RESUMEN
OBJECTIVES: The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL. METHODS: Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05). RESULTS: There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024). CONCLUSIONS: The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.
Asunto(s)
Sarcoma , Neoplasias de los Tejidos Blandos , Adulto , Humanos , Muslo/patología , Calidad de Vida , Psicometría , Sarcoma/cirugía , Sarcoma/patología , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/patología , Fuerza MuscularRESUMEN
Resumen: Introducción: la equinococosis quística músculo-esquelética es poco frecuente, pudiendo determinar retrasos diagnósticos y errores terapéuticos. Reporte de caso: presentamos el caso de un paciente con un quiste hidático primario único a nivel de la región femoral posterior derecha, infectado. Discusión: se realizó una revisión en las bases de datos PubMed y LILACS sobre el diagnóstico y manejo terapéutico de los quistes hidáticos músculo-esqueléticos primarios. Conclusiones: la equinococosis quística músculo-esquelética debe ser tenida en cuenta dentro de los diagnósticos diferenciales de tumoraciones de partes blandas en pacientes provenientes de zonas endémicas. La tomografía computada y/o resonancia magnética cumplen un rol diagnóstico y de planificación terapéutica. El tratamiento es quirúrgico, a medida del paciente y del quiste, en función de su topografía, tamaño y fundamentalmente relaciones vasculo nerviosas y musculares. Otros factores a tener en cuenta son las futuras secuelas funcionales y resultados estéticos.
Summary: Introduction: musculoskeletal cystic echinococcosis is rather an unusual condition, what may result in delayed diagnosis and therapeutic mistakes. Case report: the study presents the case of a patient with a single primary hydatid cyst in the right posterior femoral region, which is infected. Discussion: a review of PubMed and LILACS was performed to learn about diagnosis and therapeutic handling of the primary musculoskeletal hydatid cysts. Conclusions: musculoskeletal cystic echinococcosis needs to be considered among differential diagnosis of soft tissues tumors in patients coming from endemic areas. A CT scan and RMI play an important role in diagnosis and the planning of treatment. Treatment involves surgery that must be adapted to the patient and the cyst, considering its topography and size, and in particular in view of muscular and nervous vessels relationship. Other factors to bear in mind are renal sequels and esthetic aspects.
Resumo: Introdução: a equinococose cística musculoesquelética é rara e pode determinar atrasos em seu diagnóstico e erros terapêuticos. Relato do caso: apresentamos o caso de uma paciente com cisto hidrático primário único ao nível da região femoral posterior direita, infectado. Discussão: foi realizada uma revisão nas bases de dados PubMed e LILACS sobre o diagnóstico e manejo terapêutico dos cistos hidráticos osteomusculares primários. Conclusões: a equinococose cística musculoesquelética deve ser considerada no diagnóstico diferencial de tumores de partes moles em pacientes de áreas endêmicas. A tomografia computadorizada e / ou a ressonância magnética desempenham um papel no planejamento diagnóstico e terapêutico. O tratamento é cirúrgico, adaptado ao paciente e ao cisto, dependendo de sua topografia, tamanho e, fundamentalmente, das relações vascular-nervosas e musculares. Outros fatores a serem considerados são as sequelas funcionais futuras e os resultados estéticos.
