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At least 433 records · Page 24Linked to original sources
PubMed1996

The role of low-density lipoprotein apheresis as postoperative care of bypass grafting for chronic arterial occlusion.

Since November 1989, low-density lipoprotein apheresis has been applied to patients with intractable hyperlipidaemia following bypass grafting for chronic arterial occlusion of the lower extremities. The treatment group comprised six patients (four men, two women) with arteriosclerosis obliterans. In five patients, the ankle pressure index deteriorated and intermittent claudication recurred due to atherosclerotic progression. Results of low-density lipoprotein apheresis were dramatic; the deteriorated ankle pressure index and intermittent claudication improved significantly after several applications of low-density lipoprotein apheresis. Significant angiographic improvement was obtained in two patients. It is concluded that low-density lipoprotein apheresis appears to be an efficient method to preserve graft patency and treat postoperative patients with deteriorated ankle pressure index.

Angiography↗
PubMed1995

[Problems of postoperative care in urinary diversion: ureterocutaneostomy].

One hundred and nine patients underwent tubeless ureterocutaneostomy as a method of urinary diversion at the Department of Urology, Wakayama Medical College during the 22 years from 1972 to 1994. The follow-up period ranged from 4 days to 15 years, with a mean of 27.3 months. The primary disease was bladder cancer in 68 patients, uterine cancer in 23 patients, other pelvic malignancies in 11 patients and benign disease in 7 patients. We used 4 types of ureterocutaneostomy; transureteroureterocutaneostomy was done in 13 patients, bilateral ureterocutaneostomy through a single stoma in 30 patients, bilateral ureterocutaneostomy with two stomas in 4 and unilateral ureterocutaneostomy for one available kidney in 62 patients. The construction of stoma was done according to inverted U of Z-shaped skin flap method (30 cases), everted nipple stoma (37 cases) and Toyoda's method (42 cases). We evaluated the stomal condition in 72 patients who were followed more than 6 months postoperatively. Stomal stricture developed and necessitated periodic dilatation or intubation in 25 cases (34%). A better outcome was obtained in patients with dilatated ureter and everted nipple type stoma but no correlation could be found between the history of irradiation and stomal stricture. Long-term outcome of ureterocutaneostomy in 70 patients (129 renal units) was, compared to that of ileal conduit urinary diversion in 124 patients (248 renal units). Postoperative urographic findings showed progressive hydronephrosis in 14 renal units (23%) in the ureterostomy group, while 22 renal units (9%) in the ileal conduit group. However, there was no case of deterioration of renal function which was evaluated by BUN and creatinine in spite of progression of hydronephrosis. The incidence of urinary complications such as pyelonephritis and renal calculus in the successful ureterocutaneostomy group was less than that in the ileal conduit group.

Adolescent↗
PubMed1984

[Postoperative care of coronary surgery patients].

Coronary bypass surgery is a palliative procedure and medical management after surgery is best provided by the private physician in cooperation with the surgical center. Whereas digitalis is rarely indicated in patients after bypass surgery, several prospective and randomized studies have shown that the early use of anticoagulants or platelet inhibiting agents improves graft patency after surgery. This medication should be given for about one year. Complex ventricular arrhythmias (Lown III-V) are 2-3 times as frequent 6-8 weeks after aortocoronary bypass surgery as before the operation. However, they are of less prognostic importance than similar arrhythmias occurring one year after surgery. Exercise-induced angina with ST segment depression occurs in 3% of patients per year with complete revascularization, as compared to 6-10% of patients/year with less than complete revascularization. Repeat angiography after surgery is performed if limiting angina recurs. In some instances coronary angioplasty may reestablish successful bypass surgery. Mortality and morbidity of reoperation are slightly higher and the success rate is slightly lower than with a first operation. Postoperative complications, such as post-pericardiotomy syndrome, left ventricular dysfunction and hepatitis, are briefly discussed.

Anticoagulants↗
PubMedDate not supplied

Effect of corticosteroids in postoperative care following photorefractive keratectomies.

Since the start of photorefractive keratectomy (PRK) Seiler has recommended the use of topical corticosteroids during the first 3 months after surgery. The rationale for this treatment was to diminish the inflammatory reaction as well as to control the keratocytes from producing collagen and creating scars. Our knowledge of corneal wound healing in general, and after PRK in particular, is very limited and the action of corticosteroids is still unclear. Corticosteroids, when given in comparatively large topical doses, create problems. Between 15 and 30% of patients are corticosteroid responders with increased intraocular pressure. This is a threat to the eye, and also a burden for the doctor as intraocular pressure has to be checked during the treatment. The risk for cataract formation after longer periods of topically administered corticosteroids also has been discussed. In order to decrease the rise in intraocular pressure, FML has been used in place of dexamethasone. During the 4 years follow up after PRK it has been reported that a number of patients do not regress or get a scar formation if they have not used corticosteroids in the postoperative period. The reasons to avoid topical corticosteroids in some patients are a misunderstanding of their instructions, or those who have had a history of herpes infection or glaucoma. A double-masked study of the effects of corticosteroids after PRK was performed by Gartry, et al in a small group of patients. After 6 months, the results revealed that there were no differences between the corticosteroid and the non-corticosteroid group. However, the standard deviation was high.(ABSTRACT TRUNCATED AT 250 WORDS)

Cornea↗
PubMed1997

Postoperative care and complications of damage control surgery.

Damage control procedures are being used with increasing frequency as the physiologic limits of the surgical patient are approached and recognized. These patients are returned to the SICU, where rapid restoration of circulating volume, normothermia, maintenance of oxygen delivery, and correction of transfusion-associated coagulopathy are essential to the success of the technique, which requires expeditious reoperation and completion of definitive surgical management. The potential need for early return to the operating room to control surgical bleeding must be recognized, as well as the difficulty in distinguishing between surgical bleeding and ongoing hemorrhage due to hypothermia and coagulopathy. Because the damage control technique is resource intensive and involves numerous personnel, organization and leadership are important to success.

Hemostatic Techniques↗
PubMed1987

[Postoperative care following hip fracture in a hospital or a psychogeriatric nursing home? A comparative study of short or long-stay demented hospitalized elderly].

In this article the question under discussion is, whether a short stay in hospital, for an inmate of a psychogeriatric nursing home with a hip-fracture, shows better results for mortality, morbidity and mobility than a long stay. Two matched groups, of 27 inmates each, have been compared retrospectively. The first remained in hospital for a week or more (long stay), the second for a period of less than a week (short stay). There was no significant difference in mortality risk between both groups. There were less urinary infections in the short-stay group and one month after the operation mobility was better. Decubitus, wound infection and bronchopneumonia appeared equally frequent. The results justify to continue the policy in this nursing home. More research in other nursing homes is pleaded.

Aged↗