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1.
Rev Laryngol Otol Rhinol (Bord) ; 136(3): 117-9, 2015.
Artigo em Francês | MEDLINE | ID: mdl-29400031

RESUMO

Introduction: The thyroid ectopic gland is a rare anomaly, especially when it's a lingual thyroid. It is characterized by aspecific clinical presentation, causing a diagnostic problem. The diagnosis is based on a combination of imaging techniques as well as histological examination. Case presentation: We are presenting a case of a patient with thyroid basi-lingual treated surgically. Discussion: The low incidence of ectopic lingual thyroid , and their clinical variability requires radiological and isotopic investigations. Conclusion: The diagnosis of this disease is primarily histological. The management of these ectopic thyroid is surgical.


Assuntos
Tireoide Lingual/cirurgia , Disgenesia da Tireoide/cirurgia , Adulto , Feminino , Humanos , Tireoide Lingual/diagnóstico por imagem , Tireoide Lingual/patologia , Disgenesia da Tireoide/diagnóstico por imagem , Disgenesia da Tireoide/patologia
2.
Sci Total Environ ; 869: 161686, 2023 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-36690107

RESUMO

Among the most common contaminants in marine ecosystems, trace elements are recognized as serious pollutants. In Corsica (NW Mediterranean Sea), near the old asbestos mine at Canari, trace elements from the leaching of mine residues have been discharged into the sea for several decades. The aim of this study was to assess the levels of contamination in this area and the potential effects on Paracentrotus lividus (Lamarck, 1816) using pollution indices, accumulation factors and biochemical tools. For this purpose, the concentration of 24 trace elements was measured in sea urchins (gonads and gut content), macroalgae, seawater column and sediment collected at 12 stations nearby the old asbestos mine and at a reference site. The bioaccumulation of trace elements occurs as follows: macroalgae > gut > gonads. TEPI contribute to highlight contamination gradients which are mainly due to the dominant marine currents allowing the migration of mining waste along the coastline. This hypothesis was supported by TESVI, which identified characteristic trace elements in the southern area of the mine. High hydrogen peroxide content, associated with elevated catalase and glutathione-S-transferase enzyme activities, were also identified at these sites and at the reference site. Trace elements contamination as well as several abiotic factors could explain these results (e.g. microbiological contamination, hydrodynamic events, etc.). The results obtained in this study suggest that oxidative stress induced by contamination does not affect the health of Paracentrotus lividus. This work has provided a useful dataset allowing better use of sea urchins and various tools for assessing trace element contamination in coastal ecosystems.


Assuntos
Poluentes Ambientais , Paracentrotus , Oligoelementos , Animais , Paracentrotus/química , Oligoelementos/análise , Ecossistema , Poluição Ambiental
3.
Cancer Radiother ; 27(8): 712-717, 2023 Dec.
Artigo em Francês | MEDLINE | ID: mdl-37891038