Asunto(s)
Humanos , Femenino , Muslo/patología , Equinococosis/cirugía , Equinococosis/tratamiento farmacológico , Equinococosis/diagnóstico por imagen , Músculo EsqueléticoRESUMEN
BACKGROUND: Multiple primary malignant neoplasms are not frequent but are increasing in incidence. Some of them are associated with genetic syndromes such as von Hippel-Lindau syndrome and Li-Fraumeni syndrome. Dedifferentiated liposarcoma is one of the rarest soft tissue tumors, and clear cell renal carcinoma is the most frequent kidney cancer. The concomitant presence of these tumors is extremely rare; however, some cases have been reported, none of them presenting with liposarcoma of the limbs. We report an interesting case of a patient with synchronous multiple primary tumors presenting with a very rare liposarcoma associated with renal cell carcinoma (a very rare association). A review of the literature and a collection of similar cases published previously are also provided. CASE PRESENTATION: We report a case of a 62-year-old Hispanic man who presented to our institution with a left thigh mass compatible with dedifferentiated liposarcoma synchronous with metastatic clear cell renal carcinoma. Multiple treatment lines were provided with no response, with a further metastatic transformation. Genetic analysis by liquid biopsy showed some mutations that were not susceptible to targeted therapy. At the time of this report, the patient is undergoing palliative care because his nonresponsive metastatic disease persists. CONCLUSIONS: We present the first reported case of clear cell renal carcinoma synchronous with dedifferentiated liposarcoma of a limb. The association between renal cell carcinoma and dedifferentiated liposarcoma is unusual, and there are few reports of this presentation in the literature. More research about these tumors along with genetic tests needs to be performed to seek a better understanding of the fundamental basis of this rare association.
Asunto(s)
Carcinoma de Células Renales/complicaciones , Neoplasias Renales/complicaciones , Liposarcoma/complicaciones , Neoplasias Primarias Múltiples , Neoplasias de los Tejidos Blandos/complicaciones , Carcinoma de Células Renales/genética , Humanos , Neoplasias Renales/genética , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/terapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Muslo/diagnóstico por imagen , Muslo/patologíaAsunto(s)
Linfedema/etiología , Obesidad Mórbida/complicaciones , Adulto , Humanos , Masculino , Muslo/patologíaRESUMEN
Bothrops lanceolatus is an endemic Crotalidae species in Martinique, where approximately 30 cases of envenoming are managed yearly. Envenoming characteristics from Bothrops species include local tissue damage, systemic bleeding, and hemodynamic alterations. We hereby report a case of severe envenomation following B. lanceolatus snakebite to the right calf. Severe local manifestations developed progressively up to the lower limb despite adequate antivenom therapy. Systemic manifestations of venom also occurred, resulting in intensive care therapy. Surgery exploration revealed soft tissue necrosis, friability of the deep fascia, and myonecrosis. The patient needed multiple debridement procedures and fasciotomy of all leg compartments and anterior compartment of the thigh. Diagnosis of necrotizing fasciitis was confirmed by positive Aeromonas hydrophila blood cultures. This clinical case illustrates that major soft tissue infection, including necrotizing fasciitis may occur after snakebite. Abnormal coagulation tests should not delay surgical management, as severe envenoming is a life-threatening condition.
Asunto(s)
Bothrops , Manejo de la Enfermedad , Fascitis Necrotizante/etiología , Fasciotomía , Mordeduras de Serpientes/cirugía , Adulto , Aeromonas hydrophila/aislamiento & purificación , Animales , Venenos de Crotálidos/efectos adversos , Desbridamiento , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/microbiología , Femenino , Infecciones por Bacterias Gramnegativas/sangre , Humanos , Martinica , Muslo/patología , Muslo/cirugíaRESUMEN
Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion: The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Tibia/cirugía , Reconstrucción del Ligamento Cruzado Anterior/métodos , Lesiones del Ligamento Cruzado Anterior/cirugía , Inestabilidad de la Articulación/cirugía , Osteotomía/métodos , Periodo Posoperatorio , Muslo/patología , Estudios Prospectivos , Estudios de Seguimiento , Resultado del Tratamiento , Periodo Preoperatorio , Reconstrucción del Ligamento Cruzado Anterior/efectos adversos , Reconstrucción del Ligamento Cruzado Anterior/rehabilitación , Tempo Operativo , Aloinjertos/trasplante , Autoinjertos/trasplante , Tendones Isquiotibiales/trasplanteRESUMEN
PURPOSE: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. METHODS: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. RESULTS: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. CONCLUSION: The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior/cirugía , Reconstrucción del Ligamento Cruzado Anterior/métodos , Inestabilidad de la Articulación/cirugía , Tibia/cirugía , Adolescente , Adulto , Aloinjertos/trasplante , Reconstrucción del Ligamento Cruzado Anterior/efectos adversos , Reconstrucción del Ligamento Cruzado Anterior/rehabilitación , Autoinjertos/trasplante , Femenino , Estudios de Seguimiento , Tendones Isquiotibiales/trasplante , Humanos , Masculino , Tempo Operativo , Osteotomía/métodos , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Prospectivos , Muslo/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
CONTEXT AND OBJECTIVE: Lasers are widely used in treating symptomatic benign prostatic hyperplasia. In current practice, potassium titanyl phosphate (KTP) lasers are the most common type of laser systems used. The aim here was to evaluate the rapid effect of high-power laser systems after application of hypericin. DESIGN AND SETTING: Experimental animal study conducted in the Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey, in 2012. METHODS: Sixteen rats were randomized into four groups: 120 W KTP laser + hypericin; 120 W KTP laser alone; 80 W KTP laser + hypericin; and 80 W KTP laser alone. Hypericin was given intraperitoneally two hours prior to laser applications. The laser incisions were made through the quadriceps muscle of the rats. The depth and the width of the laser incisions were evaluated histologically and recorded. RESULTS: To standardize the effects of the laser, we used the ratio of depth to width. These new values showed us the depth of the laser application per unit width. The new values acquired were evaluated statistically. Mean depth/width values were 231.6, 173.6, 214.1 and 178.9 in groups 1, 2, 3 and 4, respectively. The most notable result was that higher degrees of tissue penetration were achieved in the groups with hypericin (P < 0.05). CONCLUSIONS: The encouraging results from our preliminary study demonstrated that hypericin may improve the effects of KTP laser applications. .
CONTEXTO E OBJETIVO: Lasers são amplamente utilizados no tratamento de hiperplasia benigna de próstata sintomática. Na prática atual, lasers de fosfato de titanilo de potássio (KTP) são os tipos mais comuns usados dos sistemas. O objetivo foi avaliar o efeito rápido do sistema laser de alta potência após a aplicação de hipericina. TIPO DE ESTUDO E LOCAL: Estudo experimental animal, realizado no Departamento de Urologia, Academia de Medicina Militar de Gülhane, Ancara, Turquia, em 2012. MÉTODOS: 16 ratos foram divididos aleatoriamente em 4 grupos: 120W KTP laser + hipericina; 120W KTP laser somente; 80W KTP laser + hipericina; 80W KTP laser somente. Hipericina foi dada intraperitonealmente duas horas antes da aplicação do laser. As incisões a laser foram feitas através do músculo quadríceps dos ratos. A profundidade e a largura das incisões a laser foram avaliadas histologicamente e registradas. RESULTADOS: Para padronizar o efeito do laser foi utilizada a razão entre profundidade e largura. Estes novos valores nos mostraram a profundidade da aplicação do laser de largura por unidade. Os novos valores adquiridos foram avaliados estatisticamente. Os valores da média de profundidade/largura foram 231,6, 173,6, 214,1 e 178,9 nos grupos 1, 2, 3 e 4, respectivamente. O resultado mais notável foi atingir altos graus de penetração tecidual nos grupos com hipericina (P < 0,05). CONCLUSÕES: Os resultados promissores do nosso estudo preliminar mostraram que hipericina pode melhorar os efeitos das aplicações do laser KTP. .
