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Results for “Ostomy”

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At least 919 records · Page 51Linked to original sources
PubMed2006

Effect of mitomycin C on ostium in dacryocystorhinostomy.

BACKGROUND: To observe the effect of intraoperative mitomycin C of varying concentration on postoperative ostium size after external dacryocystorhinostomy (DCR). METHODS: In this prospective controlled study, 60 cases of DCR were taken up irrespective of age and sex. Cases were divided into three groups. Group 1 was taken as a control group and operated without mitomycin C; in experimental group 2 and group 3, mitomycin C at a concentration of 0.05 mg/mL and 0.4 mg/mL was applied, respectively, for 2 min. Each group consisted of 20 cases. Half of the cases in each group underwent single-flap DCR (SFDCR) and half underwent double-flap DCR (DFDCR) surgery. Nasal endoscopic evaluation was performed on the first postoperative day, at 2 weeks and at 6 months after surgery. A Student's t-test was used to compare the osteotomy size of each group. RESULTS: At the end of the final follow up, average size of the ostium in group 1 was 3.6+/-2.36 mm2 in SFDCR and 4.5+/-3.59 mm2 in DFDCR, in group 2 was 4.8+/-4.82 mm2 in SFDCR and 4.9+/-4.12 mm2 in DFDCR, and in group 3 was 16.6+/-6.80 mm2 in SFDCR and 17.5+/-9.07 mm2 in DFDCR. The ostium size in group 3 was found to be significantly bigger in comparison with group 1 (P=0.0001 in SFDCR, P=0.001 in DFDCR) and with group 2 (P=0.0009 in SFDCR, P=0.001 in DFDCR). No statistically significant difference of ostium size was found in SFDCR and DFDCR. CONCLUSION: Mitomycin C in appropriate dose minimizes postoperative fibrosis and granulations, thereby maintaining a bigger postoperative ostium throughout the postoperative observation period.

Adolescent↗
PubMed1995

Complications of the Caldwell-Luc operation and how to avoid them.

The complications of the Caldwell-Luc operation were retrospectively studied in 1990. The case records were analysed and updated information from telephone interviews and posted questionnaires were available for most patients. One hundred and eighty-five patients with 216 procedures with a mean postoperative follow-up period of 33.5 months were studied. The commonest indication for the operation was for chronic sinusitis. There were three common complications found: facial swelling (61.9%), pain and/or numbness of the face (46.0%) and pain and/or numbness of the teeth/gums (30.9%). Rare complications are postoperative epistaxis (0.4%), oroantral fistulae (0.4%), epiphora (0.4%) and dental discoloration (0.4%). This paper discusses the pathophysiology of these complications and surgical techniques on how to avoid them. Although the use of the Caldwell-Luc operation has declined in recent years with the development of endoscopic sinus surgery, it still has occasional indications and a set of practical guidelines on how to prevent complications would be useful. The basis for treating chronic sinusitis with functional endoscopic sinus surgery at the expense of the more traditional form of treatment is also discussed.

Chronic Disease↗
PubMed1957

[Nephrostomy].

Explore the source record for details and available documents.

Humans↗
PubMed2004

Coping with bladder exstrophy: diverse results from early attempts at functional urinary tract surgery.

OBJECTIVES: To report the long-term surgical outcome in a group of patients with bladder exstrophy treated from 1960 to 1982, and to assess physical health, social integration and sexual function, as attempts at functional closure during the development of this surgery resulted in patients with differing surgical status of the genitourinary organs. PATIENTS AND METHODS: A review of medical record archives revealed 36 patients; of these, seven had died, six were untraceable and six declined to participate, leaving 15 evaluable subjects (seven men and eight women, mean age at follow-up, 35 years). Data were collected from medical records and direct interviews were conducted using a semi-structured questionnaire, after obtaining informed consent. The Short Form-36 (SF-36) v2 Health Survey instrument was used to assess health and well-being. RESULTS: Three patients have retained the use of their bladder, and 11 had initial bladder closure but required (at a mean age of 3.1 years) various urinary diversions. Eight patients had a pelvic osteotomy. Of 27 functioning renal units, 25 are in reasonable to good condition. Six men and six women had genital reconstruction. Four men are capable of penetrative intercourse and ejaculate; six women manage penetrative intercourse and five have orgasms. All patients attended mainstream school and 13 achieved examination success. Nine patients took vocational training and 11 work full-time. Five patients are married and five are in long-term relationships. Two men have achieved three pregnancies and one women has had a child. The mean total SF-36 score (maximum 3600) was 2763 in men and 2235 in women. CONCLUSIONS: Surgery for bladder exstrophy has been developing for more than 40 years and the legacy of early attempts at functional closure is a population of adults who have a diversity of lower urinary tracts, good preservation of renal function overall and acceptable sexual function. They are usually robust, healthy and well-adjusted individuals functioning well in society, often in full-time employment and long-term relationships. Adolescent follow-up must be clearly focused, incorporating a multidisciplinary team approach to facilitate a seamless transition into adulthood.