RESUMO

PURPOSE: As part of the multidisciplinary team, radiation therapists are in charge of elements of treatment preparation and delivery of radiotherapy to cancer patients. Helping scientific and technological improvements, more and more patients with cancer were treated with radiotherapy including hypofractionnated radiotherapy, that explain the increase of demands on services. The professional impacted by this increase of demands are radiation oncologists and medical physicists. The opportunity to push forward the radiation therapist's competencies appears with the possibility to shift them some tasks. In this context, a first work was performed with objectives to have an overview of the tasks shifted to radiation therapists in France, the tasks that they could perform but also to evaluate some criteria of job satisfaction. MATERIAL AND METHODS: The committee of "new status and value of status" including six radiation oncologists (the French society of radiation oncology [SFRO] et national union of radiation oncologists [SNRO]) and six radiation therapists committee members of the French association of radiation therapists (AFPPE), built a questionnaire including three parts: demographic characteristics, tasks shifted and job satisfaction criteria. In total, the questionnaire included 19 questions and 24 items assessed with a four point-Likert scale (ranging from "completely disagree" to "completely agree"). This survey, formatting with google form, was tested by the committee members and the final version was sent to the SFRO, AFPPE and SNRO members, before being disseminated on the social networks. RESULTS: From November 18th 2022 to December 31st 2022, 492 responses were received (response rate=18.3%): 55 % of the respondents had at least 11 years of experience in radiotherapy. The respondents worked in different type of health facilities (36 % in specialized cancer centres, 19.5 % in private centers, 17.5% in university and general hospital, 10.2% in general hospital). More than » of the respondents had a teaching lecturer activity, 20% had a management team activity and a research activity for 18%. Less than 10% of the respondents had another degree than that of radiation therapist: university degree (n=27), degree in dosimetry (n=11) and master (n=3). More than 76% would like to be trained and to have access to the advanced practice, more than 50% would like expend competencies with a university degree, 30% with a master and 67% would like to participate in research. Forty-two percent of the respondents were involved in a task shifting (excluding decree relating to acts and activities carried out by radiation therapists) and among the radiation therapists non-involved, 63% would be interested in being. Regarding job satisfaction, 53% of the respondents were satisfied with their job and their salary and 68% believed that their job occupation is in line with their professional aspirations. More than 2/3 of the respondents described a significant workload and mental load, 53% thought to have time for their patient care and 70% felt some organisational difficulties. CONCLUSION: This survey shows: (i) A significant involvement of radiation therapists in the task shifting; (ii) A very strong demand for career development, in particular with existing degrees or to be created degree such as advanced practice; and (iii) The need to reinforce a job satisfaction for almost the half of the respondents, linked to a workload, a mental load and some organisational difficulties.


Assuntos
Radioterapia (Especialidade) , Humanos , França , Inquéritos e Questionários , Pessoal Técnico de Saúde , Ocupações , Satisfação no Emprego
4.
Cancer Radiother ; 27(6-7): 577-582, 2023 Sep.
Artigo em Francês | MEDLINE | ID: mdl-37596123

RESUMO

PURPOSE: Radiation therapists shortage has been evaluated at national level in France, specifically in oncology radiotherapy, in terms of: (i) organizational adaptations, (ii) impact on patients care, and (iii) difficulties in deploying new missions and/or tasks delegation. MATERIALS AND METHODS: French professional organisations representing radiation therapists - SFRO, SNRO and AFPPE - sent their members a national survey (ten questions on 32 items). RESULTS: From 18 November 2022 to 31 December 2022, 55 responses were received (response rate: 31%) from radiotherapy managers or department heads; 51% had a structure comprising three to five treatment rooms (receiving 500 to 1000 patients per year [36%], or 1500 to 2000 patients per year [33%]). Activities performed were intensity-modulated radiotherapy (100%), stereotaxic radiotherapy (85%), brachytherapy (40%), adaptive radiotherapy (34%). These structures described consequences in closing machine time for 25% of them (reduction of the hourly volume greater than 10% in 57%) with the following consequences in the last 6 months: (i) an extension of the period of medical care (78%), a closing of one or more accelerators (50%) and the development of moderate hypofractionation scheme or extreme hypofractionation (50%). In current functioning, linear accelerators can deliver treatments with a team of two radiation therapists per room for a short day (43%) or two to four radiation therapists per room teams for a long day (40%). During the last 6 months, there has been a 10% increase in linear accelerators operating with a single team. (ii) regarding treatment planning: 16.4% reported a decrease in the opening amplitude (less than 20% in 44% of cases, from 20 to 50% in 33 % of cases). The initial scheduling of appointments for radiotherapy sessions was carried out by radiation therapists in 84% of the departments in current functioning (0.1 to 1 FTE dedicated to this activity in 62% of the departments). Over the last 6 months, there has been a clear reduction in the number of dedicated FTEs: [FTE=0.1 to 1]=-8%; [FTE=0]=+7%. (ii) Regarding tasks delegation (excluding the decree on acts and activities carried out by the radiation therapist): organ at risk delineation is partially performed by radiation therapist in 26% of the centres; caregiver support time in 78% (56% totally or 22% partially). This activity has been reduced by 42%. Seventy-five percent of departments want to develop new techniques, patient-centered approaches (44%), implement task delegation (organ at risk delineation: 58%; weekly consultations: 67%; positioning imaging validation: 71%), and 78% of departments are interested in developing advanced radiotherapy practice. However, the number of radiation therapists is considered insufficient in their implementation in 76% of cases (one to two FTE missing for 72% of structures). CONCLUSION: This survey shows a significant impact of radiation therapist shortage in radiotherapy oncology care (treatment delays, access to caregiver support time, workload on treatment teams), and represents a major obstacle to the development of radiotherapy structures.


