7,830 research outputs found

    Persistent Hypothermia and Excessive Sweating Following Intrathecal Morphine Administration in a Teenage Boy: A Case Report

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    INTRODUCTION: Opioids are used intrathecally to manage surgical pain. There are few reports of hypothermia after spinal morphine injection, none in the pediatric population. We present a teenager's case of mild hypothermia. CASE PRESENTATION: A 15-year-old boy was scheduled for elective abdominal laparotomy. General anesthesia was combined with spinal anesthesia, using levobupivacaine and morphine. In the recovery room, he presented a decreased tympanic temperature (34.4°C) associated with excessive sweating, hyperglycemia, and complained of feeling hot. All other vital signs were normal. It was decided to maintain clinical vigilance and hourly monitoring of temperature and glycaemia values. Despite active warming, he remained hypothermic for 16 hours, with gradual remission of symptoms and normalization of glycemic values. It is unknown how intrathecal morphine causes hypothermia. The most viable hypothesis is its effect on the hypothalamus. In our case the most probable causes of post anesthesia hypothermia were excluded; therefore, we can admit that the cause of hypothermia was the spinal administration of morphine. Some reports used naloxone and lorazepam successfully. In our report, they disappeared spontaneously 16 hours later, which corroborates our diagnosis. CONCLUSIONS: Children undergoing subarachnoid block with with intrathecal morphine may develop a disruption on thermoregulation, leading to a resistant postoperative hypothermia associated with excessive sweating.info:eu-repo/semantics/publishedVersio

    Camurati-Engelmann disease

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    Exuberant calcinosis and acroosteolysis. A diagnostic challenge

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    A case of exuberant acroosteolysis and subcutaneous tissue calcinosis in the absence of skin involvement is presented. Different hypotheses are discussed following the clinical unfolding of the case in practice

    Photonic crystal fibers as miniature monitoring platforms for petroleum characterization

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    A fiber design that allows the characterization of high and low refractive index materials is proposed and demonstrated. This fiber consists of an air-silica photonic crystal fiber supporting a Gaussian like mode confined in the fiber core and a ring mode in a region between the structured area and the fiber cladding. This versatile fiber design finds applications in the oil industry where materials of different refractive indices are found. The characterization of petroleum and CO2 using the new fiber is demonstrated. © 2012 SPIE

    Arthroscopic Anatomical Acromioclavicular Joint Reconstruction using a Button Device and a Semitendinosus Graft

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    Objective: To report a new technique for anatomical acromioclavicular (AC) joint reconstruction. Methods: In order to minimize such complications, the authors describe a new anatomical and biological AC joint repair. This technique aims to provide greater stability by using two anatomically placed clavicular tunnels and a combined construct with a double endobutton cortical fixation for primary stabilization, and to be biologically advantageous by using an autologous semitendinosus (ST) tendon graft. Additionally, the coracoclavicular ligament reconstruction is complemented with an AC joint cerclage and capsular reinforcement, which will protect the biological construction in its initial stage of healing. Results: This technique provides adequate primary and secondary biomechanical stability by passing both a semitendinosus autogenous graft and a double endobutton device, through anatomically placed and small diameter clavicle holes, without the need for coracoid drilling. Our technique showed encouraging results regarding pain resolution, range of motion, and function. At final follow-up we experienced excellent results with average pain score of 1.6, and average ROM of 159° of forward flexion, 160° of abduction, 68° of external rotation, and internal rotation level at T11. Postoperative function also showed great improvements with average ASES of 85 points, an average Constant Score of 87 and a Subjective Shoulder Value of 89 points. This technique also achieved perfectly acceptable radiographic results, with an average coracoclavicular distance increase of 0.8 mm. Regarding complications, our sample showed one case of AC join subluxation, two cases of internal saphenous nerve injury, and two partial graft tears at the suture-button interface, with none of these requiring surgical revision. Conclusion: This technique is advantageous in treatment of acromioclavicular joint dislocation and can be performed in both the subacute and chronic setting.info:eu-repo/semantics/publishedVersio
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