Medicine
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Currently, interventional injection of albumin glue and nerve sleeve plasty by cyst excision is the main treatment for sacral cysts. However, albumin glue can only be used in patients with partial cystic neck stenosis, and surgical treatment may result in postoperative complications such as numbness and cyst recurrence. Here, a modified radiculoplasty is presented, in which the lamina is restored with the nerve root wrapped with 3-dimensional (3D)-printed artificial dura mater. ⋯ Radiculoplasty with reconstruction using 3D-printed artificial dura mater and lamina restoration could be beneficial for the treatment of symptomatic sacral canal cysts.
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Tropisetron is an adjuvant for dezocine used in intravenous patient-controlled analgesia (PCA) and has been reported to provide superior pain control. It is efficacious in reducing the institutional incidence of postoperative nausea and vomiting (PONV), which decreases resource utilization and cost. However, no scientific evidence has been reported in the literature demonstrating analytical confirmation of the compatibility and stability of the combination of dezocine and tropisetron. ⋯ After a 14-day period of storage at 4°C or 25°C, the initial concentrations of dezocine and tropisetron were maintained at at least 98%. All of the mixtures remained clear and colorless throughout the observation period, and no color change or precipitation was observed. These results indicated that admixtures of 40 mg/100 mL dezocine and 5 mg/100 mL tropisetron in 0.9% sodium chloride injection were stable for at least 14 days when stored in polyolefin bags or glass bottles at 4°C or 25°C and protected from light.
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Case Reports
Primary hepatic leiomyosarcoma presenting as a thick-walled cystic mass resembling a liver abscess: A case report.
Hepatic leiomyosarcoma is a rare malignant tumor, and in rare instances, its combination with fever may lead to misdiagnosis of liver abscess. In our case, the presence of the tumor was considered by the presence of blood vessels through the observation of hepatic tumor wall. ⋯ Leiomyosarcoma is associated with a dismal prognosis, but outcomes for these patients may be improved by the combined surgical resection and chemotherapy.
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Observational Study
Self-perceived limitations and difficulties by Primary Health Care Physicians to assist emergencies.
The study was aimed to identify the training received in Emergency Medicine by physicians and the limitations and difficulties self-perceived by those physicians to assist in emergencies, as well as to analyze the differences according to the work context. Observational cross-sectional study made by a survey using a self-administered questionnaire to a representative simple random sample (with replacement) of 294 doctors (n) working at the Primary Health Care centers out of the total of 851 doctors (N) that form the staff of physicians of Primary Health Care system of Asturias (Spain). In rural areas, the most frequently mentioned reasons were the lack of practical skills (32.65%), absence of adequate material (20.41%), lack of theoretical knowledge (8.16%), and poor equipment conditions (4.08%). ⋯ The differences were significant (P = .003) among the 3 work context. The absence of practical skills is the most frequent cause referred by doctors of the 3 areas as a key to not act correctly in an emergency. The doctors of the rural area perceive that they are better prepared in general to solve emergencies and it is the professionals of 3 areas that report having carried out more basic cardiopulmonary resuscitation, advanced and attention to the polytraumatized patient courses.
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Case Reports
Corneal dysplastic melanosis associated with recurrent corneal erosions: A case report.
Pigmented lesions of conjunctiva and cornea can be observed in various conditions, from the benign nevus to malignant melanoma. Pigmented acquired melanosis (PAM) is one of them, which is a neoplastic proliferation with malignant transformation potential of melanocytes. However, to our knowledge, there has been no report as to a disturbance of corneal barrier function caused by PAM. Here we report a case of corneal PAM which led to recurrent corneal erosions. ⋯ Our report suggests that primary acquired dysplastic corneal melanosis may cause epithelial dysfunction resulting in recurrent corneal epithelial erosions.