Annales chirurgiae et gynaecologiae
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A review is given of a 15 year experience of valve replacement with Teflon cusps, pericardial cusps, Starr-Edwards, Key-Shiley, Wada-Cutter and Björk-Shiley artificial valve prosthesis. The Björk-Shiley tilting disc valves have shown the lowest gradient and blood trauma and excellent durability in more than 1 000 implantations during a 7 year period. Anticoagulation therapy is considered necessary with all types of artificial heart valves. Thrombo-embolism is negligible after aortic valve replacement (1 episode in 4 000 patient months) but still a problem in the mitral position (4 episodes in 1 000 patient months).
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
The antiemetic effect of dixyrazine in postoperative patients-- a double-blind study.
A double-blind controlled study based on 197 women undergoing legal abortion (part I) or gynaecological surgery (part II) was employed to estimate the antiemetic effect of dixyrazine. Dixyrazine or part I) or intramuscularly at the end of anaesthesia (part II) and repeated when necessary. ⋯ Overall, a marked antiemetic response in the dixyrazine groups was observed when compared with the placebo treated groups in both part I and II (p less than 0.001). Dixyrazine proved to be superior to placebo especially in patients who were not prone to nausea or who received no major postoperative analgesics (p less than 0.001).
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Comparative Study Clinical Trial Controlled Clinical Trial
A study of cumulative effects and recovery from anaesthesia with intermittent doses of althesin. A comparison with methohexitone.
The cumulative effects and post-anaesthetic recovery of Althesin were studied by comparing the drug with methohexitone in a series of 60 patients undergoing surgery for varicose veins. Anaesthesia was maintained with each anaesthetic agent in 30 patients by administration of intermittent doses of the respective drugs in accordance with the surgical stimulus. When repeat doses were required at intervals of 2 to 5 minutes, the fall off in requirements was observed with both anaesthetics, more distinctly with Althesin than with methohexitone. ⋯ Frequency of nausea and vomiting after anaesthesia was considerably higher in the Althesin group than in the methohexitone group. These symptoms might be toxic due to the excessive dosage given. Using the induction time as a basis for calculation of the potency ratio, Althesin and methohexiton were found to have the ratio of 1:33 (expressed in mu1/kg : mg/kg).
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One case of an ulcerating paraffinoma of the male mammary gland and another of the penis are reported. The former is the third and the latter the eighth of its kind described in the literature. Psychopathological features were associated with both cases, and additionally impotence with the latter. ⋯ Re-injection of paraffin later required total excision of the entire anterior thoracic skin and subcutaneous tissues and skin grafting. The penile paraffinoma was treated by complete excision and again subsequent skin grafting. Both the functional and cosmetic results of the latter were good.
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Children between the ages 1 to 3 years are particularly prone to burns by their constant desire to pull down containers of hot fluids. The resulting burns produce serious complications such as hypertrophic scars and scar contractures, which can be severe enough to cause growth disturbances. A series of 31 cases of these accidents resulting in the above sequelae was investigated. ⋯ Usually the scald could have been prevented by greater vigilance on the part of the parents. Once late complications have developed, excision of the scar tissue and subsequent skin grafting or other reconstructive procedure should be performed. However, in spite of satisfactory results, these complications have a tendency to recur during the growth period.