La semiología médica estudia los signos y síntomas de las enfermedades para realizar diagnósticos. Este caso clínico describe los hallazgos de un paciente durante el examen físico para identificar posibles problemas médicos.
La semiología médica estudia los signos y síntomas de las enfermedades para realizar diagnósticos. Este caso clínico describe los hallazgos de un paciente durante el examen físico para identificar posibles problemas médicos.
The document discusses laparoscopy procedures for various gynecological conditions such as infertility, chronic pelvic pain, ectopic pregnancy, and oncological issues. It notes that laparoscopy can be used for both diagnostic and operative purposes. It then discusses different techniques for laparoscopic access such as direct trocar insertion versus Verres needle insertion. It reviews studies comparing complication rates between different access techniques. The document emphasizes the importance of evidence-based medicine and following guidelines from organizations like NICE when determining appropriate diagnostic tests and treatments for conditions like infertility.
The document discusses laparoscopy procedures for various gynecological conditions. It begins by outlining conditions that can be diagnosed or treated via laparoscopy, including infertility, ectopic pregnancy, adhesions, endometriosis, ovarian masses, hysterectomy, uterine fibroids, and gynecological oncology issues. It then discusses different laparoscopy access techniques such as direct trocar insertion, open laparoscopy, and Verres needle insertion. It provides data on complication rates for different access methods. The document also discusses techniques for avoiding major vascular injuries during access. In summary, the document provides an overview of laparoscopy procedures and techniques for gynecological conditions.
Nuovo metodo ad ultrasuoni per il trattamento dei calcoli renaliMerqurio
This document describes a novel method using focused ultrasound to reposition kidney stones. Researchers created a kidney phantom with an artificial collecting system and lower pole. Both artificial and human kidney stones were placed in the lower pole. An ultrasound imaging probe was used to locate the stones, while a separate focused ultrasound probe could deliver bursts of ultrasound to move the stones. In experiments, stones were successfully repositioned from the lower pole to the collecting system in seconds, moving at about 1 cm/s. This noninvasive method shows promise for aiding stone clearance after surgery or during medical expulsive therapy.
The document discusses laparoscopy procedures for various gynecological conditions such as infertility, chronic pelvic pain, ectopic pregnancy, and oncological issues. It notes that laparoscopy can be used for both diagnostic and operative purposes. It then discusses different techniques for laparoscopic access such as direct trocar insertion versus Verres needle insertion. It reviews studies comparing complication rates between different access techniques. The document emphasizes the importance of evidence-based medicine and following guidelines from organizations like NICE when determining appropriate diagnostic tests and treatments for conditions like infertility.
The document discusses laparoscopy procedures for various gynecological conditions. It begins by outlining conditions that can be diagnosed or treated via laparoscopy, including infertility, ectopic pregnancy, adhesions, endometriosis, ovarian masses, hysterectomy, uterine fibroids, and gynecological oncology issues. It then discusses different laparoscopy access techniques such as direct trocar insertion, open laparoscopy, and Verres needle insertion. It provides data on complication rates for different access methods. The document also discusses techniques for avoiding major vascular injuries during access. In summary, the document provides an overview of laparoscopy procedures and techniques for gynecological conditions.
Nuovo metodo ad ultrasuoni per il trattamento dei calcoli renaliMerqurio
This document describes a novel method using focused ultrasound to reposition kidney stones. Researchers created a kidney phantom with an artificial collecting system and lower pole. Both artificial and human kidney stones were placed in the lower pole. An ultrasound imaging probe was used to locate the stones, while a separate focused ultrasound probe could deliver bursts of ultrasound to move the stones. In experiments, stones were successfully repositioned from the lower pole to the collecting system in seconds, moving at about 1 cm/s. This noninvasive method shows promise for aiding stone clearance after surgery or during medical expulsive therapy.
Litotrissia percutanea laparoscopica nel rene pelvico casi cliniciMerqurio
This document describes a novel technique of laparoscopically assisted percutaneous pyelolithotomy for treating kidney stones in pelvic kidneys. The technique was used in 3 patients with large pelvic kidney stones who were not suitable candidates for standard percutaneous or laparoscopic approaches. The procedure involves using laparoscopy to expose the renal pelvis, then inserting a needle percutaneously into the pelvis under direct visualization. The tract is dilated and a nephroscope is used to remove stones without needing to incise or suture the pelvis. This approach provides direct access to the pelvis without risks of standard percutaneous or laparoscopic techniques. All 3 patients were successfully treated with no complications and no
Chirurgia di preservazione dell'udito. lento progresso e nuove strategieMerqurio
This study evaluated hearing outcomes for 115 patients who underwent hearing preservation surgery for acoustic neuromas. The goal was to determine the tumor size and level of pre-operative hearing that resulted in high rates of preserved hearing. Two groups of patients were evaluated based on tumor size - those with tumors ≤ 10mm and those >10mm. Patients with tumors ≤ 10mm and good pre-operative hearing (≤20dB PTA, ≥80% SDS) had a 76% success rate of preserved hearing. Patients with smaller tumors but poorer pre-operative hearing had lower success rates. The authors concluded that hearing preservation surgery is most effective for acoustic neuromas ≤10mm with good pre-operative hearing and can be an optimal treatment
Il trattamento chirurgico dei tumori del labbroMerqurio
This document summarizes a study on the surgical management of lip cancer. The study examined 32 patients treated for lip cancer over 5 years. Most cases involved squamous cell carcinoma of the lower lip. Surgical excision of the tumor was performed with oncologically appropriate margins. Reconstruction after surgery posed challenges, especially for advanced or extensive lesions. Local flaps from the lip or surrounding tissues were often used for reconstruction. Neck dissection was also performed in some cases to control lymph node metastases. While early stage tumors had good postoperative outcomes, advanced lesions resulted in greater functional impairments like drooling or chewing difficulties after surgery. The document discusses the surgical and reconstructive techniques used to treat lip cancers while aiming to preserve lip appearance and
Il trattamento chirurgico dei tumori del labbroMerqurio
The document summarizes the surgical management of lip cancer. It discusses that lip cancer is most commonly squamous cell carcinoma, usually originating in the lower lip. The management of lip cancer involves controlling the primary tumor with appropriate margins while allowing for oral competence, as well as potential neck metastases. Reconstruction is challenging, especially for advanced lesions, requiring preoperative planning and various surgical techniques. Early stage tumors have better prognostic and functional outcomes after surgery compared to advanced lesions. The authors report their experience treating lip tumors and managing neck metastases.
