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

PAH clearance was carried out in 12 newborns, hospitalized in the infantile resuscitation unit for respiratory distress. 6 of these children weighed less than 2.5 kg, 4 had hyaline membrane disease, 6 had either amniotic abnormalities or transitory tachypnea, 2 were surgical patients: one right diaphragmatic hernia, one post-operative respiratory complication after intervention for neonatal occlusion. In 9 cases the newborn was under controled artificial ventilation associated with PEEP at 5 to 7 cm of water. In all of the cases, the hemodynamic, metabolic and blood gas conditions were normal. A control series of 11 newnorn was carried out in a pediatric unit, the clearance was done without urine samples, the rough value of the figures found varied from 5.5 ml per minute to 30 ml per minute in the respiratory distress series and 16 to 62 ml per minute in the control series. The analysis of these results in rendered difficult by the juxtaposition of several factors: Choice of a reference criterion: body surface area, PAH space, patient's weight theoretical weight of the kidneys. The factor of prematurity. The problem of the date of the investigation in comparison with the date of birth.
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PMID:[PAH clearance measurement without urine samples in the newborn infant with respiratory distress]. 0 69

The type of first aid given to patients requiring emergency pediatric surgery is decisive for the prognosis in many cases. With this aspect in mind, individual disease pictures from the group of connatal deformities (esophageal atresia, intestinal atresia, gastroschisis, diaphragmatic hernia and defect, myelomeningocele), from emergency surgical situations beyond the neonatal stage (acute abdomen and ileus, esophageal varices, pneumothorax), and accident injuries (blunt abdominal trauma, cranio-cerebral trauma, burns) are selected and the most important first aid measures described. But for all diseases, the general rule for the treatment of all seriously ill children applies: provision of a safe venous access, readiness to intubate, adequate oxygenation and control of the acid-base, water and electrolyte balances.
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PMID:[First aid measures in emergency pediatric surgery (author's transl)]. 41 88

In order to elaborate an epidurographic technique, the water-soluble contrast substance (verografin), oil solution of iodine, iodolipol and air were used in experimental studies on animals and in cadavers. The studies demonstrated that oil and gaslike contrast substances penetrate into the vein and create a threat of embolia formation. For epidurography the most acceptable are water-soluble contrast substances. The method of an ascending verografin epidurography was elaborated and used in clinical practice. Some indications and contraindications for epidurography are outlined. A group of 396 patients with osteochondrosis of the lumbar part of the spine was examined. The method allowed a topic diagnosis of the disc hernia not only along the spine, but in the cross-section of the motor segments (median, paramedian and lateral hernias). The studies make it possible to exclude a disc prolapse in a nonhernial form of osteochondrosis. In 32 patients with spinal tumors epidurography permitted to determine the initial growth of the tumor, its size and relation to the dura mater.
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PMID:[Verografin epidurography in the diagnosis of spinal and spondylogenic diseases]. 45 88

There is currently controversy as to the importance of the radiologic demonstration of a hiatal hernia, reflux, or both as the explanation of heartburn. It is clear, however, that clinical-radiologic correlation requires additional observations such as the straightness of the potential path for reflux, the presence of a contractile esophagogastric region, the degree of extrinsic compression of the cuff of the stomach within the hiatus, the size of the hernia, and the peristaltic activity of the body of the esophagus. Vigorous or water-swallowing maneuvers to demonstrate reflux are unreliable in individual cases. Of importance is the concept that the so-called patulous cardia, or effaced abdominal esophagus or widened or absent "submerged segment," is a variety of sliding hiatal hernia that is often neglected radiologically but may be of considerable clinical significance.
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PMID:Heartburn. The role of radiology. 94 32

