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Jens Einenkel,Babett Holler,Albrecht Hoffmelster 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.2
Anastomotic leakage is a very significant complication after posterior pelvic exenteration and a major cause of postoperative morbidity and mortality. We present a patient who underwent an optimal debulking surgery for an advanced stage ovarian cancer (FIGO IIIC). On postoperative day 12, transvaginal ultrasound revealed an anastomotic dehiscence following an unsuspicious computer tomography scan the day before. The patient was successfully managed by transanal vacuum therapy without re-laparotomy within a period of 4 weeks after diagnosis. We conclude that high-resolution transvaginal ultrasound is a crucial method in the management of complications after surgery and even allow diagnosing leakages of colorectal anastomosis. In selected cases characterized by a small leak size and a local peritonitis confined to the pelvis a transanal vacuum therapy may avoid both surgical re-intervention and creating a secondary diverting stoma.
Jens M. Kittner 대한감염학회 2014 Infection and Chemotherapy Vol.46 No.2
Background: It is unclear to which extent the rate of disclosure of the diagnosis “HIV” to the social environment and the nature ofexperienced responses are correlated with the current mental health status of HIV-infected patients living in Germany. Materials and Methods: Eighty consecutive patients of two German HIV outpatient clinics were enrolled. Patients performed theHospital Anxiety and Depression Scale (HADS) in its German version. Disclosure behaviour and the experienced responses after disclosingas perceived by the participants were assessed using a questionnaire. In addition, patients were asked to state whether theyfelt guilty for the infection on a 1-4 point Likert scale. Results: Pathological results on the anxiety scale were reached by 40% of male and 73% of female patients, and on the depressionscale by 30% of male and 47% of female patients, thus significantly exceeding recently assessed values in the German generalpopulation, except for depression in males. None of the HADS scale results was interrelated either with the rate of disclosure or theexperienced responses. 36% of patients reported to feel guilty for the infection, which was positively correlated with results from theHADS. Limitation: The time since the single disclosure events was not assessed, and the subgroup of women was comparably small. Conclusions: Despite substantial improvement in treatment, HIV-infected patients in Germany still suffer from an elevated levelof anxiety and, in part, depression. However, mental health status was neither related with disclosure behaviour nor with experiencedresponses. We hypothesize that internal beliefs may play a more important role.