- MeSH
- Electrocoagulation methods MeSH
- Epistaxis * classification therapy MeSH
- Humans MeSH
- Therapeutics * classification methods MeSH
- Endotamponade methods adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Electrocoagulation * classification methods adverse effects MeSH
- Epistaxis * pathology therapy MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Electrocoagulation methods MeSH
- Hematoma * diagnosis etiology surgery MeSH
- Neck blood supply pathology MeSH
- Humans MeSH
- Tomography, X-Ray Computed methods MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Warfarin adverse effects MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Cévní ektázie žaludečního antra (gastric antral vascular ectasia – GAVE) a syndrom solitárního rektálního vředu (solitary rectal ulcer syndrome – SRUS) jsou uváděny v literatuře jako vzácné příčiny způsobující anémii z nedostatku železa a krvácení do gastrointestinálního traktu (GIT). GAVE může způsobovat nevarikózní krvácení z horního GIT do 4 %. V případě SRUS se jedná o vzácné benigní onemocnění, které se nejčastěji projevuje krvácením z konečníku. Prezentujeme případ 75letého pacienta, který byl přijat na naši kliniku pro anémii. U stejného pacienta jsme diagnostikovali chronické krvácení z GAVE a SRUS. Oba nálezy byly ošetřeny endoskopicky: GAVE pomocí argon plazma koagulace s následnou léčbou inhibitory protonových pump a SRUS opichem adrenalinovou injekcí a naložením klipu, poté následovala lokální léčba mesalazinovými klyzmaty. Pacient byl takto úspěšně vyléčen, s výsledným stabilním hemoglobinem a bez dalších známek krvácení do GIT. Prezentujeme ojedinělý případ pacienta s chronickou anémií, jež byla způsobena koincidencí dvou vzácných onemocnění. Koincidence GAVE a SRUS nebyla zatím v literatuře publikována.
Gastric antral vascular ectasia (GAVE) and solitary rectal ulcer syndrome (SRUS) are both mentioned in the literature as rare causes of iron deficiency anemia and gastrointestinal (GI) bleeding. GAVE accounts for up to 4 % of upper non-variceal GI bleeding; SRUS is a rare benign disorder that presents with rectal bleeding. We present the case of a 75-year-old patient who was admitted to our facility with anemia. In the same patient, we encountered chronic bleeding from GAVE and SRUS. Both diagnoses were treated endoscopically: GAVE by argon plasma coagulation and a subsequent treatment with proton pump inhibitors and SRUS by adrenaline injection and clipping, consecutively treated with mesalazine enemas. The patient was successfully cured, resulting in a stable level of hemoglobin and no recurrent GI bleeding. We report a unique case of chronic GI bleeding caused by two uncommon diagnoses. The co-occurrence of GAVE and SRUS has not been previously described or published.
- MeSH
- Anemia diagnosis etiology MeSH
- Gastric Antral Vascular Ectasia * diagnosis etiology therapy MeSH
- Argon therapeutic use MeSH
- Diabetes Mellitus MeSH
- Diagnosis, Differential MeSH
- Electrocoagulation methods MeSH
- Endoscopy MeSH
- Gastrointestinal Hemorrhage MeSH
- Proton Pump Inhibitors MeSH
- Colonoscopy MeSH
- Comorbidity MeSH
- Humans MeSH
- Rectal Diseases * diagnosis physiopathology therapy MeSH
- Aged MeSH
- Syndrome MeSH
- Ulcer diagnosis physiopathology therapy MeSH
- Treatment Outcome MeSH
- Rare Diseases MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
- Keywords
- terapeutická fasetová blokáda, periradikulární blok,
- MeSH
- Anesthetics, Local therapeutic use MeSH
- Lumbar Vertebrae anatomy & histology radiography MeSH
- Back Pain * drug therapy therapy MeSH
- Clonidine therapeutic use MeSH
- Radiation Dosage MeSH
- Adult MeSH
- Electrocoagulation methods MeSH
- Glucocorticoids therapeutic use MeSH
- Thoracic Vertebrae anatomy & histology radiography MeSH
- Radiology, Interventional * MeSH
- Cervical Vertebrae anatomy & histology radiography MeSH
- Sacrum anatomy & histology radiography MeSH
- Humans MeSH
- Low Back Pain etiology drug therapy therapy MeSH
- Pain Management * methods MeSH
- Intervertebral Disc innervation MeSH
- Zygapophyseal Joint innervation MeSH
- Nerve Block methods MeSH
- Neuralgia drug therapy therapy MeSH
- Body Burden MeSH
- Analgesics, Opioid therapeutic use MeSH
- Pulsed Radiofrequency Treatment methods MeSH
- Ganglia, Spinal MeSH
- Injections, Spinal * methods MeSH
- Sympathectomy, Chemical methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
BACKGROUND: Despite high success rate of DREZ lesioning in the treatment of intractable central pain, there is still a significant incidence of patients without satisfactory post-operative effect. The aim of the study was to evaluate the long-term effect of DREZ lesioning using both a subjective assessment using a visual analog scale (VAS) to quantify residual pain and an assessment using the screening tool (painDETECT Questionnaire, PD-Q). METHODS: DREZ lesioning was performed in 52 patients from a total 441 cases with brachial plexus injury (11.8%) during a 17-year period (1995-2011). The effect of surgery was retrospectively assessed in 48 patients. RESULTS: A decrease in pre-operative pain by more than 75% (Group I) was achieved in 70.8% of patients and another 20.8% reported significant improvement (Group II). The surgery was unsucessful in 8.4% (Group III). We found a significant correlation between 'improvement' groups from both methods of assessments. Patients from Group I usually complained of residual nociceptive pain according to PD-Q, patients from Group II typically had pain of unclear origin, and all cases those in Group III suffered from neuropathic pain, Cramer's V = .66, P < .001. Overall, 66.7% of patients had resolved neuropathic pain, 20.8% patients had more serious complaints and may also suffer from residual neuropathic pain, while 12.5% had unresolved neuropathic pain. CONCLUSION: DREZ lesioning is a safe and effective method with success rates of about 90%. PD-Q scores correspond to subjective satisfaction with the surgery and it seems to be a suitable screening tool for finding patients with residual neuropathic pain after surgery.