A parallel investigation of the success of treating patients with chronic low back pain has been carried out at the Moravci Spa, at the Department for Physical Therapy and Rehabilitation and at the Rheumatology Department of Maribor Teaching Hospital. One hundred patients suffering from low-back pain were given a 14-day treatment in the termomineral water (T--36 degrees C) of the Moravci Spa. A comparative group of another 100 patients also suffering from pain in the lumbar region of the spine underwent equal balneo-physical treatment in plain water (T--32 degrees C) at the Dept. for Physical Therapy and Rehabilitation and at the Dept. of Rheumatology at Maribor Teaching Hospital, Slovenia. The educational background of the two groups features a statistically significant difference (p < 0.001): the percentage of patients with lower education was higher at the Moravci Spa (67%) compared with only 46% among those treated at Maribor Teaching Hospital. Correspondingly, the difference in occupation of the two groups were similar (p < 0.005): prevalent among the patients at Moravci Spa were bluecollar workers (40%) compared with white-collar workers (27%). The percentage of white-collar workers at Maribor Teaching Hospital was 45%. The average age of the patients treated at the Moravci Spa was 46.9 +/- 9.5 years (28-77 years), at Maribor Teaching Hospital it was 45.2 +/- 8.2 years (26-71 years). There was no statistically significant difference in age (p < 0.10) between the two groups. Generalized spondylochondrosis was present in both groups, i.e. 87%; approximately 10% of the patients from both groups underwent surgical treatment of hernia disci.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Results of a comparative study of the success of treatment of pain in the lumbar spine at the Moravske Toplice health spa, at the department of physical therapy and rehabilitation and at the department of rheumatology of the Maribor Teaching Hospital]. 136 51

Kasturba Hospital in Sevagram, India, has helped to initiate an outreach health program for nearby villages. A health insurance scheme has evolved where the community contributes sorghum for a fund and participates in decision-making and the supervision of village health workers. Contributors are entitled to free primary care and subsidized referral care. Only villages where at least 75% of the poor community agreed to enroll in the health insurance scheme were adopted by the hospital. The hospital offers insured persons free inpatient treatment for unexpected illness and a 75% subsidy for care during normal pregnancy or with cataract and hernia operations. The mobile health team, comprising auxiliary nurse-midwife, social worker, and village health worker, provides maternal and child health services in the localities. The village health workers provide symptomatic drug treatment, exercise a preventive role with the help of visiting health team members, and refer patients to hospital. The auxiliary nurse-midwife and social workers organize visits for vaccination and provide maternal and child health care. The doctor in charge treats patients in the hospital and trains village health workers. More than 75% of the villages in the area have enrolled in the scheme over the last 10 years. No vaccine-preventable illness (measles, poliomyelitis, diphtheria, whooping cough, tetanus) was reported in children or mothers after mass immunization was instituted, no maternal deaths have occurred during the past 10 years, and perinatal mortality has fallen steeply. The village health teams are now regarded as counselors on health-related matters, among them drinking-water supplies, irrigation, and programs for income generation. It is necessary to regulate the private health sector, including professionals, the drug industry, and investors. If outpatient services are opened up to the private sector, a system of universal medical insurance, financed by local government, should operate.
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PMID:Risk-sharing in rural health care. 141 30

We report on 50 term and near-term neonates (birth weight greater than 1800 g, gestational age greater than 33 weeks) with severe persistent pulmonary hypertension of the newborn (PPHN), referred to us from January 1987 to July 1991 after failure of maximum conventional treatment. All infants had paO2 less than 45 mm Hg when ventilated with peak inspiratory pressure greater than 38 cm H2O and FiO2 = 1.0, hence meeting entry criteria for extracorporeal membrane oxygenation (ECMO). High frequency oscillatory ventilation (HFOV) was tried in all patients. If sufficient oxygenation could not be achieved (paO2 less than 40 mm Hg for at least 2 h), ECMO therapy was begun, which was the case in 25 children. Neonates responding to HFOV (n = 25) were of a slightly younger gestational age (37.0 weeks vs 38.8 weeks, P less than 0.05), had higher Apgar scores and were less hypoxaemic before HFOV (paO2 36.6 mm Hg vs 28.8 mm Hg, P less than 0.01); during HFOV there was a significant rise in paO2 (greater than 150 mm Hg; P less than 0.001) and a fall in pCO2 to 21.6 mm Hg (P less than 0.001). Due to air leaks, which was the main complication of HFOV (52%), ECMO therapy had to be begun in two additional infants after an initial positive effect. HFOV tended to be successful in cases of primary PPHN, meconium aspiration and sepsis, but not in infants with lung hypoplasia as a result of diaphragmatic hernia or other reasons. Success or failure of HFOV could not be reliably predicted by any parameter.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High frequency oscillatory ventilation and extracorporeal membrane oxygenation in severe persistent pulmonary hypertension of the newborn. 142 1

