449 research outputs found

    The Geoff Egan Memorial Lecture 2011. Artefacts, art and artifice: reconsidering iconographic sources for archaeological objects in early modern Europe

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    A first systematic analysis of historic domestic material culture depicted in contemporaneous Western painting and prints, c.1400-1800. Drawing on an extensive data set, the paper proposes to methodologies and hermeneutics for historical analysis and archaeological correspondence

    Use of the infra hyoid musculo-cutaneous flap in soft palate reconstruction.

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    To review a series of 23 consecutive patients with squamous cell carcinomas arising from oropharynx who underwent infra hyoid musculo-cutaneous flap reconstruction including soft palate in alternative to free radial forearm flap or maxillofacial prosthesis. Post operative radiotherapy was performed for all patients.Every reconstruction healed quickly without major wound complications. The functional results evaluated by speech and swallowing capacities, were good for 17 patients, fair for 4 patients and bad for 2.The infra hyoid musculo-cutaneous flap is a versatile, reliable and convenient flap suitable for repairing small and medium sized defects; it can be used in combination with other flaps, and in selected cases obviates the need for a microvascular free radial forearm flap or maxillofacial prosthesis

    Reconstruction microchirurgicale et prise en charge globale des patients porteurs de cancer ORL : l’importance d’une approche qualitĂ© et d’un circuit protocolisĂ© [Microsurgical reconstruction and full management of patients with head and neck cancer: Importance of a quality approach and a circuit protocolisation]

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    Main of study: Management and surgical reconstruction of head and neck cancers remain a challenge. From the first consultation to surgery and radiotherapy, it is necessary to save time to ensure optimum treatment and better survival rates. Objectif: To establish a kind of quality approach to the management of patients with head and neck cancers. 54 patients who had microsurgical reconstruction after head and neck cancer were included in this study between 1997 and 2006. Results : Multiple data were considered: body mass index (BMI), ASA stage, age, existence of a pre-or postoperative radiotherapy, the surgeon's experience and the number of veins drainage. The success rate is superior when more than one draining vein is sutured to the flap for patients with a BMI > 20. Radiotherapy does not seem to affect the survival of the flap. Conclusion: According to current literature, the survival rate of these patients is better when the overall time care is less than 100 days. That period is possible with a perfect organization of the medical and paramedical team. Therefore, we propose to include these patients in a circuit protocolisation care, which saves time, to better inform patients and improve survival rates. Buts: la prise en charge et la reconstruction chirurgicale des cancers ORL restent un challenge. De la premiĂšre consultation Ă  la chirurgie et la radiothĂ©rapie, il est nĂ©cessaire de gagner du temps afin d’assurer une traitement optimum et un meilleur taux de survie. Objectif : Ă©tablir une sorte d’approche qualitĂ© de la prise en charge des patients porteurs de cancers ORL. 54 patients qui ont bĂ©nĂ©ficiĂ© d’une reconstruction microchirurgicale suite Ă  un cancer ORL ont Ă©tĂ© inclus dans cette Ă©tude entre 1997 et 2006. RĂ©sultats : plusieurs donnĂ©es ont Ă©tĂ© Ă©tudiĂ©es : l’index de masse corporelle (IMC), le stade ASA, l’ñge, l’existence d’une radiothĂ©rapie prĂ© ou post opĂ©ratoire, l’expĂ©rience du chirurgien ainsi que le nombre de veines de drainage. Le taux de succĂšs se rĂ©vĂšle supĂ©rieur lorsque plus d’une veine de drainage est suturĂ©e au lambeau, pour des patients ayant un IMC > 20. La radiothĂ©rapie ne semble pas avoir de rĂ©percussion sur la survie du lambeau. Conclusion : conformĂ©ment Ă  la littĂ©rature actuelle, le taux de survie de ces patients est meilleur lorsque le temps global de prise en charge est infĂ©rieur Ă  100 jours. Ce dĂ©lai court n’est possible qu’avec une parfaite organisation de l’équipe mĂ©dicale et paramĂ©dicale. De ce fait, nous proposons d’inclure ces patients dans un circuit de prise en charge protocolisĂ©, ce qui permet de gagner du temps, de mieux informer le patient et d’amĂ©liorer le taux de survie

    Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers : a pragmatic noncommercial multicentre randomized open-label parallel-group medical device trial

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    Background: Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital‐acquired pressure ulcers (PUs). Objectives: Determine if silicone foam dressings in addition to standard prevention reduce PU incidence category 2 or worse compared to standard prevention alone. Methods: Multicentre, randomised controlled, medical device trial conducted in eight Belgian hospitals. At risk adult patients were centrally randomised (n=1633) to study groups based on a 1:1:1 allocation: experimental group 1 (n=542) and 2 (n=545) ‐ pooled as the treatment group ‐ and the control group (n=546). Experimental groups received PU prevention according to hospital protocol, and a silicone foam dressing on these body sites. The control group received standard of care. The primary endpoint was the incidence of a new PU category 2 or worse at these body sites. Results: In the intention‐to‐treat population (n=1605); 4.0% of patients developed PUs category 2 or worse in the treatment group and 6.3% in the control group (RR=0.64, 95% CI 0.41 to 0.99, P=0.04). Sacral PUs were observed in 2.8% and 4.8% of the patients in the treatment group and the control group, respectively (RR=0.59, 95% CI 0.35 to 0.98, P=0.04). Heel PUs occurred in 1.4% and 1.9% of patients in the treatment and control group respectively (RR=0.76, 95% CI 0.34 to 1.68, P=0.49). Conclusions: Silicone foam dressings reduce the incidence of PUs category 2 or worse in hospitalised at‐risk patients when used in addition to standard of care. Results show a decrease for sacrum, but no statistical difference for heel/trochanter areas

    Conservative surgery for left-sided isolated tubal torsion in pregnancy

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    We report a case of severe lower abdominal pain in a pregnant woman at 35 weeks and 4 days of gestation. Early diagnosis of an isolated left-sided tubal torsion was established by ultrasound and emergency magnetic resonance imaging (MRI). Subsequent detorsion surgery was able to prevent the need for salpingectomy. The role of emergency imaging and conservative surgery in isolated tubal torsion is discussed
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