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Prevalencia de úlceras por presión en Colombia: informe preliminar
Renata Virginia González-Consuegra; Diana Marcela Cardona-Mazo; Paola Andrea Murcia-Trujillo; Gustavo David Matiz-Vera
Antecedentes. Las úlceras por presión representan una complicación del cuidado de la salud que no debe ser atribuible exclusivamente al cuidado de enfermería. Deterioran la calidad de vida de los pacientes y su familia, aumentando los costos sociales y en salud. En Colombia los indicadores epidemiológicos son escasos. El estudio expone una visión preliminar de la situación de las úlceras por presión por regiones en el país. Objetivo. Establecer la prevalencia de las úlceras por presión a nive...
Prevalencia de úlceras por presión en Colombia: informe preliminar
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Renata Virginia González-Consuegra
Full Text Available Antecedentes. Las úlceras por presión representan una complicación del cuidado de la salud que no debe ser atribuible exclusivamente al cuidado de enfermería. Deterioran la calidad de vida de los pacientes y su familia, aumentando los costos sociales y en salud. En Colombia los indicadores epidemiológicos son escasos. El estudio expone una visión preliminar de la situación de las úlceras por presión por regiones en el país. Objetivo. Establecer la prevalencia de las úlceras por presión a nivel nacional. Materiales y métodos. Estudio descriptivo, transversal, de prevalencia cruda de periodo que utiliza, como instrumento, una encuesta elaborada a partir de las directrices del Grupo Nacional para el Estudio y Asesoramiento de Úlceras por Presión y Heridas Crónicas. La encuesta fue diligenciada online por enfermeros entre septiembre y noviembre de 2013. Resultados. Se respondieron 111 encuestas, de 800 correos electrónicos enviados a enfermeros de todas las regiones de Colombia. Se encontró: el 68% de úlceras por presión en hombres, 64% en instituciones públicas, el 44% en el primer nivel, el 65% de la información proviene de personas afiliadas al régimen subsidiado de Salud. La causa principal en el 98% de los casos es la presión, seguido por cizalla, humedad e incontinencia. Se destaca el desconocimiento de los ácidos grasos hiperoxigenados y el escaso uso de superficies especiales para el manejo de la presión; el 43% no utiliza escalas para medir el riesgo. Conclusiones. Estos resultados son el preámbulo de una investigación nacional que permita establecer indicadores propios, encaminados a estrategias de prevención reales.
Limitations of Online Information on Abdominal Aortic Aneurysm
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Carolyn G. Goldberg
Full Text Available Background. Patients with AAA face a complex decision, and knowledge of the risks and benefits of each treatment option is essential to informed decision-making. Here we assess the current information on the internet accessible to patients regarding the management of AAA. Study Design. We performed a search on Google using the keywords "abdominal aortic aneurysm" and reviewed the top 50 web sites. We focused on information related to treatment options and alternatives to treatment and the risks of each option. Results. Twenty-seven websites were included in the study. Nearly 30% of websites discussed the risk of mortality and myocardial infarction after open surgery, compared to only 7.4% for both risks after EVAR. Other complications were listed by fewer websites. Fifty-five percent of websites reported that patients had a faster recovery following EVAR, but only 18.5% mentioned the risk of reintervention after EVAR or the need for long-term surveillance with CT scans. Conclusions. While most websites included descriptive information on AAA and mentioned the potential treatment options available to patients, the discussion of the risks of open surgery and EVAR was inadequate. These results suggest that websites frequently accessed by patients lack important information regarding surgical risk.
Ruptura de aneurismas de aorta abdominal. Herramienta informática para su predicción // Rupture of abdominal aortic aneurysm. Software for its prediction
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Guillermo Villalta‐Alonso
Full Text Available La ruptura de los aneurismas de aorta abdominal representa un evento clínico muy importantedebido a su alta tasa de mortalidad. Los indicadores empleados actualmente para decidir eltratamiento a pacientes con aneurismas son el diámetro máximo transversal y la tasa de crecimiento,los que pueden ser considerados insuficientes, pues no tienen una base teórica físicamentefundamentada. En el presente artículo se definen los fundamentos para el diseño de una herramientainformática para PC que permita predecir, con suficiente precisión para ser clínicamente relevante, elriesgo de ruptura de aneurismas de aorta abdominal sobre bases personalizadas del paciente. Laherramienta consta de 3 módulos, que están diseñados para procesar toda la información delpaciente e integrarla mediante un modelo que incorpora la interrelación de los factores biomecánicosde diferentes naturalezas (biológicos, estructurales y geométrico y escalas (temporal y dimensional,con el objetivo de calcular un indicador numérico y personalizado del riesgo de ruptura. Estaherramienta debe constituir un elemento auxiliar del facultativo médico en la toma de decisionesrespecto del tratamiento adecuado a pacientes con aneurisma.Palabras claves: AAA, riesgo de ruptura, modelo multiescala, predicción, herramienta informática.___________________________________________________________________AbstractThe rupture of abdominal aortic aneurysm (AAA represents an important clinical event due to its highmortality rate. Currently the criteria to decide on the treatment of AAA patients are the peaktransverse diameter and the growth rate which can be considered insufficient because they have nota reasonable physical base. The foundations for the design of PC software to predict, with sufficientaccuracy to be clinically relevant, the risk of AAA rupture on patient-specific basis are defined in thispaper. The software consists of 3 modules which are designed for processing all
ABDOPRE: dispositivo de aplicação externa para redução da pressão intra-abdominal: Experiencia clínica preliminar ABDOPRE: dispositivo de aplicación externa para reducción de presión intraabdominal: Preliminary clinical experience ABDOPRE: an external device for the reduction of intra-abdominal pressure
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Francisco Pracca
Full Text Available São descritos os objetivos de redução da pressão intra-abdominal e o projeto de um dispositivo que os atenda. O ABDO-PRE compreende, pela primeira vez, um mecanismo de servo-controle de aplicação externa que mede a pressão intravesical como variável de controle. São apresentados os resultados da aplicação em 4 pacientes com hipertensão intra-abdominal, produzindo uma redução de 16% a 35% em três casos e um aumento paradoxal da pressão em um dos casos, devido a um desajuste entre a geometria da câmara de vácuo e a alteração anatômica acarretada pela obesidade da paciente. Estes resultados são promissores em relação ao possível uso do ABDOPRE na prática clínica para redução da hipertensão intra-abdominal.Se describen los objetivos de reducción de la presión intraabdominal y el proyecto de un dispositivo que los cumpla. ABDOPRE comprende por primera vez un mecanismo servcocontrolado de aplicación externa que toma la presión intravesical como variable de control. Se presenta el resultado de la aplicación en 4 pacientes afectados por hipertensión intraabdominal, con el resultado de una reducción de entre 16% y 35% en tres casos y de un aumento paradojal de presión en un caso debido a desajuste de la geometría de la campana de vacío a la anatomía obesa del paciente. Estos resultados prometen el posible uso de ABDOPRE para la reducción de la hipertensión intraabdominal en la práctica clínica.This article describes a device for the reduction of intra-abdominal pressure. The device (ABDOPRE includes a unique external servo-control mechanism, based on urinary bladder pressure measurement. The results of ABDOPRE use in the first four intra-abdominal hypertension patients are reported; the device resulted in a reduction of intra-abdominal pressure between 16% and 35% in 3 cases and in a paradoxical increase of the intra-abdominal pressure in an obese woman, likely due to inappropriate chamber size for the patient
Banez, Gerard A.; Gallagher, Heather M.
The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…
El tema central Mujeres, Ética, Política y Participación" de este número 2 de la Revista En Otras Palabras … " ofrece diversas aproximaciones sobre la difícil coyuntura que vive Colombia. Los artículos que conforman la sección "Rehaciendo Saberes", ofrecen, desde distintos ángulos, reflexiones sobre una nueva voluntad de saber de las mujeres como primer paso para acceder a la ética, la política y sus difíciles conexiones. Allí se ubican ensayos que invitan a estudiar las relaciones entre patr...
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Desde el Jardín de Freud
Full Text Available Desde el Jardín de Freud se encuentra indexada en el IBN-Publindex (Colciencias, en categoría C, y en las siguientes bases de datos y catálogos: EBSCO, ProQuest, CLASE, Latindex, Dialnet, Rebiun, Doaj, e-Revistas y Biblioteca virtual Luis Ángel Arango.
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Desde el Jardín de Freud
Full Text Available Desde el Jardín de Freud se encuentra indexada en el IBN-Publindex (Colciencias, en categoría C, y en las siguientes bases de datos y catálogos: EBSCO, ProQuest, Latindex, Dialnet, Rebiun, Doaj, e-Revistas y Biblioteca virtual Luis Ángel Arango.
"La liberación de las mujeres pasa por el trabajo sobre el lenguaje, los imaginarios, los mitos y las representaciones que configuran lo simbólico. Hoy día la emancipación de las mujeres desborda ampliamente el marco de las luchas feministas que se encierran en la crítica del patriarcado o en las reivindicaciones de igualdad, las cuales -si bien tienen todavía en una sociedad como la colombiana una amplia significación- necesitan enriquecerse de nuevos valores para vivir la diferencia sexual ...
Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is does not always reflect the seriousness ...
Wagenlehner, F M E; Mohren, B; Naber, K G; Männl, H F K
Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.
De Waele, Jan J
Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.
Abdominal emergencies in pediatrics.
Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E
Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.
Abdominal Aortic Aneurysm (AAA)
... News Physician Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... an abdominal aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...
Preliminares en la construcción
Vélez Trujillo, Carlos Arturo
En el crecimiento y dinamismo de la construcción actual se hace imperativo para quienes tienen la responsabilidad al ejecutar un proyecto la labor d desarrollarlo conexito en todos los campos técnico-administrativos, involucrando en la mecánica del manejo métodos y herramientas que permitan el logro de los objetivos iniciales propuestos por todos los participantes en el proyecto. Esto implica contemplar algunos aspectos de la fase preliminar que debe estar desde el principio clara en el ejecu...
Childhood abdominal cystic lymphangioma
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Konen, Osnat; Rathaus, Valeria; Shapiro, Myra [Department of Diagnostic Imaging, Meir General Hospital, Sapir Medical Centre, Kfar Saba (Israel); Dlugy, Elena [Department of Paediatric Surgery, Schneider Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Freud, Enrique [Department of Paediatric Surgery, Sapir Medical Centre, Sackler School of Medicine, Tel-Aviv University (Israel); Kessler, Ada [Department of Diagnostic Imaging, Sourasky Medical Centre, Tel-Aviv (Israel); Horev, Gadi [Department of Diagnostic Imaging, Schneider Medical Centre, Tel-Aviv (Israel)
Background: Abdominal lymphangioma is a rare benign congenital malformation of the mesenteric and/or retroperitoneal lymphatics. Clinical presentation is variable and may be misleading; therefore, complex imaging studies are necessary in the evaluation of this condition. US and CT have a major role in the correct preoperative diagnosis and provide important information regarding location, size, adjacent organ involvement, and expected complications. Objective: To evaluate the clinical and imaging findings of seven children with proven abdominal cystic lymphangioma. Materials and methods: Clinical and imaging files of seven children with pathologically proven abdominal lymphangioma, from three university hospitals, were retrospectively evaluated. Patient's ages ranged from 1 day to 6 years (mean, 2.2 years). Symptoms and signs included evidence of inflammation, abnormal prenatal US findings, chronic abdominal pain, haemorrhage following trauma, clinical signs of intestinal obstruction, and abdominal distension with lower extremities lymphoedema. Plain films of five patients, US of six patients and CT of five patients were reviewed. Sequential imaging examinations were available in two cases. Results: Abdominal plain films showed displacement of bowel loops by a soft tissue mass in five of six patients, two of them with dilatation of small bowel loops. US revealed an abdominal multiloculated septated cystic mass in five of six cases and a single pelvic cyst in one which changed in appearance over 2 months. Ascites was present in three cases. CT demonstrated a septated cystic mass of variable sizes in all available five cases. Sequential US and CT examinations in two patients showed progressive enlargement of the masses, increase of fluid echogenicity, and thickening of walls or septa in both cases, with multiplication of septa in one case. At surgery, mesenteric lymphangioma was found in five patients and retroperitoneal lymphangioma in the other two
Influencia de los Programas de la Revolución en el diagnóstico precoz de la Hipertensión Portal Pre Hepática en niños. Informe preliminar: 2º Parte
Odalys Leyva González
Aborda el impacto de los Programas de la Revolución, no sólo en la esfera para lo que fueron inicialmente concebidos, sino las potencialidades para solucionar otros problemas que afectan a la comunidad y a los hospitales. Se realizó un estudio de serie de casos retrospectivo y prospectivo a partir de la aplicación del programa de diagnóstico precoz de la Hipertensión Portal Prehepática en niños. Se estudiaron 210 pacientes de riesgo mediante el ultrasonido abdominal encontrándose que sufrían ...
ePhenotyping for Abdominal Aortic Aneurysm in the Electronic Medical Records and Genomics (eMERGE) Network: Algorithm Development and Konstanz Information Miner Workflow
Borthwick, Kenneth M; Smelser, Diane T; Bock, Jonathan A; Elmore, James R; Ryer, Evan J; Ye, Zi; Pacheco, Jennifer A.; Carrell, David S.; Michalkiewicz, Michael; Thompson, William K; Pathak, Jyotishman; Bielinski, Suzette J; Denny, Joshua C; Linneman, James G; Peissig, Peggy L; Kho, Abel N; Gottesman, Omri; Parmar, Harpreet; Kullo, Iftikhar J; McCarty, Catherine A; Böttinger, Erwin P; Larson, Eric B; Jarvik, Gail P; Harley, John B; Bajwa, Tanvir; Franklin, David P; Carey, David J; Kuivaniemi, Helena; Tromp, Gerard
Background and objective We designed an algorithm to identify abdominal aortic aneurysm cases and controls from electronic health records to be shared and executed within the "electronic Medical Records and Genomics" (eMERGE) Network. Materials and methods Structured Query Language, was used to script the algorithm utilizing "Current Procedural Terminology" and "International Classification of Diseases" codes, with demographic and encounter data to classify individuals as case, control, or excluded. The algorithm was validated using blinded manual chart review at three eMERGE Network sites and one non-eMERGE Network site. Validation comprised evaluation of an equal number of predicted cases and controls selected at random from the algorithm predictions. After validation at the three eMERGE Network sites, the remaining eMERGE Network sites performed verification only. Finally, the algorithm was implemented as a workflow in the Konstanz Information Miner, which represented the logic graphically while retaining intermediate data for inspection at each node. The algorithm was configured to be independent of specific access to data and was exportable (without data) to other sites. Results The algorithm demonstrated positive predictive values (PPV) of 92.8% (CI: 86.8-96.7) and 100% (CI: 97.0-100) for cases and controls, respectively. It performed well also outside the eMERGE Network. Implementation of the transportable executable algorithm as a Konstanz Information Miner workflow required much less effort than implementation from pseudo code, and ensured that the logic was as intended. Discussion and conclusion This ePhenotyping algorithm identifies abdominal aortic aneurysm cases and controls from the electronic health record with high case and control PPV necessary for research purposes, can be disseminated easily, and applied to high-throughput genetic and other studies. PMID:27054044
Influencia de los Programas de la Revolución en el diagnóstico precoz de la Hipertensión Portal Pre Hepática en niños. Informe preliminar: 2º Parte
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Odalys Leyva González
Full Text Available Aborda el impacto de los Programas de la Revolución, no sólo en la esfera para lo que fueron inicialmente concebidos, sino las potencialidades para solucionar otros problemas que afectan a la comunidad y a los hospitales. Se realizó un estudio de serie de casos retrospectivo y prospectivo a partir de la aplicación del programa de diagnóstico precoz de la Hipertensión Portal Prehepática en niños. Se estudiaron 210 pacientes de riesgo mediante el ultrasonido abdominal encontrándose que sufrían la enfermedad un total de 6. Los Programas han dotado los servicios de imagenología con unatecnología altamente especializada que logra un gran impacto en la atención pediátrica contribuyendo a mejorar la calidad de vida.
Estudos preliminares com bromoacetamida, um novo moluscicida
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Naftale Katz
Full Text Available A bromoacetamida tem sido testada como moluscicida na República Popular da China, para tratamento de criadouros de Oncomelania, hospedeiro do Schistosoma japonicum, com bons resultados. O produto é solúvel em água, o que simplifica seu uso. Foram feitos ensaios biológicos preliminares deste produto em caramujos adultos (Biomphalaria glabrata, B. tenagophila e B. straminea, recém-eclodidos e desovas. Paralelamente foram feitos ensaios com o pentaclorofenol para avaliar a suscetibilidade dos caramujos. O produto foi testado também sobre peixes, Lebistes reticulatus. Os moluscos testados mediam 8-10 mm de diâmetro; os recém-eclodidos tinham 1-3 dias de idade e as desovas 0-1 dia de idade. A temperatura da água durante os experimentos variou de 24,3 a 27,0°C. O produto foi ativo para caramujos adultos, recém-eclodidos e desovas, em concentrações em tomo de 1 a 4 ppm. Para os peixes o produto foi menos tóxico do que para os caramujos (CLço 7,5 ppm. Estes resultados indicam que a bromoacetamida apresenta propriedades moluscicidas promissoras para o controle da Biomphalaria spp.
Cuestionario de rasgos de personalidad obsesiva (CRPO): resultados preliminares
Vallejo Ruiloba, Julio; Marcos, Teodor; Salamero, Manel
Se presentan los resultados preliminares del cuestionario de rasgos de personalidad obsesiva (CRPO) en tres muestras de población (pacientes obsesivos, pacientes depresivos con melancolía y controles sanos). cuestionario, de 31 ítems, ha demostrado ser útil y válido para discriminar el trastorno obsesivo-compulsivo personalidad.
Abdominal radiation - discharge
Radiation - abdomen - discharge; Cancer - abdominal radiation; Lymphoma - abdominal radiation ... When you have radiation treatment for cancer, your body goes through changes. About 2 weeks after radiation treatment starts, you might notice changes ...
... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...
Full Text Available ... accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives. ... kidney and bladder stones. abdominal aortic aneurysms (AAA), injuries to abdominal organs such as the spleen, liver, ...
Blunt abdominal trauma in sports.
Rifat, Sami F; Gilvydis, Rimas P
Abdominal injuries are rare in sports, but when they do occur it is important that the physician recognize the warning signs of potentially life-threatening injury to the liver, spleen, or hollow abdominal viscera. Though the sports medicine physician may not always provide definitive treatment of many of these conditions, he or she should be familiar with the preferred diagnostic modalities and latest treatment options. This information is not only essential to appropriately participate in treatment decisions, but is also important in order to make return-to-play determinations.
Kaur, Supreet; Doley, Rudra Prasad; Chabbhra, Mohinish; Kapoor, Rajeev; Wig, Jaidev
Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.
Estudos preliminares com bromoacetamida, um novo moluscicida
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Naftale Katz
Full Text Available A bromoacetamida tem sido testada como moluscicida na República Popular da China, para tratamento de criadouros de Oncomelania, hospedeiro do Schistosoma japonicum, com bons resultados. O produto é solúvel em água, o que simplifica seu uso. Foram feitos ensaios biológicos preliminares deste produto em caramujos adultos (Biomphalaria glabrata, B. tenagophila e B. straminea, recém-eclodidos e desovas. Paralelamente foram feitos ensaios com o pentaclorofenol para avaliar a suscetibilidade dos caramujos. O produto foi testado também sobre peixes, Lebistes reticulatus. Os moluscos testados mediam 8-10 mm de diâmetro; os recém-eclodidos tinham 1-3 dias de idade e as desovas 0-1 dia de idade. A temperatura da água durante os experimentos variou de 24,3 a 27,0°C. O produto foi ativo para caramujos adultos, recém-eclodidos e desovas, em concentrações em tomo de 1 a 4 ppm. Para os peixes o produto foi menos tóxico do que para os caramujos (CLço 7,5 ppm. Estes resultados indicam que a bromoacetamida apresenta propriedades moluscicidas promissoras para o controle da Biomphalaria spp.Bromocetamide has been tested as molluscicide, with good results, in the People's Republic of China, on Oncomelania, host of Schistosoma japonicum. We have conducted preliminary assays with bromoacetamide on adult snails (B. glabrata, B. tenagophila and B. straminea, newly hatched smails and egg-masses. This product has been also tested on fishes (Lebistes reticulatus. Comparative assays have been made with pentaclorophenol to evaluate the suceptibility of the snails. Snails tested had a diameter of 8-10 mm; the newly hatched were 1-3 days old and the eggs-masses. 0-1 day old. The temperature of the water varied from 24.3 to 27.5° C. Bromoacetamide was active on adult and newly hatched snails and egg-masses, in concentrations from 1-4ppm. The product was less toxic for jish (LC90 = 7,5 ppm. These results indicate that bromoacetamide has promising molluscicide
Abdominal epilepsy in chronic recurrent abdominal pain
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V Y Kshirsagar
Full Text Available Background: Abdominal epilepsy (AE is an uncommon cause for chronic recurrent abdominal pain in children and adults. It is characterized by paroxysmal episode of abdominal pain, diverse abdominal complaints, definite electroencephalogram (EEG abnormalities and favorable response to the introduction of anti-epileptic drugs (AED. We studied 150 children with chronic recurrent abdominal pain and after exclusion of more common etiologies for the presenting complaints; workup proceeded with an EEG. We found 111 (74% children with an abnormal EEG and 39 (26% children with normal EEG. All children were subjected to AED (Oxcarbazepine and 139 (92% children responded to AED out of which 111 (74% children had an abnormal EEG and 27 (18% had a normal EEG. On further follow-up the patients were symptom free, which helped us to confirm the clinical diagnosis. Context: Recurrent chronic abdominal pain is a common problem encountered by pediatricians. Variety of investigations are done to come to a diagnosis but a cause is rarely found. In such children diagnosis of AE should be considered and an EEG will confirm the diagnosis and treated with AED. Aims: To find the incidence of AE in children presenting with chronic recurrent abdominal pain and to correlate EEG findings and their clinical response to empirical AEDs in both cases and control. Settings and Design: Krishna Institute of Medical Sciences University, Karad, Maharashtra, India. Prospective analytical study. Materials and Methods: A total of 150 children with chronic recurrent abdominal pain were studied by investigations to rule out common causes of abdominal pain and an EEG. All children were then started with AED oxycarbamezepine and their response to the treatment was noted. Results: 111 (74% of the total 150 children showed a positive EEG change suggestive of epileptogenic activity and of which 75 (67.56% were females and 36 (32.43% were male, majority of children were in the age of group of 9
Abdominal Decompression in Children
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J. Chiaka Ejike
Full Text Available Abdominal compartment syndrome (ACS increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH by intra-abdominal pressure (IAP monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.
Abdominal Compartment Syndrome
Ovchinnikov V.А.; Sokolov V.А.
We considered one of the most complicated problems of surgery and intensive care — abdominal compartment syndrome. It is a severe, and in some cases lethal complication developing in major injuries and pathology of abdominal cavity and retroperitoneal space, as well as in extra-abdominal pathology. In addition, compartment syndrome can be the complication of a number of surgical procedures accompanied primarily by laparotomy wound closure with tissue tension. We demonstrated the classificatio...
Abdominal Compartment Syndrome
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Pınar Zeyneloğlu
Full Text Available Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra-abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.
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Supreet Kaur
Full Text Available Abdominal cocoon or sclerosing peritonitis refers to a rare cause of intestinal obstruction due to formation of a membrane encasing the bowel. We report a case of abdominal cocoon post blunt trauma abdomen. The patient presented with a history of subacute intestinal obstruction and a mobile abdomen lump. Abdominal cocoon was diagnosed on computed tomography. He underwent adhesiolysis with excision of membrane.
Informe preliminar sobre un hallazgo de restos humanos en urna
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Drube, Hilton
Full Text Available El objetivo de este trabajo consiste en el análisis de un conjunto esqueletal originariamente depositado en un ceramio con fines mortuorios. La vasija funeraria yacía superficialmente en adyacencias de un camino vecinal próximo a un antiguo afluente del río Dulce, en la región central de la provincia de Santiago del Estero. Toda el área inmediata a la zona del hallazgo conforma sitios de ocupación prehispánica, caracterizados por la presencia de cerámica Sunchituyoj. A pesar del estado sumamente fragmentario de la urna, y del deterioro parcial del contexto, se pudo rescatar todos los elementos óseos en ella depositados, los que corresponden a dos individuos, un adulto y un infante. Se aplicaron métodos convencionales, tanto escópicos como métricos, a fin de dilucidar la edad, sexo y estatura. El individuo adulto corresponde al sexo femenino y se estima en treinta años su edad a la muerte. Destaca en el mismo la presencia de osteofitosis en las vértebras y entesofitosis en los huesos largos. También se observa tejido óseo proliferativo en elementos costales y en el íleon. Asimismo puede evidenciarse caries e hipoplasia en el esmalte en algunas piezas dentales. Los componentes óseos del infante presentan un estado de conservación regular, estimándose en tres años su edad al deceso. A pesar de la destrucción parcial del contexto en el cual se encontraban los remanentes esqueletales en consideración, la información lograda a partir de los mismos es muy relevante, pues permite incrementar el conocimiento bioarqueológico para la región.
[Abdominal pregnancy, institutional experience].
Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q
Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.
Gastrointestinal causes of abdominal pain.
Marsicano, Elizabeth; Vuong, Giao Michael; Prather, Charlene M
Gastrointestinal causes of abdominal pain are numerous. These causes are reviewed in brief here, divided into 2 categories: acute abdominal pain and chronic abdominal pain. They are further subcategorized by location of pain as it pertains to the abdomen.
Functional Abdominal Pain in Children
... functional abdominal pain. Functional abdominal pain can be intermittent (recurrent abdominal pain or RAP) or continuous. Although ... tests are needed or whether a trial of diet changes, stress management or medication may be started. ...
[Inflammatory abdominal aortic aneurysm].
Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T
The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.
Upadhyaya, P; Karak, A K; Sinha, A K; Kumar, B; Karki, S; Agarwal, C S
Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.
Congenital Abdominal Wall Defects
DEFF Research Database (Denmark)
Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels
complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...
Protocolo preliminar da cultura de fibroblastos de gengiva humana
Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-Graduação em Odontologia. Os objetivos foram estabelecer um protocolo preliminar de cultivo primário de fibroblastos gengivais humanos e conseqüentemente, estabelecer uma linhagem celular; avaliar a viabilidade celular e os danos que os procedimentos precedentes poderiam causar na molécula de DNA. Uma biópsia de 20mm2 de mucosa ceratinizada foi fragmentada em 15 partes menores e di...
Abdominal tuberculosis: Imaging features
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Pereira, Jose M. [Department of Radiology, Hospital de S. Joao, Porto (Portugal)]. E-mail: email@example.com; Madureira, Antonio J. [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Vieira, Alberto [Department of Radiology, Hospital de S. Joao, Porto (Portugal); Ramos, Isabel [Department of Radiology, Hospital de S. Joao, Porto (Portugal)
Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis. Learning objectives:1.To review the relevant pathophysiology of abdominal tuberculosis. 2.Illustrate CT findings that can help in the diagnosis.
Full Text Available ... is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. ... GI) contrast exams and ultrasound are preferred for evaluation of acute abdominal conditions in babies, such as ...
Seiler, Christian A
Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.
Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...
... are, or may be, pregnant. Alternative Names Abdominal film; X-ray - abdomen; Flat plate; KUB x-ray ... Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also ...
Danto, L A; Wolfman, E F
Three cases of blunt abdominal trauma are presented to exemplify the mechanism of trauma and the problems of diagnosis associated with any linear blow to the abdomen. The mechanisms of visceral injury are reviewed, and special attention is directed to the abdominal wall injury that can be present in these patients. This injury has special implications in directing the operative approach and repair. An unusual aortic occlusion is described which is peculiar to this type of injury.
Urgent Abdominal Re-Explorations
Directory of Open Access Journals (Sweden)
Peskersoy Mustafa
Full Text Available Abstract Background Treatment of a number of complications that occur after abdominal surgeries may require that Urgent Abdominal Re-explorations (UARs, the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing UARs, outcomes of relaparotomies (RLs and factors that affect mortality. Methods Demographic characteristics; initial diagnoses; information from and complications of the first surgery received; durations and outcomes of UAR(s performed in patients who received early RLs because of complicated abdominal surgeries in our clinic between 01.01.2000 and 31.12.2004 were investigated retrospectively. Statistical analyses were done using the chi-square and Fisher exact tests. Results Early UAR was performed in 81 out of 4410 cases (1.8%. Average patient age was 50.46 (13–81 years with a male-to-female ratio of 60/21. Fifty one (62.96% patients had infection, 41 (50.61% of them had an accompanying serious disease, 24 (29.62% of them had various tumors and 57 (70.37% patients were operated under emergency conditions during first operation. Causes of urgent abdominal re-explorations were as follows: leakage from intestinal repair site or from anostomosis (n:34; 41.97%; hemorrhage (n:15; 18.51%; intestinal perforation (n:8; 9.87%; intraabdominal infection or abscess (n:8; 9.87%; progressive intestinal necrosis (n:7; 8.64%; stomal complications (n:5; 6.17%; and postoperative ileus (n:4; 4.93%. Two or more UARs were performed in 18 (22.22% cases, and overall mortality was 34.97% (n:30. Interval between the first laparotomy and UAR averaged as 6.95 (1–20 days, and average hospitalization period was 27.1 (3–78 days. Mortality rate was found to be higher among the patients who received multiple UARs. The most common (55.5% cause of mortality was sepsis/multiple organ failure (MOF. The rates for common mortality and sepsis/MOF-dependent mortality that occured following UAR were
Abdominal paracentesis and thoracocentesis.
Lee, Ser Yee; Pormento, James G; Koong, Heng Nung
Abdominal paracentesis and thoracocentesis are common bedside procedures with diagnostic, therapeutic and palliative roles. We describe a useful and familiar a useful and familiar technique with the use of a multiple lumen catheter commonly used for central venous line insertion for drainage of ascites or moderate to large pleural effusions. The use of a multiple lumen catheter allows easier and more rapid aspiration of fluid with a smaller probability of the side holes being blocked as compared to the standard needle or single catheter methods. This is particularly useful in situations where the dedicated commercial kits for thoracocentesis and abdominal paracentesis are not readily available.
[Abdominal actinomycosis with IUD].
Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A
We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.
LENUS (Irish Health Repository)
Murphy, Kevin P
Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient\\'s symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.
Screening for Abdominal Aortic Aneurysm
Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final ...
Abdominal aortic aneurysm repair - open
MR angiography in abdominal neoplasms
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Squillaci, E. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Crecco, M. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Grandinetti, M.L. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Maspes, F. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Lo Presti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy); Squillaci, S. [Dept. of Radiology, Cancer Research Inst. (Regina Elena), Rome (Italy); Simonetti, G. [Dept. of Radiology, Rome-2 Univ., Hospital S. Eugenio, Rome (Italy)
The role of magnetic resonance angiography (MRA) in the evaluation of vascular involvement was studied in 55 patients with abdominal neoplasms. A 2-D time-of-flight (TOF) technique was used in all patients. All patients underwent CT and MR examinations before MRA. Also, MR angiograms were compared with digital subtraction angiography in 22 cases, with Doppler US in 13 cases, and with surgical findings in 20 cases. In all patients with liver neoplasms (n=29) MRA demonstrated the absence of flow in the infiltrated segments. Pericapsular neovascularization was observed in 12 patients. Portal vein involvement was correctly detected in 27 patients. In all cases MRA demonstrated in relationship between the tumor and venous structures. Portosystemic shunts were visualized in 20 of 21 patients with portal hypertension. Vena cava thrombosis (3 cases), compression (5 cases), and displacement (2 cases) were correctly demonstrated. In renal (n=6) and adrenal gland (n=3) tumors renal vein compression was correctly detected in 2 cases, displacement in 1 case, and thrombosis in 3 cases, with only 1 false-positive finding. In 7 patients with pancreatic tumors MRA demonstrated splenic vein thrombosis in 2 cases and compression in 2 cases, with one false-positive finding. Our results indicate that MRA provides precise information regarding venous vascular involvement in abdominal neoplasms, but preoperative arterial mapping is still problematic. (orig.)
Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents.
Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław
Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents.
Physicians' Abdominal Auscultation
DEFF Research Database (Denmark)
John, Gade; Peter, Kruse; Andersen, Ole Trier
Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...
Ruptured abdominal aortic aneurysm.
Sachs, T; Schermerhorn, M
Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.
Abdominal aspergillosis: CT findings
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Yeom, Suk Keu, E-mail: firstname.lastname@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Hye Jin, E-mail: firstname.lastname@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Byun, Jae Ho, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Kim, Ah Young, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Lee, Moon-Gyu, E-mail: email@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of); Ha, Hyun Kwon, E-mail: firstname.lastname@example.com [Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap2-dong, Songpa-gu, Seoul, 138-736 (Korea, Republic of)
Objective: In order to retrospectively evaluate the CT findings of abdominal aspergillosis in immunocompromised patients. Materials and methods: CT scans were reviewed with regard to the sites, number, morphologic appearance, attenuation, and the contrast enhancement patterns of the lesions in six patients (5 women, 1 man; mean age, 43.4 years; range, 23-59 years) with pathologically proved abdominal aspergillosis by two gastrointestinal radiologists in consensus. Medical records were also reviewed to determine each patient's clinical status and outcome. Results: All patients were immunocompromised state: 4 patients received immunosuppressive therapy for solid organ transplantation and 2 patients received chemotherapy for acute myeloid leukemia. Aspergillosis involved blood vessels (n = 3), liver (n = 2), spleen (n = 2), gastrointestinal tract (n = 2), native kidney (n = 1), transplanted kidney (n = 1), peritoneum (n = 1), and retroperitoneum (n = 1). CT demonstrated solid organ or bowel infarction or perforation secondary to vascular thrombosis or pseudoaneurysm, multiple low-attenuating lesions of solid organs presenting as abscesses, concentric bowel wall thickening mimicking typhlitis, or diffuse or nodular infiltration of the peritoneum and retroperitoneum. Conclusion: Familiarity with findings commonly presenting as angioinvasive features or abscesses on CT, may facilitate the diagnosis of rare and fatal abdominal aspergillosis.
Estudio preliminar sobre la producción científica en ingeniería de software en la Argentina
Se realiza un estudio preliminar en el cual se identifican y recopilan publicaciones de los años 2009 y 2010 de las siguientes eventos: Workshop de Investigadores en Ciencias de la Computación (WICC), Congreso Argentino de Ciencias de la Computación (CACIC), Jornadas Argentinas de Informática (JAIIO) relativos a la investigación en Ingeniería de Software en Argentina y en la región. Se toma como punto de partida la conceptualizacion de Ingeniería de Software propuesta por diferentes autores....
Contrato preliminar: eficácia nos negócios jurídicos complexos
Alem, Fabio Pedro
A proposta desta dissertação é analisar criticamente o contrato preliminar nos negócios jurídicos complexos, com destaque para os graus de obrigatoriedade ou os níveis de predeterminação do conteúdo do contrato definitivo (fraco, médio e forte) e as consequências práticas do contrato preliminar nos negócios complexos. O ponto de partida do trabalho é a análise histórica e evolutiva da aplicação do contrato preliminar, seguida por uma apresentação de suas características f...
[Differential diagnosis of abdominal pain].
Frei, Pascal
Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain.
Abdominal aortic aneurysm surgery
DEFF Research Database (Denmark)
Gefke, K; Schroeder, T V; Thisted, B
The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....
Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S
Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation.
Directory of Open Access Journals (Sweden)
Rodrigo De Vivero
Full Text Available El dolor abdominal recurrente (DAR es un problema frecuente en la consulta médica y en la subespecialidad médica y quirúrgica. El DAR es frecuentemente funcional, es decir, sin una causa orgánica aparente. El diagnóstico diferencial debe incluir pérdida de peso, sangrado gastrointestinal, fiebre persistente, diarrea crónica y vómito importante. En este artículo se revisa el diagnóstico y tratamiento, pruebas diagnósticas y manejo farmacológico y ambiental.
Abdominal perfusion computed tomography.
Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit
The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.
Abdominal pregnancy- a case report.
Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc
A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.
Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies
Energy Technology Data Exchange (ETDEWEB)
Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)
Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)
Subtotal versus total abdominal hysterectomy
DEFF Research Database (Denmark)
Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael
a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION: Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women...
Abdominal Complications after Severe Burns
abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high
DEFF Research Database (Denmark)
Lindholt, Jes Sanddal
Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective....... The acceptance rate was 77%, and 95% accept control scans. Furthermore, persons at the highest risk of having an AAA attend screening more frequently. We found that 97% of the interval cases developed from aortas that initially measured 2.5-2.9 cm - i.e. approx. only 5% attenders need re-screening at 5-year...... methods for measuring the degree of wall calcification must be developed and validated....
Use of the Abdominal Aortic Tourniquet for Hemorrhage Control
AD_________________ Award Number: W81XWH-12-1-0546 TITLE: Use of the Abdominal Aortic Tourniquet for Hemorrhage Control PRINCIPAL INVESTIGATOR...subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT...SUBTITLE Use of the Abdominal Aortic Tourniquet for Hemorrhage Control 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1-0546 5c. PROGRAM ELEMENT NUMBER
Abdominal migraine in the differential diagnosis of acute abdominal pain.
Cervellin, Gianfranco; Lippi, Giuseppe
Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established.
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Nevein Mohammed Mohammed Gharib
Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.
Abdominal leiomyosarcomas: radiologic appearances at various locations
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Kurugoglu, Sebuh; Ogut, Gunduz; Mihmanli, Ismail; Korman, Ugur [Department of Radiology, Istanbul University, Cerrahpasa Medical Faculty, 34300 Istanbul (Turkey); Durak, Haydar [Department of Pathology, Istanbul University, Cerrahpasa Medical Faculty, 34300 Istanbul (Turkey)
Leiomyosarcomas are soft tissue tumors that account for approximately 15% of all soft tissue sarcomas. Leiomyosarcomas may be located at almost any part of the abdomen but especially are more common in the retroperitoneum, followed by gastrointestinal tract and genital system. They develop mainly in adult life and are very rare in children. In this article, imaging findings of leiomyosarcomas in various abdominal locations are presented. Radiologic studies are capable of providing useful information on the localization, size, changes in the internal structure of the tumor, its extension and invasion. Leiomyosarcoma should be considered in the differential diagnosis in case of detection of a large, circumscribed, and heterogenous abdominal mass. Histopathologically, diagnosis of malignancy depends particularly on mitotic counts, size, rate of necrosis, and infiltrating margins. (orig.)
Reti di città, mobilità e ambiente: il Preliminare di PTCP di Avellino
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Carmela Gargiulo
Full Text Available L'articolo propone la lettura dei contenuti del Preliminare del PTCP di Avellino, un piano per molti aspetti innovativo, soprattutto per aver coniugato pianificazione di area vasta di tipo tradizionale e logica "strategica". In particolare, l'articolo descrive idee guida, contenuti e strategie del piano orientate, prevalentemente, a stimolare lo sviluppo sostenibile di un'area in ritardo di sviluppo come la provincia irpina, attraverso la salvaguardia e valorizzazione delle risorse naturali e storico-culturali, la costruzione di reti di medie e piccole città e reti di mobilità alle diverse scale, da quella urbana a quella internazionale, e interventi sul sistema della mobilità. Nel 2004, ormai più di cinque anni fa, è stato adottato, a maggioranza assoluta (solo due gli astenuti, il Preliminare di Piano Territoriale di Coordinamento della Provincia di Avellino, dopo un lavoro di oltre due anni che ha visto impegnati gli uffici provinciali con due dipartimenti universitari. Il lavoro, che va ben oltre il significato e la valenza di un preliminare e che coniuga due pratiche di piano diverse (quella tradizionale e quella strategica ruota attorno a tre idee di fondo, tra loro strettamente interrelate, che costituiscono i criteri guida che finora ha inteso seguire la provincia di Avellino nell'attività di governo delle trasformazioni. Tali idee, quindi, costituiscono le fondamenta su cui è stato costruito il Preliminare e sono la griglia di specificazione delle strategie e degli obiettivi di piano. Esse sono alla base delle scelte elaborate per lo sviluppo compatibile del territorio, e sono riferibili alle azioni operative di trasformazione del territorio che gli Enti locali, cui è demandato tale compito, nel prossimo futuro dovranno affrontare. Le tre idee forza del Preliminare, descritte nel seguito, sono riferibili ai sistemi di risorse principali della provincia di Avellino, oggetto di una indagine analitico
Economics of abdominal wall reconstruction.
Bower, Curtis; Roth, J Scott
The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias.
Micromanaging Abdominal Aortic Aneurysms
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Lars Maegdefessel
Full Text Available The contribution of abdominal aortic aneurysm (AAA disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility.
Mortimer, Alice Emily
A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.
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Clinical and ultrasonographic features of abdominal tuberculosis in HIV positive adults in Zambia
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Vermund Sten H
Full Text Available Abstract Background The diagnosis of abdominal tuberculosis (TB is difficult, especially so in health care facilities in developing countries where laparoscopy and colonoscopy are rarely available. There is little information on abdominal TB in HIV infection. We estimated the prevalence and clinical features of abdominal (excluding genitourinary TB in HIV infected adults attending the University Teaching Hospital, Zambia. Methods We screened 5,609 medical inpatients, and those with fever, weight loss, and clinical features suggestive of abdominal pathology were evaluated further. A clinical algorithm was used to specify definitive investigations including laparoscopy or colonoscopy, with culture of biopsies and other samples. Results Of 140 HIV seropositive patients with these features, 31 patients underwent full evaluation and 22 (71% had definite or probable abdominal TB. The commonest presenting abdominal features were ascites and persistent tenderness. The commonest ultrasound findings were ascites, para-aortic lymphadenopathy (over 1 cm in size, and hepatomegaly. Abdominal TB was associated with CD4 cell counts over a wide range though 76% had CD4 counts Conclusion The clinical manifestations of abdominal TB in our HIV-infected patients resembled the well-established pattern in HIV-uninfected adults. Patients with fever, weight loss, abdominal tenderness, abdominal lymphadenopathy, ascites and/or hepatomegaly in Zambia have a high probability of abdominal TB, irrespective of CD4 cell count.
Intra-abdominal tuberculous peritonitis
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Schneider, G.; Ahlhelm, F.; Altmeyer, K.; Kramann, B. [Dept. of Diagnostic Radiology, University Hospital, Homburg (Germany); Hennes, P. [Dept. of Pediatrics, University Hospital, Homburg (Germany); Pueschel, W. [Dept. of Pathology, University Hospital, Homburg (Germany); Karadiakos, N. [Dept. of Pediatric Surgery, University Hospital, Homburg (Germany)
We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies. (orig.)
Children's (Pediatric) Abdominal Ultrasound Imaging
Full Text Available ... valuable for evaluating abdominal, pelvic or scrotal pain in children. Preparation will depend on the type of ... examinations do not use ionizing radiation (as used in x-rays ), thus there is no radiation exposure ...
Children's (Pediatric) Abdominal Ultrasound Imaging
Full Text Available ... children. Except for traumatic injury, appendicitis is the most common reason for emergency abdominal surgery. Ultrasound imaging ... of page How is the procedure performed? For most ultrasound exams, you will be positioned lying face- ...
Children's (Pediatric) Abdominal Ultrasound Imaging
Full Text Available ... of page What are some common uses of the procedure? Abdominal ultrasound imaging is performed to evaluate ... for ultrasound examinations. top of page What does the equipment look like? Ultrasound scanners consist of a ...
Updates on abdominal desmoid tumors
Institute of Scientific and Technical Information of China (English)
Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequentiy after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.
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Karen Luz Torres Rojas
Full Text Available La incidencia de embarazo ectópico ha aumentado en los últimos años hasta 1:43 recién nacidos. La variedad abdominal es una de las menos frecuentes, su incidencia es de 1:10mil nacidos vivos. El 1% de los embarazos ectópicos son abdominales y la implantación en el epiplón es una rara entidad. Pueden clasificarse como primarios o secundarios en función de que se originen o no en la cavidad peritoneal. Se presenta un caso de embarazo abdominal primario, localizado en cara posterior del útero y recto, con edad gestacional 16 semanas y feto muerto, en una paciente de 25 años, atendida en el Hospital General "Dr. Ernesto Guevara de la Serna", con antecedentes de salud, G0 P0 A0, con método anticonceptivo DIU retirado seis meses antes. Se trata de un embarazo abdominal primario, puesto que la anatomía patológica informó ausencia de invasión trofloblástica en la trompa izquierda. El manejo placentario en este caso no permitió realizar la remoción completa de la misma. El seguimiento ecográfico y control de gonadotropinas evidenció una evolución favorable de la paciente, sin requerir manejo de metotrexate.
Common abdominal emergencies in children.
D'Agostino, James
Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.
Adequacy and quality of abdominal echographies requested by primary care professionals
Auladell Ma; Caballeria Llorenç; Pera Guillem; Rodríguez Lluís; Casas José; Aznar Jesús; Miranda Dolores; Sánchez Carmen; Negrete Antonio; Castellví Josep; Bernad Jesús; Canut Santiago; Aubà Josep; Aizpurua Miren; Torán Pere
Abstract Background The value of abdominal echography in primary care is great because it is innocuous, inexpensive, easy to perform and provides a great deal of information making this the first examination to be requested in cases of probable abdominal disease. However, too many abdominal echographies are probably requested overcrowding the Departments of Radiodiagnosis with not always justified petitions or with repetition of tests based on little clinical criteria. Methods/Design The aim ...
Institute of Scientific and Technical Information of China (English)
Radoje (C)olovi(c); MarJan Micev; Miodrag Jovanovi(c); Slavko Mati(c); Nikica Grubor; Henry Dushan E Atkinson
immunoexpression, and the respiratory epithelium revealed a CK8 and CK18 immunoprofile without CK 10/13 positive elements, though neither CEA or AFP positive cells were found. To our knowledge, this is the first reported case of an abdominally located neurenteric cyst with no associated spinal anomalies.
Value of abdominal CT in the emergency department for patients with abdominal pain
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Rosen, Max P.; Siewert, Bettina; Bromberg, Rebecca; Raptopoulos, Vassilios [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215 (United States); Sands, Daniel Z. [Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215 (United States); Edlow, Jonathan [Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215 (United States)
The purpose of our study is to demonstrate the value of CT in the emergency department (ED) for patients with non-traumatic abdominal pain. Between August 1998 and April 1999, 536 consecutive patients with non-traumatic abdominal pain were entered into our study. Using a computer order entry system, physicians were asked to identify: (a) their most likely diagnosis; (b) their level of certainty in their diagnosis; (c) if they thought CT would be normal or abnormal; (d) their treatment plan (prior to knowledge of the CT results); and (e) their role in deciding to order CT. This information was correlated with each patient's post-CT diagnosis and subsequent management. Pre- and post-CT diagnoses were concordant in 200 of 536 (37%) patients. The physicians' certainty in the accuracy of their pre-CT diagnosis was less than high in 88% of patients. Prior to CT, the management plan included hospital admission for 402 patients. Following CT, only 312 patients were actually admitted; thus, the net impact of performing CT was to obviate the need for hospital admission in 90 of 536 (17%) of patients with abdominal pain. Prior to CT, 67 of 536 (13%) of all patients would have undergone immediate surgery; however, following CT only 25 (5%) actually required immediate surgery. Among patients with the four most common pre-CT diagnoses (appendicitis, abscess, diverticulitis, and urinary tract stones) CT had the greatest impact on hospital admission and surgical management for patients with suspected appendicitis. For patients with suspected appendicitis, CT reduced the hospital admission rate in 28% (26 of 91) of patients and changed the surgical management in 40% (39 of 91) of patients. Our study demonstrates the advantage of performing abdominal CT in the ED for patients with non-traumatic abdominal pain. (orig.)
