Swiss medical weekly
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Swiss medical weekly · Jan 2011
Randomized Controlled TrialThe ED50 and ED95 of ketamine for prevention of postoperative hyperalgesia after remifentanil-based anaesthesia in patients undergoing laparoscopic cholecystectomy.
Various research programmes have shown that intraoperative infusion of remifentanil has been associated with postoperative hyperalgesia. Previous studies have demonstrated that low-dose ketamine can inhibit central sensitisation and prevent opioid-induced hyperalgesia (OIH). However, the optimal ketamine dose to prevent OIH has not been determined. In the present study we aimed to determine the ED50 and ED95 of ketamine for prevention of postoperative hyperalgesia after remifentanil-based anaesthesia in patients undergoing laparoscopic cholecystectomy. ⋯ The ED50 and ED95 of ketamine for prevention of postoperative hyperalgesia after remifentanil-based anaesthesia in patients undergoing laparoscopic cholecystectomy were 0.24 mg/kg and 0.33 mg/kg respectively.
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Swiss medical weekly · Jan 2011
ReviewPre- and intra-operative mediastinal staging in non-small-cell lung cancer.
Primary mediastinal lymph node staging is important to select properly patients who can benefit from an induction treatment. The accuracy of CT scan in the evaluation of mediastinal lymph nodes is low. Further staging can be omitted in patients with negative mediastinal PET in most of the cases. ⋯ Systematic mediastinal lymph-node dissection is recommended in all cases for complete resection of NSCLC and improves pathologic staging and the prospect for adjuvant therapy. The role of mediastinal lymphadenectomy regarding overall survival and local control remains controversial but systematic lymph-node dissection might be associated with a better outcome in stage I NSCLC. Lobe-specific systematic nodal dissection is acceptable for peripheral squamous T1 tumours, if hilar and interlobar nodes are negative on frozen section studies.
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Swiss medical weekly · Jan 2011
Burden of abdominal obesity in cardiac rehabilitation patients: Results from the Swiss CaRe study.
The burden of abdominal obesity (AO) and its association with other cardiovascular risk factors is not known in coronary artery disease (CAD) patients attending cardiac rehabilitation (CR). The aim of this study was, therefore, to investigate the prevalence of AO and differences in cardiovascular risk factors between AO and non-AO patients. ⋯ AO is highly prevalent in CAD patients attending CR. AO is, independently of BMI, associated with metabolic lipid disorders and autonomic cardiovascular dysregulation, suggesting an increased cardiovascular risk. AO patients therefore need particular attention during CR and follow-up care.
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Swiss medical weekly · Jan 2011
ReviewActual evidence for neuromonitoring-guided intensive care following severe traumatic brain injury.
Therapeutic interventions following severe traumatic brain injury (TBI) are substantially influenced by complex and interwoven pathophysiological cascades involving both, local and systemic alterations. Our main duty is to prevent secondary progression of the primary damage. This, in turn, obliges us to actively search and identify secondary insults related, for example, to hypoxia, hypotension, uncontrolled hyperventilation, anaemia, and hypoglycaemia. ⋯ A more individualised and flexible treatment concept depends on extended neuromonitoring. The present review addresses current evidence in favour of extended neuromonitoring used to guide treatment options aimed at improving intensive care treatment of patients with severe TBI. With increasing experience gained by the use of extended neuromonitoring in clinical routine we may expect that the evidence obtained within the individual patient will translate to convincing evidence on a larger scale for the entire study population.
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Swiss medical weekly · Jan 2011
Clinical TrialFeasibility and safety of propofol sedation in flexible bronchoscopy.
Propofol is a sedative-hypnotic with a rapid onset of action. There are only limited data evaluating propofol for flexible bronchoscopy. We analysed the feasibility and safety of propofol for bronchoscopy in a high output tertiary care centre. ⋯ Propofol sedation for flexible bronchoscopy is feasible and safe.