Intestinal anastomosis blowout following post-operative cardiopulmonary resuscitation: A case report
Background: Pneumoperitoneum following cardiopulmonary resuscitation (CPR) is a very rare complication with a challenging management. In this paper we describe the management of a patient who suffered a blowout of his colorectal anastomosis after undergoing CPR for a cardiac arrest in the early post-operative period. Additionally, we present a thorough literature review of the management of CPR-related pneumoperitoneum. Summary: Five days after a sigmoid resection for colon cancer, a 71-year-old male went into pulseless electrical activity and CPR was initiated, with complete clinical recovery. After CPR the patient was found to have new hydropneumothorax and pneumoperitoneum. Because he had a normal abdominal examination, lack of leukocytosis, and no evidence of a bowel perforation on water-soluble CT imaging, the patient was initially managed non-operatively with close clinical follow-up. However, he failed the non-operative management and ultimately required a laparotomy demonstrating a blowout of his colonic anastomosis. Conclusion: Physicians should remain aware of the risk of damage to fresh bowel anastomoses following CPR. There should be a low threshold for surgical exploration in patients that develop CPR-related pneumoperitoneum soon after intestinal surgery, even when patient’s clinical status is stable.
Physical activity at work is an important indicator of the level of activity. Physiotherapists are one of professionals for the prevention against sedentary lifestyle. Objective: To assess the level of physical activity at work among physiotherapists in Benin and France. Method: Descriptive and analytical cross-sectional study, conducted from July 2017 to July 2018. With physiotherapists who consent to participate to this study we use a pedometer. They wear it at work for five consecutive days. The average number of daily steps at work was determined. Physiotherapist’s level of inactivity was assessed using the Baecke questionnaire. Data was analyzed using Epi Info 13.0. X2 of Pearson’s and ANOVA tests. They were used for the comparison of qualitative and quantitative variables respectively. Significance level was set at 0.05. Results: Among fifty-four physiotherapists evaluated, forty-four (81.5%) were sedentary, with a significant level of sedentary lifestyle in twenty-six cases (48.11%). This limitation of physical activity at the workplace and the level of sedentary lifestyle of the subjects were comparable among Beninese and French physiotherapists and they were not associated with any of the factors studied. Conclusion: The level of physical activity of physiotherapists at work is limited. Raising the awareness of these actors seems essential.
Since discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium the 1960s. In 1977, the first extraoral titanium implant was inserted for craniofacial rehabilitation aims. Craniofacial implants start to be popular for craniofacial reconstruction and rehabilitation. Craniofacial implants become as revaluation in rehabilitation fields, to day even large facial defect can be reconstructed via this surgical –prosthetic technique. The aim of this review is to explain and clarify the indications and techniques for such procedure.
THE COMPARISON OF THE SHOULDER MUSCLE ACTIVATION IN PATIENTS WITH ROTATOR CUFF TEAR UNDER AN ABDUCTION BRACE AMONG THE THREE POSTURES
Background: Immobilization using an abduction brace is essential for the relaxation of the rotator cuff and scapular muscles and the prevention of a retear in patients with rotator cuff tear after arthroscopic rotator cuff repair (ARCR). However, thus far, the comparison of the scapular muscle activities has not been compared among different postures under an abduction brace in patients after ARCR. Objectives: The purpose of our study was to compare the scapular muscle activities among the supine position, sitting position, and walking under an abduction brace before and after ARCR Study Design: Observational, repeated measures study. Methods: Twelve patients with full-thickness rotator cuff tears were studied. The mean patient age was 64.7 years. The scapular muscle activations of the ipsilateral limbs were measured using surface electromyography in three postures: supine position, sitting position, and walking. The integrated electromyography relative values of the upper trapezius, anterior deltoid, middle deltoid, and biceps brachii were compared preoperatively and at two weeks after ARCR. Results: The trapezius, biceps brachii, and middle deltoid in the walking showed significantly higher integrated electromyography relative values than those in the supine position, preoperatively and at two weeks after surgery. The anterior deltoid in the sitting position had significantly higher integrated electromyography relative values than those in the supine position. Conclusions: Postures affected the scapular muscle activities in ARCR patients under an abduction brace. Understanding the influence of posture on the scapular muscle activity after ARCR will help rehabilitation accurately and appropriately.