Assuntos
Braquiterapia , Radioterapia (Especialidade) , Radiocirurgia , Humanos , França , Pessoal Técnico de Saúde
5.
Cancer Radiother ; 27(8): 683-688, 2023 Dec.
Artigo em Francês | MEDLINE | ID: mdl-37839920

RESUMO

Cybersecurity is currently a major issue. Large hospitals are no longer the only main targets of attacks, but all healthcare organizations and establishments, without distinction of size or activities. The information system is defined as all the resources needed to collect images, store and process them with general distribution of multiple information within an organization. Systems are therefore crucial for the functioning of a medical department. Radiation oncology is one of the specialties most dependent on digital resources, for imaging, data transfer, dosimetry, treatment and so on.. Radiation oncology departments are therefore a prime target for ransomware attacks, which have increased significantly in recent years. Cybersecurity can be likened to a viral or bacterial attack. It is based on the two usual pillars of antimicrobial protection : hygiene and prophylaxis. In this article, we will detail by analogy the three classic levels of prevention of a bacillary attack: "primary prevention", which acts upstream of the infection; "secondary prevention", which acts at an early stage of its evolution; and "tertiary prevention", which acts on complications and risks of recurrence. This article is the result of an interprofessional group on behalf of SFRO, the French society of radiation oncology, with the aim of helping all teams to implement safety adapted to the specificities of a radiation oncology department in France.


Assuntos
Radioterapia (Especialidade) , Humanos , Hospitais , França
6.
Mar Pollut Bull ; 183: 114092, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36084613

RESUMO

This study investigated for the first time the oxidative biomarkers responses in all larval stages of sea urchin. The contamination effects were reproduced by using contaminated seawater to concentrations measured in the area adjacent to an old asbestos mine at factors of 5 and 10. The results suggested that the concentrations were not sufficiently high to induce a major oxidative stress. The biometric differences make this method a more sensitive approach for assessing the effects on sea urchin larvae. Measurements of specific activities of antioxidant enzymes at each stage suggested a high capacity of the larvae to respond to oxidative stress. This normal activity of the organism must be considered in future research. This work also highlighted the importance of spawners provenance in ecotoxicological studies. These data are essential to better understand the stress responses of sea urchin larvae and provide baseline information for later environmental assessment research.


Assuntos
Paracentrotus , Oligoelementos , Animais , Antioxidantes , Biomarcadores , Embrião não Mamífero , Larva , Paracentrotus/fisiologia
7.
Ann Chir Plast Esthet ; 56(4): 308-14, 2011 Aug.
Artigo em Francês | MEDLINE | ID: mdl-20728259

