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Hip resurfacing arthroplasty complicated by mismatched implant components

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World Journal of Orthopedics 2017年第3期8卷 286-289页

作者： Alessandro Calistri Patricia Campbell Catherine Van Der Straeten Koen Aimè De Smet Department of Orthopedic and Traumatology ANCA Clinic Implant Retrieval Lab Orthopaedic Institute for Children Department Orthopaedics and Traumatology UZ University Hospital ANCA Medical Centre

Metal-on-metal hip resurfacing has gained popularity as a feasible treatment option for young and active patients with hip osteoarthritis and high functional *** procedure should only be performed by surgeons who have trained specifically in this *** planning is essential for hip resurfacing in order to execute a successful operation and preview any technical *** authors present a case of a man who underwent a resurfacing arthroplasty for osteoarthritis of the left hip that was complicated by mismatched implant components that were revised three days afterwards for severe pain and leg length *** mistakes,although rare,can be prevented by educating operating room staff in the size and colour code tables provided by the companies on their prostheses or implant boxes.

关键词： Hip resurfacing Mismatch Revision

Fetal Instrumental Extractions at the Maternity Section of the Dakar Nabil Choucair Health Centre (Senegal) in 2017: Epidemio-clinical Aspects, Indications and Prognosis

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Open Journal of Obstetrics and Gynecology 2020年第3期10卷 390-399页

作者： Omar Gassama Babacar Biaye Boura Taoufiki Ndeye Astou Faye Djibril Diallo Aminata Niass Abdou Ndiaye Alassane Diouf Jean Charles Moreau Gynecological and Obstetric clinic of Aristide Hospital Le Dantec of Dakar Dakar Senegal

Introduction:?An instrumental extraction is performed in order to shorten the phase of expulsion of the fetus outside the maternal pelvic pathway, when there is a suspected fetal state or a defect in progression of the fetal mobile. It can be responsible for immediate or late maternal complications, which are not specific because they can occur after a normal delivery. The objectives of this work are to describe the epidemiological-clinical and prognosis aspects of deliveries assisted by instrumental extractions in a reference maternity unit in Dakar.?Materials and Methods:?This was a retrospective, descriptive and analytical study between January 1, 2017 and December 31, 2017, a period of 12 months at the maternity ward of the Nabil Choucair Health Center. The collection was carried out using the survey form completed on the basis of the analysis of the files, the delivery register and the anaesthesia register of the operating room. The parameters studied were about socio-demographic?characteristics, indications and prognosis. The data entry was carried out using the Sphinx version 5 software and the data analysis using the Epi info version?3.5?software. Results:?During the period of our study, we collected 94 instrumental?extractions. The frequency of instrumental extractions was?1.7%. The average age of the patients was 25 years with extremes of 16 to 43 years old. The average parity was 1 with extremes 1 to 6. Among parturient women, 12?patients (12.8%) had a history of suction cup, two (2.1%) had received forceps and three (3.2%) had a cesarean section. The average gestational age was 39 Weeks of Amenorrhea (WA), the average uterine?height was 32?cm, fetal heart sounds were normal in 98% parturient’ cases. The vaginal?touch had found a fully dilated cervix, a rupture of the amniotic sac with clear amniotic?fluid in 98% of parturient women and a fetus with an anterior left iliac occipito topin 69.4% of cases. The pelvis was clinically normal in all parturient wo

关键词： Instrumental Extraction Suction Cup Spoonbill Forceps

Epidemiology and Prognosis of Retroplacental Hematoma in a Maternity Ward at a Regional Hospital Center in Southern Senegal

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 149-157页

作者： Babacar Biaye Omar Gassama Mame Diarra Ndiaye Gueye Moussa Diallo Aminata Niass Mor Cisse Alassane Diouf Jean Charles Moreau Gynecological and Obstetric clinic University Hospital Aristide Le Dantec Dakar Senegal

Objectives: To study the epidemiological profile and the prognosis of the retro-placental hematoma (HRP) at the maternity ward at Kolda Regional Hospital Center. Materials and methods: This was a retrospective descriptive cross-sectional study conducted over a period of 11 years: from January 1st, 2006 to December 31st, 2016, at Kolda Regional Hospital Center. It included all patients admitted for HRP during this period. The studied parameters concerned sociodemographic characteristics, gynecological obstetrical history;clinical, therapeutic and prognostic data (non-inclusion or exclusion criteria). The data were collected from medical records, the delivery room and the surgery room registers using a collection sheet developed for this purpose. The statistical analysis of the variables studied was done with the software Epi-info 3.5. For the qualitative variables, we calculated the frequencies and for the quantitative variables, we studied the distributions. Results: During the study period, 15,343 were recorded deliveries and we carried out the diagnosis of HRP in 301 patients (1.97%). The average age of the patients was 24 years with an average parity of 4.8 deliveries. Almost all the patients (87.5%) were evacuated and half had delivered by caesarean section. Maternal and fetal deaths were 7% and 72.1%, respectively. Uterine atony accounted for 21.2% of complications. One third of the cases of uterine atony had resulted in a hysterectomy. The average duration of hospitalization was 6 days. Conclusion: The retro-placental hematoma is a serious medico-obstetric emergency. It is burdened with high maternal and fetal morbidity and mortality in developing countries.

