Journal of medicine and life
-
Introduction: Patients under mechanical ventilation are usually in the supine position due to various arterial/venous tubes attached to them. Although many studies emphasize the advantages of prone position for oxygenation, some studies enumerate its disadvantages. Objective: The aim of the present research was to determine the effect of prone position on oxygenation of patients with Acute Respiratory Failure (ARF) under mechanical ventilation in the Intensive Care Unit (ICU). ⋯ Findings: The prone position had a significant relation to Oxygen Arterial Blood (Sao2) and Pressure of Arterial Oxygen (pao2), (p-value<0.05). Also, on days one and two, there was no significant relationship between the prone position and physiological signs; however, this relation was significant on day three (p-value<0.05). Conclusions: Results showed that the prone position improves sao2 and pao2 without adverse effect on physiological signs.
-
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation method used worldwide to make causality-based inferences about brain-behavior interactions, assess cortical reactivity, and map functionally relevant brain regions inducing a controlled current pulse in a specific cortical area. Clinical applications of TMS have shown promising results in the treatment of a vast number of psychiatric and neurological conditions such as headache disorders - migraine being one of the most encountered. In patients with migraine, the pharmacologic therapy is divided in urgent/ abortive treatment of the attack and prophylactic one. ⋯ Nevertheless, many individuals continue to have attacks refractory to various prophylactic and/or abortive therapies, while others are at high risk of developing medication overuse headache. Among non-pharmacologic therapies TMS has been broadly studied as a preventive migraine treatment with good outcome results. Abbreviations: DLPFC - Dorsolateral prefrontal cortex, FDA - United States Food and Drug Administration, HF-TMS - High frequency transcranial magnetic stimulation, TMS - Transcranial magnetic stimulation, rTMS - Repetitive transcranial magnetic stimulation.
-
Objective:to analyze the efficiency of (NACT) followed by concurrent radiochemotherapy (RCT) in patients with locally advanced cervical cancer, 5-year overall, specific and disease-free survival and the prognostic factors correlated with the response and survival. Materials and methods:207 patients with cervical carcinoma stages IIB-IIIB, who received 2-4 cycles of neoadjuvant chemotherapy followed by concurrent chemoradiation were retrospectively analyzed for an objective response (OR), overall survival (OS), and disease-specific survival (DSS) rate. All patients received platinum-based NACT followed by concurrent RCT to a total dose (TD) of 46 Gy/pelvis when patients were evaluated for surgery. ⋯ The OS for stages IIB and IIIA was 84%, and 61% for stage IIIB while the DSS rates were 90% for stage IIB, 86% for stage IIIA and 72% for stage IIIB. The disease-free intervals (DFS) rates were 88%, 76% and 69% for stages IIB, IIIA and IIIB, respectively. Conclusions:Neoadjuvant chemotherapy followed by concurrent chemoradiation produces higher response rates and improvements in disease-specific survival and disease-free survival rates compared to RCT.
-
Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap. ⋯ Conclusions: The sural reverse flap is useful in the ankle and foot soft tissues reconstruction whenever we have reasons not to use a microsurgical free transfer. Venous congestion with consecutive partial or complete flap loss is a common complication, so this would not be recommended in patients with obvious acute or chronic venous stasis. The reverse sural island flap should no longer be regarded as a flap of secondary choice to free tissue transfer, but as an equally valuable alternative for small and midsized defects around the ankle and heel.
-
Comparative Study
Comparison of health-seeking characteristics of German and Belgian university students.
Introduction. The aim of this study was to determine whether the use of primary health care differs between students enrolled in Belgian and German government-funded universities. The secondary aim of the study was to determine the factors that might explain such a difference. ⋯ Conclusion. Belgian university students were more likely to attend a primary care physician than the German students. The health care seemed to be better organized for Belgian students and they were more satisfied with the delivered care.