RESUMO

BACKGROUND: Failure after head and neck reconstruction using free flap are rare but their management remains a challenging problem. The purpose of this study was to analyze the causes and the subsequent treatment of free-flap failure in head and neck reconstruction. PATIENTS AND METHODS: A retrospective review of patients who had undergone free flap transfer between 2000 and 2007 was performed in our center. Data were collected from computerized medical record to determine patient and tumor characteristics, as well as their treatment. Moreover, a univariate analysis was performed to determine factors associated with free flap failure. RESULTS: Three hundred and twelve patients had a free flap transfer after head and neck cancer resection. A total of 22 failures (7%) were encountered. Previous surgery for head and neck cancer (p=0.02), surgery after cancer recurrence (p=0.02) and reconstructions after circular pharyngolaryngectomy (p=0.008) were significantly associated with free-flap failure. A second free-flap was performed in 12 patients and the overall success rate of the repeated free flap was 92 percent (11 of 12 patients). CONCLUSION: After a free flap failure, surgeons should determine subsequent treatments after a reconsideration of the need of a second free flap, an analysis of the cause of the first flap failure and an evaluation of local and general conditions. In selected patients, second free flap has a high success rate.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço/cirurgia , Recidiva Local de Neoplasia/cirurgia , Idoso , Análise de Variância , Feminino , Humanos , Laringectomia , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Faringectomia , Procedimentos de Cirurgia Plástica , Reoperação , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Falha de Tratamento , Resultado do Tratamento
8.
Rev Laryngol Otol Rhinol (Bord) ; 132(4-5): 209-14, 2011.
Artigo em Francês | MEDLINE | ID: mdl-22908542

RESUMO

INTRODUCTION: The development of laryngeal preservation protocols has considerably modified the indications for total (pharyngo-)laryngectomy (TPL). The objectives of our study are to analyze the current indications for TPL and to evaluate the oncologic and functional outcomes after TPL and their predictive factors. METHODS: All patients who underwent TPL for squamous cell carcinoma of the larynx or hypopharynx, at our institution, between 2000 and 2009, were included in this retrospective study. Predictive factors of oncologic and functional outcomes were assessed in univariate and multivariate analyzes. RESULTS: A total of 130 patients were enrolled in our study including 119 men and 11 women, with a mean age of 65.9 years. TPL was realized for salvage in 65 patients. Extra-laryngeal tumor extension (n = 42) was the main indication for TPL in the 65 remaining patients. Overall survival was 49 and 41% at 3 and 5 years respectively. In multivariate analysis, primary tumor site (hypopharynx in comparison to larynx; p = 0.04) has a significant pejorative impact on overall survival. Oral alimentation (no enteral nutrition) was recovered successfully by 94% of the patients. In multivariate analysis, primary tumor site (hypopharynx) has a significant pejorative impact on functional results (deglutition: p < 0.0001; phonation: p = 0.03). CONCLUSION: Primary tumor site is one of the main predictive factor of oncologic and functional outcomes after TPL.


Assuntos
Neoplasias Hipofaríngeas/cirurgia , Neoplasias Laríngeas/cirurgia , Laringectomia , Faringectomia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Laríngeas/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
9.
J Environ Qual ; 39(1): 375-83, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20048325

RESUMO

To prevent the 7 to 11 million metric tons of waste foundry sand (WFS) produced annually in the USA from entering landfills, current research is focused on the reuse of WFSs as soil amendments. The effects of different WFS-containing amendments on turfgrass growth and nutrient content were tested by planting perennial ryegrass (Lolium perenne L.) and tall fescue (Schedonorus phoenix (Scop.) Holub) in different blends containing WFS. Blends of WFS were created with compost or acid-washed sand (AWS) at varying percent by volume with WFS or by amendment with gypsum (9.6 g gypsum kg(-1) WFS). Measurements of soil strength, shoot and root dry weight, plant surface coverage, and micronutrients (Al, Fe, Mn, Cu, Zn, B, Na) and macronutrients (N, P, K, S, Ca, Mg) were performed for each blend and compared with pure WFS and with a commercial potting media control. Results showed that strength was not a factor for any of the parameters studied, but the K/Na base saturation ratio of WFS:compost mixes was highly correlated with total shoot dry weight for perennial ryegrass (r = 0.995) and tall fescue (r = 0.94). This was further substantiated because total shoot dry weight was also correlated with shoot K/Na concentration of perennial ryegrass (r = 0.99) and tall fescue (r = 0.95). A compost blend containing 40% WFS was determined to be the optimal amendment for the reuse of WFS because it incorporated the greatest possible amount of WFS without major reduction in turfgrass growth.


