Articles: postoperative-complications.
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Z Psychosom Med Psychoanal · Apr 1979
Case Reports[Psychic and medical reactions in patients undergoing open heart surgery in relation to preoperative psychological condition].
This study reports some results on the postoperative psychological and medical condition of 72 open-heart surgery patients. Special emphasis is placed on the relationship between the postoperative reactions and the preoperative psychological condition of the patients as assessed by an interview. Patients whose postoperative reactions was of a psychotic paranoid type conceived the operation as a mainly technical event and had optimistic expectations for the future. ⋯ As far as the postoperative physical condition is concerned it was found that patients with the best recovery in this respect were preoperatively characterized by alexithymia. The results are discussed under psychonalytical aspects. Special emphasis is placed on the preoperative condition of alexithymia.
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The literature concerning postcardiotomy delirium contains confusing definitions and contradictory results. In a critical review of the subject, we conclude that cardiac status, the severity of physical illness, the complexity of the surgical procedure, and preoperative organic brain disease are the determining factors in postcardiotomy delirium. Preoperative anxiety, denial, and depression also have some correlation. ⋯ Long-term follow-up studies suggest that psychological problems impair functional recovery from heart surgery. The suggested treatment of patients with delirium includes chemotherapy, psychotherapy, and environmental support. Finally we suggest that investigation of biochemical abnormalities in delirium may prove to be a model for clarifying the role of neurotransmitters in functional psychiatric illnesses.
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Case Reports
The pulmonary angiographic appearance of pleurisy associated with subdiaphragmatic inflammation.
In two patients who had recently undergone major abdominal operations and were later suspected of having pulmonary emboli, pulmonary angiography showed no evidence of embolism, but in both cases one of the hemidiaphragms was clearly outlined by contrast material. It is suggested that subdiaphragmatic inflammation was responsible for this unusual appearance.
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Acute infectious arthritis is an uncommon disease that is most commonly caused by Neisseria gonorrhoeae or gram-positive cocci. Gram-negative bacteria are an infrequent and highly virulent cause of septic arthritis and most commonly enter the circulation through the urinary tract, as in this case after ureteroneocystostomy. ⋯ Early recognition and treatment with appropriate antibiotics and mechanical drainage is imperative. Needle drainage of the affected joint has been shown superior to open surgical drainage.