Annales chirurgiae et gynaecologiae
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105 valve replacements with the Björk-Shiley tilting-disc prosthesis have been performed in 99 patients with an overall mortality of 12%. The hospital mortality for 73 single aortic valve replacements was 10%, for 24 single mitral valve replacements 13%, and for 5 double valve operations 20%. ⋯ The follow-up period of the first patients with aortic valve replacement is 4 1/2 years, and that of those with mitral valve replacement over 2 1/2 years. The most common late complication in patients with mitral valve replacement was a paravalvular leak (19%), whereas in patients with aortic valve replacement slight haemolytic anaemia (4%) and late thromboembolism (3%) occurred most frequently. 84 of the 87 survivors showed manifest clinical improvement in their preoperative status and increased exercise tolerance.
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A case of intussusception of the appendix caused by an adenovillous papilloma in the appendix is reported. The condition was combined with acute appendicitis. ⋯ The aetiology is briefly discussed. The treatment is operative with removal of the appendix or an appropriate resection.
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A review is given of a 15 year experience of valve replacement with Teflon cusps, pericardial cusps, Starr-Edwards, Key-Shiley, Wada-Cutter and Björk-Shiley artificial valve prosthesis. The Björk-Shiley tilting disc valves have shown the lowest gradient and blood trauma and excellent durability in more than 1 000 implantations during a 7 year period. Anticoagulation therapy is considered necessary with all types of artificial heart valves. Thrombo-embolism is negligible after aortic valve replacement (1 episode in 4 000 patient months) but still a problem in the mitral position (4 episodes in 1 000 patient months).
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
The antiemetic effect of dixyrazine in postoperative patients-- a double-blind study.
A double-blind controlled study based on 197 women undergoing legal abortion (part I) or gynaecological surgery (part II) was employed to estimate the antiemetic effect of dixyrazine. Dixyrazine or part I) or intramuscularly at the end of anaesthesia (part II) and repeated when necessary. ⋯ Overall, a marked antiemetic response in the dixyrazine groups was observed when compared with the placebo treated groups in both part I and II (p less than 0.001). Dixyrazine proved to be superior to placebo especially in patients who were not prone to nausea or who received no major postoperative analgesics (p less than 0.001).
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Comparative Study
Comparison of thiopentone versus althesin for caesarean section.
Thiopentone and Althesin were compared in 50 patients undergoing general anaesthesia for Caesarean section. The patients were divided into group A (24 mothers) were thiopentone (3.5 mg/kg) was used for induction and group B (26 mothers) where Althesin (80 mu1/kg) was employed. Blood samples for estimating the maternal and umbilical venous and arterial blood pH, pCO2, BD and pO2 were taken at the time of delivery. ⋯ The umbilical venous and arterial pH, pCO2 and BD were well within the normal physiological range and there was no significant intergroup difference. The only significant differences were the lower umbilical venous and arterial pO2 values in the Althesin group. The clinical condition of the newborn (Apgar score) showed no significant difference between the two groups.