Int Surg
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A case of inguinal hernia containing stomach and presenting with hematemesis is reported. Initial conservative treatment was followed by elective surgery and was successful in this case. The possibility of strangulated stomach as part of the contents of inguinal hernia should be borne in mind in cases of very large hernia, presenting with hematemesis.
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Randomized Controlled Trial Clinical Trial
Systemic prophylaxis with gentamicin-metronidazole in appendicectomy and colorectal surgery: a prospective controlled clinical study.
A prospective, randomized, clinical study was carried out in 188 patients undergoing appendicectomy or colorectal surgery to test the efficacy of prophylactic, parenterally-administered antibiotics in the prevention of infection. The results show the effectiveness of the association gentamicin-metronidazole (9.4% of infections), compared to the control group with no antibiotics (39.1% of infections), X2 = 14.1; P less than 0.001).
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A retrospective analysis of direct laryngoscopies performed at our institution in 1978 was undertaken utilizing computer technology. The population which consisted of 54% males and 46% females had an average age of 50.4 years. The most common symptom was hoarseness (83.6%). ⋯ The indications: "tumor" seen on indirect laryngoscopy, sore throat, dysphagia, otalgia, upper respiratory tract obstruction, hemoptysis, cough and leukoplakia were most frequently associated with malignancy. Voice abuse occupations were most commonly associated with vocal cord polyps and tobacco and alcohol use was most frequently associated with laryngeal cancer. Eighty-five percent of direct laryngoscopies were done under general anesthesia with two-thirds utilizing direct suspension microlaryngoscopy.
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Evidence of phrenic nerve paralysis was found in 16 of 172 (9.3%) consecutive adult cardiac surgical patients who survived surgical procedures using topical cardiac hypothermia; two patients had bilateral phrenic nerve paralysis and 14 had left phrenic nerve paralysis. One or more pulmonary complications occurred in 13 of 16 patients (81.3%) with phrenic nerve paralysis while 80 of 156 (56%) had one or more pulmonary complications among patients who had no hypothermic phrenic nerve injury. Average postoperative hospital stay was 13.6 days for patients with left phrenic nerve paralysis, and 22.5 days for patients having bilateral phrenic nerve paralysis. ⋯ Phrenic paralysis did not correlate with the length or degree of systemic hypothermia on cardiopulmonary bypass. No deaths were attributed to phrenic nerve injury. With a minimum of one year follow-up, 12 of 16 patients had return of normal diaphragmatic motion, four had residual paralysis when examined between 12 and 19 months postoperatively.
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A case of traumatic ulnar artery aneurysm is presented in this study, and the relationship between the various forms of ulnar artery aneurysm and the different methods of treatment, as well as the arterial implications are discussed. The individual palmar arch anatomy may indicate and influence the choice of management technique, in each case.