Canadian journal of surgery. Journal canadien de chirurgie
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Tension pneumothorax as a complication of ventilatory support may cause severe cardiac problems. The diagnosis may be difficult. Risk factors predisposing to the misdiagnosis of this condition include atypical location of the pneumothorax. ⋯ Placement of chest tubes into the localized pneumothoraces resulted in immediate improvement in hemodynamic status in two patients, but the third patient died before the chest tube could be placed. A diagnosis of tension pneumothorax should be considered in any patient on a ventilator whose hemodynamic status deteriorates in the presence of high airway pressures. In patients with adult respiratory distress syndrome the pneumothorax can remain localized because the heavy, noncompliant lungs cannot collapse enough for air to dissect diffusely through the pleural space; pleural adhesions may also contribute to this phenomenon.
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Randomized Controlled Trial Clinical Trial
Preoperative transdermal scopolamine does not reduce the level of nausea and frequency of vomiting after laparoscopic cholecystectomy.
To determine the efficacy of scopolamine administered transdermally before laparoscopic cholecystectomy as a means of reducing postoperative nausea and vomiting. ⋯ Scopolamine administered transdermally before laparoscopic cholecystectomy does not reduce the frequency or level of nausea and vomiting postoperatively.
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To determine the role of traditional "generalist" general surgeons in Nova Scotia. ⋯ In Nova Scotia, "generalist" general surgeons presently provide non-general-surgery subspecialty services in both regional and community hospital settings.
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To study the effectiveness of treatment and the outcome in trauma patients, and to correlate these with trauma scoring systems. ⋯ The TRISS method for analysing blunt trauma is comparable to other trauma scoring systems. The correlation of outcome analysis with other scoring systems is affected by exclusion rates, pre-referral resuscitation and single- versus multiple-injury mix of cases.
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To assess the efficacy and safety of a new technique for carpal tunnel release. ⋯ Endoscopic carpal tunnel release was effective in relieving symptoms and had a low complication rate. The technique was associated with early return to work and minimal palmar pain.