The Mount Sinai journal of medicine, New York
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Several neuropsychiatric disorders such as mood, anxiety and psychotic disorders occur following cerebrovascular lesions. Post-stroke depression is the most common of these disorders and, along with post-stroke anxiety, has been shown to inhibit physical and cognitive recovery. ⋯ Much less is known about the potential impact of psychiatric conditions on recovery after stroke. Controlled trials will be able to adequately determine the effectiveness of treatment for these disorders.
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Delirium is an organic mental syndrome defined by a global disturbance in consciousness and cognition, which develops abruptly and often fluctuates over the course of the day. It is precipitated by medical illness, substance intoxication/withdrawal or medication effect. Delirium is associated with significant morbidity and mortality, and is a leading presenting symptom of illness in the elderly. ⋯ Unfortunately, the evidence to guide pharmacologic management of acute agitation in the elderly is limited. Current pharmacologic options include the typical and atypical antipsychotic agents and the benzodiazepines. These therapeutic options are reviewed in detail.
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Review Case Reports
Rapid ventricular pacing due to electrocautery: a case report and review.
It is well known that the use of electrocautery during surgery can interfere with the functioning of pacemakers. The most common problem is that the electrocautery is interpreted by the pacemaker as cardiac electrical activity, which inhibits the pacemaker from firing, leading to bradycardia. ⋯ We report a case of electrocautery causing rapid pacing during transurethral resection of bladder polyps. The possible causes of inappropriate rapid pacing are reviewed.
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The surgical outcome of percutaneous endoscopic lumbar discectomy (PELD) for adolescent lumbar disc herniation has rarely been reported on. We performed this study to evaluate the surgical outcome of PELD for adolescent lumbar disc herniation. ⋯ Adolescents who underwent PELD for single level soft lumbar disc herniation showed favorable results that were comparable to the results of open discectomy.
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Moderate-to-severe functional tricuspid regurgitation (TR) should be corrected in patients undergoing surgery for left-sided valvular diseases, to improve long-term outcomes. Several techniques of surgical repair (suture annuloplasty or prosthetic annuloplasty) to correct this condition have been described. Multiple clinical studies have shown the superiority of prosthetic remodeling annuloplasty over the other surgical approaches. Despite this, suture-based annuloplasty remains the most commonly used technique for tricuspid valve repair. A new 3-dimensional remodeling prosthesis has been developed to address the issue of residual TR. We report our early experience with this new 3-dimensional prosthetic remodeling ring, the Edwards MC 3 system. ⋯ Concomitant tricuspid valve repair for functional TR with left-sided valve surgery carries a low operative mortality. The Edwards MC 3 annuloplasty system is relatively simple to implant and corrects TR effectively (without significant residual TR), while providing excellent short-term clinical results. The 3-dimensional saddle shape of this ring may further optimize the fixation of the annulus in systolic position, and improve long-term results. Larger clinical series with longer-term follow-up are necessary to confirm these early promising results.