Canadian journal of surgery. Journal canadien de chirurgie
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Malignant hyperthermia is a potentially fatal genetic myopathy that presents when the patient is under anesthesia. It manifests as a hypermetabolic state involving tachycardia, hypercarbia, base deficit, rigidity and fever. ⋯ Historically, there has been a reluctance in local community hospitals to manage patients known to be susceptible to malignant hyperthemia, and this is a source of frustration for many families in which there is a history of this condition. This article outlines the diagnosis and management of an acute malignant hyperthermic crisis from the viewpoint of a community general surgeon and provides a review of the management of patients known to be susceptible to this condition in the surgeon's elective and emergent practice.
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To review practice patterns in a Canadian pediatric centre and develop a safe and effective care plan for managing children with splenic injuries. ⋯ Reduced admissions to the intensive care unit, shorter overall stays, omission of follow-up imaging and an earlier return to full activity should be considered in the management of children with blunt splenic injuries. Standardization of nonoperative care for such children would result in safe and more efficient delivery of health care.
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To study the vertebral involvement of the cervical spine, in particular the stability of C1-C2, in children with proven Goldenhar's syndrome. ⋯ In patients with Goldenhar's syndrome the cervical spines must be monitored carefully for C1-C2 subluxation before any proposed surgery for other malformations associated with the syndrome, so that any instability can be identified to avoid cord impingement during a general anesthetic.