Asunto(s)
Animales , Masculino , Láseres de Estado Sólido , Músculo Esquelético/efectos de los fármacos , Perileno/análogos & derivados , Fármacos Sensibilizantes a Radiaciones/farmacología , Modelos Animales , Músculo Esquelético/patología , Músculo Esquelético/efectos de la radiación , Perileno/farmacología , Distribución Aleatoria , Ratas Wistar , Muslo/patología , Muslo/efectos de la radiación , Factores de TiempoRESUMEN
El liposarcoma mixoide es un tumor del tejido conectivo de gran malignidad, poco frecuente. Se presenta el caso clínico de una paciente de 65 años de edad, raza negra, que acudió a consulta por un cuadro clínico de dolor y aumento de volumen del muslo derecho después de tres meses de recibir un trauma en esa área. El diagnóstico inicial fue un hematoma del muslo, pero la paciente no mejoró su cuadro. Después de varios estudios se llegó a la conclusión de que la paciente tenía una tumoración maligna de gran tamaño. Esta lesión respondió bien al procedimiento quirúrgico, que consistió en cirugía exerética, con margen oncológico de seguridad, con un mínimo de dos centímetros de tejido sano con resección en bloque. Esto apoyado con la quimioterapia y radioterapia ayudaron a la no recidiva del tumor(AU)
Myxoid liposarcoma is a few frequent connective tissue tumor of great malignancy. We present the clinical case of a black female patient aged 65 years who assisted the consultation with clinical features of pain and volume increase of the right thigh after three months of receiving a trauma in that area. The initial diagnosis was a thigh hematoma, but there was not an improvement of symptoms. After several studies we arrived to the conclusion that the patient had a great size malignant tumor. This lesion answered well to the surgical procedure consisting in an excerpting surgery, with a security oncologic margin, with a minimum of 2 cm of healthy tissue in block resection. There it was not a relapse of the tumor due to this procedure and the help of chemotherapy and radiotherapy(AU)
Asunto(s)
Humanos , Femenino , Anciano , Liposarcoma Mixoide/diagnóstico , Liposarcoma Mixoide/radioterapia , Liposarcoma Mixoide/cirugía , Muslo/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/radioterapia , Neoplasias Cutáneas/cirugía , Informes de CasosRESUMEN
CONTEXT AND OBJECTIVE: Lasers are widely used in treating symptomatic benign prostatic hyperplasia. In current practice, potassium titanyl phosphate (KTP) lasers are the most common type of laser systems used. The aim here was to evaluate the rapid effect of high-power laser systems after application of hypericin. DESIGN AND SETTING: Experimental animal study conducted in the Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey, in 2012. METHODS: Sixteen rats were randomized into four groups: 120 W KTP laser + hypericin; 120 W KTP laser alone; 80 W KTP laser + hypericin; and 80 W KTP laser alone. Hypericin was given intraperitoneally two hours prior to laser applications. The laser incisions were made through the quadriceps muscle of the rats. The depth and the width of the laser incisions were evaluated histologically and recorded. RESULTS: To standardize the effects of the laser, we used the ratio of depth to width. These new values showed us the depth of the laser application per unit width. The new values acquired were evaluated statistically. Mean depth/width values were 231.6, 173.6, 214.1 and 178.9 in groups 1, 2, 3 and 4, respectively. The most notable result was that higher degrees of tissue penetration were achieved in the groups with hypericin (P < 0.05). CONCLUSIONS: The encouraging results from our preliminary study demonstrated that hypericin may improve the effects of KTP laser applications.
Asunto(s)
Láseres de Estado Sólido , Músculo Esquelético/efectos de los fármacos , Perileno/análogos & derivados , Fármacos Sensibilizantes a Radiaciones/farmacología , Animales , Antracenos , Masculino , Modelos Animales , Músculo Esquelético/patología , Músculo Esquelético/efectos de la radiación , Perileno/farmacología , Distribución Aleatoria , Ratas Wistar , Muslo/patología , Muslo/efectos de la radiación , Factores de TiempoRESUMEN
INTRODUCTION: Polymelia, or congenital duplication of a limb, is an extremely rare entity in humans, with few cases reported in the literature. CASE PRESENTATION: We present the case of a six-month-old Hispanic boy born with a lower limb bud on the left posterior thigh. CONCLUSION: The infant had a favorable outcome and evolution after surgical treatment of his supernumerary limb, with no after-effects or impairment whatsoever.