Computer-Aided-Design/Computer-Aided-Manufacture or in short CAD/CAM technology is a revolutionary method which was utilized in dentistry in order to achieve more efficient and precise work that not only reduce time but also produce more patient satisfaction on the short and long term. Computer-Aided-Design (CAD) can be done by utilizing a specially designed software and an intraoral scanners or laboratory scanners which can construct a three dimensional image of scanned mouth or impression. Computer-Aided-Manufacture (CAM) on the other hand, can be done by subtractive or additive manufacturing. Subtractive manufacturing is done either by spark erosion or by a milling machine. Additive manufacturing on the other hand is made by layering technique in a step by step vertical buildup of the object or restoration. This review illustrates the indications, advantages, and limitations of CAD/CAM technology in construction of different types of restorations and the possible future of this technology.
Vulvar Squamous Cell Carcinoma usually occurs among women in their 60s or 70s. There are a limited number of reports of vulvar cancer cases younger than 30 years. These patients have usually risk factors such as human papillomavirus (HPV) infection. In this report, the authors present a rare case of invasive vulvar squamous cell carcinoma in a 21-year-old patient without HPV infection. Surgical treatment was performed, followed by adjuvant radiation therapy.
Background: Anterior talofibular ligament (ATFL) injuries are the most common in ankle torsional injuries. ATFL and peroneal tendons are both important stabilizers of lateral ankle joint. We aimed to evaluate peroneal tendons and ATFL. Methods: Fifteen nonpaired leg of fresh frozen cadavers were assessed in this study. After harvesting, ATFL diameters were measured at three points by calipers, these are fibular side, intermediate side and talar side. The mean of these three measurements were assessed and tissue a 15 lb load was applied to the peroneal tendons for 10 minutes, and the transverse diameters were measured by folding the thickest part of the tendon in a double-strand. Results: 5 single bundle, 8 double-bundle and 2 three bundles of ATFL were obtained after dissection. . There was no correlation between ATFL diameter, peroneus longus, peroneus brevis and total tendon diameters of peroneus longus and peroneus brevis in women (p> 0.05). A strong correlation was found between ATFL diameter, peroneus longus (r: 0.95), peroneus brevis (r: 0.81) and total tendon diameters of peroneus longus and peroneus brevis (r: 0.92) in men. Conclusion: Relationship between the diameter of the ATFL and peroneal tendons diameters were evaluated and a correlation was observed in males, while no correlation was observed in females.
A desmoid tumor (DT) was first described by MacFarlane in 1832. DTs are rare tumors, corresponding to only 0.03% of all neoplasia and less than 3% of all soft tissue tumors. Most of the tumors occur in the abdomen and presentation in the extremities is uncommon. Here, we present a review of the literature and the 27th case of DT of the foot.
Ageing is the major risk factor for dementia and nearly every country has seen its life expectancy rise from the beginning of the 21st century. Remaining socially connected has positive health and social implications and may be even more significant for marginalized group of people like those living with dementia. If appropriately used, social prescriptions can help deliver value-based social engagement and primary care by maximising the utilisation of resources and addressing social determinants of health, decreasing dependency on the biomedical model and thus providing a way for health care systems to deal with social determinants of health. More frequently, however, those seeking access to these programmes do not tend to do so simply due to lack of understanding and knowledge of the availability of such services. So, provision of social activities involves more than developing a program and hoping people will attend, and considering the particular situations of those living with dementia as marginalised group of people, and taking into account that there is no treatment for dementia, societies need to move toward social prescription, integrating appropriate MedTech support- targeting on those living with dementia- into such programs.
Perioperative visual loss (POVL) is a drastic complication that can result after ocular and more commonly non-ocular surgery, mostly reported after spine and cardiac bypass procedures. Despite the rarity of such complication, it has been reported following the abdominal surgeries. Overall, the most common cause of POVL is ischemic optic neuropathy but any pathology to the optical system from the cornea to the occipital lobe can lead to this rare phenomenon. Here, we are reporting the second case in the literature of post-operative visual loss after laparoscopic appendectomy. A young female, with no underlying disease, underwent laparoscopic appendectomy after septic shock secondary to acute appendicitis. Postoperatively, patient complained of complete blindness after extubation. Neurologic examination revealed bilateral near complete blindness, and hemodynamic ischemic stroke in the occipital cortex.