关键词： Retro-Placental Hematoma Mortality Kolda

T-cells in myocardial infarction:Culprit instigators or mere effectors?

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World Journal of Cardiology 2018年第10期10卷 123-126页

作者： Luca Liberale Aldo Bonaventura Fabrizio Montecucco Center for Molecular Cardiology University of ZürichSchlieren 8952Switzerland First clinic of Internal Medicine Department of Internal MedicineUniversity of GenoaGenoa 16132Italy

Immune system activation and dysfunction characterize the early phase of reperfusion after a myocardial infarction(MI). Despite initially neglected, adaptive immunity has been recently showed to play an important role in this setting. In fact, the immune system can recognize sequestered antigens released by the necrotic tissue, initiating a deleterious autoimmune vicious circle leading to worse outcome. In their recent work, Angelini et al shed the light on a new feature of post-MI which involves two "old players" of post-ischemic myocardial injury: CD31 and matrix metalloproteinase(MMP)-9. Specifically, the authors showed that an enhancement of MMP-9 release could determine the cleavage of inhibitory CD31 from CD4+ T-cells surface in patients with Acute Coronary Syndromes(ACS). These findings open the room for new studies investigating the role of MMP9 in other pathological processes associated with a reduction of CD31 functionality, such as plaque instability and rupture. Of interest, in the case of a causative role for CD31 shedding in ACS would be confirmed, there might be a potential role for the administration of CD31 protein or analogue compounds to blunt post-ischemic cardiac inflammation and improve ACS outcome.

关键词： Matrix metalloproteinase Lymphocytes Autoimmunity Inflammation Myocardial infarction Adaptive immunity

Fast track anesthesia for liver transplantation: Review of the current practice

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World Journal of Hepatology 2015年第20期7卷 2303-2308页

作者： Stephen Aniskevich Sher-Lu Pai Department of Anes- thesiology Division of Hepatobiliary and Abdominal Organ Transplant Mayo Clinic Florida

Historically,patients undergoing liver transplantation were left intubated and extubated in the intensive care unit(ICU)after a period of *** of this practice argued that these patients were critically ill andneed time to be properly optimized from a physiological and pain standpoint prior to ***,there has been a growing movement toward early extubation in transplant centers *** fueled by research into early extubation following cardiac surgery,extubation in the operating room or soon after arrival to the ICU,has been shown to be safe with proper patient ***,as experience at determining appropriate candidates has improved,some institutions have developed systems to allow select patients to bypass the ICU entirely and be admitted to the surgical ward after *** discuss the history of early extubation and the arguments in favor and against fast track *** also described our practice of fast track anesthesia at Mayo clinic Florida,in which,we extubate approximately 60%of our patients in the operating room and send them to the surgical ward after a period of time in the post anesthesia recovery unit.

关键词： Liver transplant Fast track anesthesia Early extub

Classification of femoral neck fractures according to pauwels: interpretation and confusion ——Reinterpretation: a simplified classification based on mechanical considerations

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Journal of Biomedical Science and Engineering 2010年第6期3卷 638-643页

作者： Andrej Maria Nowakowski Peter Emil Ochsner Martin Majewski Orthopedic Department University of Basel clinic for Orthopedics Lucerne Klinik St. Anna

ABSTRACT The Pauwels Classification of femoral neck fractures, initially published in 1935, is used world-wide. Unfortunately, modern textbooks give varying angle and anatomic specifications between the classified fracture grades. This inconsistency is perpetuated in the literature, so that it is difficult to compare conclusions made by different authors. Pauwels himself left room for interpretation. He published two studies, one in 1935 and one in 1973, each including 3 diagrams. The 1935 version cited an angle of 8° representing the vector of static forces acting on the femoral head. The 1973 diagrams, however, cited an angle of 16° to represent dynamic forces, without changing the angle from horizontal. This already complex sche- me is complicated by the fact that it depends on other factors such as femoral neck shaft (CCD) angle, femoral neck and head diameter, and/or distance of the fracture from the center of the femoral head. The multitude of factors argues against a rigid classification based on fixed angles from horizontal. Pauwels himself did not establish fixed critical angles between the fracture grades. In his own explanation of the system, he placed more value on mechanical considerations such as compression stress, shear stress, tensile force, shearing force, and torque. We propose therefore a simplified version of the Pauwels Classification: Grade I for fractures impacted in valgus, Grade II for fractures without free torque, and Grade III for fractures with free torque.

