C included less major resections. Median intraoperative bleeding was 1600 ml in group A, 1200 ml in group B, and 1000 ml in group C (p < 0.05 vs. group A). Median postoperative stay was comparable in all groups (8-9 days). Operation time was 542 min in group A and 464 min in group B (p < 0.01). Mortality after 30 days and 1, 2, and 5 years was similar in all groups. CONCLUSION: Perioperative outcome and long-term survival did not differ when comparing liver resection for CRC liver metastases preceded by PVE and chemotherapy or chemotherapy alone, except for the operation time. The study supports the safety of this "aggressive" combination approach in patients in need of tumor "downstaging" by chemotherapy and PVE to increase the remnant liver volume.