Obesity represents a global health problem. According to the latest studies released by the World Health Organisation (WHO), 1.7 billion currently in excess of normal weight individuals, of which approx. 75% are overweight (body mass index - BMI 25 to 30). The common form of excess adipose tissue manifestation in overweight individuals is localized fat deposits with high (abdominal) or low (buttocks and thighs) disposition. Although the overweight can be corrected relatively easy by changing behavioral habits or food, a constant physical exercises program or following a diet food are not accessible to all through the efforts of will, financial and time involved. Several methods have been studied and tested over time to eliminate more or less invasive fat deposits with varying efficacy and adverse effects. Chemical lipolysis using phosphatidylcholine as the basic substance was initially used in hypercholesterolemia and its complications and was rapidly adopted in mesotherapy techniques for the treatment of fat deposits. This study reveals the results obtained using Dermastabilon on a sample of 16 patients, the time allocated to treatment and discomfort being minimal, and rapid and notable results. There were no side effects.
This paper aims to present the benefits and results of using TCA of high concentration of 50%, in conjunction with the presentation of adverse reactions and complications. The study was conducted in Arestetic Clinic Galai during the period 10 Dec. 2015-1 Nov. 2016, on a group of 12 patients, of which 10 women and 2 men. The product used was Easy TCA 50% manufactured by SkinTech laboratories. Three coats of TCA were applied at intervals of 4 minutes each. The end result was assessed at 21 days, when the entire surface of the skin was peeled and re-epithelized. Patients were asked to assess the degree of satisfaction on a scale of 1 to 10, with 1 being the least satisfactory and 10 being the most satisfactory. As a result of this assessment, 10 patients rated the degree of satisfaction with 10 (83%) and 2 patients rated the degree of satisfaction with 9 (17%), with an average degree of satisfaction of 9.83. At 21 days, dyschromias and hyperpigmentations completely disappeared in 9 patients, while a female patient and 2 male patients still presented with barely noticeable spots. These three persons were subjected to the second peeling after 2 months, this time in two layers, and these hyperpigmentations disappeared at the end.
Valproic acid and its salt, sodium valproate, are an effective treatment for epilepsy, the most common chronic neurologic disorder worldwide. Teratogenic associations reported after embryofetal exposure has limited the recommendations of valproate use in women of childbearing age, after careful evaluation of the benefits and risks of this medication. The mechanisms of valproate damage during pregnancy are complex and incompletely clarified up to date. Maternal and fetal impact of valproate is a critical issue, standing at the base of the new consensus on practical guidelines for clinical use of antiepileptic treatment in fertile women.
Background:The aim of this study was to analyze the treatment of patients with complicated liver hydatid cysts. Methods: The records of 184 patients who had undergone surgery for complicated liver hydatid cyst in our institution during 2005 and 2014 were reviewed retrospectively. Results: Among all complications, the most common were intrabiliary rupture (140 patients) and suppuration of the cysts (27 patients). Eleven cases had a combination of two complications. Other complications were rupture in the thorax (4 cases), rupture in the peritoneum (7 patients) and vascular erosions (6 patients). Surgery was based on the nature of complications, number and sizes of hydatid cysts and patients general condition. The surgical treatment of choice was partial (peri) cystectomies and drainage of the residual cavity with suture of the biliary fistula. In cases with complications such as suppuration, remaining bile fistulas, large cyst cavities or extrahepatic location, external drainage of the common bile duct (CBD)was mandatory. Post-operative complications occurred in 45 patients (24.4 %). Postoperative mortality was 1 % (two patients). Conclusion: Appropriate investigation and well planned surgical techniques may improve the outcome of complicated liver echinococcosis. These data suggest that cyst diameter is an independent factor that is associated with a high risk of biliary-cyst communication in clinically asymptomatic patients. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) should be performed in these asymptomatic patients to reduce the incidence of postoperative complications.
Introducere: În anul 2018 cancerul de colon se afla pe locul al 5-lea ca mortalitate prin cancer, iar cancerul rectal pe locul al 10-lea. Supravieţuirea la distanţă a bolnavilor cu cancer colorectal operat în urgenţă, rămâne nesatisfăcătoare, decesul fiind datorat recidivelor locale şi a metastazelor. Scopul: Evaluarea unor corelaţii ale supravieţuirii globale cu caracteristici clinico-paraclinice, tumorale sau de tratament pentru identificarea factorilor de prognostic la pacienţii cu cancer colorectal operat în urgenţă. Material şi Metode: Am efectuat o analiză retrospectivă la 431 pacienţi cu cancer colorectal operat în urgenţă în perioada 2008-2017, cu excluderea celor 40 de pacienţi cu decese postoperatorii, cu o perioadă de urmărire de cel puţin un an. S-au efectuat corelaţii ale unor caracteristici clinico-paraclinice, tumorale sau de tratament cu supravieţuirea globală. Rezultate: În analiza statistic univariată de supravieţuire, se obţine o asociere semnificativă statistic cu: vârsta > 61 ani (p_value = 0.000049), antecedentele chirurgicale abdominal (p_value = 0,031725), bolile cardiace (p_value = 0,000007), fibrilaţia atrială (p_value = 0,007496), diagnosticul la internare (p_value = 0,034352), caşexia (p_value = 0,000000), oligoanuria (p_value = 0,000000), anemia (p_value = 0,000006) dezechilibrul hidroelectrolitic (p_value = 0,000001), localizarea tumorală (p_value = 0,000030), invazia în organele vecine (p_value = 0,000000), aspectul de pelvis îngheţat (p_value = 0,000000), carcinomatoza peritoneală (p_value = 0,000000), metastazele hepatice (p_value=0,000000), tipul de intervenţie chirurgicală (p_value = 0,000000), limfodisecţia (p_value = 0,000001), biopsia hepatică (p_value = 0,043483), reintegrarea tranzitului intestinal (p_value = 0,000000), intervenţiile seriate (p_value = 0,000000), pTNM (p_value = 0,000000), gradingul (p_value = 0,007069). Analiza de regresie multivariată Cox a arătat că: vârsta > 61 ani-HR=1.026, 95%CI(1.012, 1.039) (p_value = 0.000139), caşexia-HR = 1.358, 95%CI(1.046, 1.764) (p_value = 0,021617), carcinomatoza peritoneală-HR = 2.346, 95%CI(1.163, 4.732) (p_value = 0,017253), stadiul bolii-HR=36.745, 95%CI = (14.778, 91.366) (p_ value = 0,000000), tipul de intervenţie-HR = 0.187, 95%CI(0.045, 0.779) (p_ value = 0,021281) şi intervenţiile seriate-HR = 0.282, 95% CI(0.144,0.551) (p_ value = 000213) sunt factori de prognostic independenţi. Concluzii: Factorii de prognostic pentru bolnavii cu cancere colorectale operate în urgenţă sunt: vârsta > 61 ani, prezenţa antecedentelor chirurgicale abdominale şi a tarelor cardiace asociate, în special a fibrilaţiei atriale, diagnosticul de iminenţă de perforaţie diastatică, caşexia, oligoanuria, anemia şi dezechilibrul hidro-electrolitic prezente la internare, tumorile rectale, invazia tumorală în organe vecine, aspectul de "pelvis îngheţat", prezenţa metastazelor hepatice sau a carcinomatozei peritoneale, tumorile nediferenţiate, stadiul III sau IV, practicarea unei derivaţii interne sau neefectuarea limfodisecţiei. Vârsta peste 61 de ...
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