From all studies no uniform recommendation for parameters of diagnostic relevance can be derived. On this background it should be demanded that future research is conducted by a uniform regimen for examination and modern technique of measuring with a high temporal resolution. Under these standardised conditions the investigated parameters of the intracompartmental pressure curve should be reconsidered once more regarding diagnostic predictability by calculations of specifity and sensitivity.
The interface pressure measurement (with a few volunteers) is not suitable for a correct assessment of anti-decubitus devices. Furthermore, the use of this method is not necessary to monitor pressure relief in intensive care patients. These systems can, however be useful in the training of nursing staff.
In this study the influence of soft-care systems on subcutaneous tissue pressure and pO2 has been examined. In 14 volunteers 3 probes were implanted over the os sacrum for measurement during the 20-minute periods. Then the probands were asked to lie on a standard mattress, on 8 static beds of various kind and on 3 dynamic soft-care systems. The clinical mattress pressure values amounted to 25.5 mm Hg (+/- 5.2; n = 14). The gell-cushion showed increased values (26.9 +/- 9.5 mm Hg; n = 5). Compared to the standard mattress the other systems showed reductions in pressure from 32.7% to 83.1%. The lowest pressure was recorded with an air-supported mattress (8.3 +/- 2.3 mm Hg; n = 5). The pO2 initial values before lying down varied greatly from individual to individual (26.9-71.3 mm Hg). In the course of the 20-minute periods the pO2 value sometimes remained constant, sometimes increased and at other times it decreased. Under extreme conditions (with 8 probands asked to lie on the floor) a correlation (r = -0.787) between pressure and pO2 was observed (pressure values between 20.6 and 192.9 mm Hg). The results indicate the use of modern soft-care systems depending on the individual risk of pressure sores.
A 58 years old male patient presented with a left cervical metastasis of a poorly differentiated squamous cell carcinoma, which was diagnosed by fine needle aspiration cytology. Clinical examination, MRT scans and panendoscopy did not detect the primary tumour site. The positron emission tomography localized an uptake of FDG in the left sided base of the tongue. The patient underwent an ipsilateral modified radical neck dissection and a lateral pharyngotomy. In the left tongue base an induration was palpable which was resected with security distance. The histopathological examination showed a poorly differentiated squamous cell carcinoma with a largest extension of 5 mm x 10 mm.
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