- MeSH
- Adult MeSH
- Electrocoagulation methods MeSH
- Outcome Assessment, Health Care methods standards MeSH
- Middle Aged MeSH
- Humans MeSH
- Pain Measurement methods standards MeSH
- Spinal Nerve Roots surgery MeSH
- Young Adult MeSH
- Neuralgia diagnosis etiology surgery MeSH
- Pain, Intractable diagnosis etiology surgery MeSH
- Brachial Plexus injuries MeSH
- Surveys and Questionnaires MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Cíl: Zhodnocení vlivu bipolární termofúze tkáně BiClamp? na výsledky operací štítné žlázy, srovnání s cévní ligací. Metodika: Na ORL klinice FN Ostrava bylo v období 2006 – 2012 provedeno 1047 operací štítné žlázy. Pacienti byli rozděleni do dvou skupin – skupina I (použití cévní ligace k podvázání polárních cév a bipolární koagulace ke koagulaci menších cév), skupina II (použití termofúze tkáně BiClamp? ke koagulaci polárních cév a bipolární koagulace ke koagulaci menších cév). Je provedena analýza komplikací (pooperační krvácení s nutností revize, obrny zvratného nervu) a délky operací v závislosti na použité technice stavění krvácení během operace. Výsledky: Ve skupině I bylo provedeno 333 a ve skupině II 714 operací štítné žlázy. Četnost revize operační rány pro krvácení ve skupině I byla 14/333 (4,2 %), ve skupině II 15/714 (2,1 %) (p = 0,026). Ve skupině I byla pooperační paréza zvratného nervu pozorována u 12/600 (2 %), ve skupině II u 20/1328 (1,51 %) preparací jednoho zvratného nervu (p = 0,424). Průměrná délka trvání všech operací štítné žlázy se snížila při používání BiClamp? průměrně o 23,7 % (p < 0,001). Závěr: Bipolární termofúze tkáně BiClamp? 150(fa ERBE) je efektivní metodou hemostázy, která v porovnání s cévní ligací statisticky významně snižuje riziko pooperačního krvácení a zkracuje čas trvání operací štítné žlázy při zachování šetrnosti k okolním strukturám.
Objective: The aim of our study is to evaluate effects of BiClamp? bipolar thermofusion of tissues on results of operations of thyroid glands in comparison with a ligature of vessels. Subjects and Methods: 1047 operations of thyroid glands were performed from 2006 to 2012 at the ENT department University Hospital in Ostrava. The patients were divided into two groups – Group I (ligature of polar vessels and bipolar coagulation of smaller vessels) and Group II (usage of BiClamp? bipolar thermofusion of tissues for coagulation of polar vessels and usage of bipolar coagulation for coagulation of smaller vessels). Statistical analysis of complications (revisions of surgical wounds due to postoperative bleeding, postoperative paresis of a recurrent laryngeal nerve) and durations of operations considering method of hemostasis was performed. Results: 333 operations of thyroid glands were performed in Group I and 714 operations were performed in Group II. Frequency of revisions of surgical wounds due to postoperative bleeding was 14/333 (4.2 %) in Group I and 15/714 (2.1 %) in Group II (p = 0.026). Postoperative paresis of a recurrent laryngeal nerve was observed in 12/600 (2 %) of prepared nerves in Group I and in 20/1328 (1.51 %) in Group II (p = 0.424). Average duration of all operations of thyroid glands was lowered when BiClamp? was used by 23.7 % on average (p < 0.001). Conclusion: BiClamp? 150 bipolar thermofusion of tissues (ERBE) is an effective method of hemostasis, which lowers number of revisions of surgical wounds due to postoperative bleeding and durations of operations of thyroid gland in comparison with ligature of vessels by a statistically significant degree. At the same time, the extent of injury to other tissues during the operations remains the same..
- MeSH
- Surgical Instruments MeSH
- Operative Time MeSH
- Electrocoagulation * methods instrumentation statistics & numerical data MeSH
- Hemostasis, Surgical * methods instrumentation statistics & numerical data MeSH
- Blood Loss, Surgical prevention & control MeSH
- Humans MeSH
- Ligation methods statistics & numerical data MeSH
- Paresis complications MeSH
- Postoperative Complications MeSH
- Postoperative Hemorrhage complications MeSH
- Recurrent Laryngeal Nerve Injuries etiology complications MeSH
- Statistics as Topic MeSH
- Thyroid Gland * surgery MeSH
- Thyroidectomy MeSH
- Veins surgery MeSH
- Vascular Surgical Procedures methods instrumentation MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