Asunto(s)
Deformidades Congénitas de las Extremidades Inferiores/patología , Humanos , Lactante , Deformidades Congénitas de las Extremidades Inferiores/cirugía , Masculino , Muslo/anomalías , Muslo/patología , Muslo/cirugíaRESUMEN
Estudio de caso: Paciente de sexo masculino, de 38 años de edad,con tumor ación indolor a en muslo izquierdo de 3 años de evolución. Esta neoplasia corresponde típicamente a nódulos compuestos por células epiteloides poligonales, claras, que recuerdan a las de la notocorda y una segunda población de células e osinofílicas organizadas en cordones y nidos separados por estroma mixoide, con fenómenos de vacuolización citoplasmática similar a las del cordoma (células tipo fisalíferas).
Case Study: Male patient, 38 years old, with painless swelling in left thigh 3 years evolution. This neoplasm typicall y corresponds tonodules composed of polygonal epithelioid cells, clear, reminiscent of the notochord and a second population of eosinophilic cells arranged incords and nests separated by myxoid stroma with phenomena similar to cytoplasmic vacuolization the chordoma (physaliphorous type cells).
Asunto(s)
Humanos , Femenino , Adulto , Adulto , Mioepitelioma , Mioepitelioma/microbiología , Muslo/anomalías , Muslo/microbiología , Muslo/patologíaAsunto(s)
Araña Reclusa Parda , Piel/patología , Picaduras de Arañas/patología , Niño , Femenino , Humanos , Muslo/patologíaRESUMEN
Introducción: la gota es una alteración del metabolismo de las purinas caracterizada por hiperuricemia, con rara implicación de la región del muslo y en específico intramuscular.Objetivo: presentar este caso por la rareza de este tipo de tumoración en la porción intramuscular.Descripción: se presentó el caso clínico de un varón de 64 años, sin el diagnóstico previo de gota, que fue intervenido quirúrgicamente por una masa tumoral de partes blandas en el muslo izquierdo, con resección muscular en bloque. Se hizo una revisión de la literatura y se analizó su presentación clínica, hallazgos histológicos, pruebas diagnósticas de imagen y tratamiento terapéutico.Conclusiones: el estudio anatomopatológico confirmó el diagnóstico de tofo gotoso intramuscular del músculo vasto externo. Actualmente, el paciente se encuentra libre de síntomas y en seguimiento por el servicio de reumatología y de ortopedia(AU)
Introduction: gout is a disorder of purine metabolism characterized by hyperuricemia, with rare involvement of the thigh region, let alone intramuscular involvement.Objective: present this case due to the rarity of this type of tumor in the intramuscular portion.Description: a clinical case is presented of a male 64-year-old patient with no prior gout diagnosis, who had been operated on for a tumor mass of soft parts in the left thigh with en bloc muscle resection. A bibliographic review was conducted and an analysis carried out of the clinical presentation, histological findings, diagnostic imaging tests and therapeutic treatment.Conclusions: anatomopathological examination confirmed the diagnosis of intramuscular gout tophus of the external vastus muscle. At present the patient is free of symptoms and is being followed-up by the rheumatology and orthopedics service(AU)
Asunto(s)
Humanos , Masculino , Anciano , Hiperuricemia/etiología , Gota/complicaciones , Muslo/patología , Muslo/cirugía , Informes de CasosRESUMEN
Introducción: la gota es una alteración del metabolismo de las purinas caracterizada por hiperuricemia, con rara implicación de la región del muslo y en específico intramuscular. Objetivo: presentar este caso por la rareza de este tipo de tumoración en la porción intramuscular. Descripción: se presentó el caso clínico de un varón de 64 años, sin el diagnóstico previo de gota, que fue intervenido quirúrgicamente por una masa tumoral de partes blandas en el muslo izquierdo, con resección muscular en bloque. Se hizo una revisión de la literatura y se analizó su presentación clínica, hallazgos histológicos, pruebas diagnósticas de imagen y tratamiento terapéutico. Conclusiones: el estudio anatomopatológico confirmó el diagnóstico de tofo gotoso intramuscular del músculo vasto externo. Actualmente, el paciente se encuentra libre de síntomas y en seguimiento por el servicio de reumatología y de ortopedia(AU)
