Langenbecks Archiv für Chirurgie
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The surgical cure rates for most operable cancers have remained unchanged over the past few decades despite progress in local treatment and "prophylactic" preor postoperative radiotherapy. Due to the limitations of primary and secondary prophylaxis (prevention and "early" diagnosis), tertiary prophylaxis (adjuvant chemotherapy to prevent relapse or dissemination) has aroused considerable interest in tumor management recently. Definite progress in prolongation of the postoperative tumorfree interval has been obtained in controlled studies of breast cancer, osteogenic sarcomas and other target neoplasms. Long-term chemoprophylaxis has proved to be more effective than peroperative short courses of chemotherapy.
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Langenbecks Arch Chir · Jan 1975
Continuous positive airway pressure in the prophylaxis of the adult respiratory distress syndrome (ARDS).
Alternate patients believed to be at risk for developing ARDS were placed on CPAP for the first twenty-four hours post upper abdominal surgery. Ten of the 58 controls developed ARDS, requiring prolonged mechanical ventilation with a 30% mortality rate. ⋯ This patient, however, is believed to have had fluid overload, and responded quickly to diuretics and was extubated within two days. Thus, prophylactic CPAP has greatly decreased our postoperative morbidity and mortality related to respiratory causes.
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The combined application of Titanium plates with stainless steel screws appeared interesting, making a more elastic plate available without the risk of screw fractures. 3 different combinations of Titanium und stainless steel implants were tested in the animal and on humans. A morphometric evaluation of the soft tissue (animal) gave similar good results for stainless steel implants as for the combination of Titanium and steel, while pure Titanium gave the best result. ⋯ Delayed fracture healing or mechanical instability always gave risk to more metal deposits in the soft tissue than primary bone healing. If the advantages of Titanium seem important and if the rigidity of stainless steel screws may not be missed, the combination of the two metals appears possible and without danger.