Cir Cir
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Case Reports
[Reconstruction of the floor of the mouth with double free flap: report of three cases].
We undertook this study to describe three cases of reconstruction of the floor of the mouth with two simultaneous free flaps. ⋯ If a tumor involves osseous structures of the anterior floor of the mouth, it is best to perform surgery with wide margins with segmental resection of the mandible. Surgical technique is the decision of the surgeon: how many and which types of flaps will be used for reconstruction of the anterior floor of mouth. When there is necrosis of a free flap in the head and neck region, attempt with another free flap is recommended.
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Combinations of analgesic drugs have been used as an option for treating pain because some types of pain are difficult to relieve with conventional analgesics. This group of drugs has been combined with analgesics or drugs without analgesic effect and is called adjuvant. One such drug is caffeine. ⋯ Adjuvant caffeine is able to change the effect of metamizole in the inflammatory pain model, in which caffeine also presents an antinociceptive effect.
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Case Reports
[Acute spontaneous lumbar subdural hematoma associated with subacute cranial subdural hematoma. Case report].
Acute spontaneous spinal subdural hematoma associated with subacute cranial subdural hematoma is a rare entity. There is no precise age of presentation, and there is a slight female predominance. Origin is primary or secondary to hematologic factors or vascular and iatrogenic procedures. The main symptom is motor deficit in 57% of the cases. Surgical treatment is warranted only with neurological deficits. ⋯ Patients with cranial subdural hematoma who develop neurological symptoms in the lower extremities should have magnetic resonance imaging study to rule out spinal subdural hematoma.
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Uncontrolled bleeding leads to 40-86% of preventable deaths due to trauma. Use of NovoSeven (rFVIIa) in trauma is promising, although data supporting its utilization are limited. ⋯ This report represents our initial experience and the very first case of successful use of NovoSeven for the treatment of traumatic coagulopathic hemorrhage at the Central Military Hospital in Mexico City. A further prospective trial justifying its use in our institution is warranted.