Assuntos
Sulfato de Cálcio/química , Resíduos Industriais/efeitos adversos , Poa/efeitos dos fármacos , Eliminação de Resíduos/métodos , Dióxido de Silício/química , Solo/análise , Monitoramento Ambiental , Metalurgia , Raízes de Plantas , Brotos de Planta , Poa/crescimento & desenvolvimento , Poluentes do Solo/efeitos adversos , Poluentes do Solo/química
10.
Rev Laryngol Otol Rhinol (Bord) ; 131(2): 159-61, 2010.
Artigo em Francês | MEDLINE | ID: mdl-21284233

RESUMO

OBJECTIVE: The purpose of this article is to describe an original surgical technique allowing to treat the hollow eye. TECHNIQUE: Realization of an upper fragment of circular muscle of eyelids turned on itself during a upper blepharoplasty with fat autograft. CONCLUSION: The hollow eye is filled durably in the time. This surgical technique is simple, easily reproducible. The harmonization of outlines and the trophicity are preserved, which gives a much more natural aspect.


Assuntos
Blefaroplastia/métodos , Envelhecimento da Pele , Humanos
11.
Rev Laryngol Otol Rhinol (Bord) ; 131(2): 133-8, 2010.
Artigo em Francês | MEDLINE | ID: mdl-21284229

RESUMO

OBJECTIVE: This study is an evaluation of technical feasibility and clinical results of the wide marginal rhinoplasty. MATERIALS AND METHODS: A wide marginal approach has been used in remodeling and positioning cartilage grafts in 13 cadavers. The clinical study was focused on 20 patients with aesthetics indications and no functional need. The practise was a work on the dorsum, the tip, resections of alar and cartilage graft positioning. We investigated the feasibility of different procedures, quality of exposure and we have identified the problems and incidents of dissection. In additional a subjective evaluation of patient satisfaction and a 6 to 15 months photographic follow up were performed. RESULTS: The operative incidents and problems were similar in anatomic and clinical study. Our study found an excellent technical feasibility with an easy job in the lateral areas and more difficult in median area. CONCLUSION: Wide marginal approach in rhinoplasty doesn't substitute open rhinoplasty but can be used in specific indications.


Assuntos
Cartilagem/transplante , Rinoplastia/métodos , Adulto , Cadáver , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente
12.
Eur Ann Otorhinolaryngol Head Neck Dis ; 137(1): 61-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31178431

RESUMO

INTRODUCTION: Dysphagia is a common presenting complaint and can often be due to pharyngoesophageal diverticulum, including Zenker's diverticulum. Iatrogenic pharyngeal diverticulum, occurring after anterior cervical spine surgery, is a rare cause of dysphagia. CASE REPORT: We report the case of a 51-year-old man, with a history of anterior cervical fusion about ten years previously, who complained of chronic dysphagia and disabling episodes of aspiration. Anterolateral pharyngeal diverticulum in contact with the cervical screw plates was diagnosed on barium swallow and upper gastrointestinal endoscopy. DISCUSSION: Pharyngeal diverticulum differs from Zenker's diverticulum in terms of its position and its origin. It may occur early or late after anterior cervical spine surgery. Treatment consists of endoscopic or open surgery via a neck incision. In our case, appropriate treatment allowed complete resolution of the patient's symptoms with no complications following rigorous postoperative surveillance.


