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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We analysed the results of shoulder reconstruction using an anterolateral deltoid muscle flap plasty in 101 patients with large rotator cuff lesions. This method was first described in Apoil and Augereau in 1985. We modified and extended their technique. Regular follow-up examinations were possible in 100 patients (27 females, 73 males, age 61.3 +/- 8.7 years). One patient died of sepsis of unknown aetiology during the hospital stay. All patients suffered from severe pain and sleepless nights prior to the operation. They also had long histories of unsuccessful and frustrating treatment. The rotator cuff lesions found intraoperatively were at least 5 x 5 cm in size. We used an anterolateral deltoid muscle flap to reconstruct these large defects. Physical therapy was started on the 1 postoperative day and was continued for about 6 months (6.8 +/- 2.6 months). The average hospital stay was 10.9 +/- 5.3 days. After the treatment 90% of all patients were subjectively satisfied or very satisfied with the result, while 12% had moderate and 5% unsatisfactory results. No pain was felt at all by 75% of the patients, and 21% showed decidedly less pain. Severe pain attacks were found in only 4% of the patients, but their pain was less intense than preoperatively. The shoulder function improved significantly, and 72% recovered their strength completely. Most of the patients were able to work after 6 months. The overall result was good to very good in 83%. This high percentage of good shoulder function and patient satisfaction makes this the operation technique of choice for large rotator cuff lesions.
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PMID:[The anterolateral deltoid muscle flap-plasty: the procedure of choice in large rotator cuff defects]. 757 33

Stapled hemorrhoidopexy (SH) presents a number of complications which differ from those of traditional haemorrhoidectomy (Milligan-Morgan, diathermy haemorrhoidectomy). The follow-up shows better symptom control than other surgical techniques. Four hundred and forty-nine patients with haemorrhoids of all degrees and mucosal rectal prolapse were treated at our institution over a five-year period (1999-2004). Patients were assessed by structural interview to assess their symptoms before and after surgery, and surgical and functional outcome was assessed at 1, 3, 6, 12 and 24 months. A visual analog scale was used for postoperative pain scoring. Patient's satisfaction is the best response to all criticism. Bleeding in the early postoperative period occurred in 3.9% of all patients and in 7 cases (1.5%) reoperation was necessary. Urge to defecate, although present in 14% of patients, disappears in a few weeks. Severe pain, when present, may depend on technical failure or learning curve. Complete or incomplete recurrence occurred in 10 cases (2.2%). We had one case of rectovaginal fistula in a young woman. In 3 cases we underestimated the extent of the mucosal prolapse and the patients were reoperated on by stapled transanal rectal resection after one (2 patients) and two years. Stapled hemorrhoidopexy is a significantly less painful operation and offers significant advantages in terms of hospital stay and symptom control in the long term, making for a significantly earlier return to work. The complications are similar to those of other techniques and are easily resolved. The unusual complications described (rectal perforation, pelvic sepsis, rectovaginal fistulas) might suggest that the operation should be performed by experienced colorectal surgeons who are familiar with the technique and aware of the possible complications.
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PMID:Stapled hemorrhoidopexy. Complications and 2-year follow-up. 1719 Feb 80

Gluteal compartment syndrome is a rare condition that often develops following immobilization either secondary to illicit drug and alcohol abuse or improper surgical positioning. A case of a 22-year-old female with left lower extremity pain, weakness, and numbness after prolonged stasis from a night of drug and alcohol use is presented. She also complained of left low back pain. Her initial neurologic examination was significant for decreased deep tendon reflexes, decreased motor strength, and decreased sensation in the left lower extremity. Severe pain in the affected region persisted despite several attempts at pain control utilizing multiple modalities. An emergent MRI of the lumbar spine revealed gluteal compartment syndrome. The patient ultimately underwent emergent fasciotomy with resultant improvement in neurologic symptoms. Because presenting symptoms are frequently nonspecific in initial stages, gluteal compartment syndrome is often misdiagnosed. This can lead to unnecessary morbidity and mortality. It is important to maintain a high index of suspicion for gluteal compartment syndrome because delay in diagnosis can lead to nerve palsy, acute kidney injury, sepsis, and/or death.
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PMID:Atraumatic Gluteal Compartment Syndrome Presenting in a Young Female with Unilateral Lower Extremity Symptoms. 3083 41