Harefuah
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Ketoacidosis is a common condition in patients with new onset type 1 diabetes and remains a major reason for hospitalization of those with established disease. The major cause of mortality in ketoacidosis is cerebral edema. Although rarely diagnosed on a clinical basis, cerebral edema may have subtle manifestations and is probably under-diagnosed. Novel insights into the underlying pathophysiology of cerebral edema associated with ketoacidosis may help us treat this life threatening condition and prevent the low, yet significant, mortality associated with it.
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Over the past 20 years, a series of procedures have been designed to reconstruct the aortic root of patients with aortic insufficiency, in whom the pathology and hence, the surgery, spares the valve leaflets. The objective of this current study was to evaluate our midterm results comparing the reimplantation technique with the remodeling technique in patients with aortic regurgitation due to aortic dissection, aortic root and ascending aortic aneurysms. ⋯ In acute dissection reimplantation provides better haemostasis and there may be more stable repair, both in Marfan and non-Marfan patients. In Marfans it seems that the reimplantation technique provides better long-term results.
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Following the introduction of endoscopic techniques to other surgical fields such as general surgery, gynecology urology and thoracic surgery, cardiac surgeons sought their own methods of using minimally invasive techniques. ⋯ Thoracoscopic assisted mitral valve repair (via port access) has the potential to provide all the advantages of minimally invasive surgery: accelerates recovery, decreases pain, and maintains overall surgical efficacy, while avoiding the complications and pathology of midsternotomy. For appropriate patients, this is the method of choice in our department.
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Abdominal pain is a frequent complaint. In this report, a woman who presented with abdominal pain was found to have a contained rupture of the abdominal aorta that extended into the retroperitoneum. ⋯ The patient described, however, did not have an aneurysm, as illustrated by the abdominal CT scan and surgical findings. Therefore, abdominal or back pain may be caused by a rupture of the aorta, even in the absence of an aortic aneurysm.