Articles: postoperative-complications.
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Multicenter Study
[Pelvic fractures: epidemiology, therapy and long-term outcome. Overview of the multicenter study of the Pelvis Study Group].
Pelvic fractures are rare injuries (3-8%) when compared to fractures in other body regions. They are accompanied by high mortality (5-20%), and the survivors suffer from severe pain and pelvic-related handicaps. The German Pelvic Group (German Chapter of the AO-International & German Trauma Society) started a prospective multicenter study, including ten major trauma centers for collecting a high number of data in a short period of time (1991-1993). ⋯ Although progress in indications and treatment techniques has shown improved radiological results after unstable pelvic ring injuries when compared to earlier studies, the clinical result still remains unsatisfactory. Further analyses and studies must be conducted to identify the prognostic factors for the late sequelae. Whether it is possible influence these factors by additional surgical intervention cannot be answered at present.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Heterotopic ossification after hip arthroplasty: a randomized double-blind multicenter study tenoxicam in 147 hips.
147 patients due to have a cemented total hip arthroplasty were randomized to 4 groups. They received either tenoxicam 20 mg or 40 mg, or placebo, for 5 days or morphine on the day of operation and placebo for 4 days. ⋯ At follow-up, significantly fewer patients had heterotopic ossifications in the tenoxicam groups than in the placebo and morphine groups. There was no significant difference between the 2 tenoxicam-treated groups, and we therefore conclude that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Single dose i.v. tropisetron in the prevention of postoperative nausea and vomiting after gynaecological surgery.
In a prospective, randomized, multicentre, double-blind, placebo-controlled study, we have compared the efficacy of a single i.v. dose of tropisetron 0.5 mg, 2 mg and 5 mg in the prevention of postoperative nausea and vomiting (PONV). We studied 385 ASA class I and II female patients undergoing abdominal or vaginal gynaecological surgery, including laparoscopy. ⋯ Compared with placebo, nausea was reduced from 55% to 46%, 34% and 46% (P = 0.25, P = 0.003, P = 0.22), and need for rescue treatment from 39% to 29%, 23% and 35% (P = 0.13, P = 0.017 and P = 0.59) for the same groups. Tropisetron 2 mg appeared to be the optimal dose for prophylaxis against PONV with a side-effect profile similar to that of placebo.
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Multicenter Study
Surgery and anesthesia in sickle cell disease. Cooperative Study of Sickle Cell Diseases.
From 1978 to 1988, The Cooperative Study of Sickle Cell Disease observed 3,765 patients with a mean follow-up of 5.3 +/- 2.0 years. One thousand seventy-nine surgical procedures were conducted on 717 patients (77% sickle cell anemia [SS], 14% sickle hemoglobin C disease [SC], 5.7% S beta zero thalassemia, 3% S beta zero + thalassemia). Sixty-nine percent had a single procedure, 21% had two procedures, and the remaining 11% had more than two procedures during the study follow-up. ⋯ Perioperative transfusion was associated with a lower rate of SCD-related postoperative complications for SS patients undergoing low-risk procedures (P = .006, adjusted for age and type of anesthesia), with crude rated of 12.9% without transfusion compared with 4.8% with transfusion. In SC patients, preoperative transfusion was beneficial for all surgical risk levels (P = .009). Thus, surgical procedures can be performed safely in patients with SCD.
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Multicenter Study Clinical Trial
Role of calcium channel blockers in diabetic renal transplant patients: preliminary observations on protection from sepsis.
Diabetic recipients of kidney transplants have an excessively high risk of allograft loss, infectious complications with sepsis, cardiovascular events and early death. This study was designed in order to determine whether post-transplantation medical management influenced long-term results. ⋯ Allograft success and patient survivals may be improved and sepsis related events diminished when diabetic renal allograft recipients are treated with calcium channel blocking agents, plus or minus beta blockers. Considerable savings can be accomplished and graft results with these drugs can approach non-diabetic and live-related transplant results.