Assuntos
Vértebras Cervicais/cirurgia , Complicações Pós-Operatórias/etiologia , Fusão Vertebral/efeitos adversos , Divertículo de Zenker/etiologia , Humanos , Doença Iatrogênica , Masculino , Pessoa de Meia-Idade
13.
Sci Rep ; 10(1): 16471, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020502

RESUMO

SARS-CoV-2 has a zoonotic origin and was transmitted to humans via an undetermined intermediate host, leading to infections in humans and other mammals. To enter host cells, the viral spike protein (S-protein) binds to its receptor, ACE2, and is then processed by TMPRSS2. Whilst receptor binding contributes to the viral host range, S-protein:ACE2 complexes from other animals have not been investigated widely. To predict infection risks, we modelled S-protein:ACE2 complexes from 215 vertebrate species, calculated changes in the energy of the complex caused by mutations in each species, relative to human ACE2, and correlated these changes with COVID-19 infection data. We also analysed structural interactions to better understand the key residues contributing to affinity. We predict that mutations are more detrimental in ACE2 than TMPRSS2. Finally, we demonstrate phylogenetically that human SARS-CoV-2 strains have been isolated in animals. Our results suggest that SARS-CoV-2 can infect a broad range of mammals, but few fish, birds or reptiles. Susceptible animals could serve as reservoirs of the virus, necessitating careful ongoing animal management and surveillance.


Assuntos
Peptidil Dipeptidase A/química , Filogenia , Glicoproteína da Espícula de Coronavírus/química , Enzima de Conversão de Angiotensina 2 , Animais , Betacoronavirus/classificação , Betacoronavirus/genética , Humanos , Mamíferos , Simulação de Acoplamento Molecular , Mutação , Peptidil Dipeptidase A/classificação , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Ligação Proteica , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus/metabolismo
14.
J Plast Reconstr Aesthet Surg ; 72(1): 131-136, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30327185

RESUMO

BACKGROUND: Over the past decade, cosmetic injections of dermal fillers or fat have become a popular procedure in facial rejuvenation in an overconsuming society. However, complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones namely the glabella, the nasal dorsum or the nasolabial fold. The aim of this study was to define the vascular danger zones of the infraorbital area in order to provide guidelines helping avoid them. MATERIALS AND METHODS: The infraorbital artery, its main branches and their anastomoses with neighbouring vessels were studied in 18 fresh cadavers. Mimetic injections of inked hyaluronic acid were performed in the infraorbital area in the interest of analyzing its distribution and to determine potential vascular risks towards the infraorbital artery and its branches. RESULTS: The infraorbital artery and its branches were located in common injection regions and anastomosed to the supratrochlear artery, the dorsal nasal artery and the angular artery through the nasal branch of the infraorbital artery. Two danger zones could be depicted: injections can be risky when performed too superficially in the midcheek area, and likewise risky when performed in a periosteal layer in infraorbital hollow or tear-trough correction, because of an obvious possibility of retrograde embolism. CONCLUSION: The infraorbital artery can be involved in anatomic mechanism of arterial occlusion, further blindness and stroke, among the related neighbouring arteries. Based on the findings of this study, injections to the periosteum layer in tear-trough correction and above the periosteum on the zygomatic arch is not advised.


Assuntos
Estética , Artéria Oftálmica/anatomia & histologia , Cadáver , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Face , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/farmacologia , Injeções Intra-Arteriais/efeitos adversos , Rejuvenescimento , Fatores de Risco
15.
Ann Otolaryngol Chir Cervicofac ; 125(2): 90-3, 2008 Apr.
Artigo em Francês | MEDLINE | ID: mdl-18280455