Effetti degli integratori di calcio sul rischio di infarto del miocardio e di...Merqurio
This meta-analysis investigated whether calcium supplements increase the risk of cardiovascular events. It analyzed 15 eligible randomized controlled trials involving over 11,000 participants who took calcium supplements for an average of 4 years. The analysis found a small increased risk of myocardial infarction among those taking calcium supplements compared to placebo, with 143 people experiencing a heart attack in the calcium group versus 111 in the placebo group. There was also a non-significant trend towards increased risks of stroke and cardiovascular death. These modest increases in risk could translate to a significant burden of disease at the population level given widespread calcium supplement use. The results suggest a reassessment of calcium supplements for osteoporosis is warranted.
Il trattamento chirurgico dei tumori del labbroMerqurio
This document summarizes a study on the surgical management of lip cancer. The most common type of lip cancer is squamous cell carcinoma, usually occurring on the lower lip. Treatment involves complete excision of the primary tumor with oncologically appropriate margins while preserving lip structure and function during reconstruction. For early-stage tumors, surgery results in good aesthetic and functional outcomes. More advanced tumors require complex reconstruction techniques using local or regional flaps to restore lip shape, texture, and mobility. Management of possible neck metastases is also important, as lymph node involvement significantly reduces survival rates. The authors report their experience treating 32 cases of lip cancer with surgical excision and various reconstructive procedures.
La sindrome rino bronchiale. indagine conoscitiva sio-aimar.Merqurio
This study aimed to standardize the diagnosis and treatment of rhino-bronchial syndrome (RBS), which links inflammation of the upper and lower airways. 159 patients meeting criteria for RBS underwent a two-level diagnostic protocol including endoscopy and spirometry. RBS was confirmed in 116 patients who had higher rates of allergic and infectious diseases than unconfirmed cases. Common symptoms were nasal obstruction, rhinorrhea, cough, and dyspnea. After 3 months of treatment including steroids, antibiotics, and nasal lavage, 96% of patients recovered. The study proposes a diagnostic workflow and highlights the importance of correct diagnosis through multidisciplinary evaluation for effective treatment of RBS.
La sindrome rino bronchiale. indagine conoscitiva sio-aimar.Merqurio
This document describes a survey conducted by the Italian Society of Otorhinolaryngology and the Interdisciplinary Scientific Association for the Study of Respiratory Diseases to better understand the epidemiology, diagnosis, and treatment of rhino-bronchial syndrome. 159 patients from 9 ENT and pulmonology centers were enrolled based on clinical history and symptoms. 116 patients received a confirmed diagnosis based on examinations of the upper and lower airways. Allergic and infectious diseases were more common in patients with a confirmed diagnosis. After 3 months of standard treatment, 96% of patients recovered. The study proposes a diagnostic workflow and emphasizes the importance of correct diagnosis through multidisciplinary evaluation and treatment.
2. Presentazione caso
Una donna di 69 anni è affetta da oltre 20 di pressione alta ed è in
trattamento da circa 5 anni con un'associazione ACE inibitore e
diuretico. I suoi valori pressori non sono mai stati completamente
normalizzati, con una media intorno ai 130 - 150 mmHg per la
sistolica e i 90 mmHg per la diastolica. La paziente si reca dal suo
medico per un disturbo del visus all'occhio destro caratterizzato
dalla presenza di "macchie nere". La visita medica generale è
sostanzialmente normale. La pressione arteriosa è 165/95 mmHg
con 108 battiti al minuto.
3. Quesito Medico
Cosa pensa di fare a questo punto?
Prescrivere una visita oculistica
Prescrivere una visita neurologica
Prescrivere una visita oculistica e neurologica
Prescrivere un ecodoppler dei tronchi sovraaortici (TSA)
Prescrivere una TAC del cranio
4. Risoluzione caso
1 – Una visita oculistica con esame del fondo dell'occhio è una risposta
esatta ma incompleta, in quanto la visita oculistica è importante ma in un
paziente anziano, iperteso non adeguatamente controllato occorre
associare un disturbo visivo anche ad una patologia vascolare cerebrale.
2 - Una visita neurologica esatta, ma incompleta in quanto una visita
oculistica, non si può ignorare la consulenza specialistica anche a carico
dell'occhio.
3- Prescrivere entrambe è la risposta corretta in quanto può trattarsi sia
di un disturbo visivo che una patologia vascolare cerebrale.
4 - Un ecodoppler dei tronchi sovraaortici (TSA) incompleta. Nel
proseguo del caso questo esame si rivelerà il più utile, ma sottolinearlo già
in questa fase non è del tutto corretto.
5 – Una TAC del cranio risposta errata sia per la specificità, che per la
spesa.