Adaptation, Psychological↗
PubMed1998

Outcome states of colorectal cancer: identification and description using patient focus groups.

OBJECTIVE: Utilities for the outcome states of colorectal cancer must be measured to evaluate the cost-utility of screening and surveillance strategies for this disease. We sought to identify these outcome states, define their associated areas of morbidity, and construct representative descriptions of them for use in a utilities assessment instrument. METHODS: We identified candidate colorectal cancer outcome states based on a review of the literature and interviews with health care professionals. We organized patient focus groups from each of the candidate outcome states to examine their homogeneity and define their associated areas of morbidity. After analyzing the focus group transcripts, we identified and described outcome states of colorectal cancer for future incorporation into a utilities assessment instrument. RESULTS: Six candidate outcome states of colorectal cancer were identified based on disease stage and location at diagnosis. Thirty-eight patients then participated in six focus groups. Analysis of the focus group transcripts revealed seven areas of morbidity associated with colorectal cancer. These areas included problems with social interaction and cognition, fear of cancer recurrence, pain, fatigue, changes in bowel habits, and sexual dysfunction. Based on differences in the intensity and frequency of the symptoms reported in each of these areas, seven distinct outcome states of colorectal cancer were identified and described. CONCLUSION: Clinically distinct outcome states of colorectal cancer are determined by the stage and location of the cancer at the time of diagnosis. Descriptions of these outcome states were created using data collected from patient focus groups. These descriptions can be incorporated into a utilities assessment instrument.

Aged↗
PubMed2002

Jejunal tissue oxygenation and microvascular flow motion during hemorrhage and resuscitation.

The relationship between flow motion and tissue oxygenation was investigated during hemorrhage/retransfusion with and without dopamine in 14 pigs. During 45% bleed, jejunal microvascular hemoglobin O(2) saturation (HBjO(2)) and mucosal tissue Po(2) (Po(2)muc) were recorded in seven control and seven dopamine-treated animals. Mean arterial pressure and systemic O(2) delivery decreased during hemorrhage and returned to baseline after retransfusion. Hemorrhage decreased Po(2)muc from 33 +/- 2.8 to 13 +/- 1.6 mmHg and HBjO(2) from 53 +/- 4.9% to 32 +/- 3.9%, respectively, in control animals. During reperfusion, Po(2)muc and HBjO(2) remained low. Dopamine increased Po(2)muc from 28 +/- 4.3 to 45 +/- 4.6 mmHg and HBjO(2) from 54 +/- 5.7% to 69 +/- 1.5% and attenuated the decrease in Po(2)muc and HBjO(2) during hemorrhage. After retransfusion, dopamine restored Po(2)muc and HBjO(2) to baseline. Control animals developed rhythmic HBjO(2) oscillations with increasing amplitude (frequency, 4.5 to 7.6 cycles/min) and showed an inverse relationship between Po(2)muc and HBjO(2) oscillation amplitude. Dopamine prevented regular flow motion. The association between decreased Po(2)muc and increased oscillations in HBjO(2) after normalization of systemic hemodynamics and O(2) transport in control animals suggests a cause-and-effect relationship between low tissue Po(2) and flow motion activity within the jejunal microcirculation.

Animals↗
PubMed1995

Bilateral simultaneous percutaneous nephrolithotomy. A prospective feasibility study.

A prospective study was undertaken to assess the feasibility and safety of bilateral simultaneous percutaneous nephrolithotomy (BPNL) under single anesthesia. BPNL was attempted in 16 consecutive patients with upper tract urolithiasis suitable for percutaneous treatment bilaterally. Bilateral simultaneous PNL could be accomplished in 14 of 16 cases; the opposite side was abandoned in 2 due to technical reasons. The operating sides could be switched within a short period (15 min) by rotating the patient table by 180 degrees. The average total operating time and irrigation time was 83 and 43 min, respectively. A total of 29 tracts and 18 sessions were required for endourologic treatment of 28 units in 14 patients. There was no significant morbidity. Complete clearance was achieved in 11 of 14 patients; there was insignificant residue in 1, while 2 with major residue required adjunct JJ stenting and extra-corporeal shockwave lithotripsy. The average hospital stay was 5.4 days. After initial proficiency with endourology, preparedness for BPNL is advisable in all such cases.

