Irish journal of medical science
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Case Reports
A novel technique for repair of iatrogenic tracheal tear complicating three-stage oesophagectomy.
We report a rare case of iatrogenic tracheal tear during a three-stage oesophagectomy in a 76-year-old woman and review current literature. The tear occurred due to trauma from a double lumen endotracheal tube. We used a novel technique of repairing the tear, which extended to the carina, avoiding a second thoracotomy or full sternotomy by using the laparoscopic suturing instruments.
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Non-convulsive seizures and status epilepticus are common in brain-injured patients in intensive care units. Continuous electroencephalography (cEEG) monitoring is the most sensitive means of their detection. In centres where cEEG is unavailable, routine EEG is often utilized for diagnosis although its sensitivity is lower. ⋯ The rate of electrographic seizure detection by routine EEG in a general ICU is lower than anticipated. Earlier and more prolonged recordings are needed in this setting.
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Medium term results of reverse total shoulder replacement in patients with rotator cuff arthropathy.
The Delta III total shoulder replacement is a reversed, semi-constrained prosthesis and is recommended for the management of rotator cuff arthropathy. ⋯ Delta III prosthesis restores the function in shoulder affected by severe pain and dysfunction due to rotator cuff arthropathy. Inferior scapular notching in the post-operative radiographs was better visualised in abduction views compared with standard anteroposterior radiographs. Long-term follow-up is required to predict the effect of scapular notching.
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Preconditioning is emerging as a simple, safe and highly effective means of attenuating local and systemic effects of medical and surgical insult. Its enormous potential has not yet been harnessed and ongoing work will continue to bring it to the fore. This article covers the history, development and future clinical potential of preconditioning with particular regard to surgical insult.
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Lymphoedema can present with an array of distressing symptoms, which can pose significant management dilemmas. First-line treatment involves established therapies including elevation, manual drainage and compression hosiery. ⋯ This case highlights the role of surgical debulking in the management of an intractable case of lower limb lymphoedema with symptoms so severe that the patient requested amputation of her left lower extremity. This report also describes other surgical modalities in the management of this debilitating condition.