Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiorespiratory parameters during conventional or gasless gynecological laparoscopy under general or regional anesthesia.
Conventional laparoscopy is aided by CO2 insufflation, which may impair the cardiorespiratory system and have life-threatening implications. This procedure is conducted under general anesthesia (GA). Gasless laparoscopy supposedly eliminates most of those disadvantages, but is technically more difficult to perform. In the present study, we compared cardiorespiratory parameters of conventional abdominal laparoscopy under GA to gasless laparoscopy under general or epidural anesthesia. ⋯ General and regional anesthesia may be employed in gasless laparoscopy for gynecological surgery.
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Review
Off-pump coronary artery bypass grafting: simple concept but potentially sublime scientific value.
This review discusses the available scientific evidence of the physiological changes and clinical outcomes with off-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting is more technically demanding, and its prognostic advantage has not been clearly elucidated. This paper examines the evolution of off-pump coronary artery bypass grafting and the technical challenges of 'bypassing' the cardiopulmonary bypass machine. ⋯ A rapid advance in beating heart surgery technology occurred in the past 5 yrs enabling off-pump multivessel coronary bypass grafting to be performed with relative technical ease, thereby offsetting the propensity to incomplete revascularization which can be a major setback. The clinical outcome of patients with varying surgical risks who have off-pump coronary artery bypass grafting are comparable to those who have surgical revascularization with cardiopulmonary bypass. With the technical challenges of off-pump coronary bypass grafting surmounted, the simple concept of avoiding cardiopulmonary bypass can yield impressive results that would help to establish the routine use of this technique for myocardial revascularization.
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Despite recent advances in oncology lung cancer remains the most common cause of cancer death in the United States, and its cure rate has not improved for the past 20 years. Lung cancer has been a target for numerous screening strategies, aimed at its earlier detection, and potentially improved cure. We describe the research grounds for screening for malignancies, including types of bias inherent to screening trials and present a brief discussion of potential outcomes of screening. ⋯ Computed tomography offers many advantages over routine radiographs in screening for lung cancer. Recent data indicate an impressive stage shift and improved resectability of lung cancers detected by the CT. Large-scale studies with longer periods of follow-up will show whether these promising results will translate into an improved lung cancer-related mortality in the screened population.
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Laparoscopic repair of "sportsman's hernia" in soccer players as treatment of chronic inguinal pain.
To evaluate the clinical course of soccer players affected by chronic groin pain, who were referred for laparoscopic inguinal exploration. ⋯ Laparoscopic inguinal exploration and repair of "sportsman's hernias" in soccer players was associated with rapid recovery and fast return to full training and activity.
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The purpose of this paper is to propose methylene blue as a lifesaving alternative drug for the treatment of contrast-induced anaphylaxis. ⋯ Our findings suggest that methylene blue can be lifesaving in anaphylactic shock, notwithstanding some transitory side effects, such as cardiac rhythm disturbances and chest pain, both of which possibly originate from sudden myocardial perfusion deficits.