Adult↗
PubMedDate not supplied

Endovascular treatment of mycotic hepatic artery aneurysm in the hostile abdomen--a case report.

Mycotic hepatic artery aneurysms are rare. This report documents a case in which a mycotic hepatic artery aneurysm was associated with Crohn's disease, renal adenocarcinoma, and a urinary tract infection. Endovascular management of this mycotic hepatic artery aneurysm was successful in the setting of a hostile abdomen based on multiple previous operations, a stoma, and a scarred abdomen.

Adult↗
PubMed2005

Technology-dependency among patients discharged from a children's hospital: a retrospective cohort study.

BACKGROUND: Advances in medical technology may be increasing the population of children who are technology-dependent (TD). We assessed the proportion of children discharged from a children's hospital who are judged to be TD, and determined the most common devices and number of prescription medications at the time of discharge. METHODS: Chart review of 100 randomly selected patients from all services discharged from a children's hospital during the year 2000. Data were reviewed independently by 4 investigators who classified the cases as TD if the failure or withdrawal of the technology would likely have adverse health consequences sufficient to require hospitalization. Only those cases where 3 or 4 raters agreed were classified as TD. RESULTS: Among the 100 randomly sampled patients, the median age was 7 years (range: 1 day to 24 years old), 52% were male, 86% primarily spoke English, and 54% were privately insured. The median length of stay was 3 days (range: 1 to 103 days). No diagnosis accounted for more than 5% of cases. 41% were deemed to be technology dependent, with 20% dependent upon devices, 32% dependent upon medications, and 11% dependent upon both devices and medications. Devices at the time of discharge included gastrostomy and jejeunostomy tubes (10%), central venous catheters (7%), and tracheotomies (1%). The median number of prescription medications was 2 (range: 0-13), with 12% of cases having 5 or more medications. Home care services were planned for 7% of cases. CONCLUSION: Technology-dependency is common among children discharged from a children's hospital.

Adolescent↗
PubMed2001

Nurse prescribing in practice: patient choice in stoma care.

In the first of a new series, Janice Lee examines the choices facing nurse prescribers when selecting items for stoma management. Studies have estimated that there are up to 100,000 people with a stoma in England and Wales, and stoma care therefore forms a significant part of community nursing caseloads. The enormous range of available items means that both patient and prescriber are likely to have difficulty selecting the correct device. Patient preferences, comfort and pricing all play a part in stoma appliance selection.

Community Health Nursing↗
PubMed2001

Common stoma problems: a brief guide for community nurses.

It is estimated that there are 100,000 people in the United Kingdom who have a stoma, some 47% of whom will suffer at least one complication (Lyon and Smith, 2001). District nurses work with specialist stoma care nurses to manage the majority of these complications, so it is vital that they maintain their knowledge. This article reviews some of the stoma complications that many arise, and uses two case studies to illustrate how these may be dealt with in the community.

Aged↗
PubMed2003

Stoma siting: what the community nurse needs to know.

Stoma siting is often regarded as the most important part of preoperative preparation. Marking the abdominal skin at the proposed stoma site takes place after a period of assessment, discussion, observation, consideration and evaluation that will have begun on the first meeting between the patient and the nurse. The siting procedure is a joint decision made between the patient and the nurse about the most suitable place for their stoma. The position of the stoma should allow the patient to manage it independently and to resume their normal activities after recovery. The success of the stoma can depend on the site and its condition. The purpose of this article is to describe and discuss the siting process and how it benefits the patient. Community nurses should gain a greater understanding of the issues involved, as well as the considerations for both the nurse and the patient. This article is intended to help the community nurse feel more aware of the issues involved in siting, and feel more prepared to assist the patient to prepare for and begin their life with the stoma. The outcome and effects of a 'poorly' or 'less than ideally' sited stoma (e.g. formed during emergency surgery), and its care and management will also be discussed. Illustrations have been included to assist the reader through the process of siting.

Activities of Daily Living↗