Surrogate Markers of Abdominal Aortic Aneurysm Progression.
Wanhainen, Anders; Mani, Kevin; Golledge, Jonathan
The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Standardized reporting of reproducible methods of measuring AAA diameter is essential. Newer imaging assessments, such as volume measurements, biomechanical analyses, and functional and molecular imaging, as well as circulating biomarkers, have potential to add important information about AAA progression. Currently, however, there is insufficient evidence to recommend their routine use in clinical practice.
Full Text Available ... to remove hearing aids and removable dental work. Women will be asked to remove bras containing metal ... increase the risk of an unusual adverse effect. Women should always inform their physician and the CT ...
Full Text Available ... lives. CT has been shown to be a cost-effective imaging tool for a wide range of ... accredited facilities database . This website does not provide cost information. The costs for specific medical imaging tests, ...
Full Text Available ... images. These images can be viewed on a computer monitor, printed on film or transferred to a ... other in a ring, called a gantry. The computer workstation that processes the imaging information is located ...
A clinical dilemma: abdominal tuberculosis
Institute of Scientific and Technical Information of China (English)
Oya Uygur-Bayramicli; G(u)l Dabak; Resat Dabak
AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis.METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital,Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests,Mantoux skin test, chest X-ray and abdominal ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed.RESULTS: The median age of patients (14 females, 17males) was 34.2 years (range 15-65 years). The most frequent symptoms were abdominal pain and weight loss.Eleven patients had active pulmonary TB. The most common abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2 %). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 (45 %), nodules in 2 (10 %)and, stricture, polypoid lesions, granulomatous findings in terminal ileum and rectal fistula each in one patient (5 %).Laparoscopy on 4 patients showed dilated bowel loops,thickening in the mesentery, multiple ulcers and tubercles on the peritoneum. Patients with abdominal TB were divided into three groups according to the type of involvement.Fifteen patients (48 %) had intestinal TB, L1 patients (35.2 %) had tuberculous peritonitis and 5 (16.8 %)tuberculous lymphadenitis. The diagnosis of abdominal TB was confirmed microbiologically in 5 (16 %) and histopathologically in 19 patients (60.8 %). The
[Abdominal pregnancy care. Case report].
Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino
Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.
Abdominal wall hernia and pregnancy
DEFF Research Database (Denmark)
Jensen, K K; Henriksen, N A; Jorgensen, L N
PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...
Abdominal actinomycosis mimicking acute appendicitis.
Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis
A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.
[Gallstone ileus. Abdominal CT usefulness].
Sukkarieh, F; Brasseur, P; Bissen, L
The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.
CT appearances of abdominal tuberculosis
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Lee, W.-K., E-mail: firstname.lastname@example.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)
The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.
Diagnosis in acute abdominal pain and ongoing abdominal sepsis
Kiewiet, J.J.S.
Acute abdominal pain is a common reason for presentation at the emergency department. To establish a timely and adequate diagnosis, doctors use the pattern of complaints and physical examination as the basis for the evaluation of a patient. In this thesis we conducted a study that showed that surgeo
All in the family: headaches and abdominal pain as indicators for consultation patterns in families.
Cardol, M.; Bosch, W.J.H.M. van den; Spreeuwenberg, P.; Groenewegen, P.P.; Dijk, L. van; Bakker, D.H. de
PURPOSE: Headaches and abdominal pain are examples of minor ailments that are generally self-limiting. We examined the extent to which patterns of visits to family physicians for minor ailments, such as headaches or abdominal pain, cluster within families. METHODS: Using information from the Second
All in the Family : Headaches and Abdominal Pain as Indicators for Consultation Patterns in Families
Cardol, Mieke; Bosch, Wil J.H.M. van den; Spreeuwenberg, Peter; Groenewegen, Peter P.; Dijk, Liset van; Bakker, Dinny H. de
PURPOSE Headaches and abdominal pain are examples of minor ailments that are generally self-limiting. We examined the extent to which patterns of visits to family physicians for minor ailments, such as headaches or abdominal pain, cluster within families. METHODS Using information from the Second Du
Clinical management of abdominal trauma
Institute of Scientific and Technical Information of China (English)
FANG Guo-en; LUO Tian-hang; DU Cheng-hui; BI Jian-wei; XUE Xu-chao; WEI Guo; WENG Zhao-zhang; MA Li-ye; HUA Ji-de
Objective: To improve the prognosis of patients with abdominal trauma. Methods: Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years ranging from 3-82 years. All abdominal traumas consisted of closed traumas 360 cases, 86.7% and open traumas 55 cases, 13.3%. Results: Atotal of 407 cases 98.1% were fully recovered from trauma and the other 8 cases 1.9% died of multiple injuries. The mean injury severity score ISS of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds 6 cases, pancreatic fistula 2 cases and intestinal fistula 1 case. All these postoperative complications were cured by the conservative treatment. Conclusion: Careful case history inquisition and physical examination are the basic methods to diagnose abdomi- nal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.
Chronic Abdominal Pain in Children
C.F.M. Gijsbers (Carolien)
textabstractRecurrent abdominal pain (RAP) was first defined in 1958 by Apley as "at least 3 bouts of pain, severe enough to affect activities, over a period of at least 3 months" (1). This was a landmark publication with great impact, showing, that emotional disturbances played a role in many patie
Economic costs of abdominal obesity
DEFF Research Database (Denmark)
Højgaard, Betina; Olsen, Kim Rose; Søgaard, Jes
BACKGROUND: To examine the relationship between waist circumference and future health care costs across a broad range of waist circumference values based on individual level data. METHOD: A prospective cohort of 31,840 subjects aged 50-64 years at baseline had health status, lifestyle and socio-e...... be a potential for significant resource savings through prevention of abdominal obesity....
Open Versus Endovascular Stent Graft Repair of Abdominal Aortic Aneurysms
DEFF Research Database (Denmark)
Firwana, Belal; Ferwana, Mazen; Hasan, Rim;
We performed an analysis to assess the need for conducting additional randomized controlled trials (RCTs) comparing open and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Trial sequential analysis (TSA) is a statistical methodology that can calculate the required inform...
Abdominal aortic aneurysm repair - open - discharge
... this page: //medlineplus.gov/ency/patientinstructions/000240.htm Abdominal aortic aneurysm repair - open - discharge To use the sharing features ... References Orandi BJ, Black JH. Open repair of abdominal aortic aneurysms. In: Cameron JL, Cameron AM, eds. Current Surgical ...
Preoperative steroid in abdominal wall reconstruction
DEFF Research Database (Denmark)
Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;
INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...
Abdominal Compartment Syndrome: pathophysiology and definitions
Cheatham Michael L
Abstract "Intra-abdominal hypertension", the presence of elevated intra-abdominal pressure, and "abdominal compartment syndrome", the development of pressure-induced organ-dysfunction and failure, have been increasingly recognized over the past decade as causes of significant morbidity and mortality among critically ill surgical and medical patients. Elevated intra-abdominal pressure can cause significant impairment of cardiac, pulmonary, renal, gastrointestinal, hepatic, and central nervous ...
Superman play and pediatric blunt abdominal trauma.
Machi, J M; Gyuro, J; Losek, J D
Two pediatric patients with life-threatening intra-abdominal injuries associated with Superman play are presented. The cases illustrate the importance of knowing the mechanism of injury in the assessment of children with blunt abdominal trauma. The diagnostic value of liver enzymes and the controversies surrounding the radiographic assessment of pediatric blunt abdominal trauma are presented.
A utilização das informações de custos na gestão da saúde pública: um estudo preliminar em secretarias municipais de saúde do estado de Santa Catarina The use of costs information in public health: a preliminary study in local health departments in the state of Santa Catarina
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André Graf de Almeida
Full Text Available Este artigo analisa o uso das informações de custos pelos gestores de 20 grandes secretarias municipais da saúde do estado de Santa Catarina. Para isso, foi avaliado o perfil dos gestores entrevistados; foi verificada a existência ou não de sistemas de custos implantados nessas secretarias; foi feita uma avaliação da percepção desses gestores sobre a utilização das informações de custos no processo de tomada de decisão e foram identificadas quais informações de custos são utilizadas atualmente na gestão desses órgãos. Os entrevistados foram os ocupantes de cargos administrativos nas secretarias municipais da saúde pesquisadas. Conseguiu-se avaliar o uso das informações de custos na gestão de 18 secretarias municipais da saúde do estado de Santa Catarina. Os resultados indicam que apenas duas secretarias municipais da saúde possuem esse processo um pouco mais avançado; nas demais, o que se verifica é que existem algumas tentativas de se obter informações mais detalhadas sobre custos. Entretanto, na opinião dos entrevistados, as informações de custos são bastante importantes na gestão das secretarias.This article analyzes the use of costs information in decision-making by managers of the 20 local health departments in the state of Santa Catarina, Brazil. Public managers profiles were assessed so as to verify whether they had the schooling and experience needed to produce ethical information on certain issues. The existence of costs systems in such departments was assessed through the managers' perceptions of the use of costs information in the decision-making process, and which information is actually used. The methodology used was guided interviews, and the subjects were public employees withholding managing positions in local health departments. The goals of the study were reached as 18 local health departments in the state of Santa Catarina were assessed on their use of costs information. Results show that in
Trunk muscle activities during abdominal bracing: comparison among muscles and exercises.
Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki
Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements. Key PointsTrunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences.Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements.Abdominal bracing should be
Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease
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Ali Ridha
Full Text Available Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003. This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.
Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease
Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel
Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215
[Surgical treatment of patients for abdominal sepsis].
Kryvoruchko, I A; Usenko, O Iu; Andreieshchev, S A
Results of surgical treatment of 201 patients, suffering abdominal sepsis (AS), which have occurred after operations on abdominal organs, were analyzed. Expediency of application of modern scales for the patients state severity estimation, prognostic sign-posts and dynamic of the pathological process course in every patient was substantiated. Existing systems of prognostication (APACHE II, SOFA, MODS) are applied restrictedly for diagnosis of infection in patients, what demands relaparotomy performance in presence of clinical signs of intraabdominal infection, which persists. For prognostication of the treatment result and determination of indications for relaparotomy conduction in patients, suffering severe AS and infectious-toxic shock (ITSH), the most informative is application of the Manheim's index of peritonitis together with analysis of clinico-laboratory indices for formation of groups of patients in risk, to whom reoperation is indicated. Advantages of relaparotomy "on demand" conduction were proved in comparison with "programmed" relaparotomy during the staged surgical treatment of patients, suffering severe AS and ITSH. Complex surgical treatment with substantiation of indications and choice of adequate method of intervention secures improvement of the treatment results in these severely ill patients.
The Diagnostic Value of Intra-abdominal Pressure in Patients with Blunt Acute Abdominal Trauma
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Huseyin Narci
Full Text Available Purpose:The objective of this study was to determine the diagnostic value of intra-abdominal pressure measurement in blunt abdominal trauma patients. Method: A prospective study was performed in 49 patients with blunt trauma in our university hospital for 1 years. Patients were randomly into two groups as intra-abdominal trauma (n=28 and extraabdominal trauma (n=21 groups. Intra-abdominal pressures was measured an classified as normal (10 cm H2O or less, elevated (more than 10 cm H2O determined indirectly. Results: No significant differences were found between abdominal trauma and extra-abdominal trauma groups from the point of intra-abdominal pressure (IAP. One the other hand, in abdominal trauma group; significant differences were observed between operated patients. Intra-abdominal bleeding was found in 10 patients and all of them elevated IAP values (exceeding 16 cm H2O. For determining the intra-abdominal injury, IAP had a sensitivity of 93%, specificity 38% in patients. Conclusion: IAP exceeding 16 cm H2O with blunt abdominal trauma patients abdominal trauma can be detected. It is thought that IAP, indirect monitoring of abdominal trauma patients is a reproducible, scientific guide and simple method.To determine the efficacy of the measurement of intra-abdominal pressure in blunt abdominal trauma patients, further studies should be done. [Cukurova Med J 2012; 37(3.000: 157-161
Acupuncture Treatment of Abdominal Pain
Institute of Scientific and Technical Information of China (English)
@@ Case History Mr. Li, a university student aged 23 years, paid his first visit on July 16, 2001, with the chief complaint of abdominal pain for one day. The patient stated that one day before when it happened to be the weekend, he got abdominal pain after supper, which went worse gradually and caused him to roll all over in bed. The pain was slightly alleviated half an hour later after he had taken some pain killers. Upon inquiry, the patient said that because of their newly graduation from the university, he and his classmates were so excited that they went to have a sumptuous lunch with alcoholic drinks. And in the evening he ate again a delicious supper cooked for him by his mother, after which he continued to have some fruit and dessert.
Abdominal wound closure: current perspectives
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Williams ZF
Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques
Reflexiones preliminares sobre la responsabilidad por daños ambientales
Rodríguez, Gloria Amparo; Vargas-Chaves, Iván
[ES]Aunque la problemática de los daños ambientales ha atraído el interés sustancial de profesionales y académicos de diversas disciplinas, los motivos que impulsan esas prácticas han recibido poca atención en la literatura jurídica colombiana. Especialmente desde la perspectiva de la responsabilidad. Este capítulo presenta unas reflexiones preliminares de la responsabilidad por daños ambientales, para introducir el estudio de diversos temas, hacia una construcción doctrinal enmarcada no sólo...
Programación de robots físicos mediante interfases visuales : Reporte preliminar
Passadore, Nicolás; Parra, Gerardo; Castillo, Rodolfo del
Este trabajo tiene como objetivo realizar un análisis preliminar de la programación de robots físicos por medio de interfases gráficas. Se describe el diseño de un compilador que toma como entrada un programa generado desde una interfase visual y genera como salida un programa en código intermedio. Luego, este programa intermedio puede ser interpretado por el robot para ejecutar las acciones indicadas en el programa fuente.
Negociación y documentos preliminares en la contratación internacional
Jorge Oviedo Albán
Con el fin de establecer la relevancia de los principios de la buena fe y de libertad de formas, la doctrina y la jurisprudencia han establecido ciertas pautas que deben tenerse en cuenta en el proceso de formación del contrato internacional, así, en estas páginas se fija el análisis de las negociaciones preliminares en los contratos internacionales, en particular el estudio de la Convención de las Naciones Unidas sobre los Contratos de Compraventa Internacional de Mercaderías, y los Principi...
Diseño preliminar de un rotor de onda para motores con microturbina
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Gina P. Pérez B.
Full Text Available Este trabajo presenta un analisis preliminar sobre los beneficios de ia implementacion de un rotor de onda en una micro-turbina convencional. Este estudio se enfoca en la consecución de un punto de disefio por medio de cálculos térmicos para así lograr una geometría adecuada, la cual podra ser evaluada por medio de Dinámica de Flujo Computacional CFD para determinar la viabilidad de la implementacion de este dispositive en un motor con micro-turbina a gas de 30 lb, de empuje.
Construction of Abdominal Probabilistic Atlases and Their Value in Segmentation of Normal Organs in Abdominal CT Scans
Park, Hyunjin; Hero, Alfred; Bland, Peyton; Kessler, Marc; Seo, Jongbum; Meyer, Charles
A good abdominal probabilistic atlas can provide important information to guide segmentation and registration applications in the abdomen. Here we build and test probabilistic atlases using 24 abdominal CT scans with available expert manual segmentations. Atlases are built by picking a target and mapping other training scans onto that target and then summing the results into one probabilistic atlas. We improve our previous abdominal atlas by 1) choosing a least biased target as determined by a statistical tool, i.e. multidimensional scaling operating on bending energy, 2) using a better set of control points to model the deformation, and 3) using higher information content CT scans with visible internal liver structures. One atlas is built in the least biased target space and two atlases are built in other target spaces for performance comparisons. The value of an atlas is assessed based on the resulting segmentations; whichever atlas yields the best segmentation performance is considered the better atlas. We consider two segmentation methods of abdominal volumes after registration with the probabilistic atlas: 1) simple segmentation by atlas thresholding and 2) application of a Bayesian maximum a posteriori method. Using jackknifing we measure the atlas-augmented segmentation performance with respect to manual expert segmentation and show that the atlas built in the least biased target space yields better segmentation performance than atlases built in other target spaces.
Muscle patterning in mouse and human abdominal wall development and omphalocele specimens of humans.
Nichol, Peter F; Corliss, Robert F; Yamada, Shigehito; Shiota, Kohei; Saijoh, Yukio
Human omphalocele is a congenital defect of the abdominal wall in which the secondary abdominal wall structures (muscle and connective tissue) in an area centered around the umbilicus are replaced by a translucent membranous layer of tissue. Histological examination of omphalocele development and moreover the staging of normal human abdominal wall development has never been described. We hypothesized that omphalocele is the result of an arrest in the secondary abdominal wall development and predicted that we would observe delays in myoblast maturation and an arrest in secondary abdominal wall development. To look for evidence in support of our hypothesis, we performed a histological analysis of normal human abdominal wall development and compared this to mouse. We also conducted the first histological analysis of two human specimens with omphalocele. In these two omphalocele specimens, secondary abdominal wall development appears to have undergone an arrest around Carnegie Stage 19. In both specimens disruptions in the unidirectional orientation of myofibers were observed in the external and internal obliques, and rectus abdominis but not in the transversus abdominis. These latter findings support a model of normal abdominal wall development in which positional information instructs the orientation of myoblasts as they organize into individual muscle groups.
Lista Preliminar de las Plantas Vasculares Nativas del Departamento de Antioquía, Colombia.
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Hodge W. H.
Full Text Available En número anterior de esta revista (Volumen VII, N9 27 (1947 267-324 se hizo un modesto comienzo para recopilar en una lista preliminar todos los datos disponibles acerca de las plantas vasculares de Antioquia. El objeto de esta lista fue el de hacer aprovechables en un solo lugar las muchas referencias de las plantas de Antioquia, esparcidas en toda la literatura botánica. Dicha lista sería útil a los estudiantes del la flora local, tanto profesionales como principiantes y podría ser en el futuro el esqueleto de la flora extensiva, muy necesaria no solamente en esta área, sino para Colombia en general. Desde la publicación de la lista preliminar ha venido al conocimiento de los autores un número de datos nuevos y viejos, lo mismo que ciertos errores, tipográficos y de otras clases, que aparecen en la misma lista. El objeto de este artículo es incorporar esas adiciones y erratas a la lista original.
Peritoneoscopy of the liver after abdominal surgery.
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Full Text Available The incidence of intraperitoneal adhesion after abdominal surgery was studied. Peritoneoscopy was performed in 933 patients with liver diseases over the 6 year 5 month period from March 1974 to July 1980. Of the patients, 352 (37.7% had undergone an abdominal operation, and intraperitoneal adhesion was detected in 205 (58.2% of these patients. The liver was not observable in 5 out of 61 patients with adhesions after upper abdominal operations. Whereas, the liver was clearly observable in patients with lower abdominal operations in spite of adhesions. Out of the 581 patients without any abdominal operations, 30 patients (5.2% had adhesions in the abdominal cavity, and 6 of them had extensive adhesions that partially obscured the observation of liver surface. In all patients, peritoneoscopy was performed without complications by avoiding the surgical scar for puncture sites and ensuring a free air lumen before trocar puncture.
Abdominal compartment syndrome. Interesting aspects.
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Nicolás Rubio Silveira
Full Text Available The management of the abdominal compartiment syndrome is still a controversial point nowadays. Its early diagnosis and treatment constitute a challenge for surgeons and physicians at the intensive care unit who have to face these cases . The physiopathologic changes that can occur can lead to the patients death, constituting pulmonary thromboembolism and multiorgan failure the principal causes of death. This paper presents the principal clinical parameters and technical procedures for its diagnosis and treatment with the aim of diminishing its morbi-mortality raits in our hospitals
[Internationalization and innovation of abdominal acupuncture].
Wang, Yong-Zhou
Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.
Clinical profile of abdominal tuberculosis in children
Ira Shah; Ramya Uppuluri
Aim: A retrospective study was conducted in children, suffering from abdominal TB, attending Pediatric TB clinic from 2007 to 2009. Materials And Methods: Age-wise distribution and type of abdominal TB were analyzed with clinical features. Results : Out of 285 children with TB, 32 (11.2%) had abdominal tuberculosis. Male: Female ratio was 2.1:1. 7 (21.9%) children were 10 years of age. The most comm...
Abdominal Compartment Syndrome due to OHSS
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Firoozeh Veisi
Full Text Available Abdominal compartment syndrome is a dangerous clinical situation, usually following abdominal injuries&operations. It is seldom observed in patients with gynecologic and obstetric problems. Abdominalcompartment syndrome may be consequence ovarian hyperstimulation syndrome. A 28-year-old womanpresented as a sever ovarian hyperstimulation.The increased IAP indicated that OHSS may beconsidered a compartment syndrome. Abdominal compartment syndrome needs laparotomy orparacentesis for reduction of pressure.
Arnebia euchroma ointment can reduce abdominal fat thickness and abdominal circumference of overweight women: A randomized controlled study
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Mansour Siavash
Full Text Available Background: Obesity is a worldwide health problem which is associated with a lot of complications. One of these comorbidities is the metabolic syndrome that is in correlation with abdominal fat thickness and waist circumference. Various methods were used to reduce abdominal fat thickness such as liposuction. A noninvasive method is the topical agent. In this study, we investigated the effectiveness of Arnebia euchroma (AE ointment on the abdominal fat thickness. Materials and Methods: This study was a double-blind clinical trial which was done at the endocrinology clinic in Khorshid Hospital, Isfahan, Iran, in 2014. After explaining the procedure and obtaining informed consent, the candidates were randomly divided into the case and control groups. The participants of the case and control groups applied AE ointment or placebo for 6 weeks on their abdominal area. Body mass index, waist and buttock circumference, and abdominal fat thickness were measured in both case and control groups at their first visit and then at the next 2, 4, and 6 weeks. We used t-test for comparing parametric variables between groups, paired t-test for changes from baseline to final, and repeated measure ANOVA for changes at different steps. Results: Sixty female candidates participated in this study (thirty in each group. Ten patients left the study and fifty participants finished the trial. At the end of the study, participants had a significant weight loss (2.96 ± 1.6 kg, P < 0.001 that was slightly more in the case group (3.15 ± 1.5 kg vs. 2.75 ± 1.7, P = 0.375. Abdominal circumference also decreased significantly in the participants (11.3 ± 6.7 cm, P < 0.001, but the changes were more significant in the case group (13.9 vs. 6.5 cm, P = 0.004. Similarly, abdominal fat thickness decreased significantly in the participants (2.3 ± 1.1 cm, P < 0.001, although changes were not significantly different between two groups (2.53 vs. 2.04 cm, P = 0.139. Conclusion: Topical
Abdominal Pain in the Geriatric Patient.
Magidson, Phillip D; Martinez, Joseph P
With an aging population, emergency department clinicians can expect an increase in geriatric patients presenting with abdominal pain. Compared with younger patients, this patient population is less likely to present with classic symptoms, physical examination findings, and laboratory values of abdominal disease. However, the morbidity and mortality associated with elderly patients presenting with abdominal pathologic conditions are significant. For this reason, the clinician must be familiar with some subtle and not so subtle differences when caring for the geriatric patient with abdominal pain to ensure timely diagnosis and appropriate treatment.
Abdominal migraine in childhood: a review
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Scicchitano B
Full Text Available Beatrice Scicchitano,1 Gareth Humphreys,1 Sally G Mitton,2 Thiagarajan Jaiganesh1 1Children's Emergency Department, 2Department of Paediatric Gastroenterology, St Georges Hospital, St Georges Healthcare NHS Trust, Tooting, London, United Kingdom Abstract: The childhood condition of abdominal migraine has been described under many different synonyms, including "abdominal epilepsy", "recurrent abdominal pain", "cyclical vomiting syndrome", and "functional gastrointestinal disorder". In the early literature, abdominal migraine is included in the "childhood periodic syndrome", first described by Wyllie and Schlesinger in 1933. Abdominal migraine has emerged over the last century as a diagnostic entity in its own right thanks to the development of well defined diagnostic criteria and its recent inclusion in the International Headache Society's Classification of Headache disorders. Despite this progress, little is known about the pathophysiology of the condition, and the treatment options are poorly defined. Here we summarize the recent literature, with particular focus on establishing the diagnosis of abdominal migraine and its pathophysiology, and suggest an approach to management. Keywords: abdominal migraine, recurrent abdominal pain, abdominal epilepsy, cyclical vomiting
Percutaneous drainage of abdominal abcess
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Men, Sueleyman E-mail: firstname.lastname@example.com; Akhan, Okan; Koeroglu, Mert
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that have been described to drain pelvic abscesses include transrectal or transvaginal approach with sonographic guidance, a transgluteal, paracoccygeal-infragluteal, or perineal approach through the greater sciatic foramen with CT guidance. Both the renal and the perirenal abscesses are amenable to percutaneous drainage. Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage in most patients with psoas abscesses as well.
Patterns, Movement and Clinical Diagnosis of Abdominal Adhesions
Wright, Benjamin; Fenner, John; Gillott, Richard; Spencer, Paul; Lawford, Patricia; Bardhan, Karna Dev
Patterns in normal abdominal movement captured with medical imaging can be recognised by a trained radiologist but the process is time consuming. Abdominal adhesions present a diagnostic problem in which the radiologist is asked to detect abnormal movement that may be indicative of pathology. This paper postulates that the use of image analysis can augment the diagnostic abilities of the radiologist in respect of adhesions. Proof of concept experiments were conducted in-silico to explore the effectiveness of the technique. The results indicate that trained participants are accurate in their assessment of abnormalities when supplied with additional information from image analysis techniques. However without the additional information, participants made incorrect diagnoses on many occasions. ROC methods were used to quantify the outcomes of the in-silico experiment.
San Cristóbal de los Ángeles [Madrid]: Informe preliminar
Gutiérrez Valdivia, Blanca Alexandra
El presente documento es parte del trabajo desarrollado en el proyecto "Inmigración, vivienda y Ciudad" financiado por el Ministerio de Ciencia e Innovación En esta investigación se trata de establecer una relación entre condiciones residenciales precarias y entorno urbano deficiente. San Cristóbal de los Ángeles, en el distrito de Villaverde en Madrid, es uno de los barrios seleccionados para realizar el análisis sobre las características residenciales y urbanísticas de la población in...
Síntomas en la menopausia y el cuidado de los nietos. Informe preliminar
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Rosalinda García Campos
Full Text Available Introducción. La menopausia es un proceso restringido al ser humano. La mujer tiene una etapa post-reproductiva prolongada en la que aparecen síntomas que deterioran su calidad de vida. El valor adaptativo de la menopausia se ha atribuido al papel de las abuelas en la crianza de los nietos. También se ha planteado como explicación la teoría del conflicto reproductivo entre generaciones. Es importante definir la posible relación entre los síntomas en la menopausia y su papel en el cuidado de los nietos. Método. Efectuamos un estudio epidemiológico en sección transversal en 386 mujeres post-menopáusicas, con edad de 55 a 75 años. Se colectaron los datos antropométricos,antecedentes gineco-obstétricos, nivel socioeconómico, relaciones con hijos y nietos, y los síntomas: bochornos, sequedad vaginal, pérdida del interés sexual, depresión, ansiedad, síntomas no específicos de depresión y el síndrome del nido vacío. Se midieron glucosa, colesterol, estradiol y FSH en una muestra de sangre en ayuno. Resultados. Las voluntarias tuvieron edad media de 63 años, menopausia a los 47.7 años, 5.6 hijos y 13.1 nietos. Se encontró mayor pérdida del interés sexual en las mujeres que veían con frecuencia a sus hijos y en quienes cuidaban a sus nietos. Las calificaciones más bajas del síndrome del nido vacío, se encontraron en el grupo sin hijos o nietos. El grupo sin nietos tenía además calificaciones más bajas de síntomas no específicos de depresión. En cuanto a los factores asociados con los síntomas, la edad se asoció inversamente a bochornos y ansiedad; la escolaridad tuvo relación inversa con bochornos, depresión, ansiedad y síndrome del nido vacío. El índice de masa corporal se asoció negativamente con sequedad vaginal, pérdida del interés sexual y síntomas no específicos de depresión. FSH se asoció negativamente con la pérdida del interés sexual. Los bochornos se asociaron con el ejercicio. El número de hijos se asoció negativamente con depresión; mientras tanto el número de nietos y su cuidado correlacionaron positivamente con pérdida de interés sexual, depresión, síntomas no específicos de depresión y síndrome del nido vacío. Conclusión. El estudio confirmó la asociación de edad, escolaridad, y aumento de peso sobre los síntomas en la menopausia. Adicionalmente se encontraron calificaciones más altas de síntomas entre las mujeres que ven y cuidan a sus nietos. Esto indica que el papel de las abuelas tiene un costo físico y emocional.
Síntomas en la menopausia y el cuidado de los nietos. Informe preliminar
Rosalinda García Campos; Herlinda Aguilar Zavala; Juan Manuel Malacara H.
Introducción. La menopausia es un proceso restringido al ser humano. La mujer tiene una etapa post-reproductiva prolongada en la que aparecen síntomas que deterioran su calidad de vida. El valor adaptativo de la menopausia se ha atribuido al papel de las abuelas en la crianza de los nietos. También se ha planteado como explicación la teoría del conflicto reproductivo entre generaciones. Es importante definir la posible relación entre los síntomas en la menopausia y su papel en el cuidado de l...
Informe preliminar sobre los estudios de la petrografia del extremo occidental de Galicia
Woensdregt, C.F.
The extreme western part of Galicia around Cape Finisterre and Cape Toriñana, consists of pre-migmatic metamorphic rocks, partly migmatised, intruded by syn- and posttectonic granites. The pre-migmatic rocks are of sedimentary origin (biotite schists or gneisses) and of probable igneous origin (auge
Uso da peritoneostomia na sepse abdominal Laparostomy in abdominal sepsis
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Juvenal da Rocha Torres Neto
Full Text Available Dentre as modalidades terapêuticas da sepse abdominal, a peritoneostomia tem papel decisivo permitindo explorações e lavagens da cavidade de forma facilitada. Observamos pacientes com diagnóstico clínico de sepse abdominal internados no Serviço de Coloproctologia do Hospital Universitário da Universidade Federal de Sergipe, e que foram submetidos a peritoneostomia de janeiro de 2004 a janeiro de 2006. Foram avaliados quanto ao diagnóstico primário e secundário, tipo de peritonite secundária, antibioticoterapia, esquema de lavagens, tempo de peritoneostomia, complicações e desfecho. Estudamos 12 pacientes, com idade de 15 a 57, média de 39,3 anos. Diagnóstico primário: abdome agudo inflamatório em 6(50%, abdome agudo obstrutivo em 2(16,7%, abdome agudo perfurativo em 2(16,7%, fístula enterocutânea em 1(8,3% e abscesso intra-cavitário em 1(8,3%. Diagnóstico secundário: perfuração de cólon em 4(33,3%, abscessos intra-cavitários em 3(25%, deiscências de anastomoses em 3(25%, 1(8,3% com tumor perfurado de sigmóide e 1(8,3% com necrose de cólon abaixado. Peritonite fecal em 10(83,3% e purulenta em 2(16,7%. A antibioticoterapia teve duração média de 19 dias. Lavagens de demanda em 6(50%, programadas em 4(33,3% e regime misto em 2(16,7%. O tempo médio de peritoneostomia foi de 10,9 dias (1-36. Como complicações: evisceração em 2(16,7% e fistulização em 1(8,3%. Quatro pacientes evoluíram com óbito.Among the therapeutics approach form of abdominal sepsis, the laparostomy has a decisive role allowing cavity explorations and lavages in an easier way. We study patients with abdominal sepsis diagnoses admitted to our surgical service of Coloproctology form Sergipe´s Federal University Hospital who underwent a Bogotá Bag laparostomy associated or not with polypropylene mesh from January 2004 to January 2006. These patients were assessed as: first and second diagnosis; secondary peritonitis type; antibiotic
Mesh repair of hernias of the abdominal wall
W.W. Vrijland (Wietske)
textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are inci
Well Leg Compartment Syndrome After Abdominal Surgery
DEFF Research Database (Denmark)
Christoffersen, Jens Krogh; Hove, Lars Dahlgaard; Mikkelsen, Kim Lyngby;
BACKGROUND: Well leg compartment syndrome (WLCS) is a complication to abdominal surgery. We aimed to identify risk factors for and outcome of WLCS in Denmark and literature. METHODS: Prospectively collected claims to the Danish Patient Compensation Association (DPCA) concerning WLCS after abdominal...
Actinomycosis mimicking abdominal neoplasm. Case report
DEFF Research Database (Denmark)
Waaddegaard, P; Dziegiel, Morten Hanefeld
In a patient with a 6-month history of nonspecific abdominal complaints, preoperative examination indicated malignant disease involving the right ovary, rectum and sigmoid, but laparotomy revealed abdominal actinomycosis. Removal of the ovary and low anterior colonic resection followed by penicil...
Thoraco-abdominal aortic aneurysm branched repair
Verhoeven, E. L. G.; Tielliu, I. F. J.; Ferreira, M.; Zipfel, B.; Adam, D. J.
Open thoraco-abdominal aortic aneurysm repair is a demanding procedure with high impact on the patient and the operating team. Results from expert centres show mortality rates between 3-21%, with extensive morbidity including renal failure and paraplegia. Endovascular repair of abdominal aortic aneu
Vijaya; Sarbeshwar; Gogoi
BACKGROUND: Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential . (1,2,3) CASE PRESENTATION: We report a female patient with desmoid tumor of the abdominal wall over appendicectomy scar w ho underwent primary resection. Preoperative evaluation incl uded abdominal ultrasound, and computed tomography. The histology of this cases revealed a desmoid tumor. CONCLUSION: ...
Acute spontaneous isolated dissection of abdominal aorta
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Ali Akbar beigi
Full Text Available
Pulmonary complications of abdominal wall defects.
Panitch, Howard B
The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.
Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain
DEFF Research Database (Denmark)
Wewer, Anne Vibeke; Strandberg, C; Pærregaard, Anders;
We report on our experience with routine abdominal ultrasonography in 120 children (aged 3-15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n...... = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. CONCLUSION: The diagnostic value of abdominal ultrasonography in unselected children with recurrent abdominal pain is low. However, the direct visualization...... of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain....
Negociación y documentos preliminares en la contratación internacional
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Jorge Oviedo Albán
Full Text Available Con el fin de establecer la relevancia de los principios de la buena fe y de libertad de formas, la doctrina y la jurisprudencia han establecido ciertas pautas que deben tenerse en cuenta en el proceso de formación del contrato internacional, así, en estas páginas se fija el análisis de las negociaciones preliminares en los contratos internacionales, en particular el estudio de la Convención de las Naciones Unidas sobre los Contratos de Compraventa Internacional de Mercaderías, y los Principios de Unidroit sobre los Contratos Comerciales Internacionales, apelando no solo al análisis doctrinal de las disposiciones involucradas, sino también al de los casos relevantes fallados por tribunales estatales y arbitrales.
Negociación y documentos preliminares en la contratación internacional
Directory of Open Access Journals (Sweden)
Jorge Oviedo Albán
Full Text Available Con el fin de establecer la relevancia de los principios de la buena fe y de libertad de formas, la doctrina y la jurisprudencia han establecido ciertas pautas que deben tenerse en cuenta en el proceso de formación del contrato internacional, así, en estas páginas se fija el análisis de las negociaciones preliminares en los contratos internacionales, en particular el estudio de la Convención de las Naciones Unidas sobre los Contratos de Compraventa Internacional de Mercaderías, y los Principios de Unidroit sobre los Contratos Comerciales Internacionales, apelando no solo al análisis doctrinal de las disposiciones involucradas, sino también al de los casos relevantes fallados por tribunales estatales y arbitrales
Insectos acuáticos de la Meseta del Somuncura, Patagonia, Argentina. Inventario preliminar
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Javier MUZÓN
Full Text Available Se brinda un inventario preliminar de los insectos acuáticos de la Meseta del Somuncura y su área de influencia (Patagonia, Argentina realizado sobre la base de colecciones y registros previos de especies pertenecientes a los órdenes Ephemeroptera, Odonata, Hemiptera (Heteroptera, Trichoptera, Diptera (familias Ceratopogonidae, Culicidae y Psychodidae y Coleoptera. Se han relevado diversos tipos de ambientes en 14 localidades. El número de especies registrado asciende a 78, agrupadas en 51 géneros y 26 familias, de las cuales 33 se citan por primera vez del área. De los taxa registrados 83% de los géneros corresponden a grupos de amplia distribución (neotropicales, americanos o cosmopolitas, mientras que 41% de las especies presentan una distribución patagónica o andina.
Multi-Atlas Segmentation for Abdominal Organs with Gaussian Mixture Models.
Burke, Ryan P; Xu, Zhoubing; Lee, Christopher P; Baucom, Rebeccah B; Poulose, Benjamin K; Abramson, Richard G; Landman, Bennett A
Abdominal organ segmentation with clinically acquired computed tomography (CT) is drawing increasing interest in the medical imaging community. Gaussian mixture models (GMM) have been extensively used through medical segmentation, most notably in the brain for cerebrospinal fluid/gray matter/white matter differentiation. Because abdominal CT exhibit strong localized intensity characteristics, GMM have recently been incorporated in multi-stage abdominal segmentation algorithms. In the context of variable abdominal anatomy and rich algorithms, it is difficult to assess the marginal contribution of GMM. Herein, we characterize the efficacy of an a posteriori framework that integrates GMM of organ-wise intensity likelihood with spatial priors from multiple target-specific registered labels. In our study, we first manually labeled 100 CT images. Then, we assigned 40 images to use as training data for constructing target-specific spatial priors and intensity likelihoods. The remaining 60 images were evaluated as test targets for segmenting 12 abdominal organs. The overlap between the true and the automatic segmentations was measured by Dice similarity coefficient (DSC). A median improvement of 145% was achieved by integrating the GMM intensity likelihood against the specific spatial prior. The proposed framework opens the opportunities for abdominal organ segmentation by efficiently using both the spatial and appearance information from the atlases, and creates a benchmark for large-scale automatic abdominal segmentation.
Routine use of modified CT Enterography in patients with acute abdominal pain
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Gourtsoyianni, Sofia [Department of Radiology, University Hospital of Heraklion, Medical School of Crete, 71110 Stavrakia, Heraklion/Crete (Greece)], E-mail: email@example.com; Zamboni, Giulia A. [Department of Radiology, University Hospital GB Rossi, Verona (Italy); Romero, Janneth Y.; Raptopoulos, Vassilios D. [Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)
Purpose: To evaluate routine use of CT Enterography (CTE) in patients presenting with non-traumatic acute abdominal pain with respect to patient tolerance, imaging of intestinal detail along with conventional abdominal evaluation. Materials and methods: Modified CTE was performed in 165 consecutive patients with acute abdominal pain: ingestion, as tolerated, of 900-1200 ml of 2% barium suspension + 5 ml of Gastrografin over 45 min; 150 ml of iv contrast given in two boluses (50 and 100 ml) 3 min apart (split bolus injection protocol). Axial, coronal and sagittal reformats were reviewed by two radiologists and graded on a 5-point scale (5 best) in regard to GI tract luminal opacification and distension and abdominal organ and vascular enhancement. Results: In 81 patients the cause of abdominal pain was identified (intestinal in 54 and extraintestinal in 27). Oral contrast reached cecum in 76% of the patients and the small bowel was well distended and opacified (medians = 4). Mucosa detail was good (median = 3) and there was significant (p < 0.0001) correlation between bowel opacification and distension for both jejunum and ileum. A combined nephrographic and excretory phase was achieved (medians 4 and 5, respectively), while the great vessels were well opacified, allowing for vascular evaluation (median = 5). The rest of the abdominal structures were well visualized. Conclusion: Modified CTE is well tolerated by patients with acute non-traumatic abdominal pain, and can be used routinely as a non-invasive examination informative of bowel, vessel and organ pathology in Emergency Department patients.
Mesh repair of hernias of the abdominal wall
textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are incisional, umbilical, epigastric and Spigelian hernia. In chapter 1 an overview of hernias of the abdominal wall is described. The incidence, clinical implications and treatment options and their comp...
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Daniele Misturini ROSSI
Full Text Available Inulina e oligofrutose são polímeros de frutose encontrados em diferentes espécies vegetais e amplamente pesquisados com relação aos seus benefícios para saúde e propriedades tecnológicas na indústria de alimentos. Atualmente a chicória (Chichorium intybus é a fonte principal de inulina para aplicação industrial, mas outras espécies vegetais como Helianthus tuberosus L. (alcachofra de Jerusalém e Smallanthus sonchifolius (Poepp. H. Rob. (yacon, batata-yacon ou yacon-dos-andes têm sido pesquisadas com relação ao seu conteúdo de inulina e oligofrutose. Um levantamento preliminar do conteúdo de inulina foi realizado em 4 espécies vegetais, em sua maioria não cultivada, colhidas na região de Porto Alegre. Para isso, as raízes ou bulbos foram triturados e homogeneizados em água quente para extração da inulina, e os extratos fi ltrados analisados em HPLC. A triagem preliminar detectou a presença de inulina em todos os extratos analisados, sendo que o yacon-gaúcho (Smallanthus connatus (Spreng. H. Rob. e araruta (Maranta arundinacea L. se destacaram como as espécies de maior conteúdo de inulina dentre as plantas analisadas, com 43,18 e 45,83% de inulina em base seca, respectivamente, seguidas pelo radite nativo (Hypochaeris chillensis (Kunth Britton, que apresentou 21,05% de inulina em base seca. Estas foram superiores à batatayacon (Smallanthus sonchifolius, também analisado e que apresentou 13,37% de inulina (base seca, resultado este condizente com outros já descritos na literatura.
Radiologic findings of abdominal wall endometriosis
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Seo, Jung Wook [Inje Univ. Ilsan Paik Hospital, Goyang (Korea, Republic of)
To evaluate the imaging findings of abdominal wall endometriosis. In seven of 17 patients with surgically proven endometriosis of the abdominal wall, we retrospectively reviewed the findings of radiologic studies such as abdominal US (n=3), CT (n=4), and MRI (n=1). One patient under went more than one type of imaging, apparently. The surgical history of the seven, and their symptoms and preoperative diagnosis were reviewed, and the size, location, margin and nature of the mass, and the contrast enhancement patterns observed at radiologic studies, were assessed. The chief symptoms were palpable abdominal wall mass (n=5) and lower abdominal pain (n=2) around a surgical scar. Previous surgery included cesarean section (n=5), cesarean section with oophorectomy (n=1) and appendectomy (n=1). Masses were located in the subcutaneous fat layer (n=5) or rectus abdominis muscle (n=2), and their maximum diameter was 2.6 cm. Imaging findings, which correlated closely with the pathologic findings, included a well (n=5) or poorly marginated (n=2) solid mass, with a focal cystic area apparent in two cases. Although imaging findings of abdominal wall endometriosis may not be specific for diagnosis, the presence of a solid abdominal mass in female patients of reproductive age with a history of surgery is a diagnostic pointer.
Traumatic abdominal hernia complicated by necrotizing fasciitis.
Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa
Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.
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Sumiaki Maeo
Full Text Available Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench exercises. Surface electromyogram (EMG activities of the rectus abdominis (RA, external oblique (EO, internal oblique (IO, and erector spinae (ES muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax. The % EMGmax value during abdominal bracing was significantly higher in IO (60% than in the other muscles (RA: 18%, EO: 27%, ES: 19%. The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements
Desenvolvimento da orientação empreendedora em empresas de software: proposições preliminares Development of entrepreneurial orientation in software companies: preliminary propositions
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Cristina Dai Prá Martens
Full Text Available Este artigo apresenta proposições preliminares sobre ações para o desenvolvimento da Orientação Empreendedora OE em empresas de software. Para isso, apresenta, após uma retomada conceitual, um breve panorama da OE no setor de Tecnologia de Informação TI , a partir da visão de especialistas. Num segundo momento, explora como se dá esse comportamento em 2 empresas de software; e finalmente apresenta proposições preliminares para o desenvolvimento desse comportamento em empresas do setor. O método de pesquisa consistiu em estudo exploratório e qualitativo, realizado em 2 etapas: a primeira envolveu entrevista em profundidade com 3 especialistas do setor de TI do estado do Rio Grande do Sul, na busca de uma percepção sobre a OE no setor; a segunda contou com entrevistas em profundidade com 2 empresários do setor de software, buscando melhor compreender como ocorre a OE nessas empresas. Os resultados apontam proposições iniciais sobre o desenvolvimento da OE em empresas do setor, contribuindo, assim, para o debate sobre ações de estímulo ao empreendedorismo no contexto de empresas de software.The article presents preliminary propositions on actions for developing Entrepreneurial Orientation (EO in companies which are in the software business. Therefore it brings a conceptual retaken on EO before stating a brief panorama of the entrepreneurship in the sector of Information Technology (IT from the perspective of specialists. In the sequence the EO is exploited in 2 software businesses company and finally preliminary propositions for developing this behavior in this sector are presented. The researching method is constituted by an exploratory and qualitative study carried out in 2 stages: the first one involves interviews in depth with 3 specialists of the sector of IT in the state of the Rio Grande do Sul, that aims at searching perceptions about EO in the sector; the second step conveys interviews in depth with 2 entrepreneurs
Comunicación preliminar sobre el uso de la penicilina nebulizada en algunas afecciones del aparato respiratorio
Cortés Maal, Hernán
El objeto principal de esta comunicación preliminar sobre la terapéutica por las nebulizaciones de penicilina, es el de presentar al honorable cuerpo Médico de Colombia, un procedimiento nuevo en la aplicación de la penicilina, procedimiento que ya se ha generalizado y divulgado bastante en el estranjero y que entre nosotros se ha enmpleado muy poco.
[Abdominal tuberculosis in childhood: the clinical manifestations].
Rivera Medina, J; Almendras, M; Devoto, G; Martinez, E; Gonzales, J; Alarcón, P; Muñoz, S
The authors reviewed the histories of 133 patients with abdominal tuberculosis in Instituto Nacional de Salud del Niño (Children's Hospital), Lima, Perú, between 1989 and 1991. We found morbidity higher in scholars (67.4%). Weight lost were present in all cases and malaise in 95.3%, abdominal distension in 83.72% and abdominal pain in 79.06%. Anaemia in 76.06%, ratio albumin/globulin were altered in 74.41% leukocytosis in 67.44%. Evidence of tuberculosis on chest X-ray were detected only in 62.5%.
Imaging of small bowel-related complications following major abdominal surgery
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Sandrasegaran, Kumaresan [Department of Radiology, Indiana University Medical Center, UH 0279, 550 N. University Boulevard, Indianapolis, IN 46202 (United States); Maglinte, Dean D.T. [Department of Radiology, Indiana University Medical Center, UH 0279, 550 N. University Boulevard, Indianapolis, IN 46202 (United States)]. E-mail: email@example.com
To recognize and document the small bowel reactions following major abdominal surgery is an important key for a correct diagnosis. Usually, plain abdominal radiography is the initial imaging examination requested in the immediate postoperative period, whereas gastrointestinal contrast studies are used to look for specific complications. In some countries, especially in Europe, sonography is widely employed to evaluate any acute affection of the abdomen. CT is commonly used to assess postoperative abdominal complications; in our institution also CT enteroclysis is often performed, to provide additional important informations. Radiologist should be able to diagnose less common types of obstruction, such as afferent loop, closed loop, strangulating obstruction as well as internal hernia. This knowledge may assume a critical importance for surgeons to decide on therapy. In this article, we focus our attention on the imaging (particularly CT) in small bowel complications following abdominal surgery.
