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At least 361 records · Page 20Linked to original sources
PubMed1993

The antimicrobial effectiveness of clindamycin in diseases of the oral cavity.

Veterinary dental ultrasonic equipment can cause bacteria to be aerosolized during prophy procedures. Preoperative treatment with clindamycin prior to removal of calculus using an ultrasonic scaler can reduce aerosolized bacteria. Reduction of plaque bacteria was assessed and was statistically significant in those patients receiving clindamycin. This article describes the evaluation and results of clindamycin application when given prior to dental prophy.

Aerosols↗
PubMed1994

Reducing the pain of local anesthesia.

The administration of local anesthetic agents before cutaneous surgery usually results in discomfort. This paper reviews techniques and pharmaceutical agents that will minimize pain during this preoperative procedure.

Administration, Cutaneous↗
PubMed1976

[Summary of work session 4: Effects of calcitonin and somatostatin on the stomach and pancreas--a possible therapeutic principle].

Although calcitonin and somatostatin are polypeptid hormones of entirely different structure, in pharmacological doses they possess a similar effect to secretions of stomach and pancreas. Given intravenously, they generally inhibit the basal secretion of organs, stimulated by pentagastrin or pancreozymin, as well as the contraction of the gallbladder. Orally, calcitonin also suppresses by direct contact the secretion of the stomach. While calcitonin in higher doses shows only very slight and tolerable side effects (nausea, headache), somatostatin acts suppressively on many other hormone-regulated systems. Apart from this, disturbances of blood coagulation in monkeys and man were observed, findings which necessitate very careful application. Therapeutical trials appear reasonable with calcitonin in treating acute pancreatitis, in prophylaxis and treatment of stress ulcers with the danger of bleeding, in intensive care medicine, in preoperative procedure of Zollinger-Ellison syndrome as well as in duodenal ulcers (oral calcitonin). Double blind studies are carried out at present to answer most of these questions (acute pancreatitis, stress ulcers, duodenal ulcers), results of which should definitely be awaited.

Animals↗
PubMed1993

Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla.

Accurate prediction of postsurgical function and esthetics of the nose and upper lip requires an understanding of the relationship between maxillary surgical movement and soft tissue change. Thirty-two patients underwent Le Fort I osteotomies, some with concomitant mandibular procedures. Preoperative, postoperative, and 1-year postsurgical data derived from cephalometric and nasolabial cast analysis were compared to assess skeletodental changes, soft tissue changes, and stability. A multiple stepwise regression (including age, gender, alar cinch suture, V-Y closure, and contouring of the anterior nasal spine as variables) indicated that accurate prediction equations could be formulated, particularly if the patients were grouped by vector-specific maxillary movements. In general, the base of the nose widened in all patients regardless of the vector of surgical maxillary movement. An associated shortening of the nose was found. The nasolabial angle decreased or remained constant in most patients. The upper lip widened and lengthened at the philtral columns. Narrow noses widened more than did broad noses and alar cinch suturing widened the alar base even more. Results indicated that soft tissue changes associated with maxillary surgery may be more affected by the position of the soft tissue incision and methods used in closure than by the surgically induced hard tissue change.

Adolescent↗
PubMedDate not supplied

[Total surgical cervical occlusion. Conclusions from data of several clinica, which use total surgical cervical occlusion].

Operative Total Cervix Occlusion (TCO), and in particular early TCO (ETCO), which we introduced in 1980, continues to be an important part of the prematurity prevention program. We were therefore especially interested in obtaining not only a general idea of where, on what scale and with what results TCO is being performed, but also information on the operative technique used, the complication rate associated with it, and preoperative procedure. From the data of the 11 departments which participated in this inquiry it was established that the overall success rate of all TCO procedures performed was over 80% (659 out of 819). TCO thus enabled to substantially increase the number of infants who survived. This result is also reflected in a comparison of the pregnancies preceding and following TCO. The infant survival rate was increased from below 21% to over 74%. One surprising result was that late occlusion was performed more frequently than early occlusion at more than 50% of the clinics participating in the inquiry. This is presumably due to difficulties in defining early and late occlusion in retrospective data evaluation, and probably also explains why, based on our experience, the success rate with late occlusions was too high. Two occlusions were performed in 43 patients and three or more in 9 (including current TCO). With 14 cases (1.7%) identified the rate of complications associated with TCO is very low.

Antibiotic Prophylaxis↗
PubMed1997

[Topographical diagnosis of insulinoma of the pancreas. Value of the test of intra-arterial calcium infusion].

OBJECTIVE: The localization of insulinomas is a central problem, because none of the imaging techniques has proved sufficiently reliable for the diagnosis of tumors smaller than 2 cms. PATIENTS AND METHODS: Calcium stimulation test was performed during selective pancreatic angiogram with calcium gluconate injection in the pancreatic arteries, e.g. gastroduodenal, superior mesenteric and splenic. A simultaneous catheterization of hepatic veins through the femoral vein allowed measurement of insulin level increment after calcium stimulation. RESULTS: In our experience, this test allowed a positive location of an insulinoma in three consecutive patients presenting with organic hypoglycemia, and was useful for surgeons while non-invasive imaging techniques failed to locate the tumor in any of the three patients. DISCUSSION: The calcium stimulation test is a reliable preoperative procedure, particularly when other imaging techniques fail to locate the tumor. However it remains invasive, and our data are still too preliminary to clearly define its place within imaging techniques.