This study compared six extracorporeal membrane oxygenation (ECMO) selection criteria in 42 neonates and analyzed factors influencing the accuracy of outcome predictions. The sensitivity of the criteria in identifying fatal cases varied from 0.44 to 0.94 and the specificity of predictions of survival ranged from 0.42 to 0.69. The criterion having the highest sensitivity had the lowest specificity and conversely the criterion with the lowest sensitivity had the highest specificity. Overall accuracy of the criteria, as measured by the total number of correct outcome predictions, differed little among the criteria (23/42 to 27/42 correct predictions). Three factors influenced predictive accuracy: 1) a primary diagnosis of congenital diaphragmatic hernia (CDH) was associated with a greater mortality (P less than 0.001) and a significantly higher positive predictive value (PPV) for all criteria (P = 0.0009-0.012) than that seen in patients with other primary diagnoses; 2) calculating the alveolar-arterial oxygen gradient using an assumed, rather than measured barometric pressure, or estimating oxygenation index using a calculated, rather than a measured, mean airway pressure, increased false positive mortality predictions in non-CDH patients; and 3) requiring a peak inspiratory pressure (PIP) of at least 50 cm H2O in the definition of maximal medical management, rather than a PIP of 20-49 cm H2O, significantly increased the PPV for three of four criteria examined (P = 0.02-0.04). Awareness of these factors may facilitate the identification of neonates who need ECMO to survive.
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PMID:Comparison of six ECMO selection criteria and analysis of factors influencing their accuracy. 175 44

Primary bacterial peritonitis and catheter-associated infections compose the large majority of abdominal events in continuous ambulatory peritoneal dialysis (CAPD) patients. Yet occasionally primary pathology involving the abdominal viscera develops, and surgery is frequently considered. The early manifestations of intraabdominal inflammation or bleeding in patients undergoing CAPD depend on the pathological process, its access to the peritoneal cavity, and whether generalized bacterial peritonitis supervenes to obscure helpful physical findings. Clear dialysate is not a reliable sign that major pathology is absent, nor does initial stabilization of the clinical course with antibiotic therapy uniformly indicate that surgery will not be necessary. Polymicrobial peritonitis may develop in cholecystitis, pancreatitis, or from a colonic source, the latter featuring more bacterial species and more gram-negative and anaerobic organisms. A history directed at progression of symptoms and sites of abdominal discomfort and an examination for deep local tenderness and bowel incarcerated in an abdominal wall hernia are essential. Measurement of dialysate amylase and Gram stain of dialysate for food fibers may be helpful. Imaging techniques such as abdominal radiographs for dilated bowel or free subdiaphragmatic air, ultrasonography of the gallbladder or pancreas, computed tomographic (CT) scanning of the lower abdomen, and water-soluble contrast colonic studies may help identify the pathologic process. Special studies such as these should be considered early in the course of suspected unusual abdominal events in patients on CAPD.
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PMID:Abdominal catastrophes and other unusual events in continuous ambulatory peritoneal dialysis patients. 236 12

The congenital anomalies of the lumbosacral nerve roots have frequently been found in the past as operative findings during surgery for protruded disc and are today diagnosed preoperatively with increasing frequency. They include the more cranial or more caudal origin of a nerve root, the conjoined structure of two roots and the anastomoses between two or more roots. This study reviews the large amount of literature on these anomalies and discusses their incidence, classification and embryological origin, the anatomical structure of the anomalous roots, their clinical presentation and radiological diagnosis. Anomalous nerve roots are often asymptomatic; radicular symptoms may appear in the presence of a protruded disc or lumbar stenosis, as a result of the compression or traction of the anomalous root. Myelography with water-soluble contrast media allows a good visualization of the root sheaths and thus a good diagnostic definition of these anomalies. In symptomatic cases, the surgical treatment consists of the removal of the disc hernia, associated with hemilaminectomy and foraminotomy, to obtain a good mobilization of the anomalous root; it usually results in the remission of the radicular symptoms.
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PMID:Anomalies of the lumbosacral nerve roots. 257 45


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