[Churg-Strauss abdominal manifestation].
Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo
Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.
Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review
DEFF Research Database (Denmark)
Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue
INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted....... The PubMed, EMBASE and Cochrane databases were searched for studies on the use of abdominal binders after abdominal surgery or abdominoplasty. All types of clinical studies were included. Two independent assessors evaluated the scientific quality of the studies. The primary outcomes were pain, seroma...... to reduce seroma formation after laparoscopic ventral herniotomy and a non-significant reduction in pain. Physical function was improved, whereas evidence supports a beneficial effect on psychological distress after open abdominal surgery. Evidence also supports that intra-abdominal pressure increases...
[Inflammatory aneurysms of the abdominal aorta].
Tovar Martín, E; Acea Nebril, B
Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.
Abdominal pain - children under age 12
Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... belly Has had a recent injury to the abdomen Is having trouble breathing Call your provider if ...
Abdominal separation in an adult male patient with acute abdominal pain
Institute of Scientific and Technical Information of China (English)
We report a male patient with prolonged post-prandial abdominal distension and a sudden onset of epigastric pain initially diagnosed as acute abdomen. The patient had no history of surgery. Physical examination revealed peritonitis and abdominal computed tomography scan showed upper abdominal mesentery intorsion. The patient then underwent surgical intervention. It was found that the descending mesocolon dorsal root was connected to the ascending colon and formed a membrane encapsulating the small intestine...
Abdominal Wall Hernias: Various Imaging Features Correlated with the Anatomy of Abdominal Wall at MDCT
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Kim, Shin Young; Shin, Hyeong Cheol; Kim, Sang Won; Kim, Il Young; Kim, Young Tong [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)
Abdominal wall hernias are a common condition. However, they may develop acute complications and require surgical correction in most cases. Hence, the correct radiological examination is requisite for an accurate diagnosis. A multi-detector row CT (MDCT) provides an accurate identification of the anatomy of the abdominal wall, precise hernia type, and helps in the detection of early signs of complication. We report various imaging features of abdominal wall hernias via a MDCT.
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Marcelo Moriconi Bezerra
Full Text Available En su último informe sobre seguridad ciudadana en América Latina, el PNUD (2013resalta que, a pesar de que la región mejoró indicadores socioeconómicos habitualmente relacionados con la propagación de inseguridad, el problema no disminuyó. Por el contrario, el crimen empeoró. Para entender esta paradoja, este ensayo retoma la hipótesis de Ser violento (Moriconi, 2013 de que el verdadero problema es el colapso de la legalidad, y la violencia y el delito serían consecuencias lógicas de éste. Modificar el enfoque inicial permite diagnosticar nuevos problemas e introducir al debate variables alternativas. En este caso, se desarrolla una propuesta teórica sobre la imposibilidad de la Justicia institucional en un ambiente de alta percepción de la ilegalidad. Posteriormente, se recuperar algunas consideraciones sobre la teoría de psicología social de la Creencia en un Mundo Justo (CMJ y se ofrece un análisis preliminar sobre cómo la naturalización de Ilegalidades y las percepciones de injusticia podrían afectar seriamente la estabilidad psicológica y la autoestima de los ciudadanos. Ejemplos del caso argentino son utilizados.
Estrategias funcionales emergentes de promoción por parte de los ejecutivos del negocio bancario: Estudio preliminar a la Banca en Maracaibo
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Emmanuel Borgucci
Full Text Available En esta investigación de carácter preliminar, se trata de demostrar la existencia de estrategias funcionales emergentes por parte de los ejecutivos de negocios bancarios. Se diseñó una investigación de tipo descriptivo y se aplicó un cuestionario semiestructurado y validado con el procedimiento del pretest-test a 16 ejecutivos del área petrolera pertenecientes a 10 bancos ubicados en Maracaibo (Venezuela. Se concluye que sobre la base de una serie de habilidades personales y operativas, el ejecutivo de negocios no solamente tiene la habilidad para comunicarse, cruzar ventas o servir de asesor, sino que es una especie de departamento informal de gestión de recursos internos para alcanzar metas de captación y colocación e recursos del banco aunque en determinados momentos, como lo expresaron algunos ejecutivos de negocios, la institución se oponga consciente o inconscientemente.
[Intestinal occlusion and abdominal compartment syndrome (ACS)].
Stagnitti, Franco
Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving
A focus on intra-abdominal infections
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Sartelli Massimo
Full Text Available Abstract Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug
[Late primary abdominal pregnancy. Case report].
Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández
Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.
Surveillance intervals for small abdominal aortic aneurysms
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Bown, Matthew J; Sweeting, Michael J; Brown, Louise C
Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture.......Small abdominal aortic aneurysms (AAAs [3.0 cm-5.4 cm in diameter]) are monitored by ultrasound surveillance. The intervals between surveillance scans should be chosen to detect an expanding aneurysm prior to rupture....
Hérnia traumática da parede abdominal Traumatic abdominal hernia
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Alexandre Cruz Henriques
Full Text Available A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.
Abdominal epilepsy and foreign body in the abdomen--dilemma in diagnosis of abdominal pain.
Topno, Noor; Gopasetty, Mahesh S; Kudva, Annappa; B, Lokesh
There are many medical causes of abdominal pain; abdominal epilepsy is one of the rarer causes. It is a form of temporal lobe epilepsy presenting with abdominal aura. Temporal lobe epilepsy is often idiopathic, however it may be associated with mesial temporal lobe sclerosis, dysembryoplastic neuroepithelial tumors and other benign tumors, arterio-venous malformations, gliomas, neuronal migration defects or gliotic damage as a result of encephalitis. When associated with anatomical abnormality, abdominal epilepsy is difficult to control with medication alone. In such cases, appropriate neurosurgery can provide a cure or, at least, make this condition easier to treat with medication. Once all known intra-abdominal causes have been ruled out, many cases of abdominal pain are dubbed as functional. If clinicians are not aware of abdominal epilepsy, this diagnosis is easily missed, resulting in inappropriate treatment. We present a case report of a middle aged woman presenting with abdominal pain and episodes of unconsciousness. On evaluation she was found to have an intra-abdominal foreign body (needle). Nevertheless, the presence of this entity was insufficient to explain her episodes of unconsciousness. On detailed analysis of her medical history and after appropriate investigations, she was diagnosed with temporal lobe epilepsy which was treated with appropriate medications, and which resulted in her pain being relieved.
Management of Concomitant Cancer and Abdominal Aortic Aneurysm
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Abdullah Jibawi
Full Text Available Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis, and management dilemmas of concurrent visceral malignancy and abdominal aortic aneurysm. Method. The MEDLINE and HIGHWIRE databases (1966-present were searched. Papers detailing relevant data were assessed for quality and validity. All case series, review articles, and references of such articles were searched for additional relevant papers. Results. Current challenges in decision making, the effect of major body-cavity surgery on an untreated aneurysm, the effects of major vascular surgery on the treatment of malignancy, the use of EVAR (endovascular aortic aneurysm repair as a fairly low-risk procedure and its role in the management of malignancy, and the effect of other challenging issues such as the use of adjuvant therapy, and patients informed decision-making were reviewed and discussed. Conclusion. In synchronous malignancy and abdominal aortic aneurysm, the most life-threatening lesion should be addressed first. Endovascular aneurysm repair where possible, followed by malignancy resection, is becoming the preferred initial treatment choice in most centres.
Radiation Exposure of Abdominal Cone Beam Computed Tomography
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Sailer, Anna M., E-mail: email@example.com [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Schurink, Geert Willem H., E-mail: email@example.com [Maastricht University Medical Centre, Department of Surgery (Netherlands); Wildberger, Joachim E., E-mail: email@example.com; Graaf, Rick de, E-mail: email@example.com; Zwam, Willem H. van, E-mail: firstname.lastname@example.com; Haan, Michiel W. de, E-mail: email@example.com; Kemerink, Gerrit J., E-mail: email@example.com; Jeukens, Cécile R. L. P. N., E-mail: firstname.lastname@example.com [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands)
PurposeTo evaluate patients radiation exposure of abdominal C-arm cone beam computed tomography (CBCT).MethodsThis prospective study was approved by the institutional review board; written, informed consent was waived. Radiation exposure of abdominal CBCT was evaluated in 40 patients who underwent CBCT during endovascular interventions. Dose area product (DAP) of CBCT was documented and effective dose (ED) was estimated based on organ doses using dedicated Monte Carlo simulation software with consideration of X-ray field location and patients' individual body weight and height. Weight-dependent ED per DAP conversion factors were calculated. CBCT radiation dose was compared to radiation dose of procedural fluoroscopy. CBCT dose-related risk for cancer was assessed.ResultsMean ED of abdominal CBCT was 4.3 mSv (95 % confidence interval [CI] 3.9; 4.8 mSv, range 1.1–7.4 mSv). ED was significantly higher in the upper than in the lower abdomen (p = 0.003) and increased with patients' weight (r = 0.55, slope = 0.045 mSv/kg, p < 0.001). Radiation exposure of CBCT corresponded to the radiation exposure of on average 7.2 fluoroscopy minutes (95 % CI 5.5; 8.8 min) in the same region of interest. Lifetime risk of exposure related cancer death was 0.033 % or less depending on age and weight.ConclusionsMean ED of abdominal CBCT was 4.3 mSv depending on X-ray field location and body weight.
Preliminary ten year results from a randomised single centre mass screening trial for abdominal aortic aneurysm
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Lindholt, Jes S.; Juul, Svend; Fasting, Helge
BACKGROUND: At present, several regions and countries are considering screening for abdominal aortic aneurysm (AAA). However, The Chichester Aneurysms Screening Trial has reported poor long term benefit of screening for AAA. We therefore supplement previously published data with a preliminary......,333 were invited to an abdominal ultrasound scan at their district hospital. Information on all deaths until 15.3.2005 was obtained from the Office of Civil Registration. Information on AAA related deaths was obtained from the national registry of Causes of Deaths from 1.4.1994 to 31...
Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review
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Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue
INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted...
Childhood abdominal pain in primary care : design and patient selection of the HONEUR abdominal pain cohort
Spee, Leo A A; van den Hurk, Arjan P J M; van Leeuwen, Yvonne; Benninga, Marc A; Bierma-Zeinstra, Sita M A; Passchier, Jan; Berger, Marjolein Y
BACKGROUND: Abdominal pain in children is a common complaint presented to the GP. However, the prognosis and prognostic factors of childhood abdominal pain are almost exclusively studied in referred children. This cohort study aims at describing prognosis and prognostic factors of childhood abdomina
General Considerations of Ruptured Abdominal Aortic Aneurysm: Ruptured Abdominal Aortic Aneurysm
Lee, Chung Won; Bae, Miju; Chung, Sung Woon
Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.
Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis
Smit, M.; Buddingh, K. T.; Bosma, B; Nieuwenhuijs, V B; Hofker, H.S.; Zijlstra, J.G.
INTRODUCTION: Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS
Abdominal Compartment Syndrome and Intra-abdominal Ischemia in Patients with Severe Acute Pancreatitis
Smit, M.; Buddingh, K. T.; Bosma, B.; Nieuwenhuijs, V. B.; Hofker, H. S.; Zijlstra, J. G.
Severe acute pancreatitis may be complicated by intra-abdominal hypertension (IAH), abdominal compartment syndrome (ACS), and intestinal ischemia. The aim of this retrospective study is to describe the incidence, treatment, and outcome of patients with severe acute pancreatitis and ACS, in particula
Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.
Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L
Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (PPregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy.
Intra-abdominal pressure: an integrative review.
Milanesi, Rafaela; Caregnato, Rita Catalina Aquino
There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do
Methods of patient warming during abdominal surgery.
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Li Shao
Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.
Imaging the Abdominal Manifestations of Cystic Fibrosis
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C. D. Gillespie
Full Text Available Cystic fibrosis (CF is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis.
Abdominal aorta transplantation after programmed cryopreservation
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Song Gu; Chang-Jian Liu; Tong Qiao; Xue-Mei Sun; Jun-Hao Chen
AIM: To study the morphologic and cellular immunologic changes after homologous transplantation of the abdominal aorta in rats after programmed cryopreservation (-196°C).METHODS: Abdominal aorta was harvested from anesthetized Spraque Dawley (SD) rats for cryopreservation (group B) or immediate implantation (group A). The survival rates and apoptotic rates of aortic endothelial cells (ECs)were examined. The patency rates, histology and cellular immunologic changes of the abdominal aorta were examined on days 1, 3, 7, 14, 30, 60 after transplantation respectively.RESULTS: The survival rate of ECs after programmed cryopreservation was 90.1±1.79%, about 3.4% lower than that of uncryopreservation (93.5±1.96%). The apoptotic rates of ECs was increased after cryopreservation (7.15%vs 4.86%, P<0.05). The patency rate of group B was significantly higher than that of group A (91.6±12.9% vs 62.5±26.2%, P<0.01). CD4/CD8 ratio, TCR αβ and CD11b/CD18 ratio of group B were significantly lower than those of group A (P<0.05). Revivification of the cryopreserved abdominal aorta showed normal adventitia and intact smooth muscle cells.CONCLUSION: Cryopreservation can reduce homologous abdominal aortic antigenecity. Even if without administration of immunosuppressive agents, it is still feasible to implement homologous artery grafting in rats.
Postoperative abdominal complications after cardiopulmonary bypass
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Dong Guohua
Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.
Transverse abdominal plane neurostimulation for chronic abdominal pain: a novel technique.
Gupta, Mayank; Goodson, Robert
Management of chronic abdominal pain can be challenging. Sometimes patients fail to get adequate response from multiple medications and nerve blocks. We present a patient case report of chronic abdominal pain with a history of multiple surgeries managed successfully by neuromodulation of the transverse abdominis plane (TAP). The TAP block is a procedure in which local anesthetic is injected into the abdominal fascial plane that carries sensory nerves to the abdominal wall in order to block pain sensation. It has been shown to reduce postoperative pain and analgesic dependence after abdominal and gynecological surgeries. A 60-year-old woman presented to us for chronic abdominal pain for which medications provided little relief. She had an extensive history of abdominal surgeries and was also treated for lower back pain with surgery and less invasive procedures in the past. Under our care, she underwent 2 TAP blocks with almost complete resolution of her abdominal pain. Her pain, however, came back within a few of weeks of the procedures. Since our patient found pain relief from the TAP blocks, we proceeded with neurostimulation of the TAP for long-term pain relief. We placed a dorsal column stimulator 16 contact lead for lower back and leg pain and 8 contact leads placed in the TAP under ultrasound guidance. She has had multiple follow-ups since her TAP lead placement procedure with continued and near complete resolution of her abdominal pain. The TAP lead stimulation was helping her abdominal pain and the dorsal column lead stimulation was helping her back and leg pain.
Representação e pensamento na obra freudiana: preliminares para uma abordagem cognitiva
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Fabio Thá
Full Text Available Apresentam-se algumas considerações preliminares para uma abordagem cognitiva da doutrina psicológica presente na obra de Freud. Analisam-se as teorias freudianas da representação, do pensamento e da linguagem, com a finalidade de mostrar a coerência de seus conceitos com modelos que estão sendo debatidos atualmente nas ciências cognitivas. Correlacionando aspectos relevantes da teoria freudiana e alguns conceitos contemporâneos sobre o assunto, procura-se mostrar como os modelos atuais e o modelo freudiano concebem o pensamento como originário da experiência do sujeito, argumentando-se que não há dois processos de pensamento distintos mas diferentes padrões de conexão entre representações.Representation and thought in Freudian theory: introduction to a cognitive approach. This text presents some preliminary considerations for a cognitive approach to Freud's psychological theory of psychoanalysis. It analyses Freudian theories of representation, thinking, and language, in order to show that they are coherent with the cognitive models that are being discussed nowadays in the cognitive sciences. The text links some relevant aspects of the Freudian theory to contemporary concepts and shows how the models discussed and the Freudian models conceive the experiential origin of thought, arguing that there are not two distinct processes of thinking but different patterns of connections involving representations.
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Rubén O Meninato
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O literal e a surpresa: os "estágios preliminares do chiste"
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Ana Beatriz Freire
Full Text Available Vai-se discorrer sobre a função que as intervenções humorísticas podem desempenhar no tratamento de psicóticos, ao apaziguar a incidência do pulsional e suscitar a tomada de palavra por aqueles cuja existência não é balizada pelo falo. Para tanto, partiu-se da referência ao "chiste", efeito humorístico freudiano por excelência. A hipótese que aqui se desenha é a de que as vicissitudes econômicas relacionadas ao chiste, mesmo em seus estágios preliminares, podem esclarecer se e como tais intervenções podem ser efetivas num tratamento possível da psicose.The literal and the surprise: the preliminary stages of the wit. The target of this text is to explain in which way some humoristic interventions could help in the treatment of psychotic patients, pacifying the incidence of the "pulsional" and making the person, whose existence is not limited by the phallus, to start using speech. With this aim, our starting point was the mentioning of a "wit", or joke, the humoristic effect, which is Freudian by excellence. The hypothesis that we foresee is that the economic mishaps related to the wit, even on their preliminary stages, could clarify if and how such interventions could be effective in a possible treatment of psychosis.
Las demencias en la ciudad de Zaragoza: datos preliminares de un estudio epidemiológico.
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Antonio Lobo
Full Text Available Se emprende un estudio epidemiológico para documentar la morbilidad psíquica en la población geriátrica de Zaragoza. Se programa un "screening" en dos fases, con una tercera fase de evaluación neurológica. "Lay interviewers" estandarizados personalmente administran el Geriatric Mental State (GMS y el Mini-Examen Cognoscitivo en la primera fase y psiquiatras, asimismo estandarizados, administran en segunda fase los mismos instrumentos junto a/ History and Aetiology Schedule (HAS a probables "casos" y controles. Los resultados preliminares en 271 individuos (de los 1.134 que componen la muestra aleatoria, representativa y estratificada señalan que la prevalencia de morbilidad es del 13,3 %, con un 5,2 % de demencias y un 7% de depresiones. El programa computerizado AGECAT permite la comparación de resultados con una población británica (estudio 'Zaragoza-Liverpool", habiéndose documentado una prevalencia global de trastornos similar pero con cifras significativamente superiores en Zaragoza para diversos ítems de las secciones de "neurosis".
Pedagogia e complexidade: diálogos preliminares Pedagogy and complexity: preliminary dialogues
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Ricardo Antunes de Sá
Full Text Available O artigo tem a intenção de apresentar argumentações fundamentadas em estudos de pesquisadores que têm procurado identificar a Pedagogia como uma das áreas das ciências do homem que estuda e produz conhecimento científico sobre o fenômeno educativo. Em um primeiro momento apresenta, sucintamente, os pressupostos teóricos norteadores da teoria da complexidade, sistematizada por Edgar Morin. Por fim, ensaia-se um diálogo preliminar entre os pressupostos do pensamento complexo e a Pedagogia.The article has the intention of presenting arguments based on studies by researchers who have sought to identify education as one of the areas of science that studies the human and produces scientific knowledge about the educational phenomenon. Currently below shows, briefly, the theoretical assumptions guiding the theory of complexity, systematized by Edgar Morin. Finally, tests to a preliminary dialogue between the assumptions of complex thought and Pedagogy.
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Berni Britto
Full Text Available El presente estudio se basa en el concepto de categorías corológicas o corotipos para formular una nueva hipótesis de clasificación biogeográfica del Perú basado en la distribución de la familia Astera - ceae. La información recabada dio como resultado que existen 1669 especies de Asteraceae registradas en Perú (hasta el año 2008, distribuidas en 255 géneros. El territorio peruano se dividió en 218 Distritos de Reporte que representan a los 24 departamentos divididos en franjas de 500 m de altitud. La base de datos biogeográficos de Asteraceae se obtuvo cruzando los registros de distribución actualizados con los Distritos de Reporte, expresándose en una matriz de presencia-ausencia. El análisis de datos dio como resultado un total de 14 corotipos preliminares para el Perú: Abiseo, Amotape, Andino, Apurímac-Huan - cavelica, Chachapoyas-Huánuco, Huancabamba, Huascarán, Ica, Lima-Piura, Loreto-Ucayali, Manu, Pasco, Sandia y Tacna.
Estudo toponímico dos municípios baianos: resultado preliminar
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Clese Mary Prudente Correia
Full Text Available Conciliando as abordagens teóricas da Etnolinguística e da Lexicologia, com foco na Onomástica, apresenta-se resultado preliminar do estudo dos topônimos dos municípios do Estado da Bahia presentes nos volumes XX e XXI da Enciclopédia dos Municípios Brasileiros, publicados pelo Instituto Brasileiro de Geografia e Estatística (IBGE em 2 de julho de 1958. Neste artigo, expõe-se uma amostra dos dados coletados, enfatizando aspectos etimológicos e motivacionais predominantes no corpus analisado. Nos exemplos apresentados, destaca-se a supremacia da influência portuguesa e indígena, ao tempo em que se analisa a pouca representatividade da presença africana na toponímia baiana. Para a análise do corpus, é utilizado o sistema taxonômico proposto por Dick (1990 para um trabalho toponímico e os dados coletados, contendo informações referentes aos aspectos etimológicos, morfológicos e motivacionais dos topônimos, são registrados em fichas lexicográfico-toponímicas.
Estudio preliminar de correlación entre atención plena y componentes atencionales cognitivos en educación primaria
Albertín, Raquel
Objetivos: Se pretende obtener una información preliminar sobre la aplicación de la escala de atención plena en educación primaria y realizar un estudio preliminar sobre la correlación existente entre la atención plena y algunos componentes atencionales. Material y método: Se aplica la escala de atención plena, el test d2, el test de percepción de diferencias de caras de Yela, el SDMT y el TMT en una muestra de 22 niños de segundo ciclo de primaria. Resultados: Existe una correlac...
Abdominal Wall Endometrioma. Report of Two Cases
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Tahiluma Santana Pedraza
Full Text Available Abdominal wall endometrioma is a condition rarely seen by surgeons. It represents a diagnostic challenge due to its similarity with other tumors. This entity occurs in fertile women and often appears two to five years after gynecological and obstetric surgical procedures. It must be considered when dealing with a cyclically painful nodule located in a laparotomy scar. The diagnosis is established by histological examination; most imaging tests determine the characteristics of the lesion, concomitant lesions and the intra-abdominal origin or location in the abdominal wall. The cases of two patients treated at the General Surgery Department of the María Eugenia González Comprehensive Diagnostic Center in the Capital District, Venezuela, are presented. Wide excision of the tissue and histological examination were performed, confirming the diagnosis. The postoperative course was uneventful. This case is presented given the rarity of this condition.
Electromyographic analysis of four popular abdominal exercises.
Piering, A W; Janowski, A P; Wehrenberg, W B; Moore, M T; Snyder, A C
This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.
Abdominal Wall Desmoid during Pregnancy: Diagnostic Challenges
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Johnny Awwad
Full Text Available Background. Desmoids are benign tumors, with local invasive features and no metastatic potential, which have rarely been described to be pregnancy associated. Case. We described the rapid growth of an anterior abdominal wall mass in a 40-year-old pregnant woman. Due to its close proximity to the enlarged uterus, it was misdiagnosed to be a uterine leiomyoma by ultrasound examination. Final tissue diagnosis and radical resection were done at the time of abdominal delivery. Conclusion. Due to the diagnostic limitations of imaging techniques, desmoids should always be considered when the following manifestations are observed in combination: progressive growth of a solitary abdominal wall mass during pregnancy and well-delineated smooth tumor margins demonstrated by imaging techniques. This case emphasizes the importance of entertaining uncommon medical conditions in the differential diagnosis of seemingly common clinical manifestations.
Active learning based segmentation of Crohns disease from abdominal MRI.
Mahapatra, Dwarikanath; Vos, Franciscus M; Buhmann, Joachim M
This paper proposes a novel active learning (AL) framework, and combines it with semi supervised learning (SSL) for segmenting Crohns disease (CD) tissues from abdominal magnetic resonance (MR) images. Robust fully supervised learning (FSL) based classifiers require lots of labeled data of different disease severities. Obtaining such data is time consuming and requires considerable expertise. SSL methods use a few labeled samples, and leverage the information from many unlabeled samples to train an accurate classifier. AL queries labels of most informative samples and maximizes gain from the labeling effort. Our primary contribution is in designing a query strategy that combines novel context information with classification uncertainty and feature similarity. Combining SSL and AL gives a robust segmentation method that: (1) optimally uses few labeled samples and many unlabeled samples; and (2) requires lower training time. Experimental results show our method achieves higher segmentation accuracy than FSL methods with fewer samples and reduced training effort.
Decompressive laparotomy for abdominal compartment syndrome
Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.
Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380
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There are unstructured abstracts (no more than 256 words) and structured abstracts (no more than 480). The specific requirements for structured abstracts are as follows:An informative, structured abstracts of no more than 4-80 words should accompany each manuscript. Abstracts for original contributions should be structured into the following sections. AIM (no more than 20 words): Only the purpose should be included. Please write the aim as the form of "To investigate/ study/..."; MATERIALS AND METHODS (no more than 140 words); RESULTS (no more than 294 words): You should present P values where appropnate and must provide relevant data to illustrate how they were obtained, e.g. 6.92 ± 3.86 vs 3.61 ± 1.67, P< 0.001; CONCLUSION (no more than 26 words).
Penetrating abdominal injuries in children in Nigeria.
Ameh, E A; Nmadu, P T
This is a report of a retrospective study of 24 children managed for penetrating abdominal injury over 10 years, and it represents 34% of all abdominal injuries in children in that period. Falls onto sharp objects within and around the home were responsible for ten of the injuries, seven were injured by animal horns and four were sporting injuries. Violence and road traffic accidents were uncommon. Most patients (67%) had evisceration of omentum or intestine, and one of these was found at laparotomy to have a jejuno-jejunal intussusception. Seven children had injury to hollow viscera. There were three deaths, one each from overwhelming sepsis, tetanus and haemorrhage.
Systemic lupus erythematosus : abdominal radiologic findings
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Oh, Jae Cheon; Cho, On Koo; Lee, Yong Joo; Bae, Jae Ik; Kim, Yong Soo; Rhim, Hyun Chul; Ko, Byung Hee [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)
Systemic lupus erythematosus(SLE) is a systemic disease of unknown etiology. Its main pathology is vasculitis and serositis, due to deposition of the immune complex or antibodies. Most findings are nonspecific ; abdominal manifestations include enteritis, hepatomegaly, pancreatic enlargement, serositis, lymphadenopathy, splenomegaly, nephritis, interstitial cystitis, and thrombophlebitis. We described radiologic findings of various organ involvement of SLE; digestive system, serosa, reticuloendothelial system, urinary system, and venous system. Diagnosis of SLE was done according to the criteria of American Rheumatism Association. Understanding of the variable imaging findings in SLE may be helpful for the early detection of abdominal involvement and complications.
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向阳; 郎景和; 王友芳; 黄荣丽; 连丽娟
Twenty-eight cases of abdominal scar endometriosis from Janurary,1989 to December,1993 are reported.Of these patients,twenty-four underwent term cesarean section,and four underwent a midtrimester abortion by abdominal hysterotomy.The majority of patients manifested symptoms 1 year after the operation.The most common was a painful mass of scar tissue that became swollen and tender during menstruation.The pathogenesis,diagnosis and treatment are discussed.In correlation with the pathological findings,the effects of drug therapy are evaluated.It was found that surgical excision is the best method of treatment.
Epilepsia partialis continua (Koshevnikov: a preliminary case report Epilepsia parcial contínua (Kojevnikov: relato preliminar de um caso
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Full Text Available We report on the preliminary clinical and electrophysiological aspects of an in-patient possibly presenting epilepsia partialis continua (Koshevnikov. We discuss the different etiologies and emphasize on the possible idiopathic form in this case.Relatamos os aspectos clínicos e eletrofisiológicos preliminares de um paciente hospitalizado que possivelmente apresenta crises de epilepsia parcial contínua (Kojevnikov. Discutimos as diferentes etiologias dessa condição e salientamos a possível forma idiopática, nesse caso.
Estudio preliminar del borde dorsal del cuello en caballos de pura raza colombiana en Caracas-Venezuela
Morales, A.; Méndez, A.; Pérez Arévalo, J.
Se plantea como objetivo un estudio preliminar del borde dorsal del cuello en caballos de pura raza Colombiana en Caracas-Venezuela. Fueron estudiados un total de 57 caballos de esta raza, con edades entre 4 y 10 años, en Caracas, Venezuela. Todos ellos sometidos a ejercicio de moderada intensidad, a las mismas condiciones de alimentación y manejo. Se practicó un examen clínico mediante la inspección y palpación siguiendo el protocolo descrito para equinos. Se realizo un estudio morfológico c...
[Pathogenetic aspects of intra-abdominal hypertension in patients with abdominal sepsis].
Veliev, N A; Gasanova, D N
The authors had offered the original estimated system with the points calculation, basing on analysis of the examination and treatment results in 150 patients, suffering abdominal sepsis. The system, alike others, includes not only determination of the inflammation factors and indices of endotoxicosis, but as well as those, concerning intraabdominal pressure, the anterior abdominal wall rigidity and the tissues elasticity. Among the important indices, needed to determine, were considered those, which categorize the syndrome of intraabdominal, intrathoracic and microregional hypertension as well as the mechanisms of endotoxicosis pathogenesis. The authors recommend to use the indices of pathological consequences of this two factors while doing assessment of the abdominal sepsis severity.
Adequacy and quality of abdominal echographies requested by primary care professionals
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Auladell Ma
Full Text Available Abstract Background The value of abdominal echography in primary care is great because it is innocuous, inexpensive, easy to perform and provides a great deal of information making this the first examination to be requested in cases of probable abdominal disease. However, too many abdominal echographies are probably requested overcrowding the Departments of Radiodiagnosis with not always justified petitions or with repetition of tests based on little clinical criteria. Methods/Design The aim of the study is to evaluate the adequacy and quality of abdominal echographies requested by primary care physicians in the Maresme County (North of Barcelona, develop guidelines for indicating echographies and reevaluate this adequacy after implementing these guidelines. We will perform a two-phase study: the first descriptive, and retrospective evaluating the adequacy and quality of petitions for abdominal echographies, and in the second phase we will evaluate the impact of recommendations for indicating abdominal echographies for PC physicians on the adequacy and quality of echography petitions thereafter. This study will be carried out in 10 primary care centres in the Maresme (Barcelona. 1067 abdominal echographies requested by primary care physicians from the above mentioned centres from January 2007 to April 2010 and referred to the Department of Radiology and the same number of applications after the intervention. All the petitions for abdominal echographies requested will be analysed and the clinical histories will be obtained to determine demographic variables, the reason for the visit and for the echography petition and diagnostic orientation, clinical and echographic data, evaluation of the echographies according to the quality and variables characterising the professionals requesting the echographies including: age, sex, laboral situation, length of time in work post, formation, etc. To achieve a consensus of the adequacy of abdominal echography
Perfil epidemiológico de trauma abdominal submetido à laparotomia exploradora Epidemiologic profile of abdominal trauma submitted to laporotomy
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Nicolau Fernandes Kruel
transversal delineation, descriptive and retrospective in 185 individuals, having as a basis the information collecting referring to all the abdominal traumas, submitted to laparotomy treatment, occurred between the periods of 2003 to 2006, based on data from the HRSJ-HMG. RESULTS: The most frequent gender was the male one, which prevailed in 87% (161, being most of the individuals in the age group of 20 to 29 years old 44,3% (82 of the total; firearm injury was the main cause of abdominal trauma, representing 51,9%(96; the most frequent death cause was hypovolemic shock 47% (6; from the associated extra-abdominal lesions, the one that prevailed was the thoracic trauma with 22,2% (41. CONCLUSION: This study showed that the most frequent gender was the male one, the most frequent age group was from 20 to 29 years old, being the main cause firearm injury. The most affected structures were the small intestine, liver and spleen. Most of the patients remained hospitalized within a period of one to five days and are discharged without intercurrences.
A diagnostic approach to abdominal tuberculosis
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Eser Vardareli; Baybora Kircali
@@ TO THE EDITOR We read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.
Connective tissue alteration in abdominal wall hernia
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Henriksen, N A; Yadete, D H; Sørensen, Lars Tue
The aetiology and pathogenesis of abdominal wall hernia formation is complex. Optimal treatment of hernias depends on a full understanding of the pathophysiological mechanisms involved in their formation. The aim of this study was to review the literature on specific collagen alterations in abdom...
[A young woman with acute abdominal pain
Mooij, R.; Dillen, J. van
A 17-year-old woman was operated in a Tanzanian hospital because of a suspected ruptured ectopic pregnancy. During laparatomy an interstitial ectopic pregnancy with an intact gestational sac was found. The ectopic pregnancy had ruptured into the abdominal cavity.
Postoperative pleural effusion following upper abdominal surgery
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Nielsen, P H; Jepsen, S B; Olsen, A D
Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...
Abdominal sacral colpopexy for massive genital prolapse.
Powell; Joseph
Objective: A retrospective study to determine the success and complications of abdominal sacral colpopexy in correcting massive genital prolapse over an 8-year period between September 1989 and January 1997.Methods: The charts were reviewed for 3 patients with massive procidentia and 15 patients with symptomatic posthysterectomy vaginal vault prolapse, who desired preservation of sexual function and underwent abdominal sacral colpopexy with Marlex mesh at two community teaching hospitals.Results: In 16 of the 18 patients, one or more concurrent procedures were performed at the same time, including three Burch colpocystourethropexies and one Raz bladder neck suspension, which successfully controlled urinary stress incontinence. In three cases, staging procedures were done for ovarian neoplasia. There were no intraoperative complications. One patient developed a superficial abdominal wound infection, one patient had a deep venous thrombosis in her left leg 7 days postoperatively, and one patient experienced a 1 cm area of graft erosion 10 months postoperative requiring partial resection. Duration of follow-up has varied from 8 months to 5 years. One patient died 43 months after surgery of unrelated causes. No patients developed recurrent prolapse.Conclusions: Abdominal sacral colpopexy is a successful operation for the correction of prolapse. Serious complications are infrequent. Photographs of the technique and a review of the literature are presented.
[Albert Einstein and his abdominal aortic aneurysm].
Cervantes Castro, Jorge
The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.
Abdominal muscle function and incisional hernia
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Jensen, K K; Kjaer, M; Jorgensen, L N
of life depends largely on abdominal muscle function (AMF), and the present review thus evaluates to what extent AMF is influenced by VIH and surgical repair. METHODS: The PubMed and EMBASE databases were searched for articles following a systematic strategy for inclusion. RESULTS: A total of seven...
Reconstruction of complex abdominal wall defects
Slater, N.J.
Incisional hernia is by far the most common complication after laparotomies, occurring in 10 – 20%. Its occurrence is secondary to insufficient healing of the postoperative scar, resulting in wound dehiscence and protrusion of abdominal contents through an opening in the musculo-fascial layer of the
Genetics Home Reference: abdominal wall defect
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Pulmonary complications of upper abdominal surgery.
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Deodhar S
Full Text Available Pulmonary complications encountered in 67 patients undergoing upper abdominal surgery in our unit in one year period are analysed. Pulmonary function tests and their post-operative reduction, as also the risk factors are discussed. Pathophysiology responsible for pulmonary complications is outlined.
Unusual Differential Diagnosis of Upper Abdominal Pain
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Lanthaler Monika
The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.
[Intraabdominal hypertension and abdominal compartment syndrome
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Sonne, M.; Hilligsø, Jens Georg
Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various...
Abdominal manifestations of actinomycosis in IUD users.
Asuncion, C M; Cinti, D C; Hawkins, H B
The use of an intrauterine device (IUD) is associated with the presence of actinomyces in the female genital tract. Since IUD use is currently so prevalent, IUD-related pelvic inflammatory disease occasionally spreads to the rest of the abdomen. Two patients with abdominal actinomycosis in association with an IUD illustrate the problem; we review the general problem.
The Principles of Abdominal Wound Closure
Meijer, E. -T.; Timmermans, L.; Jeekel, J.; Lange, J. F.; Muysoms, F. E.
Background : Incisional hernia (IH) is a common complication of abdominal surgery. Its incidence has been reported as high as 39.9%. Many factors influence IH rates. Of these, surgical technique is the only factor directly controlled by the surgeon. There is much evidence in the literature on the op
Ausentismo y organización del espacio. Aportes preliminares en casos patagónicos
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Santiago Bondel
Full Text Available La presentación se corresponde con avances de un proyecto de investigación1 cuya finalidad principal está vinculada con el entendimiento de nuevas formas de organización de los espacios rurales patagónicos. Se ponen en discusión las posibilidades explicativas que sugieren, en su complejidad, distintas modalidades de tenencia de la tierra, tomando al ausentismo como característica analítica conducente. Metodológicamente concurren planteos de observación sistemática, con relevamientos bibliográficos y a campo, y la generación de referentes tipológicos. Los resultados preliminares muestran un espectro de situaciones diferenciadas en sus lógicas territoriales; así, el perfil económico rural (ganadería, minería, turismo, forestaciones, ahorro y/o especulación inmobiliaria se ve atravesado tanto por lógicas productivas como contemplativas. A todo esto, la organización de los espacios sobrelleva influencias cada vez más activas de varios procesos socio-culturales reivindicativos y/o conservacionistas. Se destaca asimismo el marco de discusión creciente de lo que se da en llamar 'territorialidad virtual', cuya asociación con el ausentismo, la sustitución dominial y los cambios en los usos del espacio resultan casi evidentes.La propuesta aspira a reflejar lineamientos básicos en la configuración espacial rural a favor de encontrar argumentos explicativos que permitan contribuir tanto con los enfoques multidisciplinarios que atañen al desenvolvimiento territorial en general, como con el Planeamiento regional.
Propuesta preliminar de una escala de satisfacción para clientes mexicanos de supermercado
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Lorena Carrete Lucero
Full Text Available Diferentes propuestas de escalas para evaluar la satisfacción de los consumidores de distintos sectores de actividad en distintas partes del mundo han sido desarrolladas. Una buena parte de de estas escalas ha sido validada en diferentes contextos profesionales y socioculturales y otra parte ha requerido ser adaptada en virtud de que las variables inherentes a la escala original no resultaron ser suficientemente relevantes para el grupo cultural de estudio. Este estudio exploratorio propone una multiescala preliminar adaptada de satisfacción de clientes de supermercados, para su aplicación en el contexto mexicano. Su estructura a priori se definió con base en la revisión de la bibliografía especializada. Una encuesta aplicada entre 771 clientes de una cadena de supermercados de cobertura nacional aporta los datos necesarios para apoyar la multidimensionalidad del concepto de satisfacción y para comenzar a identificar aquellas dimensiones latentes que más influyen en la satisfacción del consumidor mexicano.Different scale proposals have been developed as to evaluate consumer satisfaction in different activities sectors and in different parts of the world. While a great number of these scales have been validated in different professional and socio-cultural contexts, others have required adaptation because the variables related to the original scale were not found relevant to the group of consumers studied. This exploratory research proposes an adapted preliminary multi-scale to measuring consumer satisfaction in Mexican supermarkets. An a priori structure was defined based on salient literature. Furthermore, a survey among 771 customers of a supermarket chain with national coverage supplies the required data allowing verification of the multidimensionality of satisfaction. At the same time, this study proposes the identification of key influencing underlying dimensions of consumer satisfaction according to Mexican idiosyncrasy not
Aspectos preliminares del manejo reproductivo en cautiverio de la doncella (Ageneiosus pardalis Lütken, 1874
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Pedro Contreras C.
Full Text Available Objetivo. Evaluar procedimientos de manejo en cautiverio de ejemplares maduros de doncella Ageneiosus pardalis, con fines de reproducción y presentar una descripción preliminar del desarrollo embrionario y larvario para la especie. Materiales y métodos. Sobre ejemplares mantenidos en cautiverio se adelantaron dos ensayos de reproducción, así: a inducción con extracto de hipófisis de carpa EHC para la espermiación (4 mg/kg; una dosis intraperitoneal y para la ovulación (0.5 y 5 mg/kg; intraperitoneales, 0 y 12 horas; b inducción únicamente sobre hembras mantenidas en piletas, sin machos presentes, recolección y seguimiento de ovas. Resultados. Se comprobó la ovulación y la espermiación, pero no se avanzó en el desarrollo embrionario cuando se mezclaron los gametos y fueron incubados. Los ensayos con hembras inducidas, sin machos presentes, confirman el almacenamiento de esperma en los ovarios y los huevos obtenidos mostraron desarrollo embrionario completo, lográndose eclosión de larvas y el mantenimiento de alevinos. Conclusiones. El protocolo convencional de inducción fue efectivo en hembras y machos, pero la mezcla de los gametos no resultó ser un procedimiento viable para la producción de semilla en la especie. Se comprueba el almacenamiento de esperma en las hembras y la emisión espontánea de huevos fertilizados al medio cuando estas son sometidas a inducción. Tanto la forma y el tiempo de almacenamiento de esperma como los mecanismos fisiológicos que ocurren en la fecundación se desconocen.
Diagnostic accuracy of CT scan in abdominal blunt trauma
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Javad Salimi; Khadyjeh Bakhtavar; Mehdi Solimani; Patrcia Khashayar; Ali Pasha Meysamie; Moosa Zargar
Obiective: To evaluate the sensitivity and specificity of CT scan findings in Patients ith blunt abdominal trauma admitted to the university hospital.Methods: All the atients ith blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study.In the absence of any clinical anifestations,he patients underwent a diagnostic CT scan.Laparatomy was performed in those with positive CT results.Others were observed for 48 hours and discharged in case no problem as reported;otherwise they underwent laparatomy.Information on patients'demographic ata,mechanism of trauma,indication for CT scan,CT scan findings,results of laparotomy ere gathered.The sensitivity,specificity and accuracy of the CT-scan images in regard ith the organ injured were calculated.The sensitivity,specificity and accuracy of the T scan were calculated in each case.Results: CT Scan had the highest sensitivity for etecting the injuries to liver (100%) and spleen (86.6%).The specificity of the method or detecting retroperitoneal hematoma (100%) and injuries to kidney (93.5%) was higher han other organs.The accuracy of CT images to detect the injuries to spleen,liver,idney and retroperitoneal hematoma was reported to be 96.1%,94.4%,91.6% and 91.6% espectively.Conclusion: The findings of the present study reveal that CT scan could econsidered as a good choice,especially for patients with blunt abdominal trauma in eaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.
Previous Multiple Abdominal Surgeries: A Valid Contraindication to Abdominal Free Flap Breast Reconstruction?
Di Candia, Michele; Asfoor, Ahmed Al; Jessop, Zita M.; Kumiponjera, Devor; Hsieh, Frank; Malata, Charles M.
Presented in part at the following Academic Meetings: 57th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery, September 24-27, 2008, Naples, Italy.45th Congress of the European Society for Surgical Research (ESSR), June 9-12, 2010, Geneva, Switzerland.British Association of Plastic Reconstructive and Aesthetic Surgeons Summer Scientific Meeting, June 30-July 2, 2010, Sheffield Hallam University, Sheffield, UK. Background: Patients with previous multiple abdominal surgeries are often denied abdominal free flap breast reconstruction because of concerns about flap viability and abdominal wall integrity. We therefore studied their flap and donor site outcomes and compared them to patients with no previous abdominal surgery to find out whether this is a valid contraindication to the use of abdominal tissue. Patients and Methods: Twenty patients with multiple previous abdominal operations who underwent abdominal free flap breast reconstruction by a single surgeon (C.M.M., 2000-2009) were identified and retrospectively compared with a cohort of similar patients without previous abdominal surgery (sequential allocation control group, n = 20). Results: The index and control groups were comparable in age, body mass index, comorbidities, previous chemotherapy, and RT exposure. The index patients had a mean age of 54 years (r, 42-63) and an average body mass index of 27.5 kg/m2 (r, 22-38). The main previous surgeries were Caesarean sections (19), hysterectomies (8), and cholecystectomies (6). They underwent immediate (n = 9) or delayed (n = 11) reconstructions either unilaterally (n = 18) or bilaterally (n = 2) and comprising 9 muscle-sparing free transverse rectus abdominis muscle and 13 deep inferior epigastric perforator flaps. All flaps were successful, and there were no significant differences in flap and donor site outcomes between the 2 groups after an average follow up of 26 months (r, 10-36). Conclusion: Multiple previous abdominal
Diagnostic Accuracy of Secondary Ultrasound Exam in Blunt Abdominal Trauma
Rajabzadeh Kanafi, Alireza; Giti, Masoumeh; Gharavi, Mohammad Hossein; Alizadeh, Ahmad; Pourghorban, Ramin; Shekarchi, Babak
Background: In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial. Objectives: To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma. Patients and Methods: We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma p...
Isolated duodenal rupture due to blunt abdominal trauma
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Celik Atilla
Full Text Available Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.
Abdominal fedme og fedmerelaterede sygdomme hos patienter i almen praksis
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Haugan, Ketil; Rost, Dan; Knudsen, Nils;
Abdominal obesity is associated with type 2 diabetes, cardiovascular disease, dyslipidemia and hypertension. The prevalence of abdominal obesity and its relationship with these comorbidities have not previously been examined in Danish primary care patients.......Abdominal obesity is associated with type 2 diabetes, cardiovascular disease, dyslipidemia and hypertension. The prevalence of abdominal obesity and its relationship with these comorbidities have not previously been examined in Danish primary care patients....
Abdominal closed trauma in children. Trauma abdominal cerrado en el niño.
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Rogelio Rodríguez Castillo
Full Text Available Blunt abdominal trauma constitutes 90% approximately of the abdominal injuries in children. Due to the augmented size of the child trunk in relation to their extremities, the abdominal lesions are extremely frequents. The abdominal trauma is present in 20-30% of the patients with serious trauma. It's the second cause of death for accidents after the cranial traumatism in the pediatric patient. We presented the Good Clinical Practices Guideline for Blunt Abdominal Trauma, approved by consensus in the 2nd National Good Clinical Practices Workshop in Pediatric Surgery (Manzanillo, Cuba, September 31 - October 3, 2002. El trauma abdominal cerrado constituye aproximadamente el 90 % de los traumatismos abdominales en niños. Debido al tamaño aumentado del tronco del niño en relación con sus extremidades las lesiones abdominales son extremadamente frecuentes. El trauma abdominal está presente en el 20-30 % de los pacientes con trauma grave. Es la segunda causa de muerte por accidentes, después del traumatismo craneal, en el paciente pediátrico. Se presenta la Guía de Buenas Prácticas Clínicas para trauma abdominal cerrado, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.
El trauma abdominal cerrado constituye aproximadamente el 90 % de los traumatismos abdominales en niños. Debido al tamaño aumentado del tronco del niño en relación con sus extremidades las lesiones abdominales son extremadamente frecuentes. El trauma abdominal está presente en el 20-30 % de los pacientes con trauma grave. Es la segunda causa de muerte por accidentes, después del traumatismo craneal, en el paciente pediátrico. Se presenta la Guía de Buenas Prácticas Clínicas para trauma abdominal cerrado, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.