Adult↗
PubMed1997

[Injury of the extrahepatic bile ducts in multiple injuries].

During the ten-year period between 1982-1991 the authors operated in the Institute 12 casualties after perforation and avulsion of the gallbladder, 8 patients on account of injuries of the hepatocholedochus and 15 patients where after injury posttraumatic acute cholecystitis developed. The authors evaluate critically the asset of new diagnostic preoperative procedures for assessment of early indication of surgery. In the surgical tactics they prefer reconstruction procedures which prevent such serious postoperative complications as relapsing cholangitis or stricture with cholestatic affection of the liver [1,3].

Cholangiography↗
PubMed1997

Care of the patient with Clagett open-window thoracostomy.

The Clagett open-window thoracostomy is performed to give patients with empyema improved quality of life and other outcomes. Adult health nurses care for patients undergoing this procedure preoperatively, postoperatively, and at home, and must consider several important issues to prevent serious complications and facilitate family care.

Adult↗
PubMed1997

Comparison between Ki-67 index and S-phase fraction on fine-needle aspiration samples from breast carcinoma.

BACKGROUND: Fine-needle aspiration (FNA) biopsy has been used increasingly in the diagnosis and biologic characterization of breast carcinomas in patients who receive preoperative chemotherapy. Because proliferative activity of breast carcinoma has been shown to be of prognostic significance, the authors compared immunocytochemical Ki-67 growth fraction and flow cytometric S-phase fraction (SPF), both evaluated on FNA samples. METHODS: The proliferative activity of 134 FNA samples from primary breast carcinoma patients was studied using both immunocytochemistry with the monoclonal antibody Ki-67 and SPF determined by DNA flow cytometry. RESULTS: Ki-67 and SPF were evaluable in 114 and 107 cases, respectively, and both were evaluable in 95 cases. Of the 134 FNA samples studied, 37% were diploid and 63% were aneuploid. The distribution of both Ki-67 and SPF was different in diploid and aneuploid tumors. The median Ki-67 value as well as the median SPF were significantly higher in aneuploid versus diploid tumors (P < 0.001). Median Ki-67 and SPF values were used to discriminate between low versus high proliferating tumors. The overall concordance between Ki-67 and SPF was 75% (P < 0.001). A good correlation was found between Ki-67 and SPF (correlation coefficient = 0.72; P < 0.001). CONCLUSIONS: The results of the current study suggest that Ki-67 growth fraction and SPF determined by FNA may be used as measurements of the proliferative activity of breast carcinoma. The authors recommend these determinations be used as preoperative procedures in patients with a cytologic diagnosis of breast carcinoma who are candidates for neoadjuvant chemotherapy and/or endocrine therapy.

Antibodies, Monoclonal↗
PubMed1998

Color Doppler ultrasound assessment of urethral artery location: potential implication for technique of visual internal urethrotomy.

PURPOSE: We assessed the location of urethral arteries in patients with urethral stricture using color Doppler ultrasound. MATERIALS AND METHODS: We performed 41 color ultrasound studies of the urethra in 33 patients 17 to 76 years old. The linear array transducer was placed on the ventral surface of the penis and perineum to image the urethra and periurethral structures. In addition to evaluating the extent of stricture disease, color Doppler ultrasound determined the location of the urethral arteries at the segment with stricture. RESULTS: The number and site of the urethral arteries vary among individuals. Contrary to the common belief that these arteries are located at the 3 and 9 o'clock positions, we have found that in the bulbous urethra the arteries are at the 1 to 2 o'clock positions in 14% of cases, 3 to 4 in 22%, 5 to 6 in 17%, 7 to 8 in 18%, 9 to 10 in 18% and 11 to 12 in 11%. The arteries may be close to the surface of the urethral lumen, especially in patients who have undergone previous urethral procedures. Preoperative evaluation of urethral artery location may be helpful for preventing arterial bleeding at visual internal urethrotomy. CONCLUSIONS: Color Doppler ultrasound can effectively assess the extent of stricture disease and urethral artery sites. Because the location of the urethral arteries varies among patients, individual preoperative assessment is advisable. Color Doppler ultrasound is currently our imaging method of choice for evaluating strictures of the pendulous and bulbous urethra.

Adolescent↗
PubMed1998

Reharvest of iliac crest donor site cancellous bone.

