Acta chirurgica Scandinavica
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Phantom breast syndrome (PBS) developed in 11 out of 31 (35.5%) consecutive young women, who had undergone mastectomy for breast cancer. Six to 21 months after operation the patients were asked to take part in a follow-up investigation in which physical sequelae, social condition, and psychological reactions were assessed and related to the presence of PBS. There was no correlation between PBS and postsurgical physical sequelae, those who had received adjuvant radiotherapy, or the side on which mastectomy was performed. ⋯ However, the predominance did not reach a statistically significant level. Sexual identity, anxiety, affective disorder or changes in close family relationships did not reveal any distinct pattern. In our opinion, the appearance of PBS should be seen in relation to complex psychological reactions to the mastectomy.
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Renal cortical and medullary tissue oxygen tension, systemic oxygen supply as well as central and renal hemodynamics were investigated in dogs during graded hemorrhage and subsequent reinfusion of shed blood. The measurements of tissue gas tension were carried out by means of implanted Silastic tubes. The baseline renal cortical PO2 was 35 mmHg and the corresponding medullary PO2 25 mmHg. ⋯ Arterial blood PO2 was normal throughout the study. Renal venous PO2 fell during the deepest shock but consistently exceeded the corresponding tissue PO2 levels. It is concluded that hemorrhagic hypotension impaired tissue oxygenation of both cortex and medulla, the effect being greatest in the cortex.
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Comparative Study
Comparison on the pulmonary effects of rapid infusion of a crystalloid and a colloid solution.
The cardio-pulmonary effects of a rapid infusion of a crystalloid (Ringer's lactate) and a colloid solution (Dextran 40) were compared in healthy dogs. The colloid solution produced a long lasting volume expansion and hemodilution. ⋯ The total oxygen consumption increased slightly in the colloid group but decreased in the crystalloid group. The postmortem extravascular lung water content did not differ in the groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of rubber band ligation and sclerosant injection for first and second degree haemorrhoids-- a prospective clinical trial.
Fifty patients with first or mild second degree haemorrhoids were randomly allocated to sclerosant injection (26) or rubber band ligation (24). One year after treatment 24 injection and 22 rubber band ligation patients were assessed. All patients presented with rectal bleeding; injection relieved 14 and rubber band ligation relieved 17 of this symptom (N. ⋯ Rubber band ligation relieved anal pain in 10 out of 14 patients whereas injection relieved only one patient of this symptom (p less than 0.05). Neither treatment influenced pruritus ani or faecal soiling. Although rubber band ligation caused more treatment discomfort, it is an effective management for first and mild second degree haemorrhoids and it should be considered as the procedure of choice.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative influences of epidural and general anaesthesia on deep venous thrombosis and pulmonary embolism after total hip replacement.
In an investigation on deep venous thrombosis and pulmonary embolism, where neither dextran nor antithrombotic drug prophylaxis were employed, 30 patients undergoing total hip replacement were randomly allotted to one of two groups receiving either epidural or general anaesthesia. The epidural group (n = 15) was given 0.5% bupivacaine with epinephrine (5 micrograms/ml) and this was prolonged into the postoperative period for pain relief. The general anaesthesia group (n = 15) was operated on under artificial ventilation with nitrous oxide/oxygen via an endotracheal tube and intravenously administered fentanyl and pancuronium bromide. ⋯ Further, the frequency of pulmonary embolism, as determined by pulmonary perfusion lung scanning, was lower in patients receiving continuous epidural block (2 of 15) than in the general anaesthesia group (7 of 15). Possible explanations for these findings are discussed, including a hyperkinetic lower limb blood flow and lower fibrinolysis inhibition activity in patients given epidural block. Lower blood transfusion requirements in patients given epidural block might also play a role, as well as a "stabilizing" effect of local anaesthetics on platelets, leukocytes and endothelial cells.