关键词： Pauwels Garden Classification Femoral Neck Fracture

Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

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World Journal of Gastroenterology 2008年第30期14卷 4826-4829页

作者： Gian Luca Baiocchi Guido AM Tiberio Federico Gheza Marco Gardani Massimiliano Cantù Nazario Portolani Stefano Maria Giulini Surgical clinic Department of Medical and Surgical Sciences Spedali Civili di Brescia P.le Spedali Civili

Major injuries of the pancreas may result in considerable morbidity and mortality when associated with vascular and visceral injuries. In such cases, a right diagnosis and a prompt surgical intervention are necessary to give a chance to the patient. We herein describe a case of blunt abdominal trauma in a 29-year- old man whose pancreatic rupture was associated with hepatic artery, splenic vein and extrahepatic bile duct damage. Immediate surgery was performed after computer tomograghy (CT), the haemorrhagic lesions dictat the emergency transfer to the operating room. Spleno-pancreatic resection was done with reconstruction of the hepatic artery, ligation of the splenic vein and a Roux-en-Y bilio-jejunal diversion. The early post-operative course was complicated by stenosis of the arterial reconstruction, which was treated by endovascular angioplasty followed by percutaneous drainage of symptomatic pseudocyst, rest and antibiotics. Finally, the patient was discharged and was alive without clinical problems at the time when we wrote this case report. The present case underlines the clinical relevance of vascular and visceral injuries associated with pancreatic trauma and the problems arising in the diagnostic evaluation and the surgical strategy of complex multiple visceral and vascular lesions in blunt abdominal trauma.

关键词： Pancreas Trauma Vascular lesions Biliary lesions Sepsis

Spontaneous gastrojejunal fistula is a complication of gastric ulcer

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World Journal of Gastroenterology 2007年第3期13卷 483-485页

作者： Dorde M ulafi Olivera D Mateji Vladimir S Duki Miodrag D Vukevi Mirko D Kerkez clinic of Gastroenterology and Hepatology Institute of Digestive Diseases Clinical Center of Serbia Medical FacultyBelgradeSerbia clinic of Surgery Institute of Digestive Diseases Clinical Center of SerbiaMedical FacultyBelgradeSerbia Institute of Pulmonary Diseases Clinical Center of SerbiaMedical FacultyBelgradeSerbia

Spontaneous gastrojejunal fistula formation is an extremely rare complication of gastric ulcer disease. We report a 77-year old woman who presented with diffuse abdominal pain, weight loss, malaise, nausea, and occasional dark stools. Laboratory tests showed extreme hyposideremic anemia with inflammatory syndrome. In addition, biochemical parameters of malnourishment were presented. Upper endoscopy revealed the patent esophagus along the full length without any pathological changes. Large and deep ulceration with perforation in the small intestine was detected in the posterior gastric wall. The small intestine loop was reached by endoscope through spontaneously developed gastrojejunal fistula. Polytopic biopsies of described ulcerative change were carried out. Histopathologically reepithelialized ulcerous zone was seen in the gastric mucosa. Also, gastrojejunal fistula was visualized after wide opening of hepatogastric and gastrocolic ligament. Jejunal loop 25 cm from ligament of Treitz was attached to mesocolon and posterior gastric wall because of ulcer penetration. Postoperative course was uneventful, Per oral intake started on the 4^th postoperative day, and the patient was discharged on the 8^th postoperative day. In summary, this case indicates that persistent symptoms of peptic ulcer disease associated with nutritional disturbances may be caused by gastrojejunal fistula.

关键词： Gastric ulcer Spontaneous Gastrojejunal fistula

Imperforate Hymen about a Case

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Open Journal of Obstetrics and Gynecology 2019年第4期9卷 474-478页

作者： Babacar Biaye David Ngom, Aissatou Mbodji Astou Coly Niassy Diallo Aminata Niass Abdoul Aziz Diouf, Omar Gassama Mamadou Lamine Cissé Alassane Diouf Jean Charles Moreau Gynecological and Obstetric clinic Aristide Le Dantec Hospital of Dakar Dakar Senegal

Imperforate hymen?is a congenital obstructive abnormality of the female genital tract and its incidence is estimated at 1/2000 female births. The diagnosis may go unnoticed during the examination of the new born in the birth room. Most often, this malformation is discovered at puberty.?Treatment of?Imperforate hymen?is hymenotomy or hymenectomy. Different types of incisions are mentioned in the literature. We have reported the case of a 14-year-old?girl with hematocolpos and hematometra on hymenal impforforate. In cultures and religions where the loss of the hymen is a social problem among unmarried girls, a medical certificate must be given to the patient.

关键词： Imperforate Hymen Hematocolpos Hymenotomy