RESUMO

INTRODUCTION: Angiomyolipoma is a rare benign mesenchymal tumor. It often arises in the kidney and in association with tuberous sclerosis or lymphangioléiomyomatosis. Extrarenal locations have been described, especially in the liver. Only a few cases have been described in the head and neck region and these are usually not associated with tuberous sclerosis or lymphangioléiomyomatosis. MATERIAL AND METHODS: We report a case of angiomyolipoma located in the parotid gland. RESULTS: A 43-year-old man consulted for treatment with a slow-growing nodule located in his right parotid gland. Ultrasound examination and magnetic resonance imaging revealed a well-limited lesion. Fine needle aspiration cytology was not suspicious. Partial parotidectomy was performed and the tumor showed the characteristic appearance of angiomyolipoma, with an admixture of fat smooth cells and tortuous thick-walled blood vessels. Genetic analysis showed anomalies on chromosomes 7 and 18. CONCLUSION: This article discusses the presentation and management associated with this exceptional tumor.


Assuntos
Angiomiolipoma/diagnóstico , Neoplasias Parotídeas/diagnóstico , Adulto , Angiomiolipoma/diagnóstico por imagem , Biópsia por Agulha Fina , Cromossomos Humanos Par 18/genética , Cromossomos Humanos Par 7/genética , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Parotídeas/diagnóstico por imagem , Trissomia/genética , Ultrassonografia
16.
Ann Chir Plast Esthet ; 53(4): 372-7, 2008 Aug.
Artigo em Francês | MEDLINE | ID: mdl-17959297

RESUMO

Necrotizing fasciitis is a hypodermis, muscular fascia then dermis necrotizing infection. It disseminates along fascias with a mortality sometimes within 18 hours. The average mortality, reported in the literature, is about 30%. A 65-year-old man, with a history of Vaquez disease (under hydroxurea) and a smoke addiction, had an epidermoid carcinoma of the left vocal cord (T2 N0 M0). The cancer treatment consisted of a functional lymph node excision, followed by tracheotomy then by partial laryngectomy. At the end of the intervention, after removal of operative fields, it was noticed that the Montandon cannula had slid and was between the medial side of the left upper limb and the lateral side of the chest. There was a cutaneous imprint with ecchymosis on the route of the cannula. At the second postoperative day, a necrotizing fasciitis quickly developed on the left side of the chest, the medial side of the left upper limb, and the left hip without infection of the operating site. An Escherichia coli was identified in tracheal secretions and operative samples. The presumed hypothesis of this necrotizing infection is the cutaneous contamination of the thoracic wall by tracheal secretions colonized by E. coli, whose penetration was induced by the cutaneous traumatism due to the cannula. We remind, by analyzing this unusual case, the caring principles one of which diagnosis and the surgical excision must be as premature as possible. We insist on the elementary measures of protection of the support points and the good binding of cannulas.


Assuntos
Infecções por Escherichia coli/diagnóstico , Fasciite Necrosante/microbiologia , Laringectomia/efeitos adversos , Laringectomia/instrumentação , Tórax , Idoso , Carcinoma de Células Escamosas/cirurgia , Infecções por Escherichia coli/patologia , Infecções por Escherichia coli/cirurgia , Fasciite Necrosante/patologia , Fasciite Necrosante/cirurgia , Humanos , Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Masculino , Traqueotomia/métodos , Resultado do Tratamento
17.
Rev Laryngol Otol Rhinol (Bord) ; 129(4-5): 309-11, 2008.
Artigo em Francês | MEDLINE | ID: mdl-19408517

RESUMO

Bell's palsy is considered a benign pathology. However it can result in considerable long-term disability. Despite the development towards the better understanding of its physiopathology, treatment is still controversial, especially the indication of decompression surgery. Current practices are not standardised. Early medical therapy associating steroid drugs and antiviral agents after the onset of paralysis has become the gold standard. There is no evidence in favour of decompression surgery.


