RESUMEN
We report the case of a young woman who presented with acute abdomen at our hospital. The control revealed the presence of fetal parts in extra-uterin and intra-abdominal place after a late abortion. The patient was succesfully operated by celioscopy.
Asunto(s)
Abdomen Agudo/etiología , Aborto Inducido/efectos adversos , Abdomen Agudo/diagnóstico , Abdomen Agudo/cirugía , Aborto Criminal/efectos adversos , Adulto , Bélgica , Femenino , Edad Gestacional , Humanos , Laparoscopía , Turismo Médico , Embarazo , Segundo Trimestre del Embarazo , Perforación Uterina/diagnóstico , Perforación Uterina/etiología , Perforación Uterina/cirugíaRESUMEN
This is a case report, for the first time in the literature, of a third trimester pregnant woman with acute abdominal pain for which the diagnosis of varicose veins rupture was achieved by MRI.
Asunto(s)
Hemoperitoneo/diagnóstico por imagen , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Tercer Trimestre del Embarazo , Rotura Espontánea/diagnóstico por imagen , Várices/diagnóstico por imagen , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Embarazo , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Diagnóstico Prenatal/métodos , Radiografía , Várices/patologíaRESUMEN
PURPOSE OF THE STUDY: This prospective study reports our preliminary results with local anaesthesia (LA) for carotid endarterectomy (CEA). MATERIAL AND METHODS: Twenty CEA in nineteen patients were performed using a three-stage local infiltration technique. CEA were performed through a short Duplex-assisted skin incision (median length: 55 mm) using a retro-jugular approach and polyurethane patch closure (median length: 35 mm). RESULTS: There were 13 men and 6 women with a mean age of 71.2 years. The indications of CEA were asymptomatic lesions in 11 cases, stroke in 7 cases and transient ischaemic attack in 2 cases. The median degree of internal carotid artery stenosis was 90%. One patient (5%) required an intraluminal shunt. There were no peri-operative deaths, stroke or conversion to general anaesthesia (GA). The median length of stay was 3 days. CONCLUSIONS: LA is a good alternative to GA. It can be used after a feasibility study and a short teaching procedure. In our centre, it is a safe and effective procedure associated with low morbidity, high acceptance by patients and a short hospital stay.
Asunto(s)
Anestesia Local , Endarterectomía Carotidea , Anciano , Anciano de 80 o más Años , Anestésicos Locales/administración & dosificación , Bupivacaína/administración & dosificación , Bupivacaína/análogos & derivados , Endarterectomía Carotidea/métodos , Femenino , Humanos , Levobupivacaína , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Sedation is an important component of patient comfort in the intensive care unit (ICU), especially in those undergoing mechanical ventilation. Sedation that is too light or too deep can have important consequences, and therefore assessment of the degree of sedation should be an important part of patient management. Although there are many methods available to assess the degree of sedation, none is ideal. Therefore, we developed a new sedation scale and analysed its clinical impact in the management of patients undergoing mechanical ventilation. The study comprised two consecutive phases. In the first phase, the medical team did not use a sedation scale. In the second phase, the medical staff used the new sedation scale, comprising five levels, depending on the perceived degree of sedation: levels 1 and 2 = oversedation; levels 3 and 4 = correct sedation; and level 5 = undersedation. There were no significant differences in mean or highest levels between patients in the two phases (mean 2.89 (SD 0.11) vs 2.67 (0.13), P = 0.22; highest 3.16 (0.11) vs 3.10 (0.14), P = 0.78). However, the lowest level was significantly greater in patients in the second phase than in those in the first phase (2.61 (0.11) vs 2.16 (0.13); P = 0.011), indicating that the number of patients with excessive sedation was significantly reduced with the introduction of this scale. Thus the use of this scale can have a real clinical impact for patients undergoing mechanical ventilation, principally by avoiding excessive sedation.