The Mount Sinai journal of medicine, New York
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Translumbar amputation, known also as hemicorporectomy, was first described by Kredel but was not performed until 10 years later in 1960. It appears that 44 such operations have been reported but probably several others remain unpublished. ⋯ This case is remarkable in that, despite a rapidly advancing cancer of the bladder, the patient lived for over 28 years. It is gratifying to see that other surgeons and patients have not abandoned this most radical of all operations when no other therapy can preserve life.
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Comparative Study
Prostate cancer screening practices: differences between clinic and private patients.
How often prostate cancer screening tests are conducted in general practice is unknown. It is known that at the primary care level, health care delivered to uninsured and Medicaid patients and to privately insured patients differs. We investigated the frequency of digital rectal examination and prostate-specific antigen testing in a clinic (an internal medicine clinic) and a faculty private practice population at The Mount Sinai Hospital over a period of one year. ⋯ Private patients were six times more likely than clinic patients to have had prostate-specific antigen screening and seven times more likely to receive both of the recommended prostate screening tests within the past year. Results also showed that 25% of all patients were not screened for cancer by digital rectal examination. Study of a larger population is recommended to further corroborate these findings.
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Randomized Controlled Trial Clinical Trial
Improving patient-controlled analgesia: adding droperidol to morphine sulfate to reduce nausea and vomiting and potentiate analgesia.
Opioid-related side effects, including nausea and vomiting, are common in patients using morphine in patient-controlled analgesia for postoperative pain relief. The purpose of this study was to determine if the addition of droperidol to a morphine sulfate delivery system could decrease the incidences of nausea and vomiting without increasing droperidol-related side effects. Forty ASA 1 and 2 patients scheduled to undergo peripheral orthopedic surgery were randomized to receive either morphine sulfate (2 mg/mL), or morphine sulfate (1.9 mg/mL) plus droperidol (0.125 mg/mL) for postoperative self-controlled analgesia. ⋯ The patients who used morphine sulfate plus droperidol had significantly less nausea and vomiting and used significantly less morphine. No patient experienced droperidol-related side effects. We conclude that the routine addition of droperidol to morphine sulfate in self-controlled analgesia improves the comfort of patients following peripheral orthopedic surgery.