Evaluation and management of acute abdominal pain in the emergency department
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Macaluso CR
Full Text Available Christopher R Macaluso, Robert M McNamaraDepartment of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA, USAAbstract: Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.Keywords: acute abdomen, emergency medicine, peritonitis
Quality of abdominal computed tomography angiography: hand versus mechanical intravenous contrast administration in children
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Ayyala, Rama S.; Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Zurakowski, David [Boston Children' s Hospital and Harvard Medical School, Departments of Anesthesiology and Surgery, Boston, MA (United States)
Abdominal CT angiography has been increasingly used for evaluation of various conditions related to abdominal vasculature in the pediatric population. However, no direct comparison has evaluated the quality of abdominal CT angiography in children using hand versus mechanical administration of intravenous (IV) contrast agent. To compare hand versus mechanical administration of IV contrast agent in the quality of abdominal CT angiography in the pediatric population. We retrospectively reviewed the electronic medical record to identify pediatric patients (≤18 years) who had abdominal CT angiography between August 2012 and August 2013. The information obtained includes: (1) type of administration of IV contrast agent (hand [group 1] versus mechanical [group 2]), (2) size (gauge) of IV catheter, (3) amount of contrast agent administered and (4) rate of contrast agent administration (ml/s). Two reviewers independently performed qualitative and quantitative evaluation of abdominal CT angiography image quality. Qualitative evaluation of abdominal CT angiography image quality was performed by visual assessment of the degree of contrast enhancement in the region of interest (ROI) based on a 4-point scale. Quantitative evaluation of each CT angiography examination was performed by measuring the Hounsfield unit (HU) using an ROI within the abdominal aorta at two levels (celiac axis and the inferior mesenteric artery) for each child. Analysis of variance (ANOVA) using the F-test was applied to compare contrast enhancement within the abdominal aorta at two levels (celiac axis and inferior mesenteric artery) between hand administration and mechanical administration of IV contrast methods with adjustment for age. We identified 46 pediatric patients (24 male, 22 female; mean age 7.3 ± 5.5 years; range 5 weeks to 18 years) with abdominal CT angiography performed during the study period. Of these patients, 16 (35%; 1.7 ± 2.2 years; range 5 weeks to 5 years) had hand
The efficacy of adhesiolysis on chronic abdominal pain
DEFF Research Database (Denmark)
Gerner-Rasmussen, Jonas; Burcharth, Jakob; Gögenur, Ismail
INTRODUCTION: Abdominal adhesions are a frequent reason for chronic abdominal pain. The purpose of this systematic review was to investigate the evidence of performing laparoscopic adhesiolysis as a treatment for patients with chronic abdominal pain. METHODS: Medline, Embase, and The Cochrane Cen...
Interventional management of abdominal sepsis : when and how
van Goor, H
Background: To decide "how and when to treat intra-abdominal infection" is one of the most important challenges for surgeons interested in abdominal sepsis. The minimally invasive approach to intra-abdominal infection, both diagnostic and therapeutic, has gained great popularity in recent years: the
Lateral abdominal wall hernia following blunt trauma - a rare case
Michael Walsh; Antony Pittathankal; Nnamdi Nwaejike
The presence of superficial bruising, no abnormal signs on abdominal examination and a negative FAST scan of the abdomen may not be enough to rule out intra-abdominal pathology. We report on the usefulness of CT in diagnosing a post-traumatic abdominal wall hernia.
Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain
Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...
Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.
Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.
Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…
Abdominal wall paresis as a complication of laparoscopic surgery
G.H. van Ramshorst (Gabrielle); G.J. Kleinrensink (Gert Jan); J.J. Hermans (John); T. Terkivatan (Türkan); J.F. Lange (Johan)
textabstractPurpose: Abdominal wall nerve injury as a result of trocar placement for laparoscopic surgery is rare. We intend to discuss causes of abdominal wall paresis as well as relevant anatomy. Methods: A review of the nerve supply of the abdominal wall is illustrated with a rare case of a patie
Can release of urinary retention trigger abdominal aortic aneurysm rupture?
Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad
Only 50% of abdominal aortic aneurysms present with the classic triad of hypotension, back pain and a pulsatile abdominal mass. This variability in symptoms can delay diagnosis and treatment. We present the case of a patient presenting with a unique combination of symptoms suggesting that decompression of urinary retention can lead to abdominal aortic aneurysm rupture.
Práticas de risco entre os jovens: estudo preliminar sobre condutas ordálicas
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Patrícia Junqueira Grandino
Full Text Available Resumo O presente trabalho relata a discussão de uma pesquisa em andamento sobre o sentido das práticas de risco assumidas por jovens na transição para a vida adulta e resultados preliminares de um estudo piloto utilizando o Questionário de Funcionamento Ordálico. A partir da retomada do conceito de condutas ordálicas, procura-se aprofundar a análise de práticas de risco envolvendo jovens brasileiros como sintomas de um mal-estar que vivenciam na transição para a vida adulta. Realizou-se um experimento piloto com a aplicação de um questionário que avalia o funcionamento ordálico. A amostra inicial contou com 82 estudantes universitários, de ambos os sexos. Os resultados preliminares foram promissores na comparação dos quatro fatores por sexo dos sujeitos e na correlação com a idade. Avançar nessa perspectiva de investigação deve colaborar para o entendimento aprofundado dessas práticas, bem como para o desenvolvimento de ações preventivas e protetivas aos jovens.
Análisis preliminares de los materiales líticos provenientes de la Laguna Blanca Chica (Olavarría, Buenos Aires
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Pablo G. Messineo
Full Text Available En este trabajo se presentan los resultados preliminares sobre el estudio de los materiales líticos recuperado en la Laguna Blanca Chica (Partido de Olavarría, Provincia de Buenos Aires. El objetivo principal es conocer las estrategias relacionadas al aprovisionamiento y explotación de las materias primas presentes, como los procesos tecnológicos utilizados sobre las mismas. Los resultados obtenidos indican que la ftanita (55,58% y la cuarcita (43,23% fueron las materias primas más utilizadas. Los instrumentos (formales e informales presentan mayores frecuencias de ftanita. Los altos porcentajes de esta materia prima en la laguna se asemejan a otros sitios del área (e.g., Laguna La Barrancosa 2, Arroyo Tapalqué 1, lo cual puede deberse a su alta disponibilidad y excelente calidad para la talla. Por otro lado, se observa una gran variabilidad entre las rocas cuarcíticas, proponiéndose la explotación de distintas formaciones geológicas.In this paper we report some preliminary results of the study of lithic material recovered from Laguna Blanca Chica, Olavarría district, Buenos Aires Province. The main aim of the study is to gain knowledge of aspects related to the acquisition of, and technological process involved in, raw material exploitation. The results obtained show that more than 50% of the principal lithic resource used consisted of chert. Formal and informal artefacts were also made using mainly chert as the raw material. The high frequency of this raw material in the lagoon is similar to other sites in the area (e.g., Laguna La Barrancosa 2, Arroyo Tapalqué 1, and may be due to its high natural availability and good chipping quality. Even so, a great variability of quartzite rocks was observed, showing that different geological formations were exploited.
Extraction of fetal electrocardiogram (ECG) by extended state Kalman filtering and adaptive neuro-fuzzy inference system (ANFIS) based on single channel abdominal recording
Indian Academy of Sciences (India)
D Panigrahy; P K Sahu
Fetal electrocardiogram (ECG) gives information about the health status of fetus and so, an early diagnosis of any cardiac defect before delivery increases the effectiveness of appropriate treatment. In this paper, authors investigate the use of adaptive neuro-fuzzy inference system (ANFIS) with extended Kalman filter for fetal ECG extraction from one ECG signal recorded at the abdominal areas of the mother's skin. The abdominal ECG is considered to be composite as it contains both mother's and fetus' ECG signals. We use extended Kalman filter framework to estimate the maternal component from abdominal ECG. The maternal component in the abdominal ECG signal is a nonlinear transformed version of maternal ECG. ANFIS network has been used to identify this nonlinear relationship, and to align the estimated maternal ECG signal with the maternal component in the abdominal ECG signal. Thus, we extract the fetal ECG component by subtracting the aligned version of the estimated maternal ECG from the abdominal signal. Our results demonstrate the effectiveness of the proposed technique in extracting the fetal ECG component from abdominal signal at different noise levels. The proposed technique is also validated on the extraction of fetal ECG from both actual abdominal recordings and synthetic abdominal recording.
The Epidemiology of Intra-Abdominal Flora in Critically III Patients with Secondary and Tertiary Abdominal Sepsis
de Ruiter, J.; Weel, J.; Manusama, E.; Kingma, W. P.; van der Voort, P. H. J.
Background: Different micro-organisms can be cultured from abdominal fluid obtained from patients with intra-abdominal infection resulting from a perforated digestive tract. We evaluated a cohort of patients with abdominal sepsis admitted to the intensive care with the aim of obtaining more insight
In vivo strain assessment of the abdominal aortic aneurysm.
Satriano, Alessandro; Rivolo, Simone; Martufi, Giampaolo; Finol, Ender A; Di Martino, Elena S
The only criteria currently used to inform surgical decision for abdominal aortic aneurysms are maximum diameter (>5.5 cm) and rate of growth, even though several studies have identified the need for more specific indicators of risk. Patient-specific biomechanical variables likely to affect rupture risk would be a valuable addition to the science of understanding rupture risk and prove to be a life saving benefit for patients. Local deformability of the aorta is related to the local mechanical properties of the wall and may provide indication on the state of weakening of the wall tissue. We propose a 3D image-based approach to compute aortic wall strain maps in vivo. The method is applicable to a variety of imaging modalities that provide sequential images at different phases in the cardiac cycle. We applied the method to a series of abdominal aneurysms imaged using cine-MRI obtaining strain maps at different phases in the cardiac cycle. These maps could be used to evaluate the distensibility of an aneurysm at baseline and at different follow-up times and provide an additional index to clinicians to facilitate decisions on the best course of action for a specific patient.
A case report of abdominal distention caused by herpes zoster
Institute of Scientific and Technical Information of China (English)
Su-Rong Zhou; Chuan-Yu Liu
Gastrointestinal complications caused by herpes zoster are extremely rare.Here,we described a case of abdominal distention caused by herpes zoster.The patient was a 59-year-old female who suffered from unexplained paroxysmal and a burning pain on the right part of her waist and abdomen,accompanied by abdominal distention.Intestinal pseudo-obstruction was diagnosed by abdominal radiography.Distention of the right abdominal wall was still apparent after one month.In this report,we found that recovery from abdominal distention caused by herpes zoster is difficult and may require surgical intervention.
[Pain originating from the abdominal wall: a forgotten diagnostic option].
Rivero Fernández, Miguel; Moreira Vicente, Víctor; Riesco López, José María; Rodríguez Gandía, Miguel Angel; Garrido Gómez, Elena; Milicua Salamero, José María
Chronic abdominal pain is a common clinical problem in primary care, and is usually referred to gastroenterologists or general surgeons. Although up to 20% of cases of idiopathic abdominal pain arise in structures of the abdominal wall, this is frequently overlooked as a possible cause. It includes pain arising from structures of the abdominal wall including skin, parietal peritoneum, cellular subcutaneous tissue, aponeuroses, abdominal muscles and somatosensorial innervation from lower dorsal roots. The diagnosis is based on anamnesis and physical examination. Carnett's sign is a simple maneuver that discriminates between parietal and visceral pain. Management with topical anesthesia is effective in a majority of patients and can help to confirm the diagnosis.
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma
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Davood Farsi
Full Text Available Background: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT. Materials and Methods: In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. Results: A total of 104 patients was enrolled in the study. 15 patients (14.4% had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001. On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100, 93.26% (95% CI, 86-96.8, 14.83 (95% CI, 6.84-32.12, and 0, respectively. Conclusion: The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients.
Computed Tomography (CT) Perfusion in Abdominal Cancer
DEFF Research Database (Denmark)
Hansen, Martin Lundsgaard; Norling, Rikke; Lauridsen, Carsten;
on the market today based on different perfusion algorithms. However, there is no consensus on which protocol and algorithm to use for specific organs. In this article, the authors give an introduction to CT perfusion in abdominal imaging introducing technical aspects for calculation of perfusion parameters......Computed Tomography (CT) Perfusion is an evolving method to visualize perfusion in organs and tissue. With the introduction of multidetector CT scanners, it is now possible to cover up to 16 cm in one rotation, and thereby making it possible to scan entire organs such as the liver with a fixed...... table position. Advances in reconstruction algorithms make it possible to reduce the radiation dose for each examination to acceptable levels. Regarding abdominal imaging, CT perfusion is still considered a research tool, but several studies have proven it as a reliable non-invasive technique...
[Adrenal injury in blunt abdominal trauma].
Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G
10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.
Abdominal pregnancy as a cause of hemoperitoneum
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Shafi Sheikh
Full Text Available The coexistence of intrauterine and extrauterine pregnancy, the heterotopic pregnancy, is a rare obstetric phenomenon. The preoperative diagnosis of this condition is very difficult; leading to a higher maternal morbidity and fetal loss. We experienced a case of intrauterine pregnancy and ruptured abdominal pregnancy implanted on the illeocaecal region in a 26-year-old primiparous woman. She was clinically misdiagnosed as a case of ruptured ectopic pregnancy, but ultrasonography showed it to be a case of heterotopic pregnancy. Subsequently, the patient was subjected to laparotomy and the ruptured abdominal pregnancy was evacuated. She continued with the intrauterine pregnancy till term and delivered a healthy female baby. Although this condition is unusual, any general surgeon in the emergency department must be aware of this complication and its management, which is often initially misdiagnosed.
Atrophic coarctation of the abdominal aorta.
Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F
Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453
[Traumatic and iatrogenic lesions of abdominal vessels].
Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H
Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.
Idiopathic sclerosing encapsulating peritonitis: Abdominal cocoon
Institute of Scientific and Technical Information of China (English)
Jenny N Tannoury; Bassam N Abboud
Abdominal cocoon,the idiopathic form of sclerosing encapsulating peritonitis,is a rare condition of unknown etiology that results in an intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane.Preoperative diagnosis re quires a high index of clinical suspicion.The early clinical features are nonspecific,are often not recognized and it is difficult to make a definite pre-operative diagnosis.Clinical suspicion may be generated by the recurrent episodes of small intestinal obstruction combined with relevant imaging findings and lack of other plausible etiologies.The radiological diagnosis of abdominal cocoon may now be confidently made on computed tomography scan.Surgery is important in the management of this disease.Careful dissection and excision of the thick sac with the release of the small intestine leads to complete recovery in the vast majority of cases.
Intra-abdominal gout mimicking pelvic abscess
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Chen, Chia-Hui; Chen, Clement Kuen-Huang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan); National Yang-Ming University, School of Medicine, Taipei (Taiwan); Yeh, Lee-Ren; Pan, Huay-Ban; Yang, Chien-Fang [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung (Taiwan)
Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess. (orig.)
Abdominal compartment syndrome from bleeding duodenal diverticulum
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Vakhtang Tchantchaleishvili
Full Text Available Duodenal diverticuli are acquired false diverticuli of unknown etiology. Although mostly asymptomatic, they can occasionally cause upper gastrointestinal hemorrhage, rarely with massive bleeding. In this report, we present (to the best of our knowledge the first reported case of duodenal diverticular bleeding, causing abdominal compartment syndrome. Albeit a rare event, duodenal diverticular bleeding should be included in the differential diagnosis of upper gastrointestinal bleeding. As with our case, a multidisciplinary approach to managing such patients is crucial.
Abdominal manifestations of extranodal lymphoma: pictorial essay*
Fajardo, Laís; Ramin, Guilherme de Araujo; Penachim, Thiago José; Martins, Daniel Lahan; Cardia, Patrícia Prando; Prando, Adilson
In the appropriate clinical setting, certain aspects of extranodal abdominal lymphoma, as revealed by current cross-sectional imaging techniques, should be considered potentially diagnostic and can hasten the diagnosis. In addition, diagnostic imaging in the context of biopsy-proven lymphoma can accurately stage the disease for its appropriate treatment. The purpose of this article was to illustrate the various imaging aspects of extranodal lymphoma in the abdomen. PMID:28057966
Mast Cells in Abdominal Aortic Aneurysms
DEFF Research Database (Denmark)
Shi, Guo-Ping; Lindholt, Jes Sanddal
Mast cells (MCs) are proinflammatory cells that play important roles in allergic responses, tumor growth, obesity, diabetes, atherosclerosis, and abdominal aortic aneurysm (AAA). Although the presence and function of MCs in atherosclerotic lesions have been thoroughly studied in human specimens...... neighboring cells, degrade extracellular matrix proteins, process latent bioactive molecules, promote angiogenesis, recruit additional inflammatory cells, and stimulate vascular cell apoptosis. These activities associate closely with medial elastica breakdown, medial smooth-muscle cell loss and thinning...
Child abdominal tumour in tropical context: Think about schistosomiasis!
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A. M. Napon
Full Text Available Schistosomiasis presenting as an abdominal mass with chronic pain in a child is not common. This report presents case of child presenting with schistosomiasis presenting as an abdominal mass with chronic pain. Abdominal ultrasonography did not particularly contribute to definitive pre-operative diagnosis. However, pathological examination of surgical specimen confirmed Schistosoma mansoni eggs in the biospy. A decrease in the mass volume was noticed under medical treatment (Biltricide. The aim of this report was to intimate clinicians on possible abdominal schistosomiasis as differential diagnosis of childhood abdominal mass. This is a clarion call for a high index of suspicion of childhood abdominal schistosomiasis in children presenting with abdominal mass in a tropical setting.
Abdominal tuberculosis in Ahmadi, Kuwait: a clinico-pathological review.
Abdul-Ghaffar, N U; Ramadan, T T; Marafie, A A
For studying abdominal tuberculosis (TB) in Ahmadi, files off all patients admitted to our hospital with abdominal TB over 15 years (1981-1996) were reviewed. Nineteen patients are reported here. Young adults were predominant in our study. The non-Arab Asians were the most frequently affected group in relation to their population in Ahmadi, and Kuwaitis were the least frequently affected group. Abdominal pain, sweating, anorexia and fever were the most frequent presenting symptoms. Ascites and intestinal obstruction were the most frequent clinical presentations. Two patients presented with acute appendicitis and one patient had tuberculous pancreatitis. Abdominal lymph nodes, peritoneum, ileum and and caecum were the most frequently affected abdominal structures. We found laparoscopy very helpful in diagnosis of abdominal TB and we recommend it as the diagnostic method of choice. All our patients responded well to antituberculous chemotherapy. It should be kept in mind that abdominal TB still affects the indigenous and expatriate population of Kuwait.
Focal epilepsy with ictal abdominal pain: a case report.
Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo
Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities.
Risk factors of thrombosis in abdominal veins
Institute of Scientific and Technical Information of China (English)
Amit Kumar Durra; Ashok Chacko; Biju George; Joseph Anjilivelil Joseph; Sukesh Chandran Nair; Vikram Mathews
AIM: To estimate the prevalence of inherited and acquired thrombophilic risk factors in patients with abdominal venous thrombosis and to compare the risk factor profiles between Budd-Chiari syndromes (BCS) and splanchnic vein thrombosis (SVT).METHODS: In this retrospective study, 36 patients with abdominal venous thrombosis were studied.The patients were divided into Budd-Chiari group (hepatic vein, IVC thrombosis) and splanchnic venous thrombosis group (portal, splenic, superior mesenteric veins) based on the veins involved. Hereditary and acquired thrombophilic risk factors were evaluated in all patients.RESULTS: Twenty patients had SVT, 14 had BCS,and 2 had mixed venous thrombosis. Ten patients (28%) had hereditary and 10 patients (28%) acquired thrombophilic risk factors. The acquired risk factors were significantly more common in the SVT group (SVT vs BCS:45% vs 7%,x2=5.7,P=0.02) while hereditary risk factors did not show significant differences between the two groups (SVT vs BCS: 25%vs 36%, x2=0.46,P=0.7). Multiple risk factors were present in one (7%) patient with BCS and in 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and in 45% of patients with SVT.CONCLUSION: Hereditary and acquired risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis. Acquired risk factors are significantly more common in SVT patients while hereditary factors are similar in both groups.
[Hereditary angioedema: strange cause of abdominal pain].
Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio
Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.
Endovascular repair of ruptured abdominal aortic aneurysm
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Šarac Momir
Full Text Available Introduction. Rupture of an abdominal aortic aneurysm (AAA is a potentially lethal state. Only half of patients with ruptured AAA reach the hospital alive. The alternative for open reconstruction of this condition is endovascular repair (EVAR. We presented a successful endovascular reapir of ruptured AAA in a patient with a number of comorbidities. Case report. A 60-year-old man was admitted to our institution due to diffuse abdominal pain with flatulence and belching. Initial abdominal ultrasonography showed an AAA that was confirmed on multislice computed tomography scan angiography which revealed a large retroperitoneal haematoma. Because of patient's comorbidites (previous surgery of laryngeal carcinoma and one-third laryngeal stenosis, arterial hypertension and cardiomyopathy with left ventricle ejection fraction of 30%, stenosis of the right internal carotid artery of 80% it was decided that endovascular repair of ruptured AAA in local anaesthesia and analgosedation would be treatment of choice. Endovascular grafting was achieved with aorto-bi-iliac bifurcated excluder endoprosthesis with complete exclusion of the aneurysmal sac, without further enlargment of haemathoma and no contrast leakage. The postoperative course of the patient was eventless, without complications. On recall examination 3 months after, the state of the patient was well. Conclusion. The alternative for open reconstruction of ruptured AAA in haemodynamically stable patients with suitable anatomy and comorbidities could be emergency EVAR in local anesthesia. This technique could provide greater chances for survival with lower intraoperative and postoperative morbidity and mortality, as shown in the presented patient.
Midgut malrotation with chronic abdominal pain
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Anil K Wanjari
Full Text Available Abnormalities in midgut rotation occur during the physiological herniation of midgut between the 5 th and 10 th week of gestation. The most significant abnormality is narrow small bowel mesentery which is prone to volvulus. This occurs most frequently in the neonatal period, less commonly midgut malrotation presents in adulthood with either acute volvulus or chronic abdominal symptoms. It is the latter group that represents a diagnostic challenge. We report a case of a 17-year-old male patient who presented with 10-year history of nonspecific gastro-intestinal symptoms. After extensive investigation the patient was diagnosed with midgut malrotation following computed tomography of abdomen. The patient was treated with a laparoscopic Ladd′s procedure and at 3 months he was gaining weight and had stopped vomiting. A laparoscopic Ladd′s procedure is an acceptable alternative to the open technique in treating symptomatic malrotation in adults. Midgut malrotation is a rare congenital anomaly which may present as chronic abdominal pain. Abdominal CT is helpful for diagnosis.
[Abdominal multi-organ transplantation in dogs].
Kumagae, T
Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.
Sagittal Abdominal Diameter: Application in Clinical Practice
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Thaís Da Silva-Ferreira
Full Text Available Excess visceral fat is associated with cardiovascular risk factors. Sagittal abdominal diameter (SAD has recently been highlighted as an indicator of abdominal obesity, and also may be useful in predicting cardiovascular risk. The purpose of the present study was to review the scientific literature on the use of SAD in adult nutritional assessment. A search was conducted for scientific articles in the following electronic databases: SciELO , MEDLINE (PubMed and Virtual Health Library. SAD is more associated with abdominal fat (especially visceral, and with different cardiovascular risk factors, such as, insulin resistance, blood pressure, and serum lipoproteins than the traditional methods of estimating adiposity, such as body mass index and waist-to-hip ratio. SAD can also be used in association with other anthropometric measures. There are still no cut-off limits established to classify SAD as yet. SAD can be an alternative measure to estimate visceral adiposity. However, the few studies on this diameter, and the lack of consensus on the anatomical site to measure SAD, are obstacles to establish cut-off limits to classify it.
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Mª ÁNGELES CASTAÑO MOLINA
Full Text Available El consentimiento informado (CI es un proceso basado en el diálogo entre el profesional y el paciente en el que éste decide libremente sobre las posibles intervenciones en su salud. Éste es aplicable al nacimiento por cesárea y siempre que cumpla una serie de condiciones ayudará a la mejora del proceso de "humanización" del nacimiento. El objetivo general de este estudio es analizar de forma preliminar el CI de las cesáreas en varios hospitales de la Región de Murcia. Para ello hemos revisado los documentos de CI y hemos analizado quién, dónde, cuándo y cómo se realiza el proceso del CI. Los resultados muestran que todos los hospitales parten de un mismo documento y, aunque los documentos tienen en cuenta todos los elementos de un CI, no indican la fecha de su diseño ni las revisiones posteriores. Tampoco contemplan los riesgos y complicaciones que la cesárea puede tener en el recién nacido, la madre y la posterior relación madre-hijo. Se observa que el documento de CI normalmente lo ofrece el ginecólogo en la consulta, cuando la intervención es programada, aunque en ocasiones es el personal de enfermería quien después del ingreso en el hospital se lo da a firmar a la paciente. En cesáreas urgentes hay algunos hospitales que se acogen a la situación de riesgo vital y no ofrecen el CI a la mujer. En otros se ofrece haciéndolo el ginecólogo o la matrona de forma apresurada. En conclusión, el CI es un proceso que empleado de forma correcta favorece la relación entre la mujer y los profesionales sanitarios en la intervención de la cesárea. Aunque este proceso y los documentos utilizados en él, presentan en nuestro estudio, muchos aspectos positivos, la humanización de la cesárea podría incrementarse mejorando tanto la confección y actualización de estos documentos como coordinando a los diversos profesionales que participan en este proceso de CI.
Inter-observer agreement for abdominal CT in unselected patients with acute abdominal pain
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Randen, Adrienne van [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Academic Medical Center, Amsterdam (Netherlands); Lameris, Wytze [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands); Nio, C.Y.; Spijkerboer, Anje M.; Meier, Mark A.; Tutein Nolthenius, Charlotte; Smithuis, Frank; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Bossuyt, Patrick M. [University of Amsterdam, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam (Netherlands); Boermeester, Marja A. [University of Amsterdam, Department of Surgery, Academic Medical Center, Amsterdam (Netherlands)
The level of inter-observer agreement of abdominal computed tomography (CT) in unselected patients presenting with acute abdominal pain at the Emergency Department (ED) was evaluated. Two hundred consecutive patients with acute abdominal pain were prospectively included. Multi-slice CT was performed in all patients with intravenous contrast medium only. Three radiologists independently read all CT examinations. They recorded specific radiological features and a final diagnosis on a case record form. We calculated the proportion of agreement and kappa values, for overall, urgent and frequently occurring diagnoses. The mean age of the evaluated patients was 46 years (range 19-94), of which 54% were women. Overall agreement on diagnoses was good, with a median kappa of 0.66. Kappa values for specific urgent diagnoses were excellent, with median kappa values of 0.84, 0.90 and 0.81, for appendicitis, diverticulitis and bowel obstruction, respectively. Abdominal CT has good inter-observer agreement in unselected patients with acute abdominal pain at the ED, with excellent agreement for specific urgent diagnoses as diverticulitis and appendicitis. (orig.)
Intra-abdominal pressure and abdominal compartment syndrome in acute general surgery.
LENUS (Irish Health Repository)
Sugrue, Michael
BACKGROUND: Intra-abdominal pressure (IAP) is a harbinger of intra-abdominal mischief, and its measurement is cheap, simple to perform, and reproducible. Intra-abdominal hypertension (IAH), especially grades 3 and 4 (IAP > 18 mmHg), occurs in over a third of patients and is associated with an increase in intra-abdominal sepsis, bleeding, renal failure, and death. PATIENTS AND METHODS: Increased IAP reading may provide an objective bedside stimulus for surgeons to expedite diagnostic and therapeutic work-up of critically ill patients. One of the greatest challenges surgeons and intensivists face worldwide is lack of recognition of the known association between IAH, ACS, and intra-abdominal sepsis. This lack of awareness of IAH and its progression to ACS may delay timely intervention and contribute to excessive patient resuscitation. CONCLUSIONS: All patients entering the intensive care unit (ICU) after emergency general surgery or massive fluid resuscitation should have an IAP measurement performed every 6 h. Each ICU should have guidelines relating to techniques of IAP measurement and an algorithm for management of IAH.
Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department.
He, Lulu; Park, Ellen; Vachhani, Neil; Vogelius, Esben; Thupili, Chakradhar; Udayasankar, Unni
Diagnostic imaging is often an integral component in the workup of a pediatric patient with acute abdominal pain. The purpose of this study was to compare the diagnostic value of a three-view acute abdominal series (AAS) with that of a single supine view (SSV) in children with acute abdominal pain. All subjects aged ≤18 years that underwent an emergency three-view AAS examination for acute abdominal pain at a single urban hospital system were included. Retrospective evaluation of radiological diagnosis, number of radiological images, further imaging, management, and clinical outcomes was performed. "Positive" AAS studies were compared with corresponding SSV images for direct comparison of diagnostic value. Standard nonparametric statistical evaluation was performed. Five hundred forty-one AAS studies were included in the study. Greater than three radiographs were acquired in 29 % (153/541) of the subjects. Two hundred ninety-nine out of 541 AAS studies included a technically adequate SSV of the abdomen and pelvis. Most AAS examinations were categorized as negative (n = 485; 90 %). Of the 56 examinations initially classified as positive, there was no significant statistical difference between diagnostic accuracy between the AAS and SSV on retrospective evaluation. For pediatric subjects with nontraumatic acute abdominal pain, the yield of conventional radiographic study is exceedingly low. If required, a technically adequate single supine anteroposterior (AP) view of the abdomen and pelvis is sufficient for initial radiographic evaluation while reducing unnecessary radiation exposure to the patient.
Significance of residual abdominal masses in children with abdominal Burkitt's lymphoma
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Karmazyn, B.; Horev, G.; Kornreich, L. [Dept. of Diagnostic Radiology, Schneider Children' s Medical Center of Israel, Petah-Tikva (Israel); Ash, S.; Goshen, Y.; Yaniv, I. [Dept. of Hematology and Oncology, Schneider Children' s Medical Center of Israel, Petah-Tikva (Israel)
Purpose: To evaluate the natural history of children with abdominal Burkitt's lymphoma who had complete clinical remission and residual abdominal mass after treatment. Material and methods: The charts and imaging findings of all children with abdominal Burkitt's lymphoma treated and followed at our medical center between 1988 and 1999 were reviewed for the presence, management, clinical course, and prognosis of residual mass. Results: Only children who achieved complete clinical remission were included. The study group consisted of 33 children (20 boys and 13 girls) aged 2.6-17.6 years (mean 7.2 years). Of these, seven (20.6 %) were found to have a residual abdominal mass. Two underwent second-look operation with no evidence of viable tumor on histology. The remaining five were followed by imaging studies for 2.2-9.1 years (mean 6.1 years); none relapsed. Conclusion: Residual mass is not uncommon in children with abdominal Burkitt's lymphoma. The presence of residual mass in a child with complete clinical remission does not alter the long-term prognosis. Therefore, in children with Burkitt's lymphoma and residual mass with no other signs of disease activity, expectant watching may be appropriate. (orig.)
Entrevistas preliminares em psicoterapia de família: construção da demanda compartilhada
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Rebeca Nonato Machado
Full Text Available El presente trabajo es el producto de una investigación que tuvo como objetivo investigar el período de entrevistas preliminares con familias, enfocando la especificidad de la evaluación diagnóstica familiar y las implicaciones de la construcción de la demanda compartida para la adhesión de la familia a la psicoterapia. La demanda familiar compartida fue un concepto desarollado en este estudio, que significa la motivación latente que llevó el grupo a la psicoterapia. Es decir, corresponde a los contenidos interpsíquicos que todavía son incomprensibles para la familia, que no concibe el sufrimiento como algo compartido. Se postula que, en el período de entrevistas, es importante problematizar la queja inicial a veces centrada en los conflictos del sujeto-síntoma. Las intervenciones iniciales tienen como objetivo la realización de la transformación del discurso de la victimización de los familiares, llevando a un posicionamiento conjunto responsable por el sufrimiento psíquico. En la revisión de la literatura, fueron privilegiadas contribuiciones tanto del enfoque psicanalítico como algunas nociones del enfoque sistémico. Para alcanzar los objetivos propuestos, la investigación adoptó una metodología de estudios de casos clínicos. Se analizaron tres casos de psicoterapia familiar, con diferentes quejas y problemáticas. El estudio de los casos cuenta con el respaldo del analisis clínico de contenidos de las entrevistas preliminares y el analisis del material proyectivo de la aplicación del Arte Diagnóstico Familiar- ADF, instrumento de evaluación familiar. La descripción de los tres casos clínicos ilustra el período de entrevistas preliminares y el trabajo de construcción de la demanda compartida.
Association between meal intake behaviour and abdominal obesity in Spanish adults.
Keller, Kristin; Rodríguez López, Santiago; Carmenate Moreno, Margarita M
The study aims to evaluate the association between abdominal obesity with meal intake behaviour such as having a forenoon meal, having an afternoon meal and snacking. This cross-sectional study includes n = 1314 participants aged 20-79 who were interviewed during the Cardiac health "Semanas del Corazon" events in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Waist circumference, weight and height were assessed to determine abdominal obesity (waist circumference: ≥88 cm in women and ≥102 cm in men) and BMI, respectively. The intake of forenoon and afternoon meal and snacking between the participants' regular meals were assessed with a questionnaire that also included individual risk factors. The information obtained about diet was required to calculate an Unhealthy Habit Score and a score reflecting the Achievement of Dietary Guidelines. Adjusted logistic regressions were used to examine the association between abdominal obesity and the mentioned meal intake behaviour controlling for sex, age, individual risk factors, BMI and diet. Having an afternoon meal (OR 0.60; 95% CI (0.41-0.88)) was negatively associated with abdominal obesity after adjusting for all confounders, whereas the positive association of snacking (OR 1.39; 95% CI (1.05-1.85)) was not independent of BMI (OR 1.25; 95% CI (0.84-1.87)). Taking a forenoon meal did not show any associations (OR 0.92; 95% CI (0.63-1.34)) with abdominal obesity. The results obtained could be helpful in the promotion of healthy habits in nutritional education programmes and also in health programmes preventing abdominal obesity.
Mini-abdominoplasty combined with mesh used for abdominal wall endometriosis
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ZHAO Ru; WANG Xiao-jun; SONG Ke-xin; ZHU Lan; LI Bin
Background Wide excision is considered the treatment of endometriosis.It is difficult to surgeon for reconstruction of a large full-thickness defect through the abdominal-wall.We introduce a method of mini-abdominoplasty combined with mesh that can be used for reconstruction of a large full-thickness defect through the abdominal-wall after wide excision of abdominal wall endometriosis.Methods This retrospective study includes a series of patients who underwent wide excision of abdominal wall endometriosis and reconstruction of a large full-thickness defect through the abdominal-wall over a 5-year period.Information obtained from chart reviews includes age,size of lesion and defect,complications and revisions.Results The method was used for 8 patients including 2 patients with recurrence.The mean size of the masses was (3.5±2.0) cm.The mean size of the fascia defects was 7.1 cm x 8.6 cm.The mean length of follow-up was (24±12)months.There was no recurrence,no hernia,and no other complications.The technique generated only a horizontal scar.The scar and contour of the lower abdomen provided a more pleasant appearance than the traditional procedure.Conclusions Mini-abdominoplasty combined with mesh is a useful and acceptable reconstruction method for large full-thickness defects through the abdominal wall after endometriosis resection.It is feasible for wide excision with 1 cm normal tissues around the margin.It provides an aesthetically pleasing result.
Histerectomía Abdominal: Vivencias de 20 Mujeres Abdominal Hysterectomy: the life experience of twenty women
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Araceli Hernández Quintana
Full Text Available La histerectomía abdominal constituye una intervención que se realiza frecuentemente y para la cual no siempre se implementa una educación preoperatoria, teniendo en cuenta los significados que para la mujer tiene el útero. Objetivos: Identificar las actitudes, conocimientos y necesidades de la mujer. Proporcionar la información individualizada requerida y posteriormente evaluar los resultados de la intervención en el posoperatorio. Metodología: Se realizó entrevista profunda a 20 pacientes de dos instituciones de salud, una de seguridad social y otra de asistencia social, programadas para histerectomía abdominal previa autorización de las pacientes. Se recolectó la información manualmente. Se analizó bajo la teoría fundamentada. Resultados: Las categor��as más importantes previas a la intervención fueron género y falta de información, lo que influye en la visión de la cirugía y en la actitud de la paciente. En la intervención se aclararon dudas, mitos, se detectaron miedos, explicándose la actitud de las informantes y de las investigadoras. El resultado mostró cambio en la actitud y la percepción sobre la atención recibida. Conclusiones: Se concluye que entre más se conoce el proceso, la paciente se empodera y participa más, disminuye la ansiedad y presenta mejoría.The abdominal hysterectomy constitutes a frequently performed surgery, and for which there's no pre-surgery education for the patient, considering the significance that the uterus has to women. Objectives: Identify the attitudes, knowledge and needs of women. To give the required individualized information and, later, to evaluate the results educative intervention post-surgery. Methods: With previous authorization from the patients, a profound interview was applied to 20 of them, of 2 health institutions, one of social security, the other of social assistance, they were programmed for the abdominal hysterectomy. The information was collected manually
[Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].
Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila
Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.
Diagnostic accuracy of Focused Abdominal Sonography
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Cheung Kent Shek
Full Text Available 【Abstract】Objective: Focused Abdominal Sono-graphy for Trauma (FAST is widely used for the detection of intraperitoneal free fluids in patients suffering from blunt abdominal trauma (BAT. This study aimed at assessing the diagnostic accuracy of this investigation in a designated trauma centre. Methods: This was a retrospective study of BAT pa-tients over a 6 year period seen in a trauma centre in Hong Kong. FAST findings were compared with laparotomy, ab-dominal computed tomography or autopsy findings, which served as the gold standard for presence of intraperi-toneal free fluids. The patients who did not have FAST or gold standard confirmatory test performed, had preexisting peritoneal fluid, died at resuscitation or had imcomplete docu-mentation of FAST findings were excluded. The performance of FAST was expressed as sensitivity, specificity, predic-tive values (PV, likelihood ratios (LR and accuracy. Results: FAST was performed in 302 patients and 153 of them were included in this analysis. The sensitivity, specificity, positive PV, negative PV, positive LR, negative LR and accuracy for FAST were respectively 50.0%, 97.3%, 87.0%, 84.6%, 18.8, 0.5 and 85.0%. FAST was found to be more sensitive in less severely injured patients and more specific in more severely injured patients. Conclusion: FAST is a reliable investigation in the initial assessment of BAT patients. The diagnostic values of FAST could be affected by the severity of injury and staff training is needed to further enhance its effective use. Key words: Laparotomy; Autopsy; Tomography, X-ray computed; Tomography, spiral computed; Ultra-sonography
Diagnostic value of ultrasound in children with recurrent abdominal pain.
van der Meer, S B; Forget, P P; Arends, J W; Kuijten, R H; van Engelshoven, J M
In order to investigate the diagnostic value of ultrasound in children with recurrent abdominal pain and to estimate the clinical relevance of rare organic causes of abdominal pain in these patients, we prospectively examined 93 children aged between 5.5 and 12 years by means of abdominal ultrasound. In 3 patients (3.2%) an anatomic abnormality was detected, which could not account for the abdominal pain. We conclude that many organic abnormalities, that could be diagnosed by ultrasound, are clinically irrelevant as a cause of recurrent abdominal pain in children and therefore ultrasound does not significantly contribute to the diagnosis. However, ultrasound can still play a role in the work-up of children with recurrent abdominal pain in avoiding unnecessary radiologic X-ray procedures.
Recurrent abdominal pain: when an epileptic seizure should be suspected?
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Franzon Renata C.
Full Text Available Recurrent episodes of abdominal pain are common in childhood. Among the diagnostic possibilities are migraine and abdominal epilepsy (AE. AE is an infrequent syndrome with paroxystic episodes of abdominal pain, awareness disturbance, EEG abnormalities and positive results with the introduction of antiepileptic drugs. We present one 6 year-old girl who had short episodes of abdominal pain since the age of 4. The pain was followed by cry, fear and occasionally secondary generalization. MRI showed tumor in the left temporal region. As a differential diagnosis, we report a 10 year-old boy who had long episodes of abdominal pain accompanied by blurring of vision, vertigo, gait ataxia, dysarthria, acroparesthesias and vomiting. He received the diagnosis of basilar migraine. In our opinion, AE is part of a large group (partial epilepsies and does not require a special classification. Pediatric neurologists must be aware of these two entities that may cause abdominal pain.
Duodenal perforation as result of blunt abdominal trauma in childhood.
Hartholt, Klaas Albert; Dekker, Jan Willem T
Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.
A Rare Cause of Abdominal Pain; Celiac Truncus Aneurysm
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Zulfu Birkan
In this case we presented a patient who were admitted to surgery department with complaints of abdominal pain and nausea. There were no pathological findings on physical examination, direct abdominal x-ray, chest radiograph and biochemical parameters. At proximal of the celiac trunk, it was shown approximately 3x2 cm in size fusiform aneurysmal dilatation on the patient%u2019s abdominal ultrasonography and turbulence, arterial flow on the patient%u2019s abdominal doppler ultrasonography subsequently. In abdominal computed tomography we detected dense calcifications, dilatation and hypodensities that may belong to a thrombus in the lumen superior mesenteric vein (SMV. At the same time, approximately 3.5 cm segment of trunk celiak we observed aneurysm dilatation which reaching 2 cm at the widest point. Celiac trunk aneurysm is a rare cause of abdominal pain and often noticed after the complicated, thus it must always be kept in mind in the differential diagnosis.
Abdominal vascular syndromes: characteristic imaging findings
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Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D' Ippolito, Giuseppe, E-mail: email@example.com [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Mediciana. Departmento de Diagnostico por Imagem
Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital - including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome) - compressive - including 'nutcracker' syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. (author)
Retroperitoneal abscess: an extra-abdominal manifestation
Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias
Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur ...
Mycobacterium fortuitum abdominal wall abscesses following liposuction
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Al Soub Hussam
Full Text Available We describe here a case of abdominal abscesses due to Mycobacterium fortuitum following liposuction. The abscesses developed three months after the procedure and diagnosis was delayed for five months. The clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. This condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. Combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.
Should intensivist do routine abdominal ultrasound?
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Sukhen Samanta
Full Text Available Roundworm infestation is common in tropical climate population with a low socioeconomic status. We describe a case of a young male with polytrauma accident who presented with small bowel dysfunction with a high gastric residual volume during enteral feeding. While searching the etiology, the intensivist performed bedside abdominal ultrasound (USG as a part of whole body USG screening along with clinical examination using different frequency probes to examine bowel movement and ultimately found ascariasis to be the cause. This case report will boost up the wide use of bedside USG by critical care physicians in their patient workup.
Exercise-related transient abdominal pain (ETAP).
Morton, Darren; Callister, Robin
Exercise-related transient abdominal pain (ETAP), commonly referred to as 'stitch', is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours
Simulation-Based Abdominal Ultrasound Training
DEFF Research Database (Denmark)
Østergaard, Mikkel; Ewertsen, C; Konge, L;
PURPOSE: The aim is to provide a complete overview of the different simulation-based training options for abdominal ultrasound and to explore the evidence of their effect. MATERIALS AND METHODS: This systematic review was performed according to the PRISMA guidelines and Medline, Embase, Web...... of Science, and the Cochrane Library was searched. Articles were divided into three categories based on study design (randomized controlled trials, before-and-after studies and descriptive studies) and assessed for level of evidence using the Oxford Centre for Evidence Based Medicine (OCEBM) system...
Primary abdominal pregnancy following intra-uterine insemination
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Sujata Kar
Full Text Available Primary abdominal pregnancy is an extremely rare type of extrauterine pregnancy. It has been reported from many unusual intra-abdominal sites. We report a case of primary abdominal pregnancy following intra-uterine insemination (not reported earlier to our knowledge. Implanted on the anterior surface of the uterus possibly related to an endometriotic foci. Early diagnosis enabled laparoscopic management of this case.
Is fasting a necessary preparation for abdominal ultrasound?
Leven Hans; Sinan Tariq; Sheikh Mehraj
Abstract Objective To study the effect of fasting on the technical success of abdominal ultrasound examination. Methods In a randomized, prospective study, 150 patients for abdominal ultrasound were divided into two groups of 75 patients each with instructions to fast for six hours or have normal breakfast respectively. Result The technical success of the abdominal ultrasound performed by radiologists blinded to the instruction did not differ significantly between the groups. Conclusion It ap...
Endovascular Exclusion of an Abdominal Aortic Aneurysm in Patients with Concomitant Abdominal Malignancy: Early Experience
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Choi, You Ri; Chang, Nam Kyu [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Shin, Hyo Hyun; Oh, Hyun Jun; Kim, Jae Kyu; Choi, Soo Jin Na; Chung, Sang Young [Chonnam National University Hospital, Gwangju (Korea, Republic of); Yim, Nam Yeol [Armed Forces Yangju Hospital, Yangju (Korea, Republic of)
To assess the outcomes of endovascular aortic aneurysm repair (EVAR) for the treatment of an abdominal aortic aneurysm in patients undergoing curative surgical treatment for concomitant abdominal malignancy. The study included 12 patients with abdominal neoplasia and an abdominal aortic aneurysm (AAA), which was treated by surgery and stent EVAR. The neoplasm consisted of the gastric, colorectal, pancreas, prostate, and gall bladder. The follow up period was 3-21 months (mean 11.8 months). All medical records and imaging analyses were reviewed by CTA and/or color Doppler US, retrospectively. Successful endoluminal repair was accomplished in all twelve patients. The mean interval time between EVAR and surgery was 58.6 days. Small amounts of type 2 endoleaks were detected in two patients (17%). One patient developed adult respiratory distress syndrome after Whipple's operation 20 days after surgery, which led to hopeless discharge. No procedure-related mortality, morbidity, or graft-related infection was noted. Exclusion of AAA in patients with accompanying malignancy show with a relatively low procedure morbidity and mortality. Hence, endoluminal AAA repair in patients with synchronous neoplasia may allow greater flexibility in the management of an offending malignancy
Wireless system for monitoring Intra-abdominal pressure in patient with severe abdominal pathology
Sokolovskiy, S. S.; Shtotskiy, Y. V.; Leljanov, A. D.
The paper discusses an experimental design of the wireless system for monitoring intra-abdominal pressure (IAP) using Bluetooth Low Energy technology. The possibility of measuring IAP via the bladder using a wireless pressure sensor with a hydrophobic bacteria filter between the liquid transmitting medium and the sensor element is grounded.
[Abdominal artery aneurysm and associated surgical abdominal diseases: towards optimal timing].
Stilo, Francesco; Mirenda, Francesco; Mandolfino, Tommaso; La Spada, Michele; D'Alfonso, Mario; Carmignani, Amedeo; De Caridi, Giovanni; Benedetto, Filippo; Spinelli, Francesco
The purpose of this study was to assess which modalities offered the best timing in the treatment of abdominal aortic aneurysms associated with other abdominal surgical diseases. From January 1984 to December 2002, 372 patients underwent surgery for abdominal aortic aneurysms, 350 men (94%) and 22 women (6%), mean age 72 years. Of these 10% were operated on urgently. The traditional open technique was used in 307 patients, and the endovascular method in the remaining 65 cases. In 40 patients (11%) we observed other associated abdominal diseases which were treated during the same operation in 34 cases (85%). We had three deaths in the 34 cases treated in the same operation (9%). In the remaining cases no perioperative mortality was registered. There were no cases of prosthesis infection. The mean hospital stay was 9 days. Simultaneous treatment appears, on the one hand, to carry an increased operative risk and increased mortality and, on the other, to present the advantage of having to perform only one surgical procedure. The advent of the endovascular method allows us to postpone the treatment of the associated disease without increasing the technical difficulty of the second operation.
