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Ultrastructural Pathology 2017Ependymoma is a rare central nervous system neoplasm with an even rarer morphologic variant called giant-cell ependymoma (GCE). GCE has a characteristic discrepant,... (Review)
Review
Ependymoma is a rare central nervous system neoplasm with an even rarer morphologic variant called giant-cell ependymoma (GCE). GCE has a characteristic discrepant, malignant-like morphology but indolent behavior. We present the case of a 21-year-old female with an extra-axial GCE located in the sacral region. To date, 16 cases of sacral GCE have been reported in the literature, with 4 cases in the sacral region; however, all those cases were intra-axial. We present the first case of an extra-axial sacral GCE.
Topics: Ependymoma; Female; Humans; Sacrococcygeal Region; Soft Tissue Neoplasms; Young Adult
PubMed: 28609138
DOI: 10.1080/01913123.2017.1327910 -
Pediatrics in Review Mar 2011
Review
Topics: Child; Child, Preschool; Humans; Infant; Infant, Newborn; Neural Tube Defects; Prognosis; Sacrococcygeal Region; Skin Abnormalities
PubMed: 21364014
DOI: 10.1542/pir.32-3-109 -
The Tokai Journal of Experimental and... Jul 2022We report a case of severe sacral osteomyelitis and sepsis with pressure ulcer infection treated with negative pressure wound therapy with instillation and dwelling...
We report a case of severe sacral osteomyelitis and sepsis with pressure ulcer infection treated with negative pressure wound therapy with instillation and dwelling (NPWTi-d) V.A.C.ULTA from an early stage. Case: A 76-year-old man, bedridden because of dementia and an old cerebral infarction, was treated in a nursing facility for a sacral region pressure ulcer. He had a fever for three days and was transferred to the emergency department. The quick SOFA (sequential organ failure assessment) score at the hospital visit was three points. A coccyx and black mud-formed necrotic tissue attached to the sacral region pressure ulcer with a strong putrid odor sloughed off. Sacral region pressure ulcer infection, sepsis, disseminated intravascular coagulation, and purulent sacral osteomyelitis were diagnosed, and urgent debridement was performed. We treated the patient with meropenem, clindamycin, and vancomycin, and we performed irrigation debridement every day and transduced the V.A.C.ULTA care system from AOD9, that led to good granulation at the infection site. The wound area underwent simple closure on AOD35 and the patient was transferred to the medical treatment hospital. Since dressing change is relatively easy in the emergency department of a secondary medical care institution with little man power, V.A.C.ULTA therapy may be useful in treating severe cases of pressure ulcer infections.
Topics: Aged; Humans; Male; Negative-Pressure Wound Therapy; Osteomyelitis; Pressure Ulcer; Sacrococcygeal Region; Sepsis
PubMed: 35801547
DOI: No ID Found -
Journal of Thermal Biology Dec 2022Pressure Injury (PI) is a severe health problem that affects millions of people. As a preventive strategy for high-risk ICU patients, the appropriate selection of a...
BACKGROUND
Pressure Injury (PI) is a severe health problem that affects millions of people. As a preventive strategy for high-risk ICU patients, the appropriate selection of a support surface is essential for preventing PI, along with risk assessment and repositioning. Increasing skin temperature has been associated with a higher susceptibility to PI development.
OBJECTIVE
This study aimed to evaluate thermal variations related to skin pressure in the sacral area of healthy individuals lying on three different mattresses models (standard, inflatable air, and egg crate).
DESIGN
Experimental study.
MAIN OUTCOMES
Initially, a survey was performed to identify the mattresses models most used in four public university hospitals and preventive strategies adopted. And then, an experimental study was conducted with a non-probabilistic sample involving 28 individuals of both sexes, aged 18-35 years old. The volunteers were immobilized for 2 h, and temperature variations in the sacral region were obtained by acquiring thermal images.
RESULTS
A significant difference was not found in the temperature recorded on the three mattresses models before the experiment. However, there were significant differences at the 1st and 31st minute (p < 0.001). The lowest temperature values were identified in the air inflatable mattress. Post-hoc comparisons revealed a significant difference between standard or egg crate mattresses and the inflatable air model.
CONCLUSION
The inflatable air mattress should be considered for preventing pressure injury in ICU patients since the temperature had returned to the initial value (pre-test) after the 31st min. In addition to the appropriate selection surface, risk assessment and positioning are essential to PI prevention strategies.
Topics: Adolescent; Adult; Female; Humans; Male; Young Adult; Beds; Cold Temperature; Sacrococcygeal Region; Skin; Temperature; Pressure Ulcer
PubMed: 36462883
DOI: 10.1016/j.jtherbio.2022.103366 -
Presse Medicale (Paris, France : 1983) Jun 2012
Topics: Aged; Ganglioneuroma; Humans; Magnetic Resonance Imaging; Male; Sacrococcygeal Region; Sacrum; Tomography, X-Ray Computed
PubMed: 22138290
DOI: 10.1016/j.lpm.2011.06.026 -
Clinical and Experimental Dermatology Jul 2019Nuchal-type fibroma (NTF) is a rare, benign, tumour-like fibrous proliferation of unknown pathogenesis. Despite the name, approximately one-third of cases occur at...
Nuchal-type fibroma (NTF) is a rare, benign, tumour-like fibrous proliferation of unknown pathogenesis. Despite the name, approximately one-third of cases occur at extranuchal sites. We report a rare case of NTF of the sacral region, an extremely uncommon extranuchal site. As NTF is often misdiagnosed because of its rarity and histopathological similarity with other fibrous tumours, we present this case to increase understanding of this rare disease entity.
