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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Continuous cycling peritoneal dialysis (CCPD) uses a cycler to perform dialysis exchanges and requires the patient to respond to an audible alarm signifying an interruption in the therapy. Consequently, an unassisted hearing-impaired patient could not use the system. By converting the standard alarm to a vibrating signal, the cycler was successfully adapted to accommodate the special needs of our hearing-impaired patient. The items required for the modification were the Sonic Alert Wake Up Alarm (Model SA-WA300: Sonic Alert, Troy, MI, U.S.A.) and the Sonic Alert Super Shaker Bed Vibrator (Model SA-SS120V: Sonic Alert). The patient can place the vibrator under either the pillow or the mattress. When the cycler alarm is activated, vibration wakens the patient. The equipment was purchased from Harris Communications (Eden Prairie, MN, U.S.A.) through a referral by the Easter Seal Society. Three days were needed to complete training compared to an average of one or two days for patients previously trained for continuous ambulatory peritoneal dialysis (CAPD). The patient remained on cycler therapy for approximately four months when the unrelated development of an abdominal hernia required termination of peritoneal dialysis and subsequent transfer to hemodialysis. In conclusion, a modified cycler can provide a safe and efficient renal replacement therapy option for a hearing-impaired patient.
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PMID:Adaptation of the Fresenius PD+ Cycler for a hearing-impaired patient. 1104 84

Mini-Laparoscopy by reducing the instrument size and hence incision can lead to better surgical outcome. The safety and feasibility of mini-laparoscopic cholecystectomy (mini-Lch) has not been documented with a large patient sample. This observational descriptive study reports the results of 7200 cases of mini-Lch performed at Ibrahim General Hospital and Eden Multi-care hospital, Dhaka, Bangladesh by a single surgeon. From May 1998 till July 2013in total 8700 patients were offered Mini-lch and 7200 procedures were completed successfully. The operative indication, total operative time, conversion rate, hospital stay, patient satisfaction, post operative pain, complications, morbidity and mortality were reviewed. In this series conversion to open surgery was 0.39%. Average operating time was 30.22 minutes. Early acute cases (9%) did not require conversion to open. Average post operative hospital stay was 21 hours. There was no mortality in the series. Six patients developed incisional hernia at the umbilical port site and 16 patients had umbilical wound infection. Patient acceptance was excellent, postoperative analgesic requirement was less. With Mini Lch better cosmetic result was achieved, recovery was early. Minilaparoscopic cholecystectomy is an economically feasible, and more acceptable considering the cosmetic outcome and patient acceptance. Our results indicate that this procedure could be performed successfully and safely by experienced surgeons.
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PMID:Mini-Laparoscopic Cholecystectomy: Review of 7200 Cases. Could it be the New Gold Standard? 2727 61