Advances in medical sciences
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Retroperitoneal abscesses are uncommonly encountered clinical entities and they represent serious surgical infections associated with significant mortality rates because of their insidious clinical manifestations and diagnostic difficulty. The source of retroperitoneal infections is usually an organ contained within or abutting the retroperitoneum, usually the kidney and the microorganisms most commonly isolated are gram-negative bacilli. ⋯ Treatment of retroperitoneal abscesses includes identification and treatment of underlying conditions, intravenous antibiotics and adequate surgical drainage of all well-defined collections. We present a rare case of retroperitoneal abscess caused by monomicrobial Streprococcus mutans infection and discuss the possible pathogenesis, clinical presentation, diagnosis and treatment.
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Randomized Controlled Trial
Propofol vs isoflurane anesthesia-incidence of PONV in patients at maxillofacial surgery.
Prophylaxis of PONV (postoperative nausea and vomiting) is important for maxillofacial surgery. Vomiting is particularly unpleasant for the patient and undesirable as it may be detrimental to the operative area. The aim of this study is to compare the incidence of PONV after propofol with that after isoflurane anesthesia. ⋯ TIVA with propofol reduces the postoperative incidence of nausea and vomiting after maxillofacial surgery, compared with isoflurane anesthesia, and also reduces requirements of antiemetic medications.
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Necrotizing fasciitis (NF) is a rare, life-threatening soft-tissue infection, characterized by rapidly spreading inflammation, with secondary necrosis of the fascia and surrounding tissues. It is mostly caused by group A beta-haemolytic streptococci or multibacterial. A case of the 25-year-old man admitted on September 2006 to the Department of Dermatology and Venereology with suspicion of erysipelas of the left upper limb and left foot is presented. ⋯ Five months later patient was admitted to ICU in Bialystok after a suicide attempt. After next four months he died. The dramatic course of the disease is the evidence, that having an adequate knowledge about early symptoms of NF can save patient's life.
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To evaluate the diagnostic accuracy of the atopy patch test (APT) in detection of delayed-type sensitization to different food allergens, in children with digestive symptoms and with/or without cow's milk allergy. ⋯ High sensitivity and specificity of APT confirm its accuracy in diagnostics of delayed-type reactions in children with gastrointestinal symptoms. Combined atopy patch test and oral food challenge is essential for avoidance of unnecessary elimination diet. Delayed-type sensitization to other food allergens is common in children with cow's milk allergy.
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A 19 year-old woman admitted to Emergency Department with hypotension, sudden loss of vision and acute abdominal pain. Ultrasound and computed tomography demonstrated an occipital infarct in brain and ruptured intraperitoneal cyst of hydatid liver disease. Urgent laparotomy was performed and it included aspiration of cyst contents, peritoneal washing and drainage. ⋯ There was no recurrence of hydatid cysts in the follow-up of three years. We assumed that anaphylaxis after intraperitoneal rupture of hydatid liver cyst resulted with hypotension and reduced cerebral perfusion, caused the acute vision loss and other neurological symptoms. This unusual presentation of intraperitoneal rupture should be kept in mind particularly in endemic areas of hydatid disease.