Patients requiring cancellous bone grafting of an extensive deficit or multiple bone grafting procedures often lack a sufficient quantity of autogenous cancellous bone. Canine studies have indicated that a potential exists for reharvesting autogenous cancellous bone from an iliac crest donor site using a trapdoor harvesting technique. However, significant human experience with this procedure has been lacking. This report describes four patients who underwent successful reharvesting of an iliac crest donor site that provided clinically sufficient autogenous cancellous bone graft material to treat an ongoing or a new skeletal problem. These patients all met specific criteria regarding use of the trapdoor method of bone graft harvest and a minimum 24-month interval between bone grafting procedures. Preoperative computed tomography scanning of the iliac crest was useful in documenting that sufficient cancellous bone was available for reharvest. It appears that iliac crest donor site reharvesting is a specific advantage of the trapdoor technique and is a possible alternative to multiple site grafting or the use of allograft or bone substitute materials.

Adolescent↗
PubMedDate not supplied

Therapeutic play for hospitalized preschoolers in Lebanon.

Therapeutic play in the form of an interactive puppet show was administered to 50 preschool children one day before surgery in a hospital in Lebanon. A control group of 50 preschool children received routine care but no therapeutic play. Physiological and behavioral measures were assessed on admission, at the time of a stressful procedure (preoperative injection), after surgery, and after discharge. Although on admission there had been on significant differences between the means on physiological measures for the two groups, the children who received the therapeutic play intervention manifested markedly less anxiety and more cooperation and had significantly lower mean blood pressures and pulse rates during the injection than the control group. Following surgery, the experimental group took less time to void their bladders, another physiological indication of lower stress level. After hospital discharge, the children who had received therapeutic play had significantly lower scores on all six factors of the Post Hospital Behavior Questionnaire. This study demonstrates that therapeutic play is a valid means of reducing stressful responses to hospitalization and surgery among children in Lebanon.

Anxiety↗
PubMed1991

Value of preoperative physiologic assessment in outcome of patients undergoing major surgical procedures.

The preoperative physiologic assessment of patients undergoing elective major upper-abdominal surgery defines the operative risk in an objective manner. This assessment helps to identify patients who are at higher risk during certain types of abdominal procedures. Elderly patients with a combination of chronic diseases and physiologic derangements are at higher risk for the development of postoperative complications and operative death. The APACHE II score is an easy and objective tool that can be used preoperatively. In our study, patients with a high score (greater than or equal to 8) had the highest rate of postoperative complications (46%) and operative death (13%).

Abdomen↗
PubMed1990

[The combined treatment of lung cancer with one-time large-fraction preoperative irradiation].

A procedure of preoperative large single dose (7.5 Gy) irradiation of lung cancer was developed. Irradiation field included regional lymph node-bearing areas. Treatment was employed in 93 lung cancer patients. Postoperative complication and lethality rates were 14 and 2.2%, respectively. Patients presenting with metastases in the regional lymph nodes were postoperatively irradiated to the lung hilus and mediastinum (30 Gy in 10 fractions). The treatment was well tolerated. Eighty-eight patients were followed, of whom 43.3% survived 3 years. The above modality assured ablastics of surgery and allowed to minimize duration of preoperative radiotherapy.

Adenocarcinoma↗
PubMed2003

Role of gamma probes in performing minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: optimization of preoperative and intraoperative procedures.

OBJECTIVE: In the last decade, surgery of primary hyperparathyroidism (HPT) due to a solitary adenoma has moved on from the traditional wide bilateral neck exploration (BNE) to more limited approaches such as unilateral neck exploration and minimally invasive parathyroidectomy. DESIGN: To define the role of intraoperative gamma probe and injection of a low (99m)Tc-MIBI dose in performing minimally invasive radio-guided surgery (MIRS) in HPT patients with a solitary parathyroid adenoma. METHODS: From September 1999 to July 2002, 214 patients with primary HPT entered the study. All patients were preoperatively investigated by a (99m)Tc-pertechnetate/MIBI subtraction scan and high-resolution neck ultrasound. The intraoperative technique we developed differs from other previously described techniques being based on the injection of a low (37 MBq) MIBI dose in the operating theatre a few minutes before the beginning of intervention. RESULTS: On the basis of scan/ultrasound findings 147 patients were selected for a MIRS and 144 of them (98%) were successfully treated by this approach: a solitary parathyroid adenoma was removed through a small 2-2.5 cm skin incision with a mean operative time of 35 min, and a mean hospital stay of 1.2 days. In the other 67 patients with scan/ultrasound evidence of concomitant nodular goiter (n=45) or multi-gland disease (n=13) or with a negative scan (n=9), the gamma probe was utilized during a traditional BNE. A low 37 MBq MIBI dose proved to be sufficient to perform a MIRS; moreover it delivered to the patient and surgeon a low, negligible, radiation exposure dose. CONCLUSIONS: The combination of a (99m)Tc-pertechnetate/MIBI subtraction scan and neck ultrasound appears to be an accurate imaging protocol in selecting primary HPT patients as candidates for a MIRS. A MIBI dose as low as 37 MBq injected in the operating theatre just before the start of surgery appears to be adequate to perform radio-guided surgery.

Adenoma↗