Introduction: gout is a disorder of purine metabolism characterized by hyperuricemia, with rare involvement of the thigh region, let alone intramuscular involvement. Objective: present this case due to the rarity of this type of tumor in the intramuscular portion. Description: a clinical case is presented of a male 64-year-old patient with no prior gout diagnosis, who had been operated on for a tumor mass of soft parts in the left thigh with en bloc muscle resection. A bibliographic review was conducted and an analysis carried out of the clinical presentation, histological findings, diagnostic imaging tests and therapeutic treatment. Conclusions: anatomopathological examination confirmed the diagnosis of intramuscular gout tophus of the external vastus muscle. At present the patient is free of symptoms and is being followed-up by the rheumatology and orthopedics service(AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Gota/diagnóstico , Muslo/patología , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
Se describe el caso clínico de un paciente de 60 años de edad, que en 1984 sufrió lesiones traumáticas cerradas y sin fracturas, en la pelvis, caderas y ambos muslos, como consecuencia de un accidente de tránsito, el cual fue operado en el Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba por presentar derrame seroso de Morell-Lavalle, por esta causa. Se realizó exéresis total de una masa quística gigante recurrente en dos tiempos quirúrgicos. El anciano evolucionó satisfactoriamente y todavía en el 2010 se mantiene asintomático(AU)
The case report of a 60 year-old patient who suffered from blunt traumatic injuries and no fractures in the pelvis, hips and both thighs, due to an automobile accident in 1984 is described. He was surgically treated in Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba as he presented a Morell-Lavalle serous effusion. He had the total exeresis of a giant recurrent cystic mass in two surgical times. The patient had a satisfactory clinical course and in 2010 he is still asymptomatic(AU)
Asunto(s)
Humanos , Masculino , Anciano , Fracturas Cerradas , Traumatismos Cerrados de la Cabeza , Atención Secundaria de Salud , Accidentes de Tránsito , Muslo/lesiones , Muslo/patología , ContusionesRESUMEN
OBJETIVO: Determinar la versatilidad del colgajo anterolateral del muslo para la reconstrucción de defectos oncológicos de tejidos blandos en el Instituto Nacional de Enfermedades Neoplásicas entre 2006 a 2010. MATERIAL Y MÉTODO: Se realizó un estudio observacional, retrospectivo, longitudinal, que evaluó 28 pacientes con defectos oncológicos sometidos a reconstrucción con colgajo anterolateral de muslo. RESULTADOS: La edad promedio de la muestra fue 56,68±12,67 años, el 71,43 por ciento de los pacientes correspondieron al sexo masculino; La localización del defecto reparado fue en cabeza y cuello en el 64,29 por ciento de los casos, seguido por el tronco con el 21,43 por ciento; el tipo de cáncer diagnosticado más frecuente fue el epidermoide (50 por ciento), seguido por el sarcoma (14,29 por ciento) y el basocelular(14,29 por ciento); el tipo de colgajo anterolateral del muslo usado en relación a su composición fue el fasciocutáneo (67,86 por ciento), seguido por el miocutáneo (28,57 por ciento); el tipo de colgajo anterolateral del muslo usado según su vascularización fue el tipo libre (78,57 por ciento), seguido por el pediculado de base proximal (21,43 por ciento). Las complicaciones más frecuentes del área dadora fueron, la dehiscencia y la cicatriz hipertróñca; las complicaciones propias del colgajo fueron la pérdida parcial y completa; el muslo de donde se tomó el colgajo fue el izquierdo en el 78,57 por ciento. El número de anastomosis arteriales todas fueron en número de 1 (22 anastomosis arteriales) y en las anastomosis venosas, fueron 12 anastomosis en número de 1 y 10 anastomosis en número de 2. El tipo de anastomosis que predominó fue el tipo término terminal con un 96,30 por ciento y termino lateral con un 3,7 por ciento. El tiempo operatorio promedio fue 7±2,99 horas. CONCLUSIONES: El colgajo antero lateral de muslo para la reconstrucción de tejidos blandos, es versátil, hubo un relativo número de complicaciones, pero no serias, susceptibles de tratamiento