Estudio preliminar de la fauna Amphibia del valle de Sibundoy, Alto Putumayo, Colombia
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Mueses-Cisneros Jonh Jairo
Full Text Available Se realiza el estudio preliminar de la fauna Amphibia del Valle de Sibundoy, Alto Putumayo, Colombia; mediante la construcción del inventario de la fauna Amphibia, el mejoramiento en el conocimiento
de la distribución en los Andes norecuatorianos y surcolombianos de las especies involucradas y la relación en cuanto a la composición de esta fauna con la de los estudios realizados en el transecto Napo en Ecuador y transecto Montañita-Alto Gabinete en Caquetá. El estudio se basó en: 1 tres salidas de campo al Valle de Sibundoy (localizado al suroccidente de Colombia, entre 1º 05' y 1º 12' N y 76º 53' y 77º 00' O entre 2.000-2.750 msnm, realizadas en diciembre 2000-enero 2001, julio 2002 y diciembre 2003-febrero 2004, con un esfuerzo de muestreo de 198 horas/hombre; 2 revisión bibliográfica; 3 revisión de especímenes depositados en la colección de anfibios del Instituto de Ciencias Naturales de la Universidad Nacional de Colombia, Sede Bogotá (ICN y en la revisión de la base de datos de la colección de Herpetología del Instituto de Investigaciones Alexander von Humboldt (IAvH de los anfibios colectados en los departamentos de Caquetá, Nariño, Putumayo y en Ecuador. La fauna consta de 32 especies (313 especímenes agrupadas en dos órdenes, cinco familias y siete géneros; para cada especie se presenta información
sobre su historial taxonómico, reconocimiento, distribución geográfica (mapas de distribución y rangos altitudinales, coloración en vivo y en preservativo, abundancia y algunos aspectos relacionados con su historia natural; se realiza un análisis regional de esta fauna a nivel general
(Valle de Sibundoy y por localidades muestreadas, se hace una comparación con las faunas realizadas en el transecto Napo en Ecuador y en el transecto Montañita-Alto Gabinete en Caquetá y se presenta una clave taxonómica y una serie de fotografías para facilitar su reconocimiento. El estudio adem
Is fasting a necessary preparation for abdominal ultrasound?
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Leven Hans
Full Text Available Abstract Objective To study the effect of fasting on the technical success of abdominal ultrasound examination. Methods In a randomized, prospective study, 150 patients for abdominal ultrasound were divided into two groups of 75 patients each with instructions to fast for six hours or have normal breakfast respectively. Result The technical success of the abdominal ultrasound performed by radiologists blinded to the instruction did not differ significantly between the groups. Conclusion It appears that routine fasting before abdominal ultrasound is not necessary.
Why Do Abdominal Muscles Sometimes Separate during Pregnancy?
... birth weight Have repeated pregnancies During pregnancy, aggressive abdominal exercises after the first trimester also might contribute to the development of diastasis recti. If you think you have ...
Treatment of infrarenal abdominal aortic dissection concomitant with an aneurysm
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WANG Li-xin; ZHU Ting; FU Wei-guo; WANG Yu-qi; XI Xun; GUO Da-qiao; CHEN Bin; JIANG Jun-hao; YANG Ju; SHI Zhen-yu
@@ Aortic dissection occurs when layers of the aortic walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta (70%), followed by the descending aorta (22%), the aortic arch (7%) and the abdominal aorta (1/%).1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection (IAAD) concomitant with an abdominal aortic aneurysm (AAA) is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.
Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings
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Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tania Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanes, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mario Flores, E-mail: firstname.lastname@example.com [Instituto de Infectologia Emilio Ribas (IIER), Sao Paulo, SP (Brazil)
Objective: to evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and methods: retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results: abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion: computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. (author)
Evaluating clinical abdominal scoring system in predicting the necessity of laparotomy in blunt abdominal trauma
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Peyman Erfantalab-Avini; Nima Hafezi-Nejad; Mojtaba Chardoli; Vafa Rahimi-Movaghar
Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients' signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS), a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not.Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex,type of trauma, systolic blood pressure, Glasgow coma scale (GCS), pulse rate, time of presentation after trauma, abdominal clinical findings, respiratory rate, temperature, hemoglobin (Hb) concentration, focused abdominal sonography in trauma (FAST) and CASS.Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%,positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P<0.05).Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.
Abdominal obesity, cardiometabolic risk and endocannabinoid system
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G. Bittolo Bon
Full Text Available Abdominal obesity is the most prevalent manifestation of metabolic syndrome and is of central importance in the definition of global cardiometabolic risk. Visceral adipose tissue releases a large number of bioactive mediators, which influence body weight homeostasis, insulin resistance, alterations in lipids, blood pressure, coagulation, fibrinolysis and inflammation, leading to increased risk of cardiovascular events and of type 2 diabetes. Lifestyle modification is the first-line approach to the management of abdominal obesity and metabolic syndrome. However for patients at higher risk, who cannot achieve an appreciable reduction in weight and in global cardiometabolic risk with lifestyle modification alone, an adjunctive long term pharmacotherapy should be considered. The endocannabinoid system activity regulates food intake and metabolic factors through cannabinoid-1 (CB1 receptor located in multiple sites, including hypothalamus and limbic forebrain, adipose tissue, skeletal muscle, liver and the gastrointestinal tract. Evidence suggests that CB1 receptor blockade offers a novel therapeutic strategy. Data from four phase III trials suggest that rimonabant, the first cannabinoid receptor inhibitor, modulates cardiometabolic risk factors, both through its impact on body weight and metabolic parameters such as HDL-cholesterol, tryglicerides, Hb1Ac, through direct pathways that are not related to weight loss.
Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon
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Legakis Nikolaos
Full Text Available Abstract Background Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. We discuss one such rare case, outlining the fact that an intra-operative surprise diagnosis could have been facilitated by previous investigations. Case presentation A 56 year-old man presented in A&E department with small bowel ileus. He had a history of 6 similar episodes of small bowel obstruction in the past 4 years, which resolved with conservative treatment. Pre-operative work-up did not reveal any specific etiology. At laparotomy, a fibrous capsule was revealed, in which small bowel loops were encased, with the presence of interloop adhesions. A diagnosis of abdominal cocoon was established and extensive adhesiolysis was performed. The patient had an uneventful recovery and follow-up. Conclusion Idiopathic sclerosing encapsulating peritonitis, although rare, may be the cause of a common surgical emergency such as small bowel ileus, especially in cases with attacks of non-strangulating obstruction in the same individual. A high index of clinical suspicion may be generated by the recurrent character of small bowel ileus combined with relevant imaging findings and lack of other plausible etiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a "surprise" upon laparotomy and result in proper management.
Methods for abdominal respiratory motion tracking.
Spinczyk, Dominik; Karwan, Adam; Copik, Marcin
Non-invasive surface registration methods have been developed to register and track breathing motions in a patient's abdomen and thorax. We evaluated several different registration methods, including marker tracking using a stereo camera, chessboard image projection, and abdominal point clouds. Our point cloud approach was based on a time-of-flight (ToF) sensor that tracked the abdominal surface. We tested different respiratory phases using additional markers as landmarks for the extension of the non-rigid Iterative Closest Point (ICP) algorithm to improve the matching of irregular meshes. Four variants for retrieving the correspondence data were implemented and compared. Our evaluation involved 9 healthy individuals (3 females and 6 males) with point clouds captured in opposite breathing phases (i.e., inhalation and exhalation). We measured three factors: surface distance, correspondence distance, and marker error. To evaluate different methods for computing the correspondence measurements, we defined the number of correspondences for every target point and the average correspondence assignment error of the points nearest the markers.
Abdominal manifestations of cystic fibrosis in children
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Chaudry, Gulraiz; Navarro, Oscar M.; Levine, Daniel S.; Oudjhane, Kamaldine [University of Toronto, Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)
Pulmonary complications remain the main cause of mortality in cystic fibrosis, but the presenting symptoms in children are often related to gastrointestinal or pancreaticobiliary disease. Furthermore, abdominal manifestations are now seen throughout childhood, from infancy to adolescence. The child might present in the neonatal period with meconium ileus or its attendant complications. The older child might present with distal intestinal obstruction syndrome or colonic stricture secondary to high doses of pancreatic enzyme replacement. Less-common gastrointestinal manifestations include intussusception, duodenitis and fecal impaction of the appendix. Most children also show evidence of exocrine pancreatic deficiency. Radiologically, the combination of fat deposition and pancreatic fibrosis leads to varying CT and MR appearances. A higher than normal incidence of pancreatic cysts and calcification is also seen. Decreased transport of water and chloride also increases the viscosity of bile, with subsequent obstruction of the biliary ductules. If extensive, this can progress to obstructive cirrhosis, portal hypertension and esophageal varices. Diffuse fatty infiltration, hypersplenism and gallstones are also commonly seen in these patients. We present a pictorial review of the radiological appearance of these abdominal manifestations. The conditions are dealt with individually, together with typical appearances in various imaging modalities. (orig.)
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Zahir Hussain
Full Text Available BACKGROUND Abdominal wound dehiscence is a preventable complication, but is still seen. When present, it poses problem in the management of the case, increases the morbidity and mortality of the patient. The present study is a prospective study done from January 2010-May 2016 with an objective to find out the incidence of wound dehiscence, the most common pathologies associated with dehiscence and to find out the statistical significance of the difference risk factors causing wound dehiscence and to evaluate the role of tension sutures in prevention of wound dehiscence. MATERIALS AND METHODS 291 major laparotomies were followed from January 2010-September 2016. There were 21 cases of dehiscence and from the remaining 270 cases, 58 patients were chosen as controls who underwent the same procedure, but without dehiscence. 15 factors were analysed and compared between the dehiscence and control groups. RESULTS The incidence was found to be 7.2%. Peritonitis was the most common pathology. The significant factors were age more than 50, wound infection. Tension suture application has shown to reduce the incidence of wound dehiscence. CONCLUSIONS Intra-abdominal sepsis (peritonitis increases the incidence of wound dehiscence. Age >50, Uraemic, Jaundiced, Obesity, Malnutrition increases the incidence of wound dehiscence. Wound infection was a highly significant factor having 8 times more risk of dehiscence.
Spontaneous abdominal wall endometriosis: a case report.
Papavramidis, Th S; Sapalidis, K; Michalopoulos, N; Karayanopoulou, G; Raptou, G; Tzioufa, V; Kesisoglou, I; Papavramidis, S T
Endometriosis is the presence of endometrial glands and stroma outside the uterus. Spontaneous abdominal wall endometriosis (AWE) is any ectopic endometrium found superficial to the peritoneum without the presence of any previous scar. Rarely, endometriosis represents a disease of specific interest to the general surgeon, on account of its extrapelvic localisations. We describe a case with spontaneous AWE presenting as a painful mass with cyclic symptoms. A 28-year-old woman presented to the day-surgery division of our department, suffering from a painful mass in the left lower abdominal quadrant. A mobile mass of 5 x 4 cm was identified. The initial diagnosis was lipoma and excision was planned. During the operation two masses were spotted, very close to one another, and were excised within healthy limits. Pathology revealed endometrial glands surrounded by a disintegrating mantle of endometrial stroma and fibrous scar tissue in which there was a scattering of leucocytes. The woman had no scars. She was discharged from hospital after 2 hours. Two years after the excision she is free of disease and no recurrence has been observed. Spontaneous AWE is rare, accounting for 20% of all AWEs. The triad ; mass, pain and cyclic symptomatology helps in the diagnosis, but unfortunately it is not present in all cases. Spontaneous endometriomas are usually diagnosed by pathology and the treatment of choice is surgical excision.
Hepatic infarction following abdominal interventional procedures.
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Fujiwara H
Full Text Available To clarify the incidence, background, and progress of hepatic infarction following interventional procedures, cases of hepatic infarction following interventional procedures at our department during the last decade were identified by reviewing the clinical records of 1982 abdominal angiography and interventional procedures and records of abdominal CT. Nine episodes (0.5% in 8 patients were identified as hepatic infarction following an interventional procedure. Five episodes were preceded by embolization of the hepatic or celiac artery at emergency angiography for postoperative bleeding with hemorrhagic shock. Three episodes followed the elected interventional procedure for hepatocellular carcinoma, and the remaining episode occurred after 12 months of chemoinfusion through an indwelling catheter in the hepatic artery and portal vein. Hepatic arterial occlusion in all episodes and portal venous flow abnormality in 5 episodes were observed on angiography. Four patients whose liver function was initially impaired died of hepatic infarction, although the extent of the disease on CT did not appear to be related to the mortality. Multiple risk factors, including arterial insufficiency, were observed in each patient. The incidence of hepatic infarction following interventional procedures in this series was low but sometimes fatal, and occurred most frequently in emergency embolization in hemorrhagic shock.
Abdominal-Pelvic Actinomycosis Mimicking Malignant Neoplasm
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Teresa Pusiol
Full Text Available Abdominal-pelvic actinomycosis is often mistaken for other conditions, presenting a preoperative diagnostic challenge. In a 46-year-old female, computed tomography showed an abdominal-pelvic retroperitoneal mass extending from the lower pole of the right kidney to the lower pelvis. The patient had a 3-year history of intrauterine device. The mass appeared to involve the ascending colon, cecum, distal ileum, right Fallopian tube and ovary, and ureter anteriorly and the psoas muscle posteriorly. The resection of retroperitoneal mass, distal ileum appendicectomy, right hemicolectomy, and right salpingo-oophorectomy was performed. The postoperative period was uneventful. Penicillin therapy was given for six months without any complication. The retroperitoneal mass measured 4.5 × 3.5 × 3 cm, surrounded adjacent organs and histologically showed inflammatory granulomatous tissue, agglomeration of filaments, and sulfur granules of Actinomyces, with positive reaction with periodic acid Schiff. Right tubo-ovarian abscess was present. Abdominalpelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intrauterine device.
Fatigue and cardiorespiratory function following abdominal surgery.
Christensen, T; Bendix, T; Kehlet, H
Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P less than 0.01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (RS = 0.53, P less than 0.001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P less than 0.01) at all three postoperative bicycle tests. It is concluded that even electric uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.
Laparoscopy and Intra-Abdominal Sepsis
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Full Text Available Context Intra-abdominal sepsis has significant morbidity and mortality. In the developed world, there are many common causes originating from the lower gastrointestinal tract including diverticular disease, appendicitis, perforated cancers, and inflammatory bowel disease. It has a high cost and is associated with high levels of significant morbidity and mortality. Management options include radiologic drainage and surgical options include resection for more widespread sepsis. Laparoscopic surgery has increased and has been useful in elective setting. Its use in the emergency setting is less evaluated. Evidence Acquisition Evidence was acquired by searching online medical databases including Pubmed, Medline and Embase. Results Laparoscopic surgery has been shown to have a role in the acute setting. Studies show it has become the gold standard in the appendicitis. High quality Randomized controlled trials are in short supply but observational and cohort studies have shown equivalence and with increasing experience complication rates are reduced. Evidence is also increasing in the management of diverticular disease, crohn's and ulcerative colitis as well as post-operative complication management and acute presentations of colorectal cancer. Conclusions Laparoscopic surgery is feasible in the management of intra-abdominal sepsis. It has become the new accepted standard in the management of appendicitis, and is safe, feasible and increasing in the management of complex diverticular disease, acute IBD and colorectal cancer in the emergency and post-operative setting.
Enseñanza de la matemática en la secundaria. Un análisis preliminar de las percepciones de ingresantes a la PUCP
Uldarico Malaspina; Jorge Luis Bazán
En el presente artículo se muestran los resultados de un estudio preliminar sobre algunas percepciones de los ingresantes a la Pontificia Universidad Católica del Perú, acerca de la enseñanza y aprendizaje de las matemáticas en la secundaria, el uso de materiales en sus colegios y las actitudes hacia la matemática queestudian.
Rejuvenecimiento mini-invasivo subgaleal del tercio superior facial: informe preliminar The minimally invasive subgaleal upper facelift: preliminary report
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W.E. Bukret
Full Text Available El propósito del presente trabajo es presentar nuestro método para rejuvenecimiento del tercio facial superior y comunicar nuestra experiencia inicial. Describimos el abordaje subgaleal a través de mínimas incisiones y el método de fijación. En el período comprendido entre febrero del 2008 y abril del 2010 fueron intervenidos un total de 21 pacientes, 17 mujeres y 4 varones de entre 39 y 62 años de edad. Llevamos a cabo la técnica conjuntamente con cirugía de rejuvenecimiento del tercio medio facial a través de las mismas incisiones temporales en 17 casos, con blefaroplastia superior en 15 casos, con rinoplastia en 6 casos, con liposucción de cuello en 1 caso y con ritidectomía completa de cara y cuello en 9 casos. La técnica de rejuvenecimiento facial incluyó 4 ó 5 incisiones mínimas en el cuero cabelludo, despegamiento subgaleal amplio, miotomías selectivas de los músculos depresores, anclaje del músculo frontal con suturas percutáneas a una malla de polipropileno cubierta con periostio frontal y sutura de la fascia temporal superficial a la fascia temporal profunda. La media de seguimiento de los pacientes fue de 14 meses (intervalo de 3 a 26 meses. Los signos de envejecimiento se redujeron significativamente y los pacientes expresaron un alto grado de satisfacción en la mayoría de los casos. Las complicaciones fueron menores y transitorias. En conclusión, el abordaje subgaleal mini-invasivo del tercio superior facial es un procedimiento de rejuvenecimiento que da excelentes resultados, con complicaciones menores y transitorias. Creemos necesarios más estudios para determinar su eficacia a largo plazo.The aims of this article are to describe our method for rejuvenation of the upper third of the face, and communicate our initial experience; we describe the subgaleal approach through minimal incisions and our fixation method. A total of 21 patients, 17 women and 4 men between 39 and 62 years old, underwent surgery between February 2008 and April 2010. The minimally invasive subgaleal upper face lift was performed in conjunction with a middle face lift through the same temporal incisions in 17 cases, with blepharoplasty in 15 cases, rhinoplasty in 6 cases, neck liposuction 1 case, and with a full face and neck lift in 9 cases. The lifting technique included 4 or 5 small incisions in the scalp, wide subgaleal elevation, selective myotomies of the depressor muscles, anchoring of the frontalis muscle with percutaneous sutures to a polypropylene mesh covered by frontal periosteum, and suturing of the superficial temporal fascia to the deep temporal fascia. The mean follow-up was 14 months (range from 3 to 26 months. The signs of aging were significantly reduced, and most of the patients expressed a high degree of satisfaction. Complications were minor and transitory. In conclusion, the minimally invasive subgaleal approach of the upper third of the face is a rejuvenation procedure that gives excellent results, with minimal and transitory complications. More studies are necessary to determine long term efficacy.
Pseudomonas aeruginosa en agua y leche cruda: informe preliminar Pseudomonas aeruginosa in water and raw milk: preliminary report
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M. S Iramain
Full Text Available El objetivo del trabajo fue determinar la presencia de Pseudomonas aeruginosa en el agua utilizada en las tareas relacionadas al ordeño y en leche de tanque, para establecer una posible vinculación entre la contaminación del agua y de la leche cruda con esta bacteria, en tambos de la provincia de Buenos Aires. Se muestrearon y analizaron 122 tambos, obteniéndose muestras de 111 perforaciones, 92 tanques de almacenamiento de agua y 122 de leche de tanque según normas de referencia. En todos los casos se determinó la presencia de P. aeruginosa, hallándose en el 27% de las muestras de perforaciones y en el 34% de los tanques de almacenamiento. Solamente 4 establecimientos presentaron P.aeruginosa en leche de tanque, pudiéndose constatar que en tres de ellos se realizaban prácticas operativas que ponían en contacto la leche con el agua contaminada. Una vez eliminadas éstas prácticas no fue posible hallar P. aeruginosa en la leche de los tanques.The aim of this study was to determine the presence of Pseudomonas aeruginosa in the water used in milking practices and in bulk tank milk, to establish a possible relationship between water and raw bulk tank milk contamination with this bacteria, in dairy farms of Buenos Aires province. Samples from 122 dairy farms were analyzed for P. aeruginosa according to reference methods, getting 111 underground water samples and 92 water storage tank samples and 122 bulk tank milk samples. Twenty seven per cent of underground water samples were positive for P. aeruginosa as well as 34 % of storage tank samples. The bacteria was present in only 4 dairy farms bulk tanks. It was determined that in 3 of them milking management practices allowed the milk to get in contact with contaminated water. Once these practices were eliminated, no P. aeruginosa was found in bulk tank milk samples
Validation of Candidate Causal Genes for Abdominal Obesity Which Affect Shared Metabolic Pathways and Networks
Yang, Xia; Deignan, Joshua L; Qi, Hongxiu; Zhu, Jun; Qian, Su; Zhong, Judy; Torosyan, Gevork; Majid, Sana; Falkard, Brie; Kleinhanz, Robert R; Karlsson, Jenny; Castellani, Lawrence W.; Mumick, Sheena; Wang, Kai; Xie, Tao
A major task in dissecting the genetics of complex traits is to identify causal genes for disease phenotypes. We previously developed a method to infer causal relationships among genes through the integration of DNA variation, gene transcription, and phenotypic information. Here we validated our method through the characterization of transgenic and knockout mouse models of candidate genes that were predicted to be causal for abdominal obesity. Perturbation of eight out of the nine genes, with...
Management of multiple type Ⅱ endoleaks detected by duplex ultrasound after endovascular abdominal aneurysm repair
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GUO Da-qiao; LI Wei-miao; JIANG Jun-hao; SHI Zhen-yu; WANG Yu-qi; FU Wei-guo
We reported a case of multiple type Ⅱ endoleaks detected by duplex ultrasound after endovascular abdominal aneurysm repair.The patient was undergoing warfarin therapy.Duplex ultrasound was applied as the sole surveillance method during follow-up and provided the concerned information for reintervention.The endoleaks were successfully repaired by coil embolization of the collaterals from the internal iliac artery feeding the fourth lumbar artery.
Screening for abdominal aortic aneurysms Rastreamento de aneurismas da aorta abdominal
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Telmo Pedro Bonamigo
Full Text Available OBJECTIVE AND METHODS: Screening for abdominal aortic aneurysms may be useful to decrease mortality related to rupture. We conducted a study to assess the prevalence of abdominal aortic aneurysms in southern Brazil and to define risk factors associated with high prevalence of this disorder. The screening was conducted using abdominal ultrasound. Three groups were studied: Group 1 - cardiology clinic patients; Group 2 - individuals with severe ischemic disease and previous coronary surgery, or important lesions on cardiac catheterism; Group 3 - individuals without cardiac disease selected from the general population. All individuals were male and older than 54 years of age. The ultrasonographic diagnosis of aneurysm was based on an anteroposterior abdominal aorta diameter of 3 cm, or on an abdominal aorta diameter 0.5 cm greater than that of the supra-renal aorta. RESULTS: A total of 2.281 people were screened for abdominal aortic aneurysms in all groups: Group 1 - 768 individuals, Group 2 - 501 individuals, and Group 3 - 1012 individuals. The prevalence of aneurysms was 4.3%, 6.8% and 1.7%, respectively. Age and cigarette smoking were significantly associated with increased prevalence of aneurysms, as was the diagnosis of peripheral artery disease. DISCUSSION: We concluded that screening may be an important tool to prevent the mortality associated with abdominal aortic aneurysms surgery. Additionally, the cost of screening can be decreased if only individuals presenting significant risk factors, such as coronary and peripheral artery disease, smokers and relatives of aneurysm patients, are examined.OBJETIVO E MÉTODOS: O rastreamento de aneurisma da aorta abdominal infra-renal é importante pois pode diminuir a mortalidade relacionada à ruptura. Realizamos um estudo para definir a prevalência desses aneurismas em diversos segmentos da população em nossa região do Brasil. O rastreamento foi realizado utilizando-se a ecografia de abdômen. Tr
Fiber architecture of canine abdominal muscles.
Boriek, Aladin M; Ortize, Jaime; Zhu, Deshen
During respiration, abdominal muscles experience loads, not only in the muscle-fiber direction but also transverse to the fibers. We wondered whether the abdominal muscles exhibit a fiber architecture that is similar to the diaphragm muscle, and, therefore, we chose two adjacent muscles: the internal oblique (IO), with about the same muscle length as the diaphragm, and the transverse abdominis (TA), which is twice as long as the diaphragm. First, we used acetylcholinesterase staining to examine the distribution of neuromuscular junctions on both surfaces of the TA and IO muscles in six dogs. A maximum of four irregular bands of neuromuscular junctions crossed the IO, and as many as six bands crossed the TA, which is consistent with a discontinuous fiber architecture. In six additional dogs, we examined fiber architecture of these muscles by microdissecting 103 fascicles from the IO and 139 from the TA. Each fascicle contained between 20 and 30 muscle fibers. The mean length of nonspanning fibers (NSF) ranged from 2.8 +/- 0.3 cm in the IO to 4.3 +/- 0.5 cm in the TA, and the mean length of spanning fibers ranged from 4.3 +/- 0.5 cm in the IO to 7.6 +/- 1.4 cm in the TA. NSF accounted for 89.6 +/- 1.5% of all fibers dissected from the IO and 99.1 +/- 0.2% of all fibers dissected from the TA. The percentage of NSF with both ends tapered was 6.2 +/- 1.0 and 41.0 +/- 2.3% for IO and TA, respectively. These data show that fiber architecture in either IO or TA is discontinuous, with much more short-tapered fibers in the TA than in the IO. When abdominal muscles are submaximally activated, as during both normal expiration and maximal expiratory efforts, muscle force could be transmitted to the cell membrane and to the extracellular intramuscular connective tissue by shear linkage, presumably via structural transmembrane proteins.
Recent advances in equine abdominal surgery.
Smith, C L; Dowling, B A; Dart, A J
Laparoscopy is a minimally invasive procedure that has applications as a diagnostic, therapeutic and prognostic technique. Specialized equipment is necessary to perform equine laparoscopy, and there is a large range of instruments, both disposable and non-disposable available. Laparoscopic procedures described include ovariectomy, cryptorchidectomy, adhesiolysis and herniorrhaphy. Laparoscopy can be performed in a standing or dorsally recumbent position, depending on surgeon preference, patient status and the procedure to be performed. Stapling equipment is frequently used in gastrointestinal surgery in horses. Advantages include decreased surgical time and a decrease in the risk of contamination. Stapling equipment is often used in creating anastomoses, both in the large and small intestines, as well as in vessel ligation. New surgical techniques intended to decrease adhesion formation include the use of carboxymethylcellulose and bioresorbable patches. Indwelling abdominal drains can be used for peritoneal lavage following surgery and also appear to decrease the risk of adhesion formation. Improvements in post-operative care, including the treatment of post-operative ileus and endotoxaemia can significantly improve the outcome of horses that have undergone surgery for abdominal disorders. Recommendations for the use of prokinetic agents in horses with ileus vary widely. Prokinetic agents include local anaesthetics, macrolide antimicrobials, cholinergic agonists and dopamine antagonists. Endotoxaemia is common in horses following surgery for gastrointestinal disorders. The antibiotic polymyxin B binds to the circulating endotoxin molecule, decreasing its half-life in the intra-vascular space and reducing associated inflammation. This drug appears to be an effective and affordable treatment option for horses with endotoxaemia. The use of specific cyclooxygenase inhibitors in veterinary medicine have been studied recently. Selective cyclooxygenase-2 inhibitors may
Evaluation of five image registration tools for abdominal CT: pitfalls and opportunities with soft anatomy
Lee, Christopher P.; Xu, Zhoubing; Burke, Ryan P.; Baucom, Rebeccah; Poulose, Benjamin K.; Abramson, Richard G.; Landman, Bennett A.
Image registration has become an essential image processing technique to compare data across time and individuals. With the successes in volumetric brain registration, general-purpose software tools are beginning to be applied to abdominal computed tomography (CT) scans. Herein, we evaluate five current tools for registering clinically acquired abdominal CT scans. Twelve abdominal organs were labeled on a set of 20 atlases to enable assessment of correspondence. The 20 atlases were pairwise registered based on only intensity information with five registration tools (affine IRTK, FNIRT, Non-Rigid IRTK, NiftyReg, and ANTs). Following the brain literature, the Dice similarity coefficient (DSC), mean surface distance, and Hausdorff distance were calculated on the registered organs individually. However, interpretation was confounded due to a significant proportion of outliers. Examining the retrospectively selected top 1 and 5 atlases for each target revealed that there was a substantive performance difference between methods. To further our understanding, we constructed majority vote segmentation with the top 5 DSC values for each organ and target. The results illustrated a median improvement of 85% in DSC between the raw results and majority vote. These experiments show that some images may be well registered to some targets using the available software tools, but there is significant room for improvement and reveals the need for innovation and research in the field of registration in abdominal CTs. If image registration is to be used for local interpretation of abdominal CT, great care must be taken to account for outliers (e.g., atlas selection in statistical fusion).
An exceptional cause of left lower quadrant abdominal pain
Institute of Scientific and Technical Information of China (English)
Bassam Abboud; Ronald Daher
Acute appendicitis is an exceptional cause of left lower quadrant abdominal pain. Computed tomography scan is the key to its diagnosis and helps to establish its early treatment. We present a case of a 35-year-old male patient who presented acute appendicitis with redundant and loosely attached cecum which was diagnosed based on his left lower quadrant abdominal pain.
Increased Auditory Startle Reflex in Children with Functional Abdominal Pain
Bakker, Mirte J.; Boer, Frits; Benninga, Marc A.; Koelman, Johannes H. T. M.; Tijssen, Marina A. J.
Objective To test the hypothesis that children with abdominal pain-related functional gastrointestinal disorders have a general hypersensitivity for sensory stimuli. Study design Auditory startle reflexes were assessed in 20 children classified according to Rome III classifications of abdominal pain
Management of Abdominal Wounds in Thermally Injured Patients
Acute inflammatory disease 5 Superior mesenteric artery syndrome 4 Biliary tract disease 4 surface in the patients with abdominal burns, and only...ity of these critically ill patients were equally affected by polypropylene was used for fascial closure, the wound ileus , sepsis, abdominal distention
Inferior venacaval compression due to excessive abdominal packing
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M.C.B. Santhosh
Full Text Available Inferior venacaval compression is a common problem in late pregnancy. It can also occur due to compression of inferior venacava by abdominal or pelvic tumors. We report a case of acute iatrogenic inferior venacaval compression due to excessive abdominal packing during an intraabdominal surgery.
Enterotomy risk in abdominal wall repair: a prospective study.
Broek, R.P. Ten; Schreinemacher, M.H.; Jilesen, A.P.; Bouvy, N.; Bleichrodt, R.P.; Goor, H. van
OBJECTIVES: To establish the incidence and predictive factors of enterotomy made during adhesiolysis in abdominal wall repair and to assess the impact of enterotomies and long-lasting adhesiolysis on postoperative morbidity such as sepsis, wound infection, abdominal complications and pneumonia, and
Abdominal aortic aneurysms : clinical insights and outcome after endovascular repair
Zandvoort, H.J.A.
Abdominal aortic aneurysm (AAA) is a focal dilatation of the abdominal aorta. The pathophysiology of AAA is a complex multifactorial process and much is still unknown. Histologic and biochemical analysis of AAA wall characteristics can contribute to a better insight in AAA pathophysiology. To make t
Acute abdominal aortic thrombosis following the Heimlich maneuver.
Ayerdi, Juan; Gupta, Sushil K; Sampson, Lawrence N; Deshmukh, Narayan
Complications from the Heimlich maneuver are relatively infrequent. Two fatal cases of abdominal aortic thrombosis have been reported following this technique. We report on the first patient that suffered an acute thrombosis of the abdominal aorta and survived. Prompt recognition of this complication provides the only hope of survival from this rare and catastrophic complication.
Acute abdominal pain : considerations on diagnosis and management
Toorenvliet, Boudewijn Ronald
In this thesis several aspects on the diagnosing and management of patients with acute abdominal pain are investigated. 1; The efficacy and safety of standard outpatient re-evaluation for patients not admitted to the hospital after emergency department evaluation for acute abdominal pain. 2; The use
Evidence-Based Medicine Approach to Abdominal Pain.
Natesan, Sreeja; Lee, Jerry; Volkamer, Heather; Thoureen, Traci
The chief complaint of abdominal pain accounts for 5% to 10% of all presentations in the emergency department. With such broad differential and diagnostic modalities available, this article focuses on a systematic approach to evaluating abdominal pain, essential to providing patients with efficient and accurate care.
Prognosis of chronic or recurrent abdominal pain in children
Gieteling, Marieke J.; Bierma-Zeinstra, Sita M. A.; Passchier, Ban; Berger, Marjolein Y.
Background: Chronic abdominal pain (CAP) or recurrent abdominal pain is common in childhood and is rarely associated with organic disease. With modern diagnostic technology, new organic abnormalities are found in children with CAP. Thus far a causal relation between these abnormalities and CAP has n
Acute acalculous cholecystitis after abdominal wall repair (Rives-Stoppa)
DEFF Research Database (Denmark)
Reurings, Jurrian C; Diaz, Ruben P D; Penninga, Luit
-old man who developed AAC after abdominal wall repair with mesh (Rives-Stoppa procedure) 1 day after discharge from the hospital. To the best of our knowledge, this is the first paper to report AAC after abdominal incisional hernia repair. Although it is known to be more common in critically ill patients...
Hemoperitoneum in cirrhotic patients without abdominal trauma or tumor
Institute of Scientific and Technical Information of China (English)
Yuan-Ji Ma; En-Qiang Chen; Jia-Jie Lu; Ming-Zhen Tan; Hong Tang
BACKGROUND: Hemoperitoneum is associated with several emergency conditions and is especially evident when it occurs in patients with liver cirrhosis. This study aimed to assess the clinical characteristics of cirrhotic patients who did not have abdominal trauma or tumor but who developed hemoperitoneum. METHODS: Wereviewedtheclinicalrecordsof1276consecutive cirrhotic patients with hemoperitoneum at our center between January 2007 and December 2009. Hemoperitoneum was confirmed by abdominal paracentesis. RESULTS: Of the 1276 cirrhotic patients, 19 were found to have hemoperitoneum, but only 6 did not have abdominal trauma or tumor. The occurrence of spontaneous hemoperitoneum in the cirrhotic patients was therefore 0.5%. Hemoperitoneum can occur spontaneously in severely decompensated cirrhotic patients with intra-abdominal collateral vessels and high scores on the model for end-stage liver disease and Child-Pugh-Turcotte test. Most patients presented with abdominal distension, abdominal pain, increased abdominal girth and hemodynamic instability with a significant drop in the hemoglobin level. Three patients died of hemorrhagic shock within 24 hours, and the other 3 died of hepatic encephalopathy or spontaneous bacterial peritonitis after 5 to 10 days because of further decompensation of the liver. CONCLUSIONS: Hemoperitoneum can occur in cirrhotic patients who do not have abdominal trauma or tumor. It mainly occurs in severely decompensated end-stage cirrhotic patients. Cirrhotic patients with hemoperitoneum have a poor prognosis.
Surgery of gigantic infrarenal aneurysm of abdominal aorta
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N. Rustempašić
Full Text Available The case shows gigantic aneurysm of abdominal aorta, localized infrarenally, as well as aneurysms of bilateral iliac arteries, which were solved successfully by resection of aneurism of abdominal aorta, closure of iliac arteries near aortic bifurcation, and interposition of aorta-bifemural vascular graft. There were no postoperative complications,and final outcome was fully satisfactory.
Statin use and rupture of abdominal aortic aneurysm
DEFF Research Database (Denmark)
Wemmelund, H; Høgh, A; Hundborg, H H
BACKGROUND: Ruptured abdominal aortic aneurysm (rAAA) is associated with high mortality. Research suggests that statins may reduce abdominal aortic aneurysm (AAA) growth and improve rAAA outcomes. However, the clinical impact of statins remains uncertain in relation to both the risk and prognosis...
Mesenteric ischemia after abdominal aortic aneurysm repair : a systemic review
Bruggink, J. L. M.; Tielliu, I. F. J.; Zeebregts, C. J.; Pol, R. A.
Mesenteric ischemia after abdominal aneurysm repair is a devastating complication with mortality rates up to 70%. Incidence however is relatively low. The aim of this review was to provide an overview on current insights, diagnostic modalities and on mesenteric ischemia after abdominal aortic aneury
Talk to Your Doctor about Abdominal Aortic Aneurysm
... Topic En español Talk to Your Doctor about Abdominal Aortic Aneurysm Browse Sections The Basics Overview What is AAA? ... ask your doctor about getting screened (tested) for abdominal aortic aneurysm (AAA). If AAA isn't found and treated ...
Decreased mortality of abdominal aortic aneurysms in a peripheral county
DEFF Research Database (Denmark)
Lindholt, Jes Sanddal; Henneberg, E W; Fasting, H
To analyse the effect on the mortality associated with abdominal aortic aneurysms, due to the establishment of a decentralised vascular surgical unit in the county of Viborg.......To analyse the effect on the mortality associated with abdominal aortic aneurysms, due to the establishment of a decentralised vascular surgical unit in the county of Viborg....
A comparative study of iliac and abdominal aortic aneurysms
DEFF Research Database (Denmark)
Vammen, Sten; Lindholt, Jes Sanddal; Henneberg, E W
The aim of the paper is to compare the epidemiology, risk factors and manifestations of iliac and abdominal aortic aneurysms.......The aim of the paper is to compare the epidemiology, risk factors and manifestations of iliac and abdominal aortic aneurysms....
An unusual cause of abdominal pain.
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Mc Cabe, Aileen
A 26-year-old man presented to the Emergency Department with abdominal pain, diarrhoea, anorexia and haematemesis. The patient was previously diagnosed with latent tuberculosis (TB). On examination, his abdomen was diffusely tender, with localised guarding in the right iliac fossa. CT imaging of his abdomen and pelvis demonstrated a low volume of ascites, diffuse studding of the peritoneum, omental caking and several bulky low-density lymph nodes in the retroperitoneum. A laparoscopy was performed to obtain a peritoneal biopsy. Histology demonstrated fragments of peritoneum with necrotising granulomatous inflammatory infiltrate in keeping with an infectious process, favouring TB. He was commenced on rifampicin, isoniazid, pyrazinamide, ethambutol and pyridoxine under the direct observed therapy by the infectious diseases team. In view of his extensive peritoneal involvement, he was empirically started on high-dose prednisolone for symptomatic control and to reduce complications related to peritoneal adhesions.
Retroperitoneal abscess: an extra-abdominal manifestation.
Mallia, Alvin James; Ashwood, Neil; Arealis, George; Galanopoulos, Ilias
Retroperitoneal abscesses are unusual occurrences with occult and insidious presentations. There is often a lack of abdominal signs, leading to delays in drainage and high mortality rates. We report a case of thigh emphysema in an 88-year-old patient with diabetes. Prior to admission the patient reported a vague 4-week history of left thigh pain and an inability to fully weight bear. She presented to our emergency department with sepsis and acute kidney impairment. An X-ray of her left femur revealed widespread gas between muscular planes. A retroperitoneal abscess involving the left renal fossa, psoas, iliacus and upper thigh muscles was revealed on an urgent CT scan. The patient was transferred to intensive care unit (ICU) and underwent an emergency drainage. Despite ICU the patient died 2 days after admission.
[Abdominal ischemia and lesions of the pancreas].
Myshanych, T V; Moskal', O M; Arkhiĭ, E Ĭ; Sozoniuk, O V
The analysis of the results of 50 patients with diseases of coronary heart disease (25 pers.) And chronic pancreatitis (25 people) are submitted. Along with the standard test from these patients underwent Doppler-ultrasonography of abdominal aorta and its visceral branches. Conclusions: A characteristic feature of Doppler indices in AIC is to reduce Vps and Ved, and PI BbA, increase Vps, Ved, IR and PI after exercise in chBA, chC and BbA. At patients with CP with IHD feature is the increase in Ved and IR in the chC, and Ved and PI in BbA under act of loading Bleed a feature at CP with IHD must be taken into account for optimization of treatment of IHD at CP.
Abdominal CT findings of delayed postoperative complications
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Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: firstname.lastname@example.com; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)
Despite progress in surgical techniques and modern medical treatment, postoperative complications occur not infrequently and vary according to type of surgery, clinical setting, and time elapsed since surgery. In general, they can be divided into early and delayed complications. Delayed postoperative complications can be classified as specific and nonspecific. The common nonspecific delayed complications are incisional hernia and postoperative bowel obstruction. Bowel obstruction can be further categorized as obstruction related to benign or neoplastic etiology, the latter occurring in oncology patients in whom the primary surgery was related to an underlying abdominal neoplasm. Gossypiboma is another, fortunately rare, postoperative complication. Specific complications appear after specific operations and include the following: Splenosis - following splenectomy. Retained gallstones and spilled gallstones - following cholecystectomy, mainly laparoscopic. Dropped appendicolith and stump appendicitis - following appendectomy, mainly laparoscopic. Obturation obstruction by a bezoar - following gastric surgery. Afferent loop syndrome (ALS) - following Bilroth II gastrectomy. (author)
Natural history of abdominal aortic aneurysm
DEFF Research Database (Denmark)
Perko, M J; Schroeder, T V; Olsen, P S
During a 10-year period in which 735 patients presented with abdominal aortic aneurysms to our clinic, 63 were not offered operative treatment. The primary reason for choosing conservative treatment was concomitant diseases that increased the risk of operation. After 2 years of followup, half...... of the patients died, and the cumulative 5-year survival rate was 15%. Aneurysm rupture was the primary cause of death. The cumulative 5-year mortality hazard rate from rupture was 0.36, corresponding to an annual risk of rupture of 7%. The cumulative 5-year hazard rate of death from all other causes was 1.......53, corresponding to an annual risk of 30%. Diameter of the aneurysm was found to be the only factor with a significant impact on the rate of rupture. The cumulative 5-year hazard rate of rupture among patients with aneurysms or = 6 cm was 0.2 and 0.6, respectively, corresponding to an annual risk...
Abdominal vascular syndromes: characteristic imaging findings*
Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe
Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic. PMID:27777480
Standardized anatomic space for abdominal fat quantification
Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.
The ability to accurately measure subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) from images is important for improved assessment and management of patients with various conditions such as obesity, diabetes mellitus, obstructive sleep apnea, cardiovascular disease, kidney disease, and degenerative disease. Although imaging and analysis methods to measure the volume of these tissue components have been developed [1, 2], in clinical practice, an estimate of the amount of fat is obtained from just one transverse abdominal CT slice typically acquired at the level of the L4-L5 vertebrae for various reasons including decreased radiation exposure and cost [3-5]. It is generally assumed that such an estimate reliably depicts the burden of fat in the body. This paper sets out to answer two questions related to this issue which have not been addressed in the literature. How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? At what anatomic location do the volumes of SAT and VAT correlate maximally with the corresponding single-slice area measures? To answer these questions, we propose two approaches for slice localization: linear mapping and non-linear mapping which is a novel learning based strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. We then study the volume-to-area correlations and determine where they become maximal. We demonstrate on 50 abdominal CT data sets that this mapping achieves significantly improved consistency of anatomic localization compared to current practice. Our results also indicate that maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized.
Gastroesophageal reflux in children with recurrent abdominal pain.
van der Meer, S B; Forget, P P; Kuijten, R H; Arends, J W
In this study we investigated the presence of gastroesophageal reflux in children with recurrent abdominal pain and its possible relationship to food intolerance-associated duodenal inflammation. Twenty-four-hour intra-esophageal pH monitoring, an endoscopic duodenal biopsy and a small bowel 51Cr-EDTA permeability test were performed in 25 children with recurrent abdominal pain. In 14 cases (56%) the pH monitoring was abnormal, pointing to the presence of pathological gastroesophageal reflux. Treatment of gastroesophageal reflux in the latter patients resulted in resolution or improvement of abdominal pain in 10 cases (71%). Gastroesophageal reflux did not appear to be associated with either intestinal permeability to 51Cr-EDTA or duodenal biopsy findings. We conclude that pathological gastroesophageal reflex is a frequent finding in children with recurrent abdominal pain, that it is unrelated to duodenal inflammation and that there might be a causal relationship between pathological gastroesophageal reflux and recurrent abdominal pain in children.
[Abdominal ectopic pregnancy. A case report and literature review].
Puch-Ceballos, Eduardo Erik; Vázquez-Castro, Rosbel; Osorio-Pérez, Ana Isabel; Ramos-Ayala, Montserrat; Villarreal-Sosa, Conrado Otoniel; Ruvalcaba-Rivera, Everardo
Abdominal ectopic pregnancy is an extremely rare entity, which represents 1% of all ectopic pregnancies and is associated with high maternal and fetal morbidity and mortality. The maternal mortality risk of an abdominal ectopic pregnancy is seven to eight times greater than the risk of a tubal ectopic pregnancy and is 90 times greater than the risk of intrauterine pregnancy. This is a disease of difficult diagnosis that often takes place late. We report the case of a patient with an abdominal ectopic pregnancy, which was diagnosed by abdominal ultrasound in the second trimester; the patient was suc- cessfully treated with exploratory laparotomy with complete removal of the fetus and placenta. We provide a review of the literature on the risk factors for abdominal ectopic pregnancy, diagnostic tests and therapeutic options.
Z-plasty for uterus-to-abdominal-wall fistula
Institute of Scientific and Technical Information of China (English)
Lou Xiaoli; Zhang Mingli; Cui Ying; Song Jianxing
Objective: Uterus-to-abdominal-wall fistula is a very rare complication after uterine-incision delivery over the last decades. It can even lead to death. Mainly, the fistula occurs when big tension and critical infection exist within the incision of uterus and abdominal wall. Methods: The authors described the clinical presentation, pathology of uterus-to-abdominal-wall fistula, and reported their experience in 6 cases who underwent Z-plasty operation for this rare complication from January 1998 to January 2008. Results: All flaps survived completely and all the wounds in abdominal walls healed very well. The six cases were followed up for 1 to 5 years, and no fistula recurrence occurred. Conclusion: Z-plasty technique is a very simple and efficient approach to repair uterus to abdominal fistula after uterine-incision delivery.
A New Etiology for the Abdominal Compartment Syndrome: Pseudomyxoma Peritonei
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Charles Sabbagh
Full Text Available Pseudomyxoma peritonei (PMP is a rare diagnosis with an incidence of 1-2 per million. Most cases originate from an appendix which ruptures and releases mucin into the peritoneal cavity. The progression of the disease results in obstruction and cutaneous leak. Abdominal compartment syndrome is an uncommon complication of peritoneal pseudomyxoma. In the present article, we report the case of a patient with PMP and abdominal compartment syndrome. A laparotomy to decrease the abdominal pressure was performed. Three months later, a peritonectomy with hyperthermic intraperitoneal chemotherapy was performed. The patient was still alive 1 year after the procedure without any recurrence. In conclusion, acute abdominal pain and respiratory failure in patients with peritoneal PMP should lead to the measurement of the abdominal pressure but are not a contra indication for curative treatment of PMP.
Abdominal compartment syndrome successfully treated with neuromuscular blockade
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Kris T Chiles
Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.
If unnecessary computed tomography scans are performing for abdominal emergent pathologies in our radiology unit; retrospective study with comparing performed abdominal computed tomography scans with previous safer tests like ultrasound
Betul Tiryaki Bastug
Background: Abdominal computed tomography (CT) is an imaging method that uses X-rays and may be done to look for cause of abdominal pain or swelling and fever, hernia, masses, infections, injury. Besides advantages, CT use ionizing radiation, which has the potential to cause cancer. So CT may still be done if the benefits greatly outweigh the risks and it is important to minimize unnecessary CT scans. While a CT scan may provide information, it is sometimes unlikely to change the treatment. T...
