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Biomedical subjects

K Miller

Publications and source records attributed to K Miller.

743 records · Page 42Linked to original sources
PubMedDate not supplied

Early detection of anastomotic leaks after colorectal surgery by measuring endotoxin in the drainage fluid.

BACKGROUND/AIMS: Early detection of anastomotic leaks after colorectal anastomosis is essential for adequate intervention to prevent peritonitis. We investigated whether the measurement of endotoxin (LPS) concentrations in the drainage has any value for the early detection of anastomotic leaks. MATERIALS AND METHODS: Twenty two patients with colorectal anastomosis were enrolled in this study, 3 developed clinically established signs of anastomotic leaks and 19 recovered without complications. LPS concentrations in the drainage, the total daily excreted LPS amounts, leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperature were measured for up to 8 days after surgery and tested for their value to detect anastomotic leaks. RESULTS: LPS concentrations in the drainage fluid and daily excreted LPS amounts of patients with anastomotic leaks were significantly higher compared to the group without anastomotic leaks. On the third postoperative day, LPS concentrations ranged from 5270 to 6750 pg/ml in patients with anastomotic leaks and from 1 to 1848 pg/ml in patients without complications. Total daily excreted LPS amounts were 270-675 ng/day in patients with anastomotic leak and 0-92 ng/day in patients without anastomotic leaks. Both LPS-related parameters allowed reliable detection of anastomotic leaks on day 3 after surgery (Student's t-Test, p < 0.0005), while leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperatures of both patient groups were not significantly different at any time (p > 0.05). CONCLUSION: We found that the measurement of LPS concentrations in the drainage and the daily excreted LPS amount could be valuable parameters for the early detection of anastomotic leaks as early as on the third post-operative day.

Adult↗
PubMedDate not supplied

Effect of gastric mucosal protection in nonrheumatoid patients with short-term nonsteroidal anti-inflammatory drug therapy: a prospective randomized multicenter study.

BACKGROUND/AIMS: Since nonsteroidal anti-inflammatory drugs (NSAIDs) are known to cause gastrointestinal mucosal injury, concurrent administration of gastric protective agents in patients with rheumatoid disorders is often recommended. The present study was designed to determine the possible benefit of sucralfate, a gastric protective agent in patients receiving short-term therapy with NSAIDs for conditions other than rheumatoid arthritis. METHODOLOGY: In nineteen general practitioners offices a total of 208 patients were studied. Patients received either sucralfate suspension (2 x 2 g/day) or no additional medicine while being put on NSAIDs for a mean of 9 days. RESULTS: Forty patients (39%) in the sucralfate group and 71 (68%) in the control group developed gastrointestinal symptoms (p < 0.05). In the control group six patients (6%) had gastrointestinal hemorrhage and 2 patients (2%) experienced perforation of a duodenal ulcer. Gastrointestinal hemorrhage and perforation were not observed in the sucralfate group. Short-term NSAID use in nonrheumatoid patients carries a higher risk for symptoms and complications in patients that are 40 years old and above. These risk are even more pronounced in patients of 60 years of age or above, in patients with a history of peptic ulcer disease, in smokers, in patients with concomitant disease and concomitant steroid use, and with the use of diclofenac. The mean age of patients with gastrointestinal hemorrhage was 65 years. Both patients that suffered perforation of a duodenal ulcer were young (35 and 42 years) and had a history of duodenal ulcer disease. CONCLUSION: Gastric protection with sucralfate reduces the frequency of both symptoms and complications in nonrheumatoid patients receiving short-term therapy with NSAIDs.

Adolescent↗
PubMedDate not supplied

[Suicide attempts in epileptic patients during the years 1990-92. Analysis of patients in the Regional Poison Control Center in Sosnowiec].

During the years 1990-92 in the Regional Poisons Control Center in Sosnowiec 42 epileptics (20 females and 22 males) were hospitalized because of suicide attempt. It amounted to 9% of all attempters, treated there in this period. The majority of patients were males of age range from 21 to 62 years. In 23 patients the suicide attempts were performed for the first time. the main reason for suicide was the family conflicted situation. Additionally, in 14 patients the poisoning attempts have been done during alcohol abuse. In the suicide attempts the antiepileptic drugs were most frequently used, mainly carbamazepine (23 cases).

Adolescent↗
PubMedDate not supplied

[Depression in epileptic patients with and without history of suicidal attempts: preliminary report].

Depression is a significant problem in epilepsy. Suicides occur in epileptic patients five times more often than in general population. Material included 34 epileptics with 76 suicidal attempts and 24 patients with no history of suicide. Psychical state was studied with Beck Depression Inventory and Hamilton Depression Rating Scale. In the group with suicidal attempts 65% of patients had depression (54.5% of them had major depression) and in group without suicide attempts depression was noted in 54% (23% with major depression). Patients with depression were divided into two groups: group I with suicidal attempts and group II without history of suicide. In group I more patients were alcohol abusers (50% vs 31%), more were treated because of epilepsy longer than 10 years (59% vs 46%) and more had tonic-clonic seizures (82% vs 46%). In group I, 54% of patients were on polytherapy (more than half of them with fenobarbital). In group II, 31% of epileptics were on polytherapy (no one with fenobarbital). Major depression was significantly more frequent in epileptics with suicidal attempts. The severity of depression may influence the risk of suicide. Major depression may be associated with late age of onset of epilepsy, longer treatment duration, tonic-clonic seizures, polytherapy (mainly with fenobarbital) and alcohol abuse.

Adult↗