RESUMO
Immune status, severity or burden of disease, appropriate dosing of medication, and drug resistance are important considerations when treating immunosuppressed patients.
Assuntos
Traumatismos Abdominais/complicações , Fístula Biliar/etiologia , Fístula Brônquica/etiologia , Laparoscopia/métodos , Traumatismos Torácicos/complicações , Toracoscopia/métodos , Ferimentos por Arma de Fogo/complicações , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/cirurgia , Adulto , Fístula Biliar/diagnóstico , Fístula Biliar/cirurgia , Fístula Brônquica/diagnóstico , Fístula Brônquica/cirurgia , Broncoscopia , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Seguimentos , Humanos , Traumatismo Múltiplo , Esfinterotomia Endoscópica/métodos , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/cirurgia , Tomografia Computadorizada por Raios X , Ferimentos por Arma de Fogo/diagnóstico , Ferimentos por Arma de Fogo/cirurgiaRESUMO
Bone wax has been used for years by surgeons as a hemostatic agent to prevent bleeding from bone surfaces. Though the effectiveness of bone wax as a hemostatic agent while acting as a tamponade is well known, it is not without its complications. It has been documented in the medical literature that bone wax may remain in the body for many years as a foreign body and in some cases cause a giant cell reaction at various surgical sites. However, to the authors' knowledge, there has not been a reported case of a foreign body giant cell reaction secondary to the use of bone wax in the current podiatric literature. Two case studies are described to bring attention to the fact that bone wax can interfere with bone healing while remaining attached to bone as a foreign body and induce a giant cell reaction and local inflammatory effects in the human foot.
Assuntos
Reação a Corpo Estranho/cirurgia , Granuloma de Células Gigantes/cirurgia , Hemostáticos/efeitos adversos , Palmitatos/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Ceras/efeitos adversos , Adolescente , Desbridamento , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Articulação Talocalcânea/cirurgia , Irrigação TerapêuticaRESUMO
Nephrogenic systemic fibrosis (NSF) is a severely debilitating disease that was first described in the literature by Cowper and colleagues in 2000. It is pertinent to the field of podiatry because patients with NSF first manifest cutaneous symptoms in the lower extremity in the form of fibrosing lesions. To date, these lesions have been documented only in people with moderate to severe kidney failure. There is speculation that gadolinium, used as a contrast agent for imaging, might be the inciting factor that triggers a cascade of events that results in the inappropriate fibrosis both in the dermis and in deeper tissues. Nephrogenic systemic fibrosis has been shown to cause these lesions in the lungs, pleura, diaphragm, myocardium, pericardium, and dura mater, the presence of which are typically indicative of severe progression of NSF. In cases where the lesions are manifest in the periarticular tissue, joint contractures and restricted range of motion can often result. We provide a quick synopsis of NSF, and a short case study that describes the authors' experience with one of their patients who requested a surgical consult as a result of being wheelchair-bound due to NSF's sequelae.