Evaluating clinical abdominal scoring system in predict- ing the necessity of laparotomy in blunt abdominal trauma
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Erfantalab-Avini Peyman
Full Text Available 【Abstract】 Objectives: Trauma is among the lead- ing causes of death. Medical management of blunt abdomi- nal trauma (BAT relies on judging patients for whom lap- arotomy is mandatory. This study aimed to determine BAT patients' signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS, a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hos- pitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS, pulse rate, time of presentation after trauma, abdomi- nal clinical findings, respiratory rate, temperature, hemoglo- bin (Hb concentration, focused abdominal sonography in trauma (FAST and CASS. Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presen- tation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P<0.05. Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accu- racy of diagnosis. Key words: Abdominal injuries; Laparotomy; Patients; Wounds, nonpenetrating
Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis
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Edivaldo Massazo Utiyama
Full Text Available OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years; 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.
Septic patients of abdominal surgery | EU Clinical Trials Register [EU Clinical Trials Register
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Full Text Available estudio de pacientes de cirugia abdominal con sepsis que pueden desarrollar un f...ic patients of abdominal surgery Tratamiento habitual para pacientes sépticos de cirugia abdominal G. Invest
Blunt abdominal trauma: The role of focused abdominal sonography in assessment of organ injury and reducing the need for CT
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Samer Malak Boutros
Conclusion: Ultrasonography is considered the best modality in initial evaluation of blunt abdominal trauma patients as it is noninvasive, readily available, and requires minimal preparation time. Ultrasonography is very useful in follow up of patients with intra-abdominal injury and decreases use of CT which has the disadvantages of being expensive, high dose radiation.
Role of F-18 FDG PET/CT in the management of infected abdominal aortic aneurysm due to salmonella
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Choi, Seung Jin; Lee, Jin Soo; Cheong, Moon Hyun; Byun, Sung Su; Hyun, In Young [Inha University College of Medicine, Incheon (Korea, Republic of)
We present a case of infected abdominal aortic aneurysm due to salmonella enteritidis. F-18 FDG PET/CT was performed to diagnosis and during follow-up after antibiotic treatment. Computed tomography (CT) is considered to be the best diagnostic imaging modality in infected aortic lesions. In this case, a combination of CT and FDG PET/CT provided accurate information for the diagnosis of infected abdominal aortic aneurysm. Moreover, FDG PET/CT made an important contribution of monitoring disease activity during antibiotic treatment.
Changes in lateral abdominal muscles' thickness immediately after the abdominal drawing-in maneuver and maximum expiration.
Ishida, Hiroshi; Watanabe, Susumu
All lateral abdominal muscles contract more strongly during maximum expiration than during the abdominal drawing-in maneuver (ADIM). However, little is known about which of the lateral abdominal muscles is activated during maximum expiration. Thus, the purpose of this study is to quantify changes in the thickness of the lateral abdominal muscles immediately after the ADIM and maximum expiration. The thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles was measured by ultrasound imaging in 30 healthy men before and after the ADIM and maximum expiration. After the ADIM, there was no significant change in the thickness of the lateral abdominal muscles. After maximum expiration, the thickness of the TrA muscle significantly increased, and there was no significant change in the thickness of the IO and EO muscles. Thus, maximum expiration may be an effective method for TrA, rather than IO and EO, muscle training.
A kinematic comparison of four abdominal training devices and a traditional abdominal crunch.
Sands, William A; McNeal, Jeni R
Abdominal exercises are often performed on roller or rocker mechanisms, which have been aggressively promoted through the television and print media. However, justifications are lacking as to why these devices are superior to traditional abdominal exercises such as crunches. This study sought to describe and compare the range of motion (ROM) of several joints during crunches performed on 4 different abdominal conditioning devices (2 roller and 2 pivot types) and a traditional crunch exercise. Ten men (29 +/- 5.87 years, 177.5 +/- 6.46 cm, 80.96 +/- 11.72 kg) and 10 women (33.4 +/- 10.16 years, 162.23 +/- 3.83 cm, 56.99 +/- 7.36 kg) subjects agreed to participate in the study. Subjects were videotaped in the sagittal plane (60 Hz) using standard kinematic methods. Reflective markers were placed on the right temple, auditory meatus, shoulder, hip, knee, ankle, heel, toe, and 2 sternum markers placed on a foam piece strapped to the subject's chest. The videotaped movements were automatically digitized (PEAK5 2-D) and the data smoothed using a Butterworth filter. Relative angular ROMs of the head (temple, auditory meatus, shoulder); neck (auditory meatus, shoulder, hip); trunk (near sternum, shoulder, hip); hip (shoulder, hip, knee); sternum/head (sternum near and sternum far with temple and auditory meatus); sternum/trunk (sternum near and sternum far with shoulder and hip); and a sum of 4 angles (head, neck, trunk, hip) were calculated. Sex by equipment repeated measures analyses of variance (ANOVAs) were calculated on the angles of the 5 exercises. When no main effect for sex was found, the data were collapsed across sex and a one-way ANOVA with repeated measures was calculated on the resulting data. Post hoc analyses of pairwise differences were calculated using Tukey's honestly significant difference statistic. Results showed that crunches performed with the abdominal devices resulted in less ROM in all angles measured when compared with a traditional crunch. The
Consumo de bebida alcoólica e adiposidade abdominal em doadores de sangue Consumo de bebida alcohólica y adiposidad abdominal en donadores de sangre Alcohol consumption and abdominal fat in blood donors
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Márcia Gonçalves Ferreira
ón lineal múltiple, con los modelos ajustados para la edad, actividad física, tabaquismo y adiposidad total. RESULTADOS: Posterior al ajuste, la circunferencia de la cintura y la relación cintura/cuadril se mantuvieron asociados positivamente al consumo de cerveza (p=0,02 y al total de alcohol consumido (p=0,01 y 0,03, respectivamente. El consumo de aguardiente mostró asociación solamente con la circunferencia de la cintura (p=0,04. CONCLUSIONES: El consumo de alcohol, particularmente de cerveza, se asoció con la localización abdominal de gordura.OBJECTIVE: To evaluate the association between alcohol consumption and abdominal fat. METHODS: Cross-sectional study carried out in a sample of male blood donors (n=1,235, aged 20-59 years, in the city of Cuiabá, Central-West Brazil, between August 1999 and January 2000. Waist circumference and waist-to-hip ratio were indicators of abdominal fat, adjusted for total adiposity. Weight, height, waist and hip circumferences were measured. Alcohol consumption was evaluated using a questionnaire collecting information on type, frequency, and amount of consumption. The association between alcohol consumption and abdominal fat was assessed through multiple linear regression models adjusted for age, physical activity, smoking, and percent of body fat. RESULTS: After adjustment, waist circumference and waist-to-hip ratio were positively associated with beer (p = 0.02 and total alcohol consumption (p=0.01; p=0.03, respectively. Waist circumference was positively associated with spirit consumption (p=0.04. CONCLUSIONS: Alcohol intake, particularly beer, was positively associated to abdominal fat.
Low-dose multiphase abdominal CT reconstruction with phase-induced swap prior
Selim, Mona; Rashed, Essam A.; Kudo, Hiroyuki
Multiphase abdominal CT is an imaging protocol in which the patient is scanned at different phases before and after the injection of a contrast agent. Reconstructed images with different concentrations of contrast material provide useful information for effective detection of abnormalities. However, several scanning during a short period of time eventually increase the patient radiation dose to a remarkable value up to a risky level. Reducing the patient dose by modulating the x-ray tube current or acquiring the projection data through a small number of views are known to degrade the image quality and reduce the possibility to be useful for diagnosis purpose. In this work, we propose a novel multiphase abdominal CT imaging protocol with patient dose reduction and high image quality. The image reconstruction cost function consists of two terms, namely the data fidelity term and penalty term to enforce the anatomical similarity in successive contrast phase reconstruction. The prior information, named phase-induced swap prior (PISP) is computed using total variation minimization of image acquired from different contrast phases. The new method is evaluated through a simulation study using digital abdominal phantom and real data and results are promising.
A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.
Agnaeber, K; Bodalal, Z
We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.
Abdominal circumference contributes to absence of wasting in Brazilian children.
César, J A; Victora, C G; Morris, S S; Post, C A
A number of population groups in Latin America show high prevalences of stunting (low height-for-age) despite very low rates of wasting (weight-for-height deficits). One possible explanation for this phenomenon is an increase in abdominal circumference, which would affect children's weights but not their heights. This study was designed to describe the abdominal circumferences of a group of poor children from Northeast Brazil, and to relate these to their weight-for-weight z-score. Children (n = 252) participating in a government growth monitoring program were studied. The prevalence of stunting (below -2 SD) was 26.2%, but only 1.2% were wasted. Abdominal circumferences increased with age up to 36 mo, followed by a slight decline after 48 mo. Abdominal circumference was the anthropometric measurement most closely associated with weight-for-height, with a coefficient of determination of 41%. Even after adjusting for arm circumference, abdominal circumference continued to explain 16% of the variation in weight-for-height. Despite slight differences in measurement techniques, the study children had consistently larger abdominal girths than a sample of North American children. These findings must be verified by replication but highlight a possible contribution of abdominal circumference in the determination of levels of wasting.
The effect of abdominal massage in reducing malignant ascites symptoms.
Wang, Tsae-Jyy; Wang, Hung-Ming; Yang, Tsai-Sheng; Jane, Sui-Whi; Huang, Tse-Hung; Wang, Chao-Hui; Lin, Yi-Hsin
As many as 50% of end-stage cancer patients will develop ascites and associated symptoms, including pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, dyspnea, perceived abdominal bloating, and immobility. Abdominal massage may stimulate lymph return to the venous system and reduce ascites-related symptoms. The purpose of this study was to test the effect of abdominal massage in reducing these symptoms and reducing ascites itself as reflected in body weight. For a randomized controlled design using repeated measures, a sample of 80 patients with malignant ascites was recruited from gastroenterology and oncology units of a medical center in northern Taiwan and randomly assigned to the intervention or the control group. A 15-minute gentle abdominal massage, using straight rubbing, point rubbing, and kneading, was administered twice daily for 3 days. The control group received a twice-daily 15-minute social interaction contact with the same nurse. Symptoms and body weight were measured in the morning for 4 consecutive days from pre- to post-test. In generalized estimation equation modeling, a significant group-by-time interaction on depression, anxiety, poor wellbeing, and perceived abdominal bloating, indicated that abdominal massage improved these four symptoms, with the greatest effect on perceived bloating. The intervention had no effect on pain, tiredness, nausea, drowsiness, poor appetite, shortness of breath, mobility limitation, or body weight. Abdominal massage appears useful for managing selected symptoms of malignant ascites.
Abdominal expiratory muscle activity in anesthetized vagotomized neonatal rats.
Iizuka, Makito
The pattern of respiratory activity in abdominal muscles was studied in anesthetized, spontaneously breathing, vagotomized neonatal rats at postnatal days 0-3. Anesthesia (2.0% isoflurane, 50% O(2)) depressed breathing and resulted in hypercapnia. Under this condition, abdominal muscles showed discharge late in the expiratory phase (E2 activity) in most rats. As the depth of anesthesia decreased, the amplitude of discharges in the diaphragm and abdominal muscles increased. A small additional burst frequently occurred in abdominal muscles just after the termination of diaphragmatic inspiratory activity (E1 or postinspiratory activity). Since this E1 activity is not often observed in adult rats, the abdominal respiratory pattern likely changes during postnatal development. Anoxia-induced gasping after periodic expiratory activity without inspiratory activity, and in most rats, abdominal expiratory activity disappeared before terminal apnea. These results suggest that a biphasic abdominal motor pattern (a combination of E2 and E1 activity) is a characteristic of vagotomized neonatal rats during normal respiration.
Abdominal injuries in communal crises: The Jos experience
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Emmanuel Olorundare Ojo
Full Text Available Background: Abdominal injuries contribute significantly to battlefield trauma morbidity and mortality. This study sought to determine the incidence, demographics, clinical features, spectrum, severity, management, and outcome of abdominal trauma during a civilian conflict. Materials and Methods: A prospective analysis of patients treated for abdominal trauma during the Jos civil crises between December 2010 and May 2012 at the Jos University Teaching Hospital. Results: A total of 109 victims of communal conflicts with abdominal injuries were managed during the study period with 89 (81.7% males and 20 (18.3% females representing about 12.2% of the total 897 combat related injuries. The peak age incidence was between 21 and 40 years (range: 3–71 years. The most frequently injured intra-abdominal organs were the small intestine 69 (63.3%, colon 48 (44%, and liver 41 (37.6%. Forty-four (40.4% patients had extra-abdominal injuries involving the chest in 17 (15.6%, musculoskeletal 12 (11%, and the head in 9 (8.3%. The most prevalent weapon injuries were gunshot 76 (69.7%, explosives 12 (11%, stab injuries 11 (10.1%, and blunt abdominal trauma 10 (9.2%. The injury severity score varied from 8 to 52 (mean: 20.8 with a fatality rate of 11 (10.1% and morbidity rate of 29 (26.6%. Presence of irreversible shock, 3 or more injured intra-abdominal organs, severe head injuries, and delayed presentation were the main factors associated with mortality. Conclusion: Abdominal trauma is major life-threatening injuries during conflicts. Substantial mortality occurred with loss of nearly one in every 10 hospitalized victims despite aggressive emergency room resuscitation. The resources expenditure, propensity for death and expediency of timing reinforce the need for early access to the wounded in a concerted trauma care systems.
La estructura de la vegetación en Colombia: una síntesis preliminar
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Cantillo Higuera Édgard Ernesto
Full Text Available Este estudio permitió definir la estructura de la vegetación boscosa de Colombia de manera preliminar. Un total de 56.559 registros de datos fueron considerados en 285 levantamientos, para un área total de 447.420 m2, correspondientes al transecto del macizo del Tatamá, en la cordillera Occidental, el transecto Parque Los Nevados en la cordillera Central, el transecto Sumapaz y la serranía del Perijá en la cordillera Oriental, el bajo río San Juan (región Pacífica, el departamento de Córdoba (región Caribe, el Trapecio Amazónico (región Amazónica y la sierra de la Macarena (región de la Orinoquia, incluyendo otros estudios de caso más locales. Los resultados de los análisis determinan que existe variabilidad en los paráme tros estructurales de los componentes vertical (altura del dosel y horizontal (densidad, área basal, cobertura
y riqueza entre las regiones naturales y sus comunidades vegetales con iguales límites altitudinales,
(región de vida tropical <1.000 m de las regiones estudiadas (Caribe, Pacífico, Orinoquia, Amazonas y
valles interandinos, estando esta variación relacionada con la variación de la precipitación y la disponibilidad
de agua en el suelo. La cobertura relativa promedio en individuos con DAP 10 cm en el estrato
Arbóreo Superior no se registró en la vertiente occidental en los transectos Sumapaz y TPN, mientras que
el valor mayor se encontró en la serranía del Perijá; en el Arbóreo Inferior es menor en la v. oriental, cordillera
Central (TPN y muy dominante en la serranía de la Macarena; el Subarbóreo es más bajo en la serranía
de la Macarena y la v. occidental, cordillera Occidental (T. Tatamá y más alto en la serranía del Perijá. La variación en la altura promedio del dosel de los grupos florísticos es más bajas en la región Caribe y mayor en los valles interandinos. El número promedio de individuos con DAP 10 cm en 0,1 ha es menor en la
Bullhorn hernia: A rare traumatic abdominal wall hernia
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Bimaljot Singh
Full Text Available Traumatic abdominal wall hernia (TAWH is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.
Abdominal pain – learning when not to intervene!
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Niranjan Tachamo
Full Text Available Epiploic appendagitis (EA is an uncommon cause of abdominal pain. It is a benign condition but may mimic other serious causes of acute abdomen such as appendicitis, diverticulitis, and gynecological emergency in severe cases. Knowledge of this condition in the differential diagnosis of abdominal pain can save unnecessary hospital admission, antibiotics, and surgery. In this article, we present the case of a 43-year-old female who presented to our hospital with a 2-day history of right lower quadrant abdominal pain and diarrhea. She was diagnosed with EA with computed tomography of abdomen with contrast and was managed conservatively with good outcome.
Abdominal pain in long-term spinal cord injury
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Finnerup, Nanna Brix; Faaborg, Pia Møller; Krogh, Klaus;
/discomfort. There was no relation of abdominal pain to other types of pain.Conclusion:Chronic pain located in the abdomen is frequent in patients with long-term SCI. The delayed onset following SCI and the relation to constipation suggest that constipation plays an important role for this type of pain in the spinal cord injured.......Objectives:To describe the prevalence and character of chronic abdominal pain in a group of patients with long-term spinal cord injury (SCI) and to assess predictors of abdominal pain.Study design:Postal survey.Setting:Members of the Danish Paraplegic Association.Methods:We mailed a questionnaire...
Desmoid tumors of the abdominal wall: A case report
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Textor Hans Jochen
Full Text Available Abstract Background Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential. Case Presentation We report on two female patients with desmoid tumor of the abdominal wall who underwent primary resection. Both patients had a history of an earlier abdominal surgery. Preoperative evaluation included abdominal ultrasound, magnetic resonance imaging and computed tomography. The histology in both cases revealed a desmoid tumor. Conclusion Complete surgical resection is the first line management of this tumor entity.
Negative pressure device for intra-abdominal pressure reduction
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David, M; Geido, D; Pracca, F; Sanchez, G; Simini, F; Zoppolo, C [Nucleo de Ingenierfa Biomedica, Universidad de la Republica O. del Uruguay, Hospital de ClInicas, Av. Italia S/N, 11600, Montevideo (Uruguay)
A device that generates negative extra-abdominal pressure (ABDOPRE) for treatment of patients with high intra-abdominal pressure was developed. It includes pressure sensors for transducing intra-abdominal pressure through an intra-vesical catheter and negative pressure in the vacuum bell which is placed over the abdomen. By means of a control system, a pattern for reducing IAP is set, according to a clinical protocol. The external negative pressure is generated using a vacuum pump connected to the bell. The system registers the values of interest for the medical history. The system is being tested over ICU patients, registering a satisfactory IAP reduction.
Fournier's gangrene secondary to intra-abdominal processes.
Gerber, G S; Guss, S P; Pielet, R W
We report 2 cases of necrotizing fasciitis of the perineum, perianal area, and male genitalia (Fournier's gangrene) that arose secondary to intra-abdominal infectious processes (ruptured appendicitis and diverticulitis). Management consisted of immediate debridement of necrotic tissue, exploratory laparotomy, and diverting colostomy. The presence of an acute abdominal process was not immediately evident on initial evaluation of either patient. This demonstrates the critical importance of considering intra-abdominal infection in patients with Fournier's gangrene when the more commonly seen urinary tract, perirectal, and traumatic causes are not readily apparent.
Calcified abdominal pregnancy with eighteen years of evolution: case report
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Renato Passini Júnior
Full Text Available CONTEXT: The lithopedion (calcified abdominal pregnancy is a rare phenomenon and there are less than 300 cases reported in the medical literature. CASE REPORT: In this case, a 40 year-old patient had had her only pregnancy 18 years earlier, without medical assistance since then. She came to our hospital with pain and tumoral mass of approximately 20 centimeters in diameter. Complementary examinations (abdominal X-ray, ultrasonography and computerized tomography demonstrated an extra-uterine abdominal 31-week pregnancy with calcification areas. Exploratory laparotomy was performed, with extirpation of a well-conserved fetus with partially calcified ovular membranes.
Synovial sarcoma of the abdominal wall: An unusual presentation
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Parag J Karkera
Full Text Available Synovial sarcoma (SS is a malignant mesenchymal neoplasm which commonly occurs in the extremities in close association with tendon sheaths, bursae, joint capsules, and fascial structures. Rarely, SS may be present in unexpected location such as the abdominal wall. Surgical resection with wide margins is the initial standard treatment; however, a multimodal approach including radiotherapy and chemotherapy is often favored. Here, we present a case of SS of the anterior abdominal wall in a 14-year-old patient with a right upper abdominal lump. He underwent wide surgical excision and has received adjuvant chemotherapy. He is doing well on follow-up of six months.
Fetal weight estimation by ultrasonic measurement of abdominal circumference.
Kearney, K; Vigneron, N; Frischman, P; Johnson, J W
The purpose of this study was to compare ultrasonic measurements of fetal abdominal circumference to ultrasonic measurements of fetal biparietal diameter, as a means of estimating fetal body weight. Of 58 fetuses who had abdominal circumferences measured, 48 (82%) of the predicted weights were within 15% of the actual birth weights. Forty-four of the same 58 fetuses had satisfactory biparietal diameter measurements, but only 21 (48%) of the predicted weights were within 15% of the actual birthweights. Ultrasonic measurement of abdominal circumference appears to be a more reliable index of fetal body weight than other currently available techniques.
Estudio preliminar de la diversidad genética en procedencias de Sabal mexicana de Nicaragua aplicando marcadores moleculares
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Domingo Guido
Full Text Available PARA EVALUAR DE FORMA PRELIMINAR LA VARIABILIDAD GENÉTICA de 12 procedencias de Sabal mexicana Mart. en el Occidente de Nicaragua, se aplicó la técnica Random Amplified Polymorphic DNA (RAPD. De las 42 bandas generadas por seis cebadores en una muestra de 44 individuos, 92.8% resultaron polimórficas. El mayor polimorfismo lo presentaron las procedencias en las cuales se analizó un mayor número de muestras (5, destacándose El Limonal (82.78% y Santa Rosa (78.82%. El agrupamiento de las muestras en un dendrograma refleja alta diversidad genética entre ellas (25% de similitud. La mayoría de las muestras se ubican independientemente de la procedencia a la que pertenecen y de su localización geográfica, lo que puede ser debido principalmente al pequeño número de muestras (máximo 5 por procedencia, aunque también puede ser el resultado del pequeño número de cebadores (6 y a que, probablemente, la mayor diferencia genética se encuentre dentro y no entre las procedencias.
Propagación por estacas y estudio preliminar del establecimiento in vitro de granadilla (Passiflora ligularis, juss
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Dora Flores
Full Text Available La granadilla (Passiflora ligularis es una especie de polinización abierta, razón por la cual presenta un alto porcentaje de variabilidad genética. En Costa Rica este cultivo ofrece una opción de diversificación agrícola para la zona de Los Santos y El Guarco de Cartago. El uso de técnicas biotecnológicas como el cultivo de tejidos favorece la explotación de este, ya que permitiría el establecimiento de plantaciones más homogéneas que contribuirían a mejorar el rendimiento y la calidad del fruto. El objetivo de esta investigación fue establecer la metodología de propagación por estacas y realizar un estudio preliminar que conduzca al establecimiento in vitro de material. Se realizaron tres introducciones de estacas al invernadero y es empleado Agrirrot (0,01% AIB para inducir el enraizamiento; se obtuvo un 50% o más de enraizamiento y brotación de las estacas en cada introducción. Para el establecimiento in vitro se introdujeron brotes provenientes de estacas pretratadas en el invernadero. Se obtuvo un 37,5% de explantes muertos por quema, un 50% presentó contaminación fungosa, bacteriana o ambas y un 12,5% de material limpio y brotado.
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Jemima Alván Alvarado
Full Text Available El objetivo del presente trabajo fue realizar una evaluación preliminar de la riqueza y abundancia de las comunidades de macroinvertebrados bentónicos colectados en dos estratos (orilla y 1 metro de profundidad de la Laguna de Quistococha (Loreto, Perú. Las muestras de orilla fueron colectadas utilizándose una red de colecta de bentos (en forma de D con malla de 1 mm2, mientras que las de 1 m de profundidad fueron colectadas con una draga tipo Eckman, colectándose en total 30 muestras (15 de orilla y 15 de 1 m de profundidad. En la orilla se registró la mayor riqueza (11 especies y abundancia (109 individuos de macroinvertebrados bentónicos, en comparación con la de 1 m de profundidad, donde solo se registraron 5 especies y 51 individuos, registrándose diferencias significativas según la prueba de Mann-Whitney (P<0,05. Para todas las zonas de colecta, la especie Chironomus sp. fue la más abundante tanto en orilla (79 individuos, 72,48%, como a 1 m de profundidad (43 individuos, 84,31%.
As Figuras Complexas de Rey: normas preliminares com crianças de 9 e 10 anos
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Pagliuso, Lígia
Full Text Available Este trabalho objetivou desenvolver normas preliminares para o teste das Figuras Complexas de Rey em 120 crianças de 9 e 10 anos, de ambos os sexos, de Ribeirão Preto-SP, com indicadores de desenvolvimento típico, subdivididas em função da origem escolar: Grupo 1 (n = 61: escola pública e Grupo 2 (n = 59: escola particular. Buscou-se, assim, equilibrar a amostra a partir de realidades sociais distintas. Utilizou-se questionário com pais para triagem dos participantes (excluídos atraso escolar e dificuldades no desenvolvimento geral, avaliados individualmente pela Escala Especial das Matrizes Progressivas de Raven e Figuras Complexas de Rey, aplicados nas próprias escolas. Os resultados evidenciaram efeitos significativos da origem escolar no desempenho nas Figuras de Rey. Diferenças significativas foram identificadas entre os atuais dados e padrões de crianças da região Sul do Brasil, evidenciando necessidade de normas específicas em diferentes realidades socioculturais para adequadas possibilidades interpretativas desta técnica de avaliação psicológica
Experience with irrigation analgesia after abdominal hysterectomy
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R. V. Garyaev
Full Text Available A prospective randomized clinical trial was performed in 100 patients who underwent abdominal hysterectomy under endotracheal anesthesia based on sevoflurane and fentanyl. Intraoperatively, ketorolac 30 mg was administered intramuscularly after induction of anesthesia and paracetamol 1 g was injected intravenously 30–40 minutes prior to surgical termination in a control group (n = 25. For postoperative anal- gesia, promedol, tramadol, and ketorolac were used intramuscularly and paracetamol was given intravenously. Three study groups (n = 2 in each differed from the control group in that during wound suturing a multiperforated catheter was placed above the peritoneum over a length of 15 cm, through which a 10-ml bolus of 0.75 % ropivacaine was first administered, followed by continuous infusion of 0.2 % ropivacaine at a rate of 8 ml/hour for 36 hours. In one irrigation group, ketorolac 30 mg was injected intramuscularly t.i.d. for 2 days; in another group, the agent was added to a ropivacaine solution calculated with reference to 180 mg for 2 days; in the third group, ketoprofen 100 mg instead of ketorolac was used b.i.d. for 2 days. Pain level (by digital rating scale, 0–10 and the need for analgesics were measured. There was no sta- tistical significant difference in the level of pain and the need for analgesics between the wound irrigation and control groups.
Percutaneous Zenith endografting for abdominal aortic aneurysms.
Heyer, Kamaldeep S; Resnick, Scott A; Matsumura, Jon S; Amaranto, Daniel; Eskandari, Mark K
A completely percutaneous approach to infrarenal abdominal aortic aneurysm (AAA) endografting has the theoretic benefits of being minimally invasive and more expedient. Our goal was to demonstrate the utility of this approach using a suprarenal fixation device and a suture-mediated closure system. We conducted a single-institution, retrospective review of 14 patients who underwent percutaneous AAA repair with the Zenith device between August 2003 and March 2007. Immediate and delayed access-related outcomes were examined over a mean follow-up of 12.1+/-2.0 months. Mean AAA size was 5.6 cm. Immediate arterial closure and technical success rate was 96% (27/28 vessels). One immediate hemostatic failure required open surgical repair. Over follow-up, one vessel required operative repair for new-onset claudication. No other immediate or delayed complications (thrombosis, pseudoaneurysm, infection, or deep venous thrombosis) were detected. A percutaneous approach for the treatment of AAA has several advantages over femoral artery cutdown but also has its own unique set of risks in the immediate and late postoperative period. Ultimately, the "preclose technique" can be safely applied for the Zenith device despite its large-bore delivery system.
Pulsatile blood flow in Abdominal Aortic Aneurysms
Salsac, Anne-Virginie; Lasheras, Juan C.; Singel, Soeren; Varga, Chris
We discuss the results of combined in-vitro laboratory measurements and clinical observations aimed at determining the effect that the unsteady wall shear stresses and the pressure may have on the growth and eventual rupturing of an Abdominal Aortic Aneurysm (AAA), a permanent bulging-like dilatation occurring near the aortic bifurcation. In recent years, new non-invasive techniques, such as stenting, have been used to treat these AAAs. However, the development of these implants, aimed at stopping the growth of the aneurysm, has been hampered by the lack of understanding of the effect that the hemodynamic forces have on the growth mechanism. Since current in-vivo measuring techniques lack the precision and the necessary resolution, we have performed measurements of the pressure and shear stresses in laboratory models. The models of the AAA were obtained from high resolution three-dimensional CAT/SCANS performed in patients at early stages of the disease. Preliminary DPIV measurements show that the pulsatile blood flow discharging into the cavity of the aneurysm leads to large spikes of pressure and wall shear stresses near and around its distal end, indicating a possible correlation between the regions of high wall shear stresses and the observed location of the growth of the aneurysm.
Prevention of peroperative hypothermia in abdominal surgery.
Kristensen, G; Guldager, H; Gravesen, H
It is important to reduce or prevent heat loss during anaesthesia, especially in patients with restricted cardiopulmonary reserves. To test a specially developed esophageal thermal tube (GK-esophageal thermal tube) for this purpose, 33 patients were randomly divided into two groups: Group A were given heat transferred to the central core during operation, using the GK-tube with circulating 41.7 degrees C warm water. Group B received no active warming. All patients were scheduled for major abdominal operation. In both groups there was a temperature fall in the induction phase. In Group B the temperature continued to fall slowly during operation, resulting in a median end-temperature of 34.9 degrees C. In Group A the temperature rose slowly after induction of heat via the tube, resulting in a median end-temperature of 36.8 degrees C in this actively warmed group. The temperature difference is significant (P less than 0.001). The median operating time was 3h 30 min in both groups. After 2 h of anaesthesia the median temperature in Group A was 36.1 degrees C and in Group B 35.0 degrees C. This difference is also significant (P less than 0.001). The described method was easy to use and without complications. We recommend this method to prevent peroperative hypothermia in all patients suspected to have limited cardiopulmonary reserves. The possible hazards and how to avoid these are described.
Postpartum intra-abdominal haemorrhage: Case report
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Tubić-Pavlović Aleksandra
Full Text Available Introduction. The most frequent cause of gynaecological haemoperitoneum is ruptured ectopic pregnancy. Haemoperitoneum after a normal vaginal delivery is rare and it is associated with high maternal mortality. Case report. A 22-year-old primipara had a normal vaginal delivery. She experinced acute abdominal pain and hypovolemic shock ten hours after the delivery and was referred to our hospital twenty one hours after the delivery. An urgent ultrasound profile was done, which revealed free fluid in pelvis and in the whole abdomen. An immediate laparotomy was done and 2 litres of blood were found within the peritoneal cavity. The uterine wall was intact. We found a haematoma on the anterior wall of rectum and livid colours of broad ligament. The peritoneal cavity was cleaned and revised. Any injury of the spleen or liver was excluded. Discussion and conclusion. Haematoperitoneum after a normal vaginal delivery is rare but life threatening to mothers. It is important to recognize this condition to avoid delay in diagnosis and treatment because of high maternal mortality. Our patient was bleeding from superficial rectal vessels. Only a few cases with undefined aetiologies have been reported in literature.
Osteoprotegerin Prevents Development of Abdominal Aortic Aneurysms.
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Batmunkh Bumdelger
Full Text Available Abdominal aortic aneurysms (AAAs, which commonly occur among elderly individuals, are accompanied by a risk of rupture and subsequent high mortality. Establishment of medical therapies for the prevention of AAAs requires further understanding of the molecular pathogenesis of this condition. This report details the possible involvement of Osteoprotegerin (OPG in the prevention of AAAs through inhibition of Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL. In CaCl2-induced AAA models, both internal and external diameters were significantly increased with destruction of elastic fibers in the media in Opg knockout (KO mice, as compared to wild-type mice. Moreover, up-regulation of TRAIL expression was observed in the media by immunohistochemical analyses. Using a culture system, both the TRAIL-induced expression of matrix metalloproteinase-9 in smooth muscle cells (SMCs and the chemoattractive effect of TRAIL on SMCs were inhibited by OPG. These data suggest that Opg may play a preventive role in the development of AAA through its antagonistic effect on Trail.
Familial abdominal aortic aneurysm: prevalence and implications for screening.
Adams, D C; Tulloh, B R; Galloway, S W; Shaw, E; Tulloh, A J; Poskitt, K R
The high prevalence of abdominal aortic aneurysm (AAA) in men over the age of 65 has led to the establishment of ultrasound screening programmes for this group. The apparent familial tendency towards AAA formation suggests that relatives of aneurysm patients may form another subpopulation in whom screening is appropriate. The first degree relatives of 100 consecutive aneurysm patients were identified. Of 110 relatives over 50 years of age, two were known to have had AAA and ultrasound scans were performed on 74, providing information on aortic size for 76 relatives (69%). No further aortic aneurysms (antero-posterior diameter > or = 4.0 cm) were found on scanning. However, nine relatives were demonstrated to have aortic dilatation (2.5-3.9 cm). Aortic dilatation was observed in 21% of male first degree relatives over 50 years of age, affecting 27% of sons and 17% of brothers. Only 4% of the sisters and none of the daughters were found to have aortic dilatation. The prevalence of aortic enlargement seems to be sufficiently high amongst male first degree relatives of AAA patients over 50 years of age to justify aortic screening.
Plain abdominal radiographs in children with inflammatory bowel disease
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Taylor, G.A.; Nancarrow, P.A.; Hernanz-Schulman, M.; Teele, R.L.
The value of plain abdominal radiography in children with inflammatory bowel disease (IBD) has not been ascertained. We reviewed the scout radiographs prior to first barium examination in 100 children with IBD (53 Crohn, 47 ulcerative colitis (UC) and scout films prior to excretory urography in 50 patients who had no clinical evidence of intestinal disease (controls)). The films were reviewed without clinical information, and the abnormalities on each film scored according to severity and location. Criteria included: mural thickening, dilatation and mucosal abnormalities of the small bowel and colon, as well as abnormal quantity and/or distribution of feces in the colon. Eighty percent (40/50) of the films in the control group were interpreted as normal. Abnormalities suggestive of IBD were presented in 73% of the IBD group (76% Crohn and 72% UC). Thirty-one percent of the films in the IBD group had a moderately abnormal score (>=3) or markedly abnormal score (>=5) at presentation. The most reliable radiographic findings were: mucosal abnormality in the colon and small bowel and an abnormal stool pattern (feces completely absent or only present in one colonic segment). The clinical presentation of IBD in childhood is often vague and nonspecific. Abnormalities in plain films of the abdomen are common in these patients and may be helpful in suggesting the presence and, to a great degree, the severity of disease in these children.
Contemporary Applications of Ultrasound in Abdominal Aortic Aneurysm Management
Scaife, Mark; Giannakopoulos, Triantafillos; Al-Khoury, Georges E.; Chaer, Rabih A.; Avgerinos, Efthymios D.
Ultrasound (US) is a well-established screening tool for detection of abdominal aortic aneurysms (AAAs) and is currently recommended not only for those with a relevant family history but also for all men and high-risk women older than 65 years of age. The advent of minimally invasive endovascular techniques in the treatment of AAAs [endovascular aneurysm repair (EVAR)] has increased the need for repeat imaging, especially in the postoperative period. Nevertheless, preoperative planning, intraoperative execution, and postoperative surveillance all mandate accurate imaging. While computed tomographic angiography and angiography have dominated the field, repeatedly exposing patients to the deleterious effects of cumulative radiation and intravenous nephrotoxic contrast, US technology has significantly evolved over the past decade. In addition to standard color duplex US, 2D, 3D, or 4D contrast-enhanced US modalities are revolutionizing AAA management and postoperative surveillance. This technology can accurately measure AAA diameter and volume, and most importantly, it can detect endoleaks post-EVAR with high sensitivity and specificity. 4D contrast-enhanced US can even provide hemodynamic information about the branch vessels following fenestrated EVARs. The need for experienced US operators and accredited vascular labs is mandatory to guarantee the reliability of the results. This review article presents a comprehensive overview of the literature on the state-of-art US imaging in AAA management, including post-EVAR follow-up, techniques, and diagnostic accuracy. PMID:27303669
Trauma abdominal em grávidas Abdominal trauma in pregnant women
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Gustavo Pereira Fraga
Full Text Available OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5. Seis mulheres (46,2% estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014. CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with
Papel da laparoscopia no trauma abdominal penetrante The role of laparoscopy in penetrating abdominal trauma
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Luiz Carlos Von Bahten
Full Text Available OBJETIVO: O papel da laparoscopia na redução da taxa de laparotomias não-terapêuticas e da morbidade em pacientes vítimas de trauma abdominal penetrante tem sido amplamente discutido durante os últimos anos. O objetivo do presente estudo é relatar a experiência inicial de um hospital universitário no manejo laparoscópico de pacientes com trauma abdominal penetrante. MÉTODO: Durante um período de três anos, a laparoscopia foi realizada em 37 pacientes vítimas de trauma abdominal penetrante, hemodinamicamente estáveis. Os prontuários médicos foram revisados e os parâmetros analisados foram as indicações do procedimento, lesões associadas, necessidade de conversão, tempo de permanência hospitalar e complicações. RESULTADOS: Houve 18 (48,6% casos de laparoscopias diagnósticas (LD positivas e 19 (51,4% negativas. Dos pacientes com LD positiva, oito (44,4% foram submetidos à laparotomia exploradora com finalidade terapêutica ou para melhor delineamento da lesão. Houve 10 (55,6% LD positivas nas quais não foi realizada conversão para cirurgia aberta. Quatro pacientes apresentaram lesões reparáveis laparoscopicamente, sendo realizado hepatorrafia (n=2 e frenorrafia (n=2. Os outros seis pacientes apresentavam lesões isoladas sem sangramento ativo, e a laparotomia não-terapêutica foi evitada. Os pacientes receberam dieta no primeiro dia de pós-operatório e o tempo médio de hospitalização foi de 3,8 dias. CONCLUSÕES: Nossa experiência inicial confirma que a laparoscopia é um bom método de avaliação e tratamento no trauma penetrante. A morbidade relacionada à laparotomias desnecessárias pode ser minimizada quando o procedimento é bem indicado, e o tratamento pode ser realizado com sucesso em casos selecionados.BACKGROUND: The role of laparoscopy in reducing the rate of non-therapeutic laparotomies and the morbidity in patients sustaining penetrating abdominal trauma has been widely discussed over the last
Caracterización preliminar de la susceptibilidad sísmica en el entorno de la localidad de Sampacho, Córdoba, Argentina
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Romina Daga
Full Text Available
The city of Sampacho, situated in Rio IV department, center of Argentina, it is located in an intraplate region with proved historical and current seismic activity, where the level of seismicity, which is important, makes a low constant seismic geoamenace to the all region. It is worth mentioning that it was epicenter of two historical earthquakes (year 1934, considerated two of the most destructive ones within of the zone of reduced seismicity.
In this paper characterizes preliminarily the Seismic Susceptibility in the sourrounding areas of Sampacho City, as a base for future studios of seismic microzoning and evaluation of Seismic-Risk. The following methodology emphatized the local Iithologic, geomorphologic and hydrologic factors, which may have an important incidence in the displacement of elastic wave front.
It also defines five classes of susceptibility from superimpose of information levels (lithology and depth oflevel freatic, from wich the moderately low prevails. The areal distribution of them is presented in a preliminary Map of Seismic Susceptibility in digital support, being this one the first document developed on this theme for the region.
La localidad de Sampacho, situada en el Departamento Rio Cuarto, Provincia de Córdoba, centro de la Republica Argentina, se encuentra emplazada en una regi
[Abdominal pregnancy: hormon concentrations during the postpartal period with placenta remaining intra-abdominal (author's transl)].
Gethmann, U; Mönkemeier, D
It is reported of an abdominal pregnancy at term. The placenta was left in situ because of the high risk of intraabdominal bleedings. Thereby it was possible to measure hormon concentrations of the fetoplacental unit without the fetal compartment. Within 10 days after delivery we determined the plasma levels of estradiol-17 beta, estriol, progesterone, HCS, alpha1fetoprotein, and the excretion of the total estrogens in the urines. There was near the same decrease of hormon concentrations in the post partal time comparable with that of a normal pregnancy. Only the HCS concentrations didn't change in the first 9 days after delivery.
Ethnic differences in anthropometric measures and abdominal fat distribution
DEFF Research Database (Denmark)
Rønn, Pernille F.; Andersen, Gregers S.; Lauritzen, Torsten
BACKGROUND: Ethnic variation in abdominal fat distribution may explain differences in cardiometabolic risk between populations. However, the ability of anthropometric measures to quantify abdominal fat is not clearly understood across ethnic groups. The aim of this study was to investigate...... the associations between anthropometric measures and visceral (VAT) and subcutaneous abdominal adipose tissue (SAT) in Inuit, Africans and Europeans. METHODS: We combined cross-sectional data from 3 studies conducted in Greenland, Kenya and Denmark using similar methodology. A total of 5275 individuals (3083 Inuit......, 1397 Africans and 795 Europeans) aged 17-95 years with measures of anthropometry and ultrasonography of abdominal fat were included in the study. Multiple regression models with fractional polynomials were used to analyse VAT and SAT as functions of body mass index (BMI), waist circumference, waist...
Pylephlebitis: a rare complication of an intra-abdominal infection
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Katherine Wong
Full Text Available Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition.
A case of lipoma of parietal peritoneum causing abdominal pain.
Bang, Chang Seok; Kim, Yeon Soo; Baik, Gwang Ho; Han, Sang Hak
Lipomas are common benign tumors of mature adipose tissue, enclosed by thin fibrous capsules. They can occur on any part of the body; however, peritoneal lipoma is extremely rare. We encountered a case of a 75-year-old man presenting with intermittent abdominal pain, who had undergone right hemicolectomy due to colon cancer. Abdominal computerized tomography showed a well-defined heterogenous fatty mass measuring 4.5 × 3.5 cm in size, suggesting fat necrosis located in the abdominal wall. Laparotomy showed a very large soft mass of peritoneum. Pathologically, the tumor was diagnosed as lipoma containing fat necrosis located in parietal peritoneum not fixed to any organs, but with small bowel adhesion. Due to its rare etiologic origin and obscure cause of development, we report on a case of lipoma of parietal peritoneum causing abdominal pain.
Prosthetics and Techniques in Repair of Animal's Abdominal Wall.
Karrouf, Gamal; Zaghloul, Adel; Abou-Alsaud, Mohamed; Barbour, Elie; Abouelnasr, Khaled
The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.
The potential participation of abdominal pressure in preeclampsia.
Zhang, Andy K
Preeclampsia is a major cause of maternal and perinatal mortality and morbidity. Regardless of susceptibility or predisposing conditions and risk factors, the degree of increase in abdominal pressure is directly related to the severity of preeclampsia, particularly in women with hydatidiform mole. When increased abdominal pressure is normalized by delivery, preeclampsia is cured. Recent genetic studies highlighted two leading risk factors for preeclampsia: chronic renal disease and T235 homozygosity for the AGT gene. Thus, while there is increased abdominal pressure in pregnancy, an imbalanced renin angiotensin system and renal injuries lead to a vicious cycle of increasing abdominal pressure and further renal injuries. A hypothesis for the potential participation of pressure in preeclampsia is described and the amelioration of preeclampsia through postural intervention and the possible therapeutic effect of angiotensin is suggested.
[Perioperative pain management for abdominal and thoracic surgery].
Englbrecht, J S; Pogatzki-Zahn, E M
Abdominal and thoracic surgical procedures can result in significant acute postoperative pain. Present evidence shows that postoperative pain management remains inadequate especially after "minor" surgical procedures. Various therapeutic options including regional anesthesia techniques and systemic pharmacotherapy are available for effective treatment of postoperative pain. This work summarizes the pathophysiological background of postoperative pain after abdominal and thoracic surgery and discusses the indication, effectiveness, risks, and benefits of the different therapeutic options. Special focus is given to the controversial debate about the indication for epidural analgesia, as well as various alternative therapeutic options, including transversus abdominis plane (TAP) block, paravertebral block (PVB), wound infiltration with local anesthetics, and intravenous lidocaine. In additional, indications and contraindications of nonopioid analgesics after abdominal and thoracic surgery are discussed and recommendations based on scientific evidence and individual risk and benefit analysis are made. All therapeutic options discussed are eligible for clinical use and may contribute to improve postoperative pain outcome after abdominal and thoracic surgical procedures.
Renal failure after operation for abdominal aortic aneurysm
DEFF Research Database (Denmark)
Olsen, P S; Schroeder, T; Perko, M
Among 656 patients undergoing surgery for abdominal aortic aneurysm, 81 patients (12%) developed postoperative renal failure. Before operation hypotension and shock occurred in 88% of the patients with ruptured aneurysm, whereas none of the patients operated electively were hypotensive. Dialysis...
Torsion of a parasitic myoma that developed after abdominal myomectomy.
Cho, In Ae; Baek, Jong Chul; Park, Ji Kwon; Song, Dae Hyun; Kim, Wan Ju; Lee, Yoon Kyoung; Park, Ji Eun; Shin, Jeong Kyu; Choi, Won Jun; Lee, Soon Ae; Lee, Jong Hak; Paik, Won Young
Iatrogenic parasitic myomas are rare. The condition is defined by the presence of multiple smooth-muscle tumorous nodules in the peritoneal cavity. This may be attributable to seeding of myoma particles during uterine surgery. The clinical course is usually indolent. The disease is often asymptomatic and is usually discovered only incidentally. A 38-year-old woman who had undergone abdominal myomectomy 7 months prior presented with acute abdominal pain and a huge pelvic mass. We performed exploratory laparotomy. A parasitic mass 17 cm in diameter with a twisted omental pedicle was identified. En bloc excision of the mass and omentum was performed, followed by total abdominal hysterectomy. Histopathological examination of multiple sections revealed features compatible with an infarcted leiomyoma. Thus, we present a very rare case of an iatrogenic, rapidly growing parasitic myoma complicated by omental torsion (which caused the acute abdominal pain). We also offer a literature review.
Functional abdominal pain causing Scurvy, Pellagra, and Hypovitaminosis A
Severe vitamin deficiency disease is rarely seen in developed countries. We present an atypical case of a young man with scurvy, pellagra, and hypovitaminosis A, caused by longstanding functional abdominal pain that severely limited his ability to eat.
Traumatic abdominal wall hernia: A case report and literature review
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Osama S. Al Beteddini
Conclusion: Traumatic abdominal wall hernia presents a diagnostic as well as a therapeutic challenge. The therapeutic approach is governed by a multitude of factors emphasizing the need of a patient-tailored, case by case management plan.
Psychological Profile of Children with Headache and Recurrent Abdominal Pain
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J Gordon Millichap
Full Text Available The psychological profile of 70 patients (age range 4-18 years; mean 11 years with headache, 70 with recurrent abdominal pain (RAP, and 70 controls was compared using the Child Behaviour Checklist 4-18 (CBCL.
Ruptured abdominal aortic aneurysm and aortoiliac vein fistula.
