Pro: Factor Concentrates are Essential for Hemostasis in Complex Cardiac Surgery
CARDIAC SURGICAL PATIENTS may bleed for multiple reasons that are related to acquired coagulopathy during surgery or from underlying disease processes that predispose to inflammation and hemorrhage. Patients also may have pre-existing hemostatic derangements due to the growing and widespread use of anticoagulants for cardiovascular disease; these may include patients with atrial fibrillation, mechanical heart valves, venous thromboembolism, or ventricular assist devices. Bleeding in these settings can be amplified by the inflammatory cascade associated with extracorporeal blood flow through the cardiopulmonary bypass circuit, resulting in fibrinolysis, consumption of coagulation factors, dilutional changes, and hypothermia.
ConclusionThere is no need to alter the dosage of oral anticoagulants prior to dental extractions provided the INR is within the therapeutic range of 2.0 –4.0, extractions are done in least traumatic manner and local measures are used to control postoperative hemorrhage, thereby reducing the risk of thromboembolic episodes in these patients.
AbstractBackgroundVazirani –Akinosi nerve block technique is an established and a reliable technique to achieve anaesthesia in mandible with high success rate and is useful in cases where Halstead’s technique fails to provide desired anaesthetic effect.Materials and MethodsA total of 140 ASA-I or ASA-II patients, both genders, between 16 and 45 years who required extraction of mandibular tooth were divided into two groups. Group A received nerve block through Halstead technique, while Group B received nerve block through Vazirani–Akinosi technique with 2% lignocaine containing 1:200,000 adrenaline. ...
ConclusionThough the complication rate was found to be higher than most of the other studies, they were minor which resolved without any intervention. The cases with complications were clustered at the beginning of the series which suggests the steep learning curve and the importance of surgeons ’ experience and skill involved in this procedure.
Authors: Braga AFA, Teixeira CEFA, Carvalho VH PMID: 31607376 [PubMed - as supplied by publisher]
This study suggested that the recurrence rate of tenosynovial giant cell tumors of the hand was closely related to the tumor number and tumor growth patterns.
Conclusions Labiolysis is a simple surgical operation with a short learning curve, which relieves symptoms, improves quality of life associated with iatrogenic labium minus fusion, and provides an esthetically pleasing surgical outcome. In this study group, no minor and no major surgical complications were observed, and no reoperation was performed.
The authors regret that there is a type error in the introduction section, the mid-nineteenth century needs to be, replaced with mid twentieth century.
Authors: Rajab TK Abstract The rat is an important model organism for lung transplantation research. Orthotopic rat lung transplantation is a complex procedure, which requires advanced microsurgical techniques. This technical paper describes in detail highly reproducible intraoperative microsurgical techniques and peri-operative management, including the donor procedure, recipient anesthetic management, the recipient operation and anticipated peri-operative complications. PMID: 31608698 [PubMed - as supplied by publisher]
Authors: Bodnar J Abstract The anesthetic propofol is used in a number of medical applications including surgery, procedural sedation, refractory status epilepticus, alcohol withdrawal, and critical care sedation. The manner in which it is dosed and administered in each environment varies, tailored to the specific task at hand. Because the use of propofol in end-of-life care is uncommon, providers may lack practical experience, and resources that are specific to this specialized application are not comprehensive and largely based on dosing and administration as it is done on the intensive care unit. The purpose of ...
CONCLUSIONS: The 23mm ALLEGRA valve had favourable (<20mmHg) gradients in all surgical valves sized ³21mm, even when the THV was implanted low. In 19mm sized Mitroflow and Epic valves, gradients were elevated (>20mmHg). While there was no major difference in mean transvalvular gradients, leaflet pinwheeling was worse at lower implantation depths. PMID: 31607682 [PubMed - as supplied by publisher]