Assuntos
Paralisia de Bell/cirurgia , Descompressão Cirúrgica , Medicina Baseada em Evidências , Humanos
18.
J Stomatol Oral Maxillofac Surg ; 119(1): 75-78, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29030276

RESUMO

INTRODUCTION: Cutting and drilling guides manufactured using computer-aided design/computer-aided manufacturing (CAD/CAM) technologies have attracted increasing interest in orthognathic surgery, particularly in complex cases. The development of these guides requires virtual surgery planning and three-dimensional modelling before they can be printed in titanium, polyamide or resin. We report the use of a personalized titanium device to assist bilateral sagittal split osteotomy (BSSO) with or without genioplasty combined with individual implants for repositioning and fixation. This one-piece guide for both sides of the BSSO allows the initiation of cutting and drilling with less invasive drill placement and greater accuracy. PROCEDURE: The titanium guide was manufactured using CAD/CAM technologies after conventional digital planning of BSSO. Intraoperatively, the guide was fitted on each side of the mandibular occlusal surface and screwed to predesigned drill holes. The guide facilitates the predrilling of screw holes and the initiation of cutting for buccal, lingual and external oblique ridge corticotomy using a piezosurgery device. CONCLUSION: Based on our experience, we think that this guide is a promising new tool to assist BSSO. It helped limit the extent of tissue detachment required and provided the strength necessary for accurate bone cutting and drilling. It also allowed the accurate fixation of preformed plates to obtain occlusion as per virtual planning.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Oclusão Dentária , Osteotomia Mandibular , Titânio
19.
Eur Ann Otorhinolaryngol Head Neck Dis ; 135(1S): S7-S10, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29361440

RESUMO

The laryngeal monitoring of the inferior and superior laryngeal nerves, and the vagus nerve, has advanced for last years, in practice of thyroid and parathyroid surgery. Different methods are used, using direct or indirect laryngeal stimulation and also intermittent or continuous nerve registration. At present time, various recommendations of it in the world use are reported, and availability of the tool used remains a limit in some countries. The aim of this Icon during Ifos 2017 was to share knowledge about laryngeal intraoperative nerve monitoring (LIONM) procedures and to evaluate current practices used to improve the quality of thyroid and parathyroid surgery. Benefits of LIONM were discussed with three experts (Pr G. Randolph from Boston, Pr Henning Dralle from Halle in Germany, Pr Hoon Yub KIM from Seoul). All of them have been actively involved in the development and use of laryngeal nerve monitoring during thyroid and parathyroid surgery.


Assuntos
Complicações Intraoperatórias/prevenção & controle , Traumatismos do Nervo Laríngeo/prevenção & controle , Monitorização Intraoperatória , Tireoidectomia , Humanos , Guias de Prática Clínica como Assunto , Gestão de Riscos
20.
Eur Ann Otorhinolaryngol Head Neck Dis ; 134(5): 299-302, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28320599

RESUMO

INTRODUCTION: Surgery for primary hyperparathyroidism, targeted by ultrasound and scintigraphy, satisfies the theoretical criteria allowing ambulatory surgery. The purpose of this study was to validate this strategy on a homogeneous case series assessed by this imaging strategy. MATERIAL AND METHODS: All patients operated for primary hyperparathyroidism by ambulatory surgery from 01/01/13 to 30/04/15 were included in this retrospective study. The usual endpoints of ambulatory surgery were evaluated. RESULTS: A total of 144 patients were operated for primary hyperparathyroidism during the study period. Ambulatory surgery was possible in 67 patients, who all had a preoperative diagnosis of parathyroid adenoma. All patients were assessed by ultrasound and 66 patients were assessed by sestamibi scintigraphy, resulting in targeted unilateral neck surgery in 98.5% of cases. Two patients had to be hospitalised overnight due to minor complications. CONCLUSION: Surgery for primary hyperparathyroidism can be performed with short operating times in carefully selected patients with a low complication rate, thereby allowing ambulatory surgery.


Assuntos
Adenoma/diagnóstico , Adenoma/cirurgia , Procedimentos Cirúrgicos Ambulatórios , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/cirurgia , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Humanos , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/etiologia , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Paratireoidectomia/métodos , Cintilografia/métodos , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Ultrassonografia
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