Gyoten, Takayuki; Doi, Toshio; Yamashita, Akio; Fukahara, Kazuaki; Kotoh, Keiju; Yoshimura, Naoki
A 67-year-old man was admitted with severe abdominal pain and back pain. Computed tomography showed an infrarenal abdominal aortic aneurysm (8.4 × 8.3 cm) and a large retroperitoneal hematoma. Immediately afterwards, the patient suffered circulatory collapse and was rushed to the operating theater. A fistula communicating with the left iliac vein was found. It was repaired with a Dacron patch while balloon-tipped catheters controlled the bleeding. The abdominal aortic aneurysm was replaced with a bifurcated graft. The postoperative course was uneventful. There have been few reports of successful repair of a ruptured abdominal aortic aneurysm associated with aortoiliac arteriovenous fistula.
Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture.
Kontopodis, Nikolaos; Metaxa, Eleni; Papaharilaou, Yannis; Tavlas, Emmanouil; Tsetis, Dimitrios; Ioannou, Christos
Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it. The peak wall stress, the role of the unique geometry of every individual abdominal aortic aneurysm as well as the mechanical properties and the local strength of the degenerated aneurysmal wall, all confer to rupture risk. In this review article, the assessment of these variables through mechanical testing, advanced imaging and computational modeling is reviewed and the clinical perspective is discussed.
Asthma Associates With Human Abdominal Aortic Aneurysm and Rupture
DEFF Research Database (Denmark)
Liu, Cong-Lin; Wemmelund, Holger; Wang, Yi
OBJECTIVE: Both asthma and abdominal aortic aneurysms (AAA) involve inflammation. It remains unknown whether these diseases interact. APPROACH AND RESULTS: Databases analyzed included Danish National Registry of Patients, a population-based nationwide case-control study included all patients...
Abdominal actinomycosis associated with intrauterine device: CT features.
Laurent, T; de Grandi, P; Schnyder, P
Abdominal actinomycosis is a severe and progressive peritoneal infection, due to an anerobic gram-positive bacterium, Actinomyces israelii. The presence of a long-standing intrauterine device (IUD) is a well-known risk factor in young women. We report two cases of pelviperitoneal actinomycosis appearing in two young women with acute low abdominal pain. Abdominal CT demonstrated multiple solid or encapsulated peritoneal masses with marked contrast enhancement and infiltration of the adjacent mesenteric fat. Laparoscopy confirmed the presence of intraperitoneal abscesses which contained Actinomyces israelii. High doses of amoxicillin and clavulanic acid (Augmentine) were given and following CT scan after 2 and 6 weeks showed a slow, but complete, resolution of the lesions. Although the radiologic presentation of actinomycosis is nonspecific, the diagnosis should be raised in the presence of pseudotumoral mesenteric infiltration, particularly in young women with an IUD. Abdominal CT is a useful method for diagnosis and for follow-up.
Massive ovarian oedema: an unusual abdominal mass in infancy.
Moon, Rebecca J; Mears, Alice; Kitteringham, Lara J; Gonda, Peter; Kohler, Janice A; Davies, Justin H
We describe a 13-month-old female who presented with vaginal bleeding, breast and pubic hair development and an abdominal mass. She underwent emergency laparotomy and left-sided salpingoophorectomy. Histological examination of the resected ovary revealed massive ovarian oedema, a rare non-neoplastic enlargement of the ovary. Consideration of this diagnosis in patients with an abdominal mass and endocrine disturbance may allow conservative surgery and preservation of fertility.
Abdominal Wall Endometrioma after Laparoscopic Operation of Uterine Endometriosis
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Tihomir Vukšić
Full Text Available Endometriosis is presence of functional endometrium outside of uterine cavum. As a pluripotent tissue, endometrium has the possibility of implanting itself almost everywhere; even implantation in abdominal wall was described, but it is not common site. This case report presents implantation of functional endometrium in abdominal wall, inside scar tissue, and after insertion of a laparoscopic trocar port. Final diagnosis was confirmed by pathohistological examination.
Safety of early pain relief for acute abdominal pain.
Attard, A.R.; Corlett, M. J.; Kidner, N. J.; Leslie, A. P.; Fraser, I. A.
OBJECTIVES--(a) to determine the efficacy of papaveretum in treating pain when administered early to patients presenting with acute abdominal pain and (b) to assess its effect on subsequent diagnosis and management. DESIGN--Prospective, randomised, placebo controlled study. SETTING--Walsgrave Hospital, Coventry. SUBJECTS--100 consecutive patients with clinically significant abdominal pain who were admitted as emergencies to a surgical firm. INTERVENTIONS--Intramuscular injection of up to 20 m...
[Abdominal tuberculosis in children. A review apropos of 13 cases].
Vidal, M L; del Castillo, F; Arroba, M L; Borque, C; García Hortelano, J
Thirteen cases of abdominal tuberculosis are presented; some of them in active or symptomatic stage and others in latent or abdominal calcification form. Many of these patients were diagnosed through the finding of a source of infected cattle after diagnosis of one of symptomatic patients. Pathogenesis, clinical findings and diagnostic difficulty are commented, as well a sanitary importance of the problem, since M. bovis is still a currently found organism in daily practice.
A Rare Cause of Abdominal Pain in Children: Hereditary Angioedema
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Deniz Özçeker
Full Text Available Hereditary angioedema (HA is a rare, autosomal-dominant genetic disorder presenting with recurrent attacks of angioedema. The most commonly involved organs include the extremites, face, neck, upper respiratory tract, genital region and the gastrointestinal tract. Edema of the intestinal mucosa can cause temporary obstruction and severe abdominal pain that can be confused with acute abdomen. Pediatricians and emergency physicians should keep in mind this rare disease in the differential diagnosis of severe abdominal pain.
Extra-Abdominal Desmoid Tumors Associated with Familial Adenomatous Polyposis
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George T. Calvert
Full Text Available Extra-abdominal desmoid tumors are a significant cause of morbidity in patients with familial adenomatous polyposis syndrome. Understanding of the basic biology and natural history of these tumors has increased substantially over the past decade. Accordingly, medical and surgical management of desmoid tumors has also evolved. This paper analyzes recent evidence pertaining to the epidemiology, molecular biology, histopathology, screening, and treatment of extra-abdominal desmoid tumors associated with familial adenomatous polyposis syndrome.
Abdominal candidiasis is a hidden reservoir of echinocandin resistance.
Shields, Ryan K; Nguyen, M Hong; Press, Ellen G; Clancy, Cornelius J
FKS mutant Candida isolates were recovered from 24% (6/25) of abdominal candidiasis patients exposed to echinocandin. Candida glabrata (29%) and Candida albicans (14%) mutants were identified. Multidrug-resistant bacteria were recovered from 83% of FKS mutant infections. Mutations were associated with prolonged echinocandin exposure (P = 0.01), breakthrough infections (P = 0.03), and therapeutic failures despite source control interventions (100%). Abdominal candidiasis is a hidden reservoir for the emergence of echinocandin-resistant Candida.
Torsion of a parasitic myoma that developed after abdominal myomectomy
Cho, In Ae; Baek, Jong Chul; Park, Ji Kwon; Song, Dae Hyun; Kim, Wan Ju; Lee, Yoon Kyoung; Park, Ji Eun; Shin, Jeong Kyu; Choi, Won Jun; Lee, Soon Ae; Lee, Jong Hak; Paik, Won Young
Iatrogenic parasitic myomas are rare. The condition is defined by the presence of multiple smooth-muscle tumorous nodules in the peritoneal cavity. This may be attributable to seeding of myoma particles during uterine surgery. The clinical course is usually indolent. The disease is often asymptomatic and is usually discovered only incidentally. A 38-year-old woman who had undergone abdominal myomectomy 7 months prior presented with acute abdominal pain and a huge pelvic mass. We performed exp...
Is screening for abdominal aortic aneurysm acceptable to the population?
DEFF Research Database (Denmark)
Lindholt, Jes Sanddal; Juul, Søren; Henneberg, E W
The aim of the study was to analyse whether the selection and recruitment for hospital-based mass screening for abdominal aortic aneurysms (AAA) is acceptable for the population according to the criteria from the Council of Europe.......The aim of the study was to analyse whether the selection and recruitment for hospital-based mass screening for abdominal aortic aneurysms (AAA) is acceptable for the population according to the criteria from the Council of Europe....
Using Abdominal CT Data for Visceral Fat Evaluation
Background: Quantitative assessment of body fat is important for the diagnosis and treatment of diseases related to obesity, Computed tomography (CT) becoming the standard procedure for measuring the abdominal fat distribution. Material and method: The retrospective study included 111 inpatients, who underwent routine abdominal CT exams in the Radiology Laboratory of SCJU Tg.Mures (2013). MPR MDCT (SOMATOM AS 64) data was processed using a custom written MATLAB R2009b software, ImageJ being u...
Renal replacement therapies after abdominal aortic aneurysm repair--a review.
Hudorović, Narcis; Lovricević, Ivo; Brkić, Petar; Ahel, Zaky; Vicić-Hudorović, Visnja
The objective of this review is to assess the incidence of postoperative acute renal failure that necessitates the application of hemofiltration and to determine the factors that influence the outcome in patients undergoing surgical repair of abdominal aortic aneurysm. In addition, the review aims to assess the outcomes of postoperative early hemofiltration as compared to late intensive hemofiltration. Different forms of renal replacement therapies for use in abdominal aortic aneurysm surgery patients are discussed. Electronic literature searches were performed using Pubmed, Medline, Embase, Sumsearch, Cinahil, The Cochrane Central Register of Controlled Trials and Excerpta Medica. The search identified 419 potentially eligible studies, of which 119 were excluded based on the title and abstract. Of the remaining 300 studies, full articles were collected and re-evaluated. Forty-five articles satisfied our inclusion criteria, of which only 12 were of the IA Level of evidence. The search results indicated that the underlying disease, its severity and stage, the etiology of acute renal failure, clinical and hemodynamic status of the patient, the resources available, and different costs of therapy might all influence the choice of the renal replacement therapy strategy. However, clear guidelines on renal replacement therapy duration are still lacking. Moreover, it is not known whether in acute renal failure patients undergoing abdominal aortic aneurysm surgery, renal replacement therapy modalities can eliminate significant amounts of clinically relevant inflammatory mediators. This review gives current information available in the literature on the possible mechanisms underlying acute renal failure and recent developments in continuous renal replacement treatment modalities.
Análisis preliminares de los materiales líticos provenientes de la Laguna Blanca Chica (Olavarría, Buenos Aires)
Pablo G. Messineo; Lázaro D'Augerot
En este trabajo se presentan los resultados preliminares sobre el estudio de los materiales líticos recuperado en la Laguna Blanca Chica (Partido de Olavarría, Provincia de Buenos Aires). El objetivo principal es conocer las estrategias relacionadas al aprovisionamiento y explotación de las materias primas presentes, como los procesos tecnológicos utilizados sobre las mismas. Los resultados obtenidos indican que la ftanita (55,58%) y la cuarcita (43,23%) fueron las materias primas más utiliza...
Análisis demográfico preliminar de Taxus globosa Schlecht en el Parque Nacional El Chico, Hidalgo, México
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Fernando Zavala Chávez
Full Text Available Se presenta una evaluación preliminar de la población de individuos juveniles de Taxus globosa Schlecht en el parque nacional El Chico, Hidalgo, efectuada mediante el análisis del número de individuos y algunas de sus características dasométricas, además de incluir datos de semillas. Se discute el estatus de conservación de la especie, pues resultó difícil argumentar sobre la escasez o riesgo de desaparición de T. globosa en el área.
Normas de Derecho Internacional Privado: capítulo IV del título preliminar del Código Civil
I. El Título Preliminar del Código civil y las normas de Derecho internacional privado: 1. Introducción. 2. Incidencia de la Constitución en orden a las fuentes del Derecho internacional privado. 3. La dispersión normativa del Derecho internacional privado español. 4. Autonomía sustancial del Derecho internacional privado y diversidad de procedimientos de producción normativa. II. Antecedentes de la codificación estatal del Derecho internacional privado. III. Modelos de codificación estatal d...
Diseño preliminar de la configuración de cabina para la aeronave de entrenamiento primario phaeton PT-01
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Juan Esteban Gaviria García
Full Text Available El espacio en cabina de una aeronave influye directamente en las capacidades de la tripulación a la hora de realizar su trabajo. La comodidad, el ambiente, Ia iluminacion, la forma en que se presenta toda Ia información de la aeronave en los instrumentos son algunos de los factores que son considerados en toda situación de vuelo. La metodología de diseiio preliminar de este espacio de cabina y su interacción con la tripulacion basada en procesos de diseño centrados en el ser humano, sera el principal topico de este artículo.
Otiniano Cáceres, Manuel Eduardo; Departamento de Operaciones Unitarias, Facultad de Química e Ingeniería Química UNMSM; Romero y Otiniano, P.; Departamento de Análisis y Diseño de Procesos, Facultad de Química e Ingeniería Química, UNMSM.; Guerrero, M.; Departamento de Química Orgánica,Facultad de Química e Ingeniería Química,Universidad Nacional Mayor de San Marcos,Lima,Perú.; Linares, T.; Departamento de Química Orgánica, Facultad de Química e Ingeniería Química, UNMSM.; Salas, G.; Departamento de Operaciones Unitarias, Facultad de Química e Ingeniería Química UNMSM; Lombira, J.; Departamento de Operaciones Unitarias, Facultad de Química e Ingeniería Química UNMSM; Helfer, H.; Departamento de Análisis y Diseño de Procesos, Facultad de Química e Ingeniería Química, UNMSM.; Cárdenas, J.; Departamento de Análisis y Diseño de Procesos, Facultad de Química e Ingeniería Química, Universidad Nacional Mayor de San Marcos
Se presentan los resultados preliminares de los ensayos experimentales realizados para la obtención del etanol anhidro utilizando destilación discontinua extractiva con una sal disuelta como el cloruro de sodio. Para los ensayos se utilizaron una planta piloto de destilación discontinua de acero inoxidable que cuenta con un sistema de adquisición de datos. Los resultados muestran que no se alcanza la composición del azeótropo que es de 95.6 % en peso de etanol.
Efecto del tramadol en la motilidad del ciego en dos equinos sanos (estudio preliminar
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Anastasia Cruz-Carrillo
Full Text Available El tramadol (analgésico opioide atípico es utilizado ampliamente en humanos y, en menor proporción, en animales, por falta de productos comerciales de uso veterinario. Es un analgésico eficaz que produce efectos adversos suaves, en comparación con los opioides típicos. Se propone su uso como alternativa en el manejo del dolor en equinos, a partir de la hipótesis de que al estimular los receptores opioides de manera suave, los efectos adversos en los equinos deben ser menores. Así, el objetivo del presente trabajo fue determinar el efecto del tramadol en la motilidad de la musculatura lisa de la base del ciego en equinos sanos. Se utilizaron tres equinos, a los cuales, mediante intervención quirúrgica, se les colocaron dos electrodos en la base del ciego, y se exteriorizaron sus extensiones por la pared abdominal, para conectarlas a un equipo de registro electromiográfico que permitió la valoración de la actividad intestinal 15 días después de colocados los electrodos y después de aplicar 1,2 mg de tramadol/kg de peso. Se comprobó que después de aplicar el tramadol hubo un descenso leve de la intensidad de las contracciones musculares, los sonidos intestinales estuvieron presentes, no hubo atonía, cólico ni estreñimiento. Adicionalmente, se comprobó su gran eficacia analgésica y la ausencia de cualquier efecto adverso. Se concluye que bajo las condiciones aquí planteadas, el tramadol no deprimió la motilidad del ciego en equinos sanos, aunque disminuyó la intensidad de las contracciones musculares en el ciego.
Actinomycosis Presenting as an Abdominal Mass in a Child
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Rahsan Özcan
Full Text Available Abdominal actinomycosis in childhood period is very rare and a relation to trauma is not well established. Herein we report a case that appeared subsequent to abdominal trauma. A 17 years old boy presented with left lower quadrant abdominal mass and signs of acute abdomen. The symptoms of abdominal discomfort began after a fall from height 3 months before admission. There were signs of acute abdomen at physical examination. Ultrasound of abdomen demonstrated a mass; CT scan findings pointed to a suspicious "internal hernia". An emergency laparotomy was performed. During surgery, a mass located over sigmoid colon and infiltrating the lateral abdominal wall was found. It was removed en bloc with the adjacent omentum. Except for the thickened sigmoid colon, no other pathologies were present at laparotomy. The pathology specimen revealed the actinomyces infection. The patient was treated with oral penicillin after discharge and the follow-up was uneventful. We advocate, keeping the actinomyces infection in mind in cases presenting with abdominal mass of unknown origin in childhood period.
Ascariasis as a cause of recurrent abdominal pain.
Guzman, Gerly Edson; Teves, Pedro Montes; Monge, Eduardo
Ascariasis is the most common helminthic infection in developing countries. It may cause chronic abdominal pain, tenderness and bloating. Our aim is to report a case of acute episodic abdominal pain and pancreatitis associated with ascariasis. We report a 59-year-old female patient who was admitted for acute abdominal pain, having had several previous similar events before one of them was diagnosed as acute idiopathic pancreatitis. On admission, her physical exam was normal. Laboratory results showed hemoglobin 12.2 g/dL, white blood cell count 11 900 cells/mm(3), eosinophils 420 cells/mm(3), serum amylase 84 IU/mL, lipase 22 IU/mL and normal liver function tests. Abdominal ultrasound and a plain abdominal X-ray were also normal. An upper endoscopy showed round white worms in the duodenum and the stomach, some of them with bile in their intestines. The intestinal parasites were diagnosed as Ascaris lumbricoides, and the patient was started on albendazole, with full recovery within a week. We believe that ascariasis should be considered in patients with recurrent abdominal pain and idiopathic pancreatitis.
Analysis of closed abdominal injury in pregnant women
Institute of Scientific and Technical Information of China (English)
TU Chang-di; WANG Shao-juan; ZHOU Ri-guang; WEI Yang-yi; TAN Qiang
Objective: To explore the characteristics of closed abdominal injury in pregnancy women and its treatment.Methods: The clinical data of 37 pregnancy patients with closed abdominal injury treated in our hospital from June 1993 to June 2003 were collected and analyzed.Results: All the 37 patients were treated with operation. Among them 2 early pregnancy patients with intestinal rupture and 1 patient with retroperitoneal hematoma were treated under laparoscope; in other 34 pregnancy patients laparotomy was performed. Of the 34 patients 8 used cesarean section because premature separation of placenta and enlarged womb interrupted the management of intra-abdominal organ injury. In the 37 patients 33 (89.1%) were cured, 4 (10.8%) die, postoperative complication rate was 16.2% (6/37). Two patients (5.4%) suffered from abdominal cavity infection, 3 (8.1%) from pulmonary infection, and 1 (2.7%) had multi-organ failure.Conclusions: For pregnancy patients with closed abdominal injury, besides obsteric diseases intra-abdominal injury should be given much attention. Accurate diagnosis and timely treatment can gain the time to save the life of both mother and fetus.
[Abdominal wall closure by incisional hernia and herniation after laparostoma].
Mischinger, H-J; Kornprat, P; Werkgartner, G; El Shabrawi, A; Spendel, S
As hernias and abdominal wall defects have a variety of etiologies each with its own complications and comorbidities in various constellations, efficient treatment requires patient-oriented management. There is no recommended standard treatment and the very different clinical pictures demand an individualized interdisciplinary approach. Particularly in the case of complicated hernias, the planning of the operation should focus on the problems posed by the individual patient. Treatment mainly depends on the etiology of the hernia, immediate or long-term complications and the efficiency of individual repair techniques. Abdominal wall repair for recurrent herniation requires direct closure of the fascia generally using the sublay technique with a lightweight mesh. It is still unclear whether persistent inflammation, mesh dislocation, fistula formation or other long-term complications are due to certain materials or to the surgical technique. With mesh infections it has been shown to be advantageous to remove a polytetrafluoroethylene (PTFE) mesh, while the combination of systemic and local treatment appears to suffice for a polypropylene or polyester mesh. Heavier meshes in the sublay position or plastic reconstruction with autologous tissue are indicated as substitutes for the abdominal wall for giant hernias, repeated recurrences and large abdominal wall defects. A laparostoma is increasingly more often created to treat septic intra-abdominal processes but is very often responsible for a complicated hernia. If primary repair of the abdominal wall is not an option, resorbable material or split skin is used for coverage under the auspices of a planned hernia repair.
Epidemiology, diagnosis and management of functional abdominal pain in children: A look beyond the belly
Korterink, J.J.
Chronic abdominal pain represents a common problem in children. In almost 90% of children presenting with chronic abdominal pain, no organic cause is found and a diagnosis of functional abdominal pain is made. Initially this condition was referred to as 'recurrent abdominal pain' by Apley and Naish
The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.
LENUS (Irish Health Repository)
Carney, John
Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial.
Comparison of abdominal muscle thickness according to feedback method used during abdominal hollowing exercise.
Lee, Sangyong; Han, Seulki; Lee, Daehee
[Purpose] This study was intended to examine the most effective feedback method for contracting the musculus transversus abdominis muscle by using basic training, a pressure biofeedback unit, and real-time ultrasonographic imaging during abdominal hollowing exercise training. [Subjects and Methods] The subjects in this study were 30 healthy young students in their twenties. Thirty subjects were divided randomly and equally into the basic training, the pressure biofeedback unit, and real-time ultrasonographic imaging groups. All of the subjects received abdominal hollowing exercise training for 15 minutes. The subjects in the pressure biofeedback unit group were trained by using a pressure biofeedback unit. Those in the real-time ultrasonographic imaging group received training with monitoring of possible contraction of their musculus transversus abdominis muscles on ultrasonography. [Results] In all the three groups, the musculus transversus abdominis became significantly thicker, but more significantly in the real-time ultrasonographic imaging group than in the basic training group. [Conclusion] The feedback method using real-time ultrasonographic imaging may be more effective in thickening the musculus transversus abdominis muscle during exercise than the traditional feedback method with manual contact only. However, it is insufficient in terms of overall qualitative improvement of exercise outcome.
Complications of transcatheteral occlusion of abdominal arteries
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Vogel, H.; Belz, Buecheler, E.
The number of transcatheteral occulsion of abdominal arteries reported so far enables us to differentiate between complications, which are specific for the methods used, or which are organ-specific and material-specific. Among the complications specific for the methods concerned are: complications occuring in angiography; tumour embolism in the lung; transport of embolic material into the lung; transport of embolic material into the arteries of the lower half of the body; renal insufficiency; necrosis; and, finally, abscess formation. Among the organ-specific complications are: necrosis (especially of the spleen and in the operated upper gastro-intestinal tract); abscess formation (spleen, kidneys, liver); retroperitoneal phlegmones (kidney); relapsing haemorrhages (gastro-intestinal tract, kidneys); renal insufficiency (in case of pre-existing renal damage); hypertension (described so far as transient blood pressure increase only); hypertensive crisis (after renal artery occulsion for malignant hypertension); hepatic insufficiency and gallbladder infarction (in embolisation of the liver); transport of embolic material into adjacent arteris (in case of embolisation, into the vessels of the truncus coeliacus); and, finally, hypoglycaemia (in embolisation of the liver). Among the material-specific complications are: adhesion of the catheter tip to the vascular wall (Bucrylate); dislocation of Gianturco's spiral; allergic (anaphylactic) reaction to the embolic material (not described so far); recanalisation (in case of absorbable substances such as Fibrospum and Gelfoam); substitutive blood supply via the formation or extension of collaterals; necrosis in peripherally (capillary) occluding substances such as Bucrylate and Ethibloc; and, finally, abscess formation (in case of non-sterile embolic material). Some of these complications can be classified under more than one category.
Abdominal aortic surgery and renal anomalies
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Ilić Nikola
Full Text Available Introduction. Kidney anomalies present a challenge even for the most experienced vascular surgeon in the reconstruction of the aortoilliac segment. The most significant anomalies described in the surgery of the aortoilliac segment are a horse-shoe and ectopic kidney. Objective. The aim of this retrospective study was to analyze experience on 40 patients with renal anomalies, who underwent surgery of the aortoilliac segment and to determine attitudes on conventional surgical treatment. Methods. In the period from 1992 to 2009, at the Clinic for Vascular Surgery of the Clinical Centre of Belgrade we operated on 40 patients with renal anomalies and aortic disease (aneurysmatic and obstructive. The retrospective analysis involved standard epidemiological data of each patient (gender, age, risk factors for atherosclerosis, type of anomaly, type of aortic disease, presurgical parameter values of renal function, type of surgical approach (laparatomy or retroperitoneal approach, classification of the renal isthmus, reimplantation of renal arteries and perioperative morbidity and mortality. Results. Twenty patients were males In 30 (70% patients we diagnosed a horse-shoe kidney and in 10 (30% ectopic kidney. In the cases of ruptured aneurysm of the abdominal aorta the diagnosis was made by ultrasound findings. Pre-surgically, renal anomalies were confirmed in all patients, except in those with a ruptured aneurysm who underwent urgent surgery. In all patients we applied medial laparatomy, except in those with a thoracoabdominal aneurysm type IV, when the retroperitonal approach was necessary. On average the patients were under follow-up for 6.2 years (from 6 months to 17 years. Conclusion. Under our conditions, the so-called double clamp technique with the preservation of the kidney gave best results in the patients with renal anomalies and aortic disease.
The effect of abdominal resistance training and energy restricted diet on lateral abdominal muscles thickness of overweight and obese women.
Noormohammadpour, Pardis; Kordi, Ramin; Dehghani, Saeed; Rostami, Mohsen
The role of transabdominal muscles (external oblique, internal oblique and transversus abdominis) on core stability has been shown previously. Energy restricted diet and abdominal resistance training are commonly used by overweight and obese people to reduce their weight. In this study we investigated the impact of 12 weeks concurrent energy restricted diet and abdominal resistance training on the thickness of the lateral abdominal muscles of 19 obese and overweight women employing ultrasonography in resting and drawing-in maneuvers. The results showed significant increase of the muscle thicknesses during drawing-in maneuver after 12 weeks intervention. Based on our findings, it can be concluded that 12 weeks concurrent abdominal resistance training and energy restricted diet in addition to weight loss lead to improvement of transabdominal muscles thickness in obese and overweight people. Considering the role of these muscles in core stability, using this therapeutic protocol in obese people, particularly in those who have weakness of these muscles might be helpful.
Electromyographic investigation of abdominal exercises and the effects of fatigue.
Robinson, Mark; Lees, Adrian; Barton, Gabor
Abdominal exercises are widely used to develop the anterior muscles of the trunk. These exercises can be undertaken without the aid of equipment, but increasingly manufacturers are developing equipment which purportedly enhances the training effect for abdominal muscles. As there are many different products and exercises used for abdominal muscle development, it is likely that some are more effective than others. This study aimed to investigate the effectiveness of five commonly performed abdominal exercises. A second aim was to investigate the effects of fatigue on these exercises. Five different types of abdominal exercise [standard crunch (sit-up) with bent knees, gym ball crunch, crunch with 5 kg weight held behind the head, legs raised crunch and a commercially manufactured roller crunch] were examined using integrated surface electromyography (IEMG). The lower rectus abdominis (LRA), upper rectus abdominis (URA) and obliquus externus abdominis (EO) of 15 healthy male participants [age (mean +/- SD) 22.2 +/- 6.8 years; height 1.77 +/- 0.06 m; mass 79.3 +/- 10.7 kg] were monitored using a four-channel special purpose EMG data logger. Three trials of each exercise were performed in random order and normalized to enable comparisons between muscles and exercises. At a later date, ten participants were then re-tested when fresh and after a 30 min whole-body fatigue protocol that specifically targeted the abdominal muscles. Two exercises were evaluated, the abdominal roller crunch and legs raised crunch, which were judged to be the least and most effective, respectively, of the five exercises previously used. The normalized IEMG showed significant (p crunch = 86.0 +/- 7.5%; legs raised crunch = 79.9 +/- 5.1%; 5 kg weight crunch = 65.1 +/- 13.4%; standard crunch = 56.2 +/- 3.2%; and roller crunch = 45.0 +/- 11.4%). Post-fatigue, the normalized mean IEMG for both exercises increased significantly (p 0.05). It was concluded that exercises can be constructed to provide
Análise preliminar do tratamento de Diabetes mellitus com Polissacarídeo de Tremella fuciformis
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Vinicius de Oliveira Cardoso
Full Text Available Introdução: O Diabetes mellitus é uma desordem metabólica que ocorre no mundo inteiro, caracterizada por hiperglicemia associada a problemas com secreção ou ação da insulina ou, ainda por alterações no metabolismo intermediário de carboidratos, proteína e lipídeos. O cogumelo Tremella fuciformis (Basideomycota foi isolado no Brasil e levado para a China onde tem sido produzido e utilizado como alimento por apresentar diversas atividades biológicas como anti-inflamatório, anti-mutagênico, reduz hipertensão, reduz diabetes entre outras propriedades relacionadas com imunidade. A Embrapa de Brasília tornou isolar o cogumelo e enviou a universidade para os testes preliminares. Objetivo: O presente trabalho teve como objetivo induzir a diabetes em ratos e realizar tratamento com polissacarídeo (PS extraído do cogumelo gelatinoso Tremella fuciformis, desenvolvido em frascos no laboratório. Método: Ratos, no total de 28 animais foram divididos em 4 grupos sendo: 1-Normal grupo recebendo dieta normal e água; 2-Sacarose grupo recebendo ração normal e uma solução de sacarose 20% por 65 dias; 3-Sacarose + PS grupo recebendo ração normal + solução de sacarose (65dias e por gavagem PS na concentração de 1mmol (nos últimos 20 dias sendo uma vez/semana ; 4-idem ao grupo 3, entretanto PS com concentração de 2mmol. No período, os ratos (uma vez/semana foram pesados e submetidos a teste de glicose (fita Accu Check e, depois sacrificados com dose letal de analgésico e coleta do sangue para testes de glicose, colesterol, triglicérides, creatinina e HDL. Resultados: Os resultados parciais demonstraram que os animais submetidos à dieta com sacarose aumentaram o peso e glicemia. Já os animais submetidos a tratamento com o PS permaneceram com o peso praticamente constante e, redução da glicemia. A creatinina tem sido um parâmetro para diagnosticar problemas renais, mas os animais em todos os tratamentos, não apresentaram
Abdominal pain in a 70-year-old Danish population. An epidemiological study of the prevalence and importance of abdominal pain
DEFF Research Database (Denmark)
Kay, L; Jørgensen, Torben; Schultz-Larsen, K
In order to assess the prevalence and importance of abdominal pain in the elderly, an epidemiological study of a 70-year-old Danish population was carried out. Seventy two percent of 1119 randomly selected persons answered a questionnaire concerning abdominal pain. One year prevalence of abdominal...... pain was 28% among women and 17% among men (p abdominal pain no significant sex difference was found as regards location, severity, frequency, or medicine consumption. Eleven percent of the men and 19% of the women had abdominal pain which they considered to be of importance...... to their well-being in terms of frequency, severity, or need of medicine (sex difference: chi 2 = 10.18, df = 2, p abdominal pain judged their general health to be better than those who had experienced abdominal pain (p abdominal pain is frequent...
Análisis factorial confirmatorio de la Escala de Estilos de Crianza de Steinberg: validez preliminar de constructo
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César Merino Soto
Full Text Available Se estudió la validez de constructo y confiabilidad interna de la Escala de Estilos de Crianza de L. Steinberg que se administró a una muestra de 224 adolescentes entre 11 y 19 años de un colegio público en Lima. Mediante el análisis factorial confirmatorio de grupo múltiple, la estructura de tres subescalas (Compromiso, Autonomía Psicológica y Control Conductual/Supervisión se mantuvo en general estable, aunque la agrupación teórica de los ítems tendió a estar influenciada por la distribución de los ítems. La confiabilidad alfa para las subescalas solo alcanzó niveles marginales de aceptación y se reconoció el probable impacto del error de medición aleatorio. Los resultados muestran que el instrumento utilizado es una herramienta potencial para la investigación, pero estos hallazgos son preliminares y se requieren estudios adicionales para evaluar la generalización del análisis efectuado. The present study tried to find evidences of construct validity and internal reliability for the Parenting Styles Scale of L. Steinberg. The instrument was applied in a sample of 224 adolescents from 11 to 19 years old from a public school of Lima. With a strategy of multiple group confirmatory factor analysis, the three-subscale structure (Commitment, Psychological Autonomy and Behavior Control/Supervision was in general stable, although the theoretical grouping of the items was influenced by the distribution of the item. The alpha reliability reached marginal levels and the probable impact of the random error was recognized. Results show that this instrument is a potential tool for research, but these findings are preliminary and additional studies are required to evaluate the generalization of the analysis.
Estudio preliminar. Patologías digitales más frecuentes en el pie de la bailaora de flamencoe
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José Manuel Castillo López
Full Text Available Este estudio tiene como objetivos, en primer lugar, dar a conocer las principales deformidades digitales de los pies, asociadas -por su alta incidencia- a la práctica profesional del baile flamenco femenino. Así como, poner de manifiesto la necesidad de llevar a cabo estudios de mayor magnitud para determinar si existe una relación estadísticamente significativa entre la práctica del baile flamenco con las deformidades y patologías podológicas descritas, y la importancia de la investigación en el campo de la medicina del deporte, y de la ortopodología y biomecánica en pos de hallar tratamientos preventivos y/o paliativos en su caso.En este estudio epidemiológico preliminar, llevado a cabo con la colaboración de la Universidad de Sevilla-Área Clínica de Podología y Departamento de Podología- Agencia Andaluza para el Desarrollo del Flamenco, Fundación Cristina Heeren de Arte Flamenco, Centro de Baile Flamenco Ana Moya, y el Centro de Investigación de Flamenco Telethusa, se han evaluado a 28 bailaoras profesionales activas en la provincia de Sevilla, con una actividad mínima de 20h semanales. En dicha muestra se han determinado las patologías podológicas presentes, sintomatología, hábitos de uso de calzado específico, y hábitos podológicos. Los resultados muestran una alta incidencia de patologías digitales como el H.A.V. (juanetes, dedos en garra, y onicopatías.
Implantes con grabado ácido y pasivado químico: estudio preliminar sobre carga precoz
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JMª Martínez-González
Full Text Available Presentamos un estudio sobre un nuevo sistema de implantes en los que su superficie se encuentra tratada mediante un procedimiento de grabado ácido y pasivado químico. El número de pacientes que integraron este ensayo fue de quince, a los cuales se les colocaron un total de setenta implantes sobre situaciones diferentes, en cuanto a calidad y cantidad óseas se refiere. Los resultados ofrecen, en una primera fase, un 95,71% de éxito, permitiendo realizar la carga protésica en un tiempo aproximado de dos meses, lo que nos hace establecer como conclusiones preliminares que este tipo de superficie implantaría permite reducir el tiempo de espera de nuestros pacientes con unos resultados similares a los obtenidos con otras superficies más convencionales.We are submitting a study on a new implant system in which the surface of the implant is treated by means of a process of acid etching and chemical passivation. The fifteen patients that were included in this assay were given a total of seventy implants according to the different states and conditions of bone quality and quantity. After the first stage the results showed a success rate of 95.71%, which means that prothesis loading can be effected within a period of approximately two months, and which has led us to stablish, by way of preliminary conclusions, that this type of implant surface means that the waiting time for our patients can be reduced, and that results similar to those obtained using other, more conventional surfaces can be achieved.
Inventario preliminar de las especies de la familia Orquidaceae en La Vereda La Granja del municipio de Sasaima, Cundinamarca, Colombia
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Ordóñez B. Juan Camilo
Full Text Available La familia Orquidaceae tiene la mayor diversidad del reino vegetal, presenta variaciones en cuanto al hábitat, floración, polinización, entre otros aspectos. Colombia registra aproximadamente 3.500 especies en 250 géneros, representando el 10% de la diversidad de la vegetación mundial. Este trabajo presenta un inventario preliminar, sobre las orquidáceas de la Vereda "La Granja" del municipio de Sasaima, Cundinamarca, Colombia. El muestreo se realizó en transectos desde la zona urbana municipal, por la carretera que conduce al municipio de la Vega, hasta "La Ye" ubicada a 500 m del río Gualiva, abarcando un total de 10 km. El trabajo en campo incluyó una ficha morfotaxonómica de caracterización, destacando: descripción del hábitat y especie, condiciones ambientales, épocas de floración, abundancia y huéspedes en caso de epifitismos. La identificación de géneros se basó en las claves de Gentry y Valdivieso, y la de especies se hizo por comparación de muestras y fotografías con la publicación de Villegas. Se registraron 41 especies agrupadas en 27 géneros, de estos se destaca Epidendrum. El 56% de las especies son poco comunes, y solo el 7,3% muy abundantes. El hábitat más común es el Epífito. La época de mayor floración se encuentra entre abril-marzo.
Calculo Preliminar de la Tasa de Meteorización del Batolito Antioqueño, Cordillera Central, Colombia
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Carolina Garcia
Full Text Available Este trabajo es una estimación preliminar del tiempo necesario para generar la espesa capa de saprolito que caracteriza el perfil de meteorización actual de un batolito cuarzodiorítico cretácico que aflora en altiplanos de la Cordillera Central de Colombia, entre 5º50' y 7º00' de latitud Norte y 74º50' y 75º35' de longitud Oeste y a alturas entre 750 y 2700 m.Se utilizan datos obtenidos previamente mediante el análisis de la composición química de las aguas superficiales de cuatro cuencas con áreas diferentes, ubicadas sobre el Batolito Antioqueño, al este de Medellín. Los cáculos se hicieron con el método basado en la pérdida de componentes en solución utilizando diferentes valores de solutos. Al utilizar la pérdida de sílice se obtiene un tiempo de meteorización de unos 6 x 10 6 años, comparable con el obtenido mediante la datación de las cenizas volcánicas mas antiguas que recubren la topografía actual y que indican la fecha mínima de configuración de la superficie de erosión.A pesar de resultar de una serie de suposiciones simplificadoras, este resultado es interesante y justifica la realización de determinaciones mas detalladas. Confirma la larga preservación de superficies de erosión antiguas conformadas sobre un saprolito que desde hace varios millones de años no ha sido sometido a una erosión profunda, fenómeno poco común en una zona tectónicamente activa como la estudiada.
Abdominal wall repair with human acellular dermal autograft
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Roel E. Genders
Full Text Available Repair of abdominal wall defects in the presence of contamination or infection is a significant problem. The loss of tissue warrants enforcement of the abdominal wall, preferably by autologous material. However, autologous repair often requires extensive surgery. This paper presents a review of available literature of placement of an acellular human dermis to repair an abdominal fascia defect, in contaminated as well as in non-contaminated surgical fields. It is illustrated with a case report that describes the successful reconstruction of an infected abdominal wall defect with a human acellular dermis allograft. A systematic literature review was undertaken with searches performed in the Pubmed and Cochrane databases for the period up till March 2009, using the search terms Alloderm [Substance Name], Hernia [Mesh] and the key words acellular dermis, acellular dermal matrix, human acellular dermal allograft and abdominal wall defect. To assess methodological quality, each article was subjected to a modification of the methodological index for non-randomized studies (MINORS according to Slim et al. Two items from the original index were not included because none of the studies selected had an unbiased assessment of the study end points and in none of the studies was a prospective calculation of the study size performed. Seventeen studies were included in the review. Data were extracted regarding study design, number of patients, surgical technique, followup period, contaminated or non-contaminated area of the fascia defect, mortality and morbidity (hemorrhage, seroma, wound dehiscence, infection of the operative procedure, the longterm results (removal of the graft, reherniation and bulging and level of evidencey. A total of 169 short-term complications and 151 longterm complications occurred after 643 surgical procedures reconstructing both contaminated and clean abdominal wall defects by implantation of an HADA. Human acellular dermal allograft
Open abdomen procedure in managing abdominal compartment syndrome in a child with severe fungal peritonitis and sepsis after gastric perforation
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Wei Lai
Full Text Available Abdominal compartment syndrome with increased abdominal pressure resulted in multi-organ dysfunctions can be lethal in children. The open abdomen procedure intentionally leaves the abdominal cavity open in patients with severe abdominal sepsis and abdominal compartment syndrome by temporarily relieving the abdominal pressure. We reported our experience of open abdomen procedure in successfully treating a 4-year old boy with abdominal compartment syndrome caused by severe fungal peritonitis and sepsis after gastric perforation.
Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock
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Derrick J. N. Dauplaise
Full Text Available Objective. To describe a profoundly immunocompromised (panleukopenia child with septic shock who developed abdominal compartment syndrome (ACS and was successfully treated with surgical decompression. Design. Individual case report. Setting. Pediatric intensive care unit of a tertiary children's hospital. Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT 5 days prior to developing septic shock secondary to Streptococcus viridans and Escherichia coli ACS developed after massive fluid resuscitation, leading to cardiopulmonary instability. Interventions. Emergent surgical bedside laparotomy and silo placement. Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction. Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.
Effects of simvastatin in abdominal sepsis in rats Efeitos da sinvastatina na sepse abdominal em ratos
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José Luiz de Souza Neto
Full Text Available PURPOSE: Statins are widely recognized as hypolipemic drugs, but some studies have observed anti-inflammatory and immunomodulatory effects, known as pleiotropic. The aims of this work was to study possible anti-inflammatory effects of simvastatin in abdominal sepsis. Serum pro-inflammatory cytokines and leukocytes count were determined in an experimental model of abdominal sepsis, using cecal ligation and puncture (CLP in rats. METHODS: Twenty eigth Wistar rats weighing 285±12g were randomly divided in: CLP/Sinvastatin rats (n=7, treated with 10 mg/Kg of oral simvastatin 18 and 2 hs berofe CLP; CLP/Saline group rats (n=7, treated with oral saline; group Sham/Simvastatin (n=7, treated with simvastatin, and group Sham/Saline (n=7, treated with saline. Serum TNF-alpha, IL-1beta and IL-6 by ELISA and total leukocytes, neutrophils, lymphocytes, and eosinophils were determined 24 hs after CLP. ANOVA and Tukey test were used considering significant pOBJETIVO: As estatinas são agentes reconhecidamente hipolipemiantes. Vários estudos têm revelado que eles têm ações pleiotrópicas, como antiinflamatória e imunomoduladora. Tentando-se entender o papel antiinflamatório da sinvastatina na sepse, foram analisados os níveis de citocinas pró-inflamatórias e contagem de leucócitos em modelo de sepse abdominal por ligadura e punção do ceco (LPC em ratos. MÉTODOS: Foram utilizados 28 ratos Wistar pesando 285±12g, assim divididos: grupo sepse (n=14, submetidos a LPC e grupo sham (n=14, submetidos a laparotomia e manipulação suave do ceco. No grupo LPC/sinvastatina (n=7 os ratos receberam 10mg/kg de sinvastatina via oral 18 e 2 horas antes da LPC e no grupo LPC/salina (n=7 os ratos receberam injeção oral de solução salina 0,9 %. Os animais dos grupos sham/sinvastatina (n=7 e sham/salina (n=7 receberam o mesmo tratamento. Dosagem de TNF-alfa, IL-1beta e IL-6 por ELISA e contagem de leucócitos totais, neutrófilos, linfócitos e eosin
Aneurisma de aorta abdominal na infância Abdominal aortic aneurism in childhood
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Abdo Farret Neto
Full Text Available The authors report a case of an abdominal aortic aneurism involving all visceral branches minus the Inferior Mesenteric artery in a 4-year-old girl. There was sugestive evidence that the arterial disease had an inflamatory or infectious etiologic factor. The most probable etiological factors could be salmonelas infection of the arterial wall or Takayasu's disease secondary to tuberculosis. The treatment with antibiotic to salmonelas infection during ten days, followed by tuberculostatic therapy for six months was chosen. Concerning the age, the arteries involved and the inflamatory aspect of the aneurysm, the surgical option became an alternative to the clinic treatment in case of any future evidence of the aneurysm enlargement. The patient became asymptomatic as soon as the antibiotic has been started. The control of the aneurysm evolution will be made by ecography each three months.
[Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].
Nikul'nikov, P I; Liksunov, O V; Ratushniuk, A V; Lugovs'koĭ, E V; Kolesnikova, I M; Lytvynova, L M; Kostiuchenko, O P; Chernyshenko, T M; Hornyts'ka, O V; Platonova, T M
Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.
Humanidades digitales: la censura y los laudatorios en las preliminares del Siglo de Oro español; Madrid y Guzmán de Alfarache
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Witton Becerra Mayorga
Full Text Available Este artículo presenta los resultados del estudio de la censura y los laudatorios en algunas preliminares de la literatura del Siglo de Oro español. Fue realizado con la metodología de " queries " en la plataforma Sylvadb del Laboratorio Culturplex. El traba - jo se divide en cuatro partes: introducción, donde se definen los elementos teóricos desde los cuales se aborda la investigación; metodología, en la que se tratan los pasos de la investigación desde la lectura, la elaboración de la base de datos, las consultas ( searchs y preguntas ( queries ; resultados, en los cuales se indican los resultados obtenidos de la investigación, y por último están las conclusiones, que señalan dos asuntos que aportan nuevas propuestas al campo de los estudios literarios respecto a las humanidades digitales y al trabajo sobre las preliminares.
Estudio Teórico Preliminar de Fármacos Anti-VIH, Inhibidores No Nucleosídicos de la Transcriptasa Reversa Preliminary Theoretical Study on HIV-1, Non-Nucleoside Reverse Transcriptase Inhibitors
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Martín A Dragonetti
Full Text Available Una serie de compuestos derivados de quinoxalina, benzoxazina y benzodiazepina fue utilizada para realizar un estudio teórico preliminar que permita plantear un potencial grupo farmacóforo que conduzca a la síntesis de posibles inhibidores no-nucleosídicos de la transcriptasa reversa del virus del SIDA. El estudio teórico se llevó a cabo utilizando modelado molecular asistido por computadora. Se analizaron las conformaciones obtenidas para los compuestos en estudio (densidad atómica de carga y del arreglo espacial de los grupos atómicos. Los resultados se compararon con la información aportada por los complejos cristalográficos (fármaco-transcriptasa reversa extraídos de una base de datos de proteínas. Este estudio permitió establecer los requerimientos esenciales para que un compuesto se comporte como inhibidor de la transcriptasa reversa del VIH-1 y encontrar el potencial farmacóforo común a este tipo de fármacos.A series of quinoxaline, benzooxazine and benzodiazepine derivatives was selected to perform a preliminary theoretical study tending to find a potential pharmacophoric group that could lead to the synthesis of non nucleoside inhibitors of the HIV-1 reverse transcriptase. The theoretical study was performed using computer-assisted molecular modeling. The achieved final conformations of the selected compounds were compared and analyzed in terms of the atomic charge density and the atomic groups arrangements. The results were compared with information extracted from the crystallographic complexes (drug-reverse transcriptase reported in a protein data bank. This analysis enables to establish the essential requirements for a compound inhibition behavior of the HIV-1 reverse transcriptase and to find a potential pharmacophore common to this type of compounds.
Traumatic abdominal wall hernia in two adults: a case series
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Agarwal Nitin
Full Text Available Abstract Introduction Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. Case presentations A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well. Conclusion Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.
Open abdomen management of intra-abdominal sepsis.