Topics: Asymptomatic Diseases; Dermis; Fibroma; Humans; Male; Sacrococcygeal Region; Skin Neoplasms; Subcutaneous Tissue; Young Adult
PubMed: 30294793
DOI: 10.1111/ced.13760 -
Clinical Autonomic Research : Official... Feb 2018We recently defined genetic traits that distinguish sympathetic from parasympathetic neurons, both preganglionic and ganglionic (Espinosa-Medina et al., Science... (Review)
Review
We recently defined genetic traits that distinguish sympathetic from parasympathetic neurons, both preganglionic and ganglionic (Espinosa-Medina et al., Science 354:893-897, 2016). By this set of criteria, we found that the sacral autonomic outflow is sympathetic, not parasympathetic as has been thought for more than a century. Proposing such a belated shift in perspective begs the question why the new criterion (cell types defined by their genetic make-up and dependencies) should be favored over the anatomical, physiological and pharmacological considerations of long ago that inspired the "parasympathetic" classification. After a brief reminder of the former, we expound the weaknesses of the latter and argue that the novel genetic definition helps integrating neglected anatomical and physiological observations and clearing the path for future research.
Topics: Ganglia, Parasympathetic; Ganglia, Sympathetic; Humans; Sacrococcygeal Region; Spinal Cord
PubMed: 29103139
DOI: 10.1007/s10286-017-0478-7 -
Journal of Wound, Ostomy, and...The purpose of this systematic review was to identify and evaluate the use of prophylactic foam dressings for prevention of hospital-acquired pressure injuries (HAPIs).
PURPOSE
The purpose of this systematic review was to identify and evaluate the use of prophylactic foam dressings for prevention of hospital-acquired pressure injuries (HAPIs).
METHODS
A systematic review was conducted in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis Statement (PRISMA).
SEARCH STRATEGY
Four researchers independently conducted searches in Health Source, Cochrane of Systematic Reviews, CINAHL, and PubMed. Search terms included: "pressure* OR skin breakdown AND sacrum*"; "ICU patient* OR critical care patient*"; and "foam dressing OR prophylactic* or prevent*."
FINDINGS
The search identified 380 articles; 14 met eligibility criteria. The methodological quality of the included studies was variable. Findings from all studies included in our review support a decrease in HAPI incidence with use of sacral foam dressings.
IMPLICATIONS
Findings from this review suggest that prophylactic foam dressings decrease sacral HAPI occurrences in critical care patients. While additional research is needed, current best evidence supports use of prophylactic foam sacral dressings for patients at risk for HAPI.
Topics: Bandages; Hospitals; Humans; Incidence; Pressure; Pressure Ulcer; Sacrococcygeal Region; Wound Healing
PubMed: 33951710
DOI: 10.1097/WON.0000000000000762 -
Medical Archives (Sarajevo, Bosnia and... Apr 2021Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during...
BACKGROUND
Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during infancy, then involute at an unpredictable rate, extent of involution, and quality of residual tissue. Depending on the location, they may be associated with anomalies of other organ systems (PHACE, PELVIS syndroms). In recent decades, knowledge about hemangiomas has improved, and therefore therapeutic possibilities have improved. Today, the non-selective beta blocker-propranolol is considered the drug of first choice in the treatment of infantile hemangiomas. It is desirable to start treatment in the proliferative phase of hemangioma growth for the best possible effect. The dynamics of drug administration, time interval of dose increase and monitoring of patients during treatment vary from one Institution to another and are still the subject of discussion.
OBJECTIVE
We presented the case of a child with infantile hemangioma of the lumbo-sacral region, treated with combination therapy with systemic propranolol and topical timolol, with satisfactory effect in the end.
CONCLUSION
Propranolol is considered a drug with well-studied side effects and a safety profile. During 6 months of treatment, it leads to complete or almost complete withdrawal of the hemangioma. Treatment should be started in the hemangioma proliferation phase for the best possible therapeutic effect.
Topics: Administration, Topical; Adrenergic beta-Antagonists; Bosnia and Herzegovina; Female; Hemangioma; Humans; Infant; Propranolol; Sacrococcygeal Region; Timolol; Treatment Outcome; Vasodilator Agents
PubMed: 34219878
DOI: 10.5455/medarh.2021.75.158-161 -
Nature Clinical Practice. Urology Dec 2008Urinary retention without an identifiable urological cause presents a diagnostic and therapeutic challenge. Patients with nonobstructive chronic urinary retention... (Review)
Review
Urinary retention without an identifiable urological cause presents a diagnostic and therapeutic challenge. Patients with nonobstructive chronic urinary retention usually have to rely on intermittent self-catheterization or indwelling suprapubic or transurethral catheters, which significantly affect quality of life. For some patients, however, sacral neuromodulation (SNM) offers an effective therapeutic alternative, and women with primary disorder of urethral sphincter relaxation (Fowler's syndrome) seem to respond particularly well to this treatment. Although the mechanism of action of SNM is not well understood and requires further investigation, it seems to involve afferent mediation of spinal cord reflexes and brain networks. The evolution of SNM devices and improvements in surgical and testing techniques, especially the introduction of the two-stage tined lead procedure, have considerably reduced the failure, adverse event and surgical revision rates associated with SNM, ensuring that this modality is an effective minimally invasive treatment for urinary retention.
Topics: Electric Stimulation Therapy; Humans; Implants, Experimental; Quality of Life; Sacrococcygeal Region; Sacrum; Urinary Retention
PubMed: 19002127
DOI: 10.1038/ncpuro1251