OBJETlVE: To determine the versatility of the anterolateral thigh flap for reconstruction of soft tissue defects oncology at the National Institute of Neoplastic Diseases from 2006 to 2010. MATERIAL AND METHODS: An study observational, retrospective, longitudinal, which evaluated 28 patients with defects tor cancer that undergoing flap reconstruction with anterolateral thigh. RESULTS: The mea n age of the sample was 56,68±12,67 years, 71,43 per cent of the patients were male. The location of the defect repaired was in the head and neck in 64,29 per cent of cases, followed by the trunk with 21,43 per cent, the type cancer most frequently diagnosed was epidermoid (50 per cent), followed by sarcoma (14,29 per cent) and basocelular (14,29 per cent), the type of anterolateral thigh flap used in relation to its composition was the fasciocutaneous (67,86 per cent). followed by myocutaneous (28,57 per cent); the type used anterolateral thigh flap as vascularization was free (78,57 per cent), followed by proximal pedicle base (21,43 per cent). The donor area complications were dehiscence and hypertrophic scarring, the most frequent complications were flap own partial and complete loss, the leg where the flap was taken was left at 78,57 per cent. The number of arterial anastomoses were all in number 1 (22 arterial anastomosis) and the venous anastomosis, were 12 in number of 1 and 10 anastomoses in number 2. The type of anastomosis predominant was term terminal type with 96,30 per cent and finished lateral with a 3,7 per cent lateral. Mean operative time was 7±2.99 hours. CONCLUSIONS: The anterior lateral thigh flap for reconstruction of soft tissue, is versatile, there was a relative number of complications, but not serious, treatable
Asunto(s)
Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Muslo/patología , Neoplasias de los Tejidos Blandos/complicaciones , Procedimientos de Cirugía Plástica , Colgajos Quirúrgicos , Estudios Longitudinales , Estudios Observacionales como Asunto , Estudios RetrospectivosRESUMEN
BACKGROUND: Drug regulatory agencies (DRA) support prescription of generic products of intravenous antibiotics assuming therapeutic equivalence from pharmaceutical equivalence. Recent reports of deaths associated with generic heparin and metoprolol have raised concerns about the efficacy and safety of DRA-approved drugs. METHODOLOGY/PRINCIPAL FINDINGS: To challenge the assumption that pharmaceutical equivalence predicts therapeutic equivalence, we determined in vitro and in vivo the efficacy of the innovator product and 20 pharmaceutically equivalent generics of gentamicin. The data showed that, while only 1 generic product failed in vitro (MIC = 45.3 vs. 0.7 mg/L, P<0.05), 10 products (including gentamicin reference powder) failed in vivo against E. coli due to significantly inferior efficacy (E(max) = 4.81 to 5.32 vs. 5.99 log(10) CFU/g, PAsunto(s)
Infecciones Bacterianas/complicaciones
, Medicamentos Genéricos/farmacocinética
, Medicamentos Genéricos/uso terapéutico
, Gentamicinas/farmacocinética
, Gentamicinas/uso terapéutico
, Neutropenia/tratamiento farmacológico
, Muslo/patología
, Animales
, Antiinfecciosos/farmacología
, Modelos Animales de Enfermedad
, Medicamentos Genéricos/farmacología
, Gentamicinas/farmacología
, Ratones
, Pruebas de Sensibilidad Microbiana
, Neutropenia/complicaciones
, Neutropenia/microbiología
, Especificidad de Órganos/efectos de los fármacos
, Reproducibilidad de los Resultados
, Análisis de Supervivencia
, Equivalencia Terapéutica
, Muslo/microbiología