Adkins, Amy L; Robbins, James; Villalba, Mario; Bendick, Phillip; Shanley, Charles J
Despite surgical advances, antimicrobial therapy, and intensive care, the morbidity and mortality of intra-abdominal sepsis remains high. The primary purpose of this study was to determine whether open abdomen management of intra-abdominal sepsis reduces intensive care unit (ICU) and hospital mortality. The records of 81 consecutive patients with open abdomen management for intra-abdominal sepsis admitted to the surgical ICU from January 1998 to April 2002 were retrospectively reviewed. Outcomes were compared to a historical control group with primary abdominal closure, also admitted to the surgical ICU with intra-abdominal sepsis and matched for sex, age, source of sepsis, and APACHE III score. ICU mortality for the open abdomen group was 25 per cent versus 17 per cent for the control group. Hospital mortality was 33 per cent and 25 per cent for the open abdomen patients and historical controls, respectively. Both ICU and hospital length of stay were significantly longer for the open abdomen group. An overall fistula rate of 14.8 per cent was demonstrated in the open abdomen patients. A significant difference in overall ICU and hospital mortality was not demonstrated between patients treated with open abdomen management and historical controls. A prospective randomized study accounting for extent of sepsis may define a role for open abdomen management in selected subgroups of patients.
Conservative management of post-appendicectomy intra-abdominal abscesses
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Dhaou Mahdi
Full Text Available Abstract Purpose Appendicitis is the most common abdominal inflammatory process in children which were sometimes followed by complications including intra-abdominal abscess. This later needs classically a surgical drainage. We evaluated the efficacy of antibiotic treatment and surgical drainage. Methods Hospital records of children treated in our unit for intra-abdominal post appendectomy abscesses over a 6 years period were reviewed retrospectively. Results This study investigates a series of 14 children from 2 to 13 years of age with one or many abscesses after appendectomy, treated between 2002 and 2007. Seven underwent surgery and the others were treated with triple antibiotherapy. The two groups were comparable. For the 7 patients who receive medical treatment alone, it was considered efficient in 6 cases (85% with clinical, biological and radiological recovery of the abscess. There was one failure (14%. The duration of hospitalization from the day of diagnosis of intra-abdominal abscess was approximately 10.28 days (range 7 to 14 days. In the other group, the efficacy of treatment was considered satisfactory in all cases. The duration of hospitalization was about 13 days (range: 9 to 20. Conclusion Compared to surgical drainage, antibiotic management of intra-abdominal abscesses was a no invasive treatment with shorter hospitalization.
[Drug therapy of acute and chronic abdominal pain].
Streitberger, Konrad; Stüber, Frank; Kipfer Buchli, Irène; Stamer, Ulrike M
For drug therapy a differentiation of acute and chronic pain is essential. In emergency situations of acute abdominal pain a fast diagnosis is mandatory. Analgesia should be provided as soon as possible. The different groups of analgesics should be used according to their known effects, side effects and contraindications. Postoperative pain after abdominal surgery has to be considered as a special condition of acute abdominal pain. Main treatment options are non opioid analgesics and opioids. Opioids can be administered intravenously via patient controlled analgesia (PCA) devices. In major abdominal surgery neuroaxial analgesia, preferentially administered via an epidural catheter provides excellent pain relief with positive impact on gastrointestinal motility and patients' recovery. Because of difficulties to allocate chronic abdominal pain to a specific organ, causal treatment often turns out to be difficult. Peripheral and central sensitization, as well as an alteration of the endogenous pain modulation comes to the fore in these chronic pain conditions. Co-analgesics like anticonvulsants and antidepressants are utilized to reduce sensitization and improve the endogenous pain modulating system. Non drug approaches and alternative treatment options might be useful. In contrast, orally or transcutaneously administered opioids are the principal corner stone for the treatment of cancer pain.
Supraspinal TRPV1 modulates the emotional expression of abdominal pain.
Jurik, Angela; Ressle, Andrea; Schmid, Roland M; Wotjak, Carsten T; Thoeringer, Christoph K
The transient receptor potential vanilloid receptor type-1 (TRPV1) is critically involved in peripheral nociceptive processes of somatic and visceral pain. However, the role of the capsaicin receptor in the brain regarding visceral pain remains elusive. Here, we studied the contribution of TRPV1 to abdominal pain transmission at different nociceptive pathway levels using TRPV1 knock-out mice, resiniferatoxin-mediated deletion of TRPV1-positive primary sensory neurons, and intracerebral TRPV1 antagonism. We found that constitutive genetic TRPV1 deletion or peripheral TRPV1 deletion reduced acetic acid-evoked abdominal constrictions, without affecting referred abdominal hyperalgesia or allodynia in an acute pancreatitis model of visceral pain. Notably, intracerebral TRPV1 antagonism by SB 366791 significantly reduced chemical and inflammatory spontaneous abdominal nocifensive responses, as observed by reduced expressions of nociceptive facial grimacing, illustrating the affective component of pain. In addition to the established role of cerebral TRPV1 in anxiety, fear, or emotional stress, we demonstrate here for the first time that TRPV1 in the brain modulates visceral nociception by interfering with the affective component of abdominal pain.
Synthetic, biological and composite scaffolds for abdominal wall reconstruction.
Meintjes, Jennifer; Yan, Sheng; Zhou, Lin; Zheng, Shusen; Zheng, Minghao
The reconstruction of abdominal wall defects remains a huge surgical challenge. Tension-free repair is proven to be superior to suture repair in abdominal wall reconstruction. Scaffolds are essential for tension-free repair. They are used to bridge a defect or reinforce the abdominal wall. A huge variety of scaffolds are now commercially available. Most of the synthetic scaffolds are composed of polypropylene. They provide strong tissue reinforcement, but cause a foreign body reaction, which can result in serious complications. Absorbable synthetic scaffolds, such as Dexon™ (polyglycolic acid) and Vicryl™ (polyglactin 910), are not suitable for abdominal wall reconstruction as they usually require subsequent surgeries to repair recurrent hernias. Composite scaffolds combine the strength of nonabsorbable synthetic scaffolds with the antiadhesive properties of the absorbable scaffold, but require long-term follow-up. Biological scaffolds, such as Permacol™, Surgisis(®) and Alloderm(®), are derived from acellular mammalian tissues. Non-cross-linked biological scaffolds show excellent biocompatibility and degrade slowly over time. However, remnant DNA has been found in several products and the degradation leads to recurrence. Randomized controlled trials with long-term follow-up studies are lacking for all of the available scaffolds, particularly those derived from animal tissue. This article provides an overview of the different types of scaffolds available, and presents the key clinical studies of the commercially available synthetic, composite and biological scaffolds for abdominal wall reconstruction.
Improving the provision of driving advice on discharge after abdominal surgery.
Buss, Imogen; Gould, Laura
Ensuring the safety of patients is a vital duty of a doctor. It is their responsibility to advise patients about activity limitations on discharge from hospital. This study aims to assess the current provision of driving advice for patients after abdominal surgery and institute improvements to this provision of information in North Bristol NHS Trust. A preliminary questionnaire ascertained current doctor's knowledge regarding limitations of driving postoperatively and whether information was communicated to patients. Baseline retrospective data were collected from electronic discharge summaries to determine documentation of advice provision. Educational interventions were introduced, followed by data collection after each intervention. Initial questionnaires demonstrated poor knowledge amongst doctors and a lack of provision of driving advice postoperatively. After multiple educational interventions, the provision of driving advice on electronic discharge summaries increased from 0% (0) at baseline to 75% (9). Initially, the provision of driving advice postoperatively was poorly documented for inpatients undergoing abdominal surgery; following multiple educational interventions, the provision of written advice improved. Future plans include the introduction of prewritten sentences onto the electronic discharge summaries to facilitate ease of information provision and a reaudit in 12 months.
Ejaculate parameters in patients with abdominal obesity
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E. A. Epanchintseva
compared with the third group, moreover the indicated decline was more pronounced in men of the 1st group. The content of SHBG in serum was also significantly lower in the 1st and 2nd groups in relation to the 3rd group. Comparison of ejaculate indicators revealed significant differences in the 1st and 2nd groups of men, differing in the type of fat distribution, in terms of volume of ejaculate, share of progressively motile sperm and DNA fragmentation level. Differences are identified for some indicators of ejaculate between the 1st and 3rd groups, but the differences between the 2nd and 3rd groups on any indicator are not detected. Conclusion. The revealed differences indicate a negative effect on the ejaculate indicators, particularly of upper type of fat distribution, peculiar to the men of the 1st group. The obtained results justify the assumption that abdominal obesity with upper type fat distribution is an independent risk factor of male fertility reduction.
Ejaculate parameters in patients with abdominal obesity
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E. A. Epanchintseva
compared with the third group, moreover the indicated decline was more pronounced in men of the 1st group. The content of SHBG in serum was also significantly lower in the 1st and 2nd groups in relation to the 3rd group. Comparison of ejaculate indicators revealed significant differences in the 1st and 2nd groups of men, differing in the type of fat distribution, in terms of volume of ejaculate, share of progressively motile sperm and DNA fragmentation level. Differences are identified for some indicators of ejaculate between the 1st and 3rd groups, but the differences between the 2nd and 3rd groups on any indicator are not detected. Conclusion. The revealed differences indicate a negative effect on the ejaculate indicators, particularly of upper type of fat distribution, peculiar to the men of the 1st group. The obtained results justify the assumption that abdominal obesity with upper type fat distribution is an independent risk factor of male fertility reduction.
Preliminary evaluation of the "Dengue-MI" technology for Aedes aegyptimonitoring and control Avaliação preliminar da tecnologia "MI-Dengue" para o monitoramento e controle do Aedes aegypti
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Álvaro Eduardo Eiras
Full Text Available Limitations in the laboratory identification of Aedes aegypti and processing of field data based on larval surveys led to the development of the "Intelligent Dengue Monitoring" technology (MI-Dengue. MI-Dengue consists of a trap that captures gravid female Ae. aegypti, coupled with a computerized system for field data collection, transmission, and access to georeferenced maps in real time. The current study describe the first experience with a system for monitoring adult Ae. aegypti and presents the preliminary results in three municipalities that adopted MI-Dengue as a strategy to identify key areas and orient control measures. Weekly georeferenced maps and an entomological indicator (Mean Female Aedes Index provided information on infested areas and infestation levels, color-coded according to the number of captured female Ae. aegypti, and indicated risk-free, dengue alert, and critical situations that triggered appropriate control measures. The preliminary results suggest that the adoption of this control strategy with house-to-house visits in a 200m radius of the positive trap helped reduce dengue in the municipalities that adopted the system.As limitações na identificação do Aedes aegypti em laboratório e no processamento das informações obtidas em campo pelo método da pesquisa larvária levaram ao desenvolvimento do "Monitoramento Inteligente da Dengue" (MI-Dengue. O MI-Dengue consiste em uma armadilha que captura fêmeas grávidas de Ae. aegypti associada ao sistema informatizado de coleta, transmissão e acesso das informações de campo, e mapas georreferenciados em tempo real. O objetivo deste trabalho foi descrever pela primeira vez um sistema de monitoramento de adultos de Ae. aegypti e apresentar os resultados preliminares em três municípios que adotaram o MI-Dengue como estratégia para identificar áreas e direcionar as ações de controle. Semanalmente, mapas georreferenciados e o indicador entomológico (IMFA
Vertical compared with transverse incisions in abdominal surgery
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Grantcharov, T P; Rosenberg, J
OBJECTIVE: To reach an evidence-based consensus on the relative merits of vertical and transverse laparotomy incisions. DESIGN: Review of all published randomised controlled trials that compared the postoperative complications after the two main types of abdominal incisions, vertical and transverse......, and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less.......0001), and regarding late incisional hernia the pooled odds ratio was 1.68 (95% confidence interval 1.10 to 2.57. p = 0.02). CONCLUSIONS: Transverse incisions in abdominal surgery are based on better anatomical and physiological principles. They should be recommended, as the early postoperative period is associated...
Abdominal wall closure after a stomal reversal procedure.
López-Cano, Manuel; Pereira, José Antonio; Villanueva, Borja; Vallribera, Francesc; Espin, Eloy; Armengol Carrasco, Manuel; Arbós Vía, María Antonia; Feliu, Xavier; Morales-Conde, Salvador
The closure of a temporary stoma involves 2 different surgical procedures: the stoma reversal procedure and the abdominal wall reconstruction of the stoma site. The management of the abdominal wall has different areas that should be analyzed such us how to avoid surgical site infection (SSI), the technique to be used in case of a concomitant hernia at the stoma site or to prevent an incisional hernia in the future, how to deal with the incision when the stoma reversal procedure is performed by laparoscopy and how to close the skin at the stoma site. The aim of this paper is to analyze these aspects in relation to abdominal wall reconstruction during a stoma reversal procedure.
[Mediastino-abdominal lipomatosis. Description of a case].
Potestà, D; Mecenate, F
The authors describe a case of mediastino-abdominal lipomatosis. The patient, who is 70 years old, was kept under observation, because of her recent state of illness. This state of illness was initially interpreted as angor attacks and a left ventricular failure. Only after the results of a CT examination showing a characteristic disproportion between the endothoracic-endoabdominal adipose tissue and the subcutaneous tissue, a correct interpretation was given. As a result the patient's state of illness was attributed to a compression of the adipose tissue growth in the abdominal and thoracic cavity. The etiology of mediastino-abdominal lipomatosis is still unknown. Therapy consists in removing the lipomas surgically when they cause a compression of the trachea and the upper vena cava.
Ultrasonographic abdominal anatomy of healthy captive caracals (Caracal caracal).
Makungu, Modesta; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N; Groenewald, Hermanus B
Abdominal ultrasonography was performed in six adult captive caracals (Caracal caracal) to describe the normal abdominal ultrasonographic anatomy. Consistently, the splenic parenchyma was hyperechoic to the liver and kidneys. The relative echogenicity of the right kidney's cortex was inconsistent to the liver. The gall bladder was prominent in five animals and surrounded by a clearly visualized thin, smooth, regular echogenic wall. The wall thickness of the duodenum measured significantly greater compared with that of the jejunum and colon. The duodenum had a significantly thicker mucosal layer compared with that of the stomach. Such knowledge of the normal abdominal ultrasonographic anatomy of individual species is important for accurate diagnosis and interpretation of routine health examinations.
[The role of laparoscopy in emergency abdominal surgery].
Balén, E; Herrera, J; Miranda, C; Tarifa, A; Zazpe, C; Lera, J M
Abdominal emergencies can also be operated on through the laparoscopic approach: the approach can be diagnostic laparoscopy, surgery assisted by laparoscopy or laparotomy directed according to the findings of the laparoscopy. The general contraindications refer above all to the state of haemodynamic instability of the patient and to seriously ill patients (ASA IV). In the absence of any specific counter-indications for the specific laparoscopic procedure to be carried out, many abdominal diseases requiring emergency surgery can be performed with the laparoscopic approach. The most frequent indications are appendicitis, acute colecistitis, gastroduodenal perforation, occlusion of the small intestine, and some abdominal traumas. With a correct selection of patients and the appropriate experience of the surgeon, the results are excellent and better than open surgery (less infection of the wound, complications, hospital stay and postoperative pain). A detailed explanation is given of the basic aspects of the surgical technique in the most frequent procedures of emergency laparoscopy.
A pictorial review of imaging of abdominal tumours in adolescence
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Rasalkar, Darshana D.; Chu, Winnie C.W. [Chinese University of Hong Kong, Prince of Wales Hospital, Department of Diagnostic Radiology and Organ Imaging, Shatin, New Territories, Hong Kong (China); Cheng, Frankie W.T.; Li, Chi Kong [Chinese University of Hong Kong, Prince of Wales Hospital, Department of Paediatrics, Shatin, Hong Kong (China); Hui, Sze Ki [Princess Margaret Hospital, Department of Obstetrics and Gynaecology, Hong Kong (China); Ling, Siu Cheung [Princess Margaret Hospital, Department of Paediatric and Adolescent Medicine, Hong Kong (China)
Neoplastic abdominal tumours, particularly those originating from embryonal tissue (such as hepatoblastoma and nephroblastoma) and neural crest cells (such as neuroblastoma), are well-documented in young children. Neoplasms of adulthood, most commonly carcinoma of different visceral organs, are also well-documented. Abdominal tumours in adolescence constitute a distinct pathological group. The radiological features of some of these tumours have been described only in isolated reports. The purpose of this pictorial essay was to review the imaging findings of various kinds of abdominal tumours in adolescent patients (with an age range of 10-16 years) who presented to the Children Cancer Center of our institution in the past 15 years. Some tumours, though rare, have characteristic imaging appearances (especially in CT) that enable an accurate diagnosis before definite histological confirmation. (orig.)
A prospective study on geriatric abdominal surgical emergencies
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Deepak R. Chavan
Results: 128 patients aged 60 years or more who presented with abdominal emergency surgical conditions were studied. Most common cause for emergency abdominal surgery was perforated peptic ulcer (38% followed by intestinal obstruction (17%. The most common post-operative complication was surgical site infection (29%. Mortality rate was 17%. Most common cause of death was septic shock with multi organ dysfunction. Conclusion: Geriatric population is an important subgroup of population undergoing emergency abdominal surgeries. Most common cause is peptic ulcer perforation followed by intestinal obstruction due to adhesions. More than the age per say, the delay in presentation may be the cause for mortality in this age group. The therapeutic outcome in patients with co morbid factors like hypertension and diabetes mellitus in control, were similar to other patients. [Int J Res Med Sci 2014; 2(3.000: 963-971
An Experimental Animal Model for Abdominal Fascia Healing after Surgery
DEFF Research Database (Denmark)
Burcharth, J; Pommergaard, H-C; Klein, M
Background: Incisional hernia (IH) is a well-known complication after abdominal surgical procedures. The exact etiology of IH is still unknown even though many risk factors have been suggested. The aim of this study was to create an animal model of a weakly healed abdominal fascia that could...... be used to evaluate the actively healing fascia. Such an animal model may promote future research in the prevention of IH. Methods: 86 male Sprague-Dawley rats were used to establish a model involving six experiments (experiments A-F). Mechanical testing of the breaking strength of the healed fascia...... of mechanical breaking strength. This new animal model employed myofascial closing after a full thickness abdominal incision using a running suture with fast-absorbable suture material. This technique produced a weak myofascial layer compared with the control tissue measured in terms of breaking strength after...
Abdominal lymphadenopathy:An atypical presentation of enteric fever
Institute of Scientific and Technical Information of China (English)
Nayla Ahmed; Zeb I Saeed; Muhammad Tariq
This is a case report of a patient who presented to the Aga Khan University Hospital with generalized abdominal lymphadenopathy and high-grade fever. Due to ambiguous clinical findings, which were suggestive of either abdominal tuberculosis, or a lymphoma, the patient was started on empirical anti-tuberculous treatment due to the endemicity of tuberculosis in this region. The blood culture reports, however, were reported to grow colonies of Salmonellaparatyphi A; thus the diagnosis of the patient was changed to enteric fever, and the patient improved on the subsequently started therapy of ceftriaxone 2 000 mg bid. To the best of our knowledge, this is the first reported case of a patient suffering from enteric fever whose primary clinical findings were abdominal lymphadenopathy and fever.
Support Vector Machine Diagnosis of Acute Abdominal Pain
Björnsdotter, Malin; Nalin, Kajsa; Hansson, Lars-Erik; Malmgren, Helge
This study explores the feasibility of a decision-support system for patients seeking care for acute abdominal pain, and, specifically the diagnosis of acute diverticulitis. We used a linear support vector machine (SVM) to separate diverticulitis from all other reported cases of abdominal pain and from the important differential diagnosis non-specific abdominal pain (NSAP). On a database containing 3337 patients, the SVM obtained results comparable to those of the doctors in separating diverticulitis or NSAP from the remaining diseases. The distinction between diverticulitis and NSAP was, however, substantially improved by the SVM. For this patient group, the doctors achieved a sensitivity of 0.714 and a specificity of 0.963. When adjusted to the physicians' results, the SVM sensitivity/specificity was higher at 0.714/0.985 and 0.786/0.963 respectively. Age was found as the most important discriminative variable, closely followed by C-reactive protein level and lower left side pain.
Early recovery after abdominal rectopexy with multimodal rehabilitation
DEFF Research Database (Denmark)
Basse, Linda; Billesbølle, Per; Kehlet, Henrik
PURPOSE: Abdominal rectopexy without sigmoid resection is usually associated with a hospital stay of four to ten days. Recent developments have shown that a multimodal rehabilitation program with epidural analgesia and early oral feeding and mobilization will reduce hospital stay after colonic...... resection. The aim of this study was to describe the results after abdominal rectopexy with a multimodal rehabilitation program. METHODS: Thirty-one consecutive patients with rectal prolapse, median age 69 (range, 24-85) years and including 14 patients of American Society of Anesthesiologists physical...... status III to IV, were scheduled for abdominal rectopexy with a multimodal rehabilitation program including 48 hours thoracic epidural analgesia or patient-controlled anesthesia (3 patients), early oral nutrition and mobilization, and a planned two-day postoperative hospital stay. Follow-up was done...
Haemodynamic and respiratory effects of an abdominal compression binder
DEFF Research Database (Denmark)
Toft, M.H.; Bulow, J.; Simonsen, L.
In order to elucidate the circulatory and respiratory effects of a newly developed abdominal compression binder 25 healthy, normal weight subjects were studied. In supine position the central haemodynamics were measured and estimated with a Finapress device. Lower extremity venous haemodynamics...... with or without the abdominal compression binder. The results show that the compression binder significantly increases the venous volume in the lower extremities as showed by a reduction in the venous capacitance in the lower extremities and a reduction in the stroke volume and cardiac output, while it does...... not influence the pulmonary volumes. It is concluded that the applied abdominal binder significantly affects peripheral and central haemodynamics. It should therefore be used with caution when in the supine position for longer periods, as the pooling of blood it induces in the lower extremities may have...
Abdominal syndromes and functional ability in the elderly
DEFF Research Database (Denmark)
Kay, L; Avlund, K
Data concerning a random cohort of 1,119 70-year-old subjects were analyzed to evaluate the association between Upper Dyspepsia and Irritable Bowel Syndrome and functional ability. Seven hundred and thirty-four subjects were interviewed about abdominal symptoms and were visited at home by an occu...... that abdominal syndromes are associated to functional ability, suggesting that there is a diffuse disorder affecting both smooth and striated muscles.......Data concerning a random cohort of 1,119 70-year-old subjects were analyzed to evaluate the association between Upper Dyspepsia and Irritable Bowel Syndrome and functional ability. Seven hundred and thirty-four subjects were interviewed about abdominal symptoms and were visited at home...
Abdominal actinomycosis associated with intrauterine device: CT features
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Laurent, T. [Dept. of Radiology, CHUV-1011, Lausanne (Switzerland); Grandi, P. de [Dept. of Gynecology-Obstetrics, CHUV-1011, Lausame (Switzerland); Schnyder, P. [Dept. of Radiology, CHUV-1011, Lausanne (Switzerland)
We report two cases of pelviperitoneal actinomycosis appearing in two young women with acute low abdominal pain. Abdominal CT demonstrated multiple solid or encapsulated peritoneal masses with marked contrast enhancement and infiltration of the adjacent mesenteric fat. Laparoscopy confirmed the presence of intraperitoneal abscesses which contained Actinomyces israelii. High doses of amoxicillin and clavulanic acid (Augmentine) were given and following CT scan after 2 and 6 weeks showed a slow, but complete, resolution of the lesions. Although the radiologic presentation of actinomycosis is nonspecific, the diagnosis should be raised in the presence of pseudotumoral mesenteric infiltration, particularly in young women with an IUD. Abdominal CT is a useful method for diagnosis and for follow-up. (orig./MG)
Bowel and mesenteric injuries from blunt abdominal trauma: a review.
Iaselli, Francesco; Mazzei, Maria Antonietta; Firetto, Cristina; D'Elia, Domenico; Squitieri, Nevada Cioffi; Biondetti, Pietro Raimondo; Danza, Francesco Maria; Scaglione, Mariano
The bowel and the mesentery represent the third most frequently involved structures in blunt abdominal trauma after the liver and the spleen. Clinical assessment alone in patients with suspected intestinal and/or mesenteric injury from blunt abdominal trauma is associated with unacceptable diagnostic delays. Multi-detector computed tomography, thanks to its high spatial, time and contrast resolutions, allows a prompt identification and proper classification of such conditions. The radiologist, in fact, is asked not only to identify the signs of trauma but also to provide an indication of their clinical significance, suggesting the chance of conservative treatment in the cases of mild and moderate, non-complicated or self-limiting injuries and focusing on life-threatening conditions which may benefit from immediate surgical or interventional procedures. Specific and non-specific CT signs of bowel and mesenteric injuries from blunt abdominal trauma are reviewed in this paper.
Report of a Case of Primary Abdominal Pregnancy
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Sh Beigi
Full Text Available Ectopic pregnancy (EP is a potentially life-threatening condition in which the embryo implants outside the uterine endometrial cavity. Abdominal pregnancy is an atypical site wherein the product of conception lies totally outside the reproductive tract. Primary abdominal pregnancy is a very rare condition with a high mortality rate. Diagnosis is often late or misdiagnosed. The aim of introducing this case report is to present a new case of early primary abdominal pregnancy. Despite regular menstrual bleeding and contraception with IUD (intrauterine device, this pregnancy occurred in a 24-year old woman. Emergency laparotomy was performed because of abdominal pain, unstable condition and positive urine pregnancy test. It revealed more than 1500 ml of blood in the abdominal cavity. The uterus, both fallopian tubes and ovaries were completely intact. A 3X4 cm mass lateral to the left utersacral ligament was observed and resected. Since IUD strings could not be identified, endometrial currettage was performed and then the IUD was removed. Histological report of the mass and tissue of uterine cavity was placental villi and secretory endometrium, respectively, which according to Studdifords criteria is a new case of early primary abdominal pregnancy. To reduce maternal mortality and morbidity, early recognition of ectopic pregnancy is critical. According to review of the literature and the case report, a high index of suspicion is vital for the early diagnosis of ectopic pregnancy because the signs and symptoms of EP overlap with many surgical and gynecologic conditions. With early diagnosis of EP, we can suggest many therapeutic options and also retain fertility (if desired by patient, while minimizing disease and treatment-related morbidity.
Abdominal pain: a synthesis of recommendations for its correct management
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Daniela Tirotta
Full Text Available Abdominal pain represents one of the most important diagnostic challenges for any physician and its correct interpretation and management require a proper systematic approach and sometimes an urgent action. Moreover the guidelines that can be referred to for indications about the most adequate management procedures are few and often focused only on radiologic management. Consequently, the approach to abdominal pain is often empirical. Therefore, we propose a review of the literature on the diagnosis of abdominal pain, which may contribute to improve the diagnosis and treatment of this complex condition through a systematic review of the evidences available in this field. As to our methodology, we conducted an extensive search in the main guideline databases (SIGN, ICSI, NICE, National Guideline Cleringhouse, CMA Infobase, NZ Guidelines Group, National System Guidelines, Clinical Practice Guidelines Portal, eGuidelines, using as key words abdominal pain and abdominalgia. The guidelines were assessed according to the 2010 Italian version of the AGREE (Appraisal of Guidelines, Research and Evaluation II methodology. Afterwards we formulated our main recommendations associated with the corresponding levels of evidence and focused our attention on some grey areas, which we investigated with further research using Medline and the main systematic review databases (Cochrane database. The four main grey areas investigated were: hospital admission criteria, prognostic stratification, need for analgesic treatment and possibility of attributing abdominalgia to an abdominal pain syndrome. We then formulated our consesus-based recommendations on the grey areas. Abdominal pain management remains a complex issue for internists. As with other diagnostic challenges, it would be advisable to develop additional guidelines based on a multidisciplinary approach and not only focused on radiological management.
Cauda equina syndrome presenting as abdominal pain: a case report.
LENUS (Irish Health Repository)
Ellanti, Prasad
Cauda equina syndrome (CES) is an uncommon entity. Symptoms include bowel and bladder dysfunction, saddle anesthesia, and varying degrees of lower limb motor and sensory disturbances. The consequences of delayed diagnosis can be devastating, resulting in bowel and bladder incontinence and lower limb paralysis. There is little in literature regarding abdominal pain as a significant feature of the initial presentation of CES. We present the case of a 32-year-old woman with CES who presented to the emergency department with gradually worsening lower abdominal pain.
A Rare Cause of Abdominal Pain: Primary Epiploic Appendagitis (PEA
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Gulbanu Erkan
Full Text Available Primary epiploic appendagitis (PEA is a rare disease caused by torsion or spontaneous thrombosis of the central vein that drains epiploic appendages (EA. Primary Epiploic Appendagitis (PEA is an ischemic infarction. Although PEA is a self-limiting disease and does not require surgical intervention in most cases, it may mimic diseases that require surgical intervention or aggressive medical therapy, such as appendicitis, diverticulitis, or cholecystitis. In order to avoid unnecessary surgical intervention, PEA should be kept in mind when patients present with acute abdominal pain. In this report, we present a PEA case admitted with abdominal pain.
Vínculos entre la obesidad abdominal y la dislipidemia
Pedro Enrique Miguel Soca
Tomando como punto de partida la discusión de un artículo publicado por la propia revista Finlay en su número anterior, la presente carta se refiere a algunas alteraciones que relacionan la obesidad abdominal con la dislipidemia.
Linking Abdominal Obesity and Dyslipidemia
Considering as a start point the discussion of an article published by this same ...
An unusual case of fever and abdominal pain
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Arundhati G Diwan
Full Text Available Ascariasis is one of the commonest parasitic infestations in tropical countries. Main symptoms are pain in abdomen, weight loss, diarrhea and passage of worms in stool. If acute, it may present as intestinal obstruction, perforation, cholangitis, appendicitis and pancreatitis. The incidence of hepato-biliary ascariasis is probably underestimated. We report a case which presented to us with fever, abdominal pain and weight loss of a month′s duration, mimicking abdominal tuberculosis. On investigations, patient was found to have ascariasis of gall bladder, terminal ileum, caecum and appendix, causing simultaneous inflammation of all these structures.
CT findings of benign omental lesions following abdominal cancer surgery
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Lee, Sang Yun; Kim, Dong Won; Cho, Jin Han; Kwon, Hee Jin; Ha, Dong Ho; Oh, Jong Young [Diagnostic Radiology, Dong-A University College of Medicine, Busan (Korea, Republic of)
The greater omentum is the largest peritoneal fold and can be the origin of primary pathologic conditions, as well as a boundary and conduit for disease processes. Most diseases involving the omentum manifest with nonspecific and overlapping features on computed tomography (CT). In particular, varying benign disease processes of traumatic, inflammatory, vascular, or systemic origin can occur in the omentum during the follow-up period after surgery for intra-abdominal malignancy. It can be challenging for radiologists due to various spectrum of CT findings. Thus, we reviewed the CT findings of various benign omental lesions after surgery for intra-abdominal malignancy.
Infected abdominal aortic aneurysm due to Morganella morganii: CT findings.
Kwon, Oh Young; Lee, Jong Seok; Choi, Han Sung; Hong, Hoon Pyo; Ko, Young Gwan
An infected aortic aneurysm, or mycotic aneurysm, is a rare arterial dilatation due to destruction of the infected vessel wall. Common pathogens resulting in an infected aortic aneurysm are Salmonella and Clostridium species, as well as Staphylococcus aureus; Morganella morganii, on the other hand, is very rare. An infected abdominal aortic aneurysm has tendencies to grow rapidly and to rupture. The mortality rate is high in patients undergoing emergent surgical intervention. We report the case of a 65-year-old man who presented with an infected abdominal aortic aneurysm caused by M. morganii. A high index of suspicion and imaging tests are necessary in order to diagnose an infected aortic aneurysm.
Recurrent abdominal pain in children: a clinical approach.
Quek, S H
The term 'recurrent abdominal pain', or RAP, refers mainly to the duration of painful period and frequency of pain. The commonly accepted duration is at least three months in the preceding period, and over this three-month period, there are at least three episodes of pain that are severe enough to affect the daily activities of the affected patients. Over the years, with advances in medical technology and better understanding of the pathophysiology of abdominal pain, more and more organic causes have been identified. However, the most common cause of RAP in children is still functional in origin.
Diffusion-weighted MRI in abdominal oncology:Clinical applications
Institute of Scientific and Technical Information of China (English)
Reiji; Sugita; Kei; Ito; Naotaka; Fujita; Shoki; Takahashi
Diffusion-weighted magnetic resonance imaging(DWI) provides image contrast that is different from that obtained by conventional magnetic resonance techniques.Although previously,DWI has been used to evaluate various diseases of the central nervous system,several technical advances have expanded the clinical applications of DWI beyond the central nervous system.As a result,many reports have been published on the use of DWI in abdominal diseases.Particularly,abdominal DWI has now being focused on evaluation o...
Fast abdominal magnetic resonance imaging; Schnelle Abdomenbildgebung in der Magnetresonanztomografie
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Budjan, J.; Schoenberg, S.O.; Riffel, P. [University Medical Center Mannheim (Germany). Dept. of Clinical Radiology and Nuclear Medicine
Abdominal imaging is the driving force that necessitates the development of numerous techniques for accelerated image acquisition in magnetic resonance imaging (MRI). Today, numerous techniques are available that enable rapid, high spatial resolution acquisition for both T1 and T2 weighted images. These techniques open new opportunities in the detection and classification of numerous pathologies in the abdomen. However, there is still ongoing progress in the development of fast and ultrafast sequences and promising techniques are currently close to clinical application. With these 4D-technologies, MRI is becoming the central imaging modality for dynamic, motion-compensated imaging of the parenchymal abdominal organs such as liver, pancreas and kidney.
Diversidad haplotípica en el manatí Trichechus manatus en Cuba: resultados preliminares
Hernandez-Martinez, Damir; Alvarez-Aleman, Anmari; Bonde, Robert K.; Powell, James A.; Garcia-Machado, Erik
The aim of this analysis was to obtain information regarding the mtDNA haplotype composition of the manatee (T. manatus) occupying the Cuban archipelago. A fragment of 410 bp of the non-coding region was analyzed for 12 individual manatees from Cuba and one from Florida, USA. Only two haplotypes were identified. Haplotype A1, found exclusively in Florida (including in the sample analyzed here) but also found in Mexico, the Dominican Republic and Puerto Rico, was the most frequent haplotype (11 of the 12 samples from Cuba) and widely distributed. The second haplotype A3, previously referred to as endemic from Belize, was identified from an individual stranded in Isabela de Sagua, north of Cuba. These preliminary results provide information about three major aspects of manatee biology: (1) the mtDNA genetic diversity of T. manatus in Cuba seems low as compared to other regions of the Caribbean; (2) the Cuban population likely belongs to the group comprising Florida and the portions of the Greater Antilles; and (3) the territories of Belize and Cuba have exchanged individuals at present or in a relatively recent past.
[Mutual role of factors of endotoxicosis and intra-abdominal hypertension syndrome in pathogenesis of abdominal sepsis].
Veliev, N A; Gasanova, D N; Ismailov, V F
The mutual role of the main factors of endotoxicosis and intraabdominal hypertension syndrome (IHS) were studied in pathogenesis of abdominal sepsis, basing on analysis of the treatment results in 156 patients, suffering this disease. The contents of neutrophils, macrophages, interleukins (IL-6, IL-10) were studied in peritoneal exudate as the indices of the source of inflammation in abdominal cavity. There was established the mutual strengthening of the endotoxicosis and IHS factors, what causes the clinical signs of the organ dysfunction, determines the course severity and outcome of pathological process in the organism. Such approach to pathogenesis of abdominal sepsis permits in time and adequately to elaborate the certain program of treatment in the patients.
Endotension: rupture of abdominal aortic aneurysm Endotensão: ruptura de aneurisma de aorta abdominal
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Alexandre Campos Moraes Amato
Full Text Available Aortic endovascular exclusion technique called 'chimney' consists of placing stents through abdominal aortic visceral branches and a prosthesis that excludes the thoraco-abdominal aneurysm. Stents and an aortic endoprosthesis are placed in the renal arteries. This method is primarily used when open surgery is too risky. The mechanism that provides aneurysm sac increase without the visible presence of endoleaks has not been fully elucidated. The expansion of the aneurysm sac, due to endotension, is difficult to diagnose, even with the use of advanced imaging tests. Its diagnosis is made by exclusion. We present a case of a late complication in a high-risk patient after a 'chimney' endovascular procedure. Following the surgery, the patient presented a ruptured aneurysm sac without a visible endoleak. A second intervention was not feasible due to the high risk of occluding all of the branches, and complicated by previous 'chimney'. Endotension is a possible cause of aneurysm rupture and death.A técnica de exclusão endovascular conhecida como 'chaminé' consiste na colocação de stent em ramos viscerais e de endoprótese excluindo o aneurisma toracoabdominal. São colocados stents revestidos nas artérias renais e uma endoprótese aórtica, que o método utilizado quando a cirurgia aberta tem risco muito alto. O mecanismo que causa a expansão aneurismática sem a presença detectável de vazamento pelos métodos de imagem não está completamente esclarecido. A expansão do saco aneurismático por endotensão é de difícil diagnóstico, mesmo com o uso de técnicas de imagem avançadas, como tomografia computadorizada e eco-Doppler, sendo o diagnóstico por exclusão. Apresenta-se um caso de complicação tardia após o tratamento endovascular pela técnica da 'chaminé'. Após a cirurgia, o paciente apresentou ruptura sem endoleak visível. Outro procedimento endovascular foi impossibilitado pela técnica da 'chaminé', que dificulta novos
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Santiago Morello
Full Text Available Escallonia alpina y E. rubra (Escalloniaceae comparten su área de distribución en el sur de los Andes y se diferencian por pocos caracteres morfológicos diagnósticos, tales como la disposición de las flores y la presencia y tipo de glándulas; sin embargo, en algunas poblaciones no es posible asignar los individuos a una u otra especie. Además, se han reconocido y descrito como híbridos varias formas de transición entre ambas. El objetivo de este trabajo es examinar la variabilidad genética poblacional de Escallonia alpina y E. rubra, y analizar si se corresponde con la variabilidad morfológica observada. Se estudió la morfología en 39 individuos de cinco poblaciones sobre los que también se realizó un análisis de AFLP. Se investigó la relación entre los individuos mediante análisis de ordenación, agrupamiento y de asignación bayesiana. Además se calcularon índices de diversidad y se realizó una prueba de Man- tel. A partir del análisis morfológico, se asignaron dos poblaciones a cada especie, mientras que una población con individuos con morfología intermedia no se pudo asignar unívocamente a ninguna de las dos especies. Se observó una fuerte correspondencia entre las especies delimitadas mediante caracteres morfológicos diagnósticos tradicionales y el patrón de AFLP. La evidencia morfológica y molecular preliminar nos permitió reconocer a Escallonia alpina y E. rubra como dos especies distintas, y a una población con caracteres morfológicos y genéticos intermedios que podrían ser el resultado de flujo génico interespecífico o de una separación incompleta de linajes.
Estudio fitoquímico preliminar y actividad antimalárica del extracto etanólico total decoccocypselum
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Manuel Enrique Taborda Martínez
Full Text Available ResumenEl surgimiento y expansión de cepas del Plasmodium falciparum resistentes a las drogas establecidas en los esquemas de tratamiento de primera línea para la malaria no complicada, enfatiza la importancia de la búsqueda de nuevos compuestos activos contra este parasito. El presente estudio muestra la presencia de terpenoides y cumarinas en el análisis fitoquímico preliminar de Coccocypselum hirsutum Rubiaceae. La evaluación de la actividad antimalarica consistió en inhibición de la maduración del parásito de formas jóvenes a esquizontes dentro del eritrocito (ensayo de maduracion. Se realizó con el extracto etanólico total de la especie frente a dos cepas de Plasmodium falciparum FVO y FBC-2, resistente a cloroquina, cada extracto fue ensayado por triplicado a concentraciones de 280, 140, 70 y 35 ppm. Como resultado se obtuvo valores no significativos de actividad antimalarica menores del 20% demostrando la capacidad de no inhibir la invasión de P. falciparum en células sanguínea in Vitro. (Duazary 2009-II 118-123AbstractThe emergence and spread of strains of falciparum plasmodium resistant to drugs in the schemes of first-line treatment for non complicated malaria, emphasizes the importance of finding new active compounds against this parasite. This study shows the presence of terpenoids and coumarins in the preliminary phytochemical analysis of Coccocypselum hirsutum Rubiaceae. The antimalarial activity was evaluated by inhibiting the maturation of young forms of the parasite within the erythrocyte esquizontes (test of maturity. It was carried out with the whole ethanol extract of the species against two strains of Plasmodium falciparum FVO and FBC-2, resistant to chloroquine; each extract was tested in triplicate at concentrations of 280, 140, 70 and 35 ppm. The results obtained were under 20%, which are not significant values of antimalarial activity. This demonstrates the inability to inhibit the invasion of P
Construcción y arquitectura industrial para el siglo XXI: un análisis preliminar
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del Caño Gochí, A.
Full Text Available This paper presents a preliminary analysis, performed by the authors. on the past, present and possible future of the main issues related to the design and construction of industrial complexes. Among others. those issues include the industrial development; structural analysis and design methods; design tools; construction materials; structural types; types of non-structural systems (façade, Roof, building services; technology of construction processes; precast and industrialized systems; construction project management; construction labour; energy-related features of the industrial complexes; methodologies, technology and labour for manufacturing; environmental issues; aesthetics; planning of industrial areas (industrial parks. technology parks; industrial plants location. Some conclusions are specific to the design and construction of industrial complexes, whereas other are common to the other construction subsectors.El presente artículo expone un análisis preliminar realizado por los autores sobre la evolución histórica de los principales aspectos de la construcción y arquitectura industrial, así como de las posibles líneas que podría seguir la evolución a futuro de cada uno de dichos aspectos. Los aspectos analizados son: el desarrollo industrial; los métodos de cálculo y dimensionamiento estructural; las herramientas de diseño; los materiales de construcción; las tipologías estructurales; los sistemas constructivos no estructurales; la tecnología de los procesos constructivos; la prefabricación e industrialización; la organización y dirección del proyecto; la mano de obra para la construcción; los aspectos energéticos; las tecnologías y filosofías de fabricación y su mano de obra; el respeto al medio ambiente; la estética; el urbanismo industrial; y otros aspectos como la seguridad, la recuperación de construcciones industriales históricas, o la localización y emplazamiento, entre otros. Algunas de las
Resultados preliminares de um projeto sobre a ecologia dos flebotomineos vetores de leishmaniose tegumenar no estado da Bahia
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Italo A. Sherlock
Full Text Available São apresentados resultados preliminares de um projeto sobre a ecologia dos flebotomíneos, vetores de leishmaniose tegumentar, numa área de plantação de cacau no sul do Estado da Bahia, Brasil. Nesta área existem 60 casas, afastadas entre si, onde vivem 229 habitantes e 31 cães. Entre os moradores, 45% tinham reação de Montenegro positiva; destes, 8,8% eram portadores de úlceras em atividade e 37% de cicatrizes de úlceras. Dos cães, 22% eram soropositivos. Dos 7 cães com úlceras, apenas 3 eram soropositivos. Em 14% das casas inspecionadas, foram encontrados flebótomos. Durante dois anos, 72 hamsters foram mantidos como sentinelas em casas de pacientes com úlceras leishmanióticas, porém nehum adquiriu a infecção. Foram coletados e identificados 5.614 exemplares de flebótomos pertencentes a 14 diferentes espécies. Entre estas, Lutzomyia whitmani (92% e Lutzomyia intermedia (4,8 % eram as espécies mais abundantes. Esses flebótomos, muito antropofílicos, podiam ser encontrados dentro das casas e nas suas periferias e são provavelmente, os principais vetores da doença no ambiente doméstico. As outras 12 espécies eram menos frequentes e mais encontrados em ambientes silvestres, onde também picavam o homem. A maioria das espécies começava a aparecer às 17 horas, no crepúsculo, e alcançava sua densidade máxima às 24 horas, quando declinava até desaparecer às 6 horas da manhã. L. whitmani em todas as fases lunares foi capturada com a mesma densidade, enquanto L.intermedia foi mais abundante durante a fase de lua nova. Centenas de flebótomos coletados mensalmente durante o segundo ano de observações, permanecem preservados em nitrogênio líquido, aguardando o ajustamento de técnicas de PCR para a verificação da taxa de infecção natural desses vetores por leishmânia. Os resultadosfinais de todo o projeto serão publicados tão logo seja examinado esse material.
Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective
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Asok Kurup
Full Text Available Regional epidemiological data and resistance profiles are essential for selecting appropriate antibiotic therapy for intra-abdominal infections (IAIs. However, such information may not be readily available in many areas of Asia and current international guidelines on antibiotic therapy for IAIs are for Western countries, with the most recent guidance for the Asian region dating from 2007. Therefore, the Asian Consensus Taskforce on Complicated Intra-Abdominal Infections (ACT-cIAI was convened to develop updated recommendations for antibiotic management of complicated IAIs (cIAIs in Asia. This review article is based on a thorough literature review of Asian and international publications related to clinical management, epidemiology, microbiology, and bacterial resistance patterns in cIAIs, combined with the expert consensus of the Taskforce members. The microbiological profiles of IAIs in the Asian region are outlined and compared with Western data, and the latest available data on antimicrobial resistance in key pathogens causing IAIs in Asia is presented. From this information, antimicrobial therapies suitable for treating cIAIs in patients in Asian settings are proposed in the hope that guidance relevant to Asian practices will prove beneficial to local physicians managing IAIs.
Beat-to-beat heart rate detection in multi-lead abdominal fetal ECG recordings.
Peters, C H L; van Laar, J O E H; Vullings, R; Oei, S G; Wijn, P F F
Reliable monitoring of fetal condition often requires more information than is provided by cardiotocography, the standard technique for fetal monitoring. Abdominal recording of the fetal electrocardiogram may offer valuable additional information, but unfortunately is troubled by poor signal-to-noise ratios during certain parts of pregnancy. To increase the usability of abdominal fetal ECG recordings, an algorithm was developed that enhances fetal QRS complexes in these recordings and thereby provides a promising method for detecting the beat-to-beat fetal heart rate in recordings with poor signal-to-noise ratios. The method was evaluated on generated recordings with controlled signal-to-noise ratios and on actual recordings that were performed in clinical practice and were annotated by two independent experts. The evaluation on the generated signals demonstrated excellent results (sensitivity of 0.98 for SNR≥1.5). Only for SNRheart rate detection exceeded 2 ms, which may still suffice for cardiotocography but is unacceptable for analysis of the beat-to-beat fetal heart rate variability. The sensitivity and positive predictive value of the method in actual recordings were reduced to approximately 90% for SNR≤2.4, but were excellent for higher signal-to-noise ratios.
The role of 3D volumetric MR sequences in diagnosing intraventricular neurocysticercosis: preliminar results
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Francisco Edward Frota Mont'Alverne Filho
Full Text Available OBJECTIVE: The purpose of this paper was to investigate the role of two three-dimensional magnetic resonance (MRI sequences: enhanced spoiled gradient recalled echo (SPGR, and fast imaging employing steady-state acquisition (FIESTA in the evaluation of intraventricular neurocysticercosis cysts and scolices. METHOD: Seven neurocysticercosis patients suspected of presenting intraventricular lesions were evaluated by magnetic resonance imaging using enhanced SPGR, and FIESTA. RESULTS: Enhanced SPGR detected eight cystic lesions, with scolices in four. Contrast enhancement was observed in three cysts. FIESTA also detected eight cystic lesions with the presence of scolices in seven of those cystic lesions. Four patients presented parenchymal involvement, while the remaining three presented the racemose form. CONCLUSION: FIESTA and SPGR are sequences that can detect intraventricular cysts of neurocysticercosis, and FIESTA also is good for the detection of the scolex. Considering this information we suggest that FIESTA and SPGR should be included in the MRI protocol for the investigation of intraventricular neurocysticercosis.