Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The orbit is a cone-shaped structure formed by rigid bony walls within which the globe and retrobulbar contents are encased. Anteriorly, the orbital septum and eyelids form another relatively inflexible boundary. The medial and lateral canthal tendons attach the eyelids to the orbital rim and also limit any anterior displacement of the globe. Although small increases in orbital volume can be compensated for by forward displacement of the globe and prolapse of fat, a rapid rise in intraorbital pressure normally ensues. This increase in pressure within the confined space of the orbit causes decreased perfusion with associated ischaemic damage not unlike that seen in other compartment syndromes. We report a case of traumatic orbital compartment syndrome successfully decompressed by means of a lateral canthotomy.
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PMID:Traumatic orbital compartment syndrome: importance of prompt recognition and management. 1747 16

Many surgeons recommend rest and restricting activities to their patients after surgery. The aim of this review is to summarize the literature regarding types of activities gynecologic surgeons restrict and intra-abdominal pressure during specific activities and to provide an overview of negative effects of sedentary behavior (rest). We searched PubMed and Scopus for years 1970 until present and excluded studies that described recovery of activities of daily living after surgery as well as those that assessed intra-abdominal pressure for other reasons such as abdominal compartment syndrome and hypertension. For our review of intra-abdominal pressure, we excluded studies that did not include a generally healthy population, or did not report maximal intra-abdominal pressures. We identified no randomized trial or prospective cohort study that studied the association between postoperative activity and surgical success after pelvic floor repair. The ranges of intra-abdominal pressures during specific activities are large and such pressures during activities commonly restricted and not restricted after surgery overlap considerably. There is little concordance in mean peak intra-abdominal pressures across studies. Intra-abdominal pressure depends on many factors, but not least the manner in which it is measured and reported. Given trends towards shorter hospital stays and off work intervals, which both predispose women to higher levels of physical activity, we urge research efforts towards understanding the role of physical activity on recurrence of pelvic organ prolapse and urinary incontinence after surgery.
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PMID:Activity restrictions after gynecologic surgery: is there evidence? 2334 Aug 79

A single neonatal surgical unit treated 42 cases of gastroschisis over a 12-year period (1981-1993). The surgical management of each case was individualised, but every attempt was made to perform a primary repair when possible, based on the premise that this strategy gave the best outcome. The eviscerated intestine was evaluated with the patient under general anaesthesia. Serosal peel was not removed and intestinal atresias were not repaired. Gangrenous intestine was resected. The contents of the bowel were emptied proximally via a large naso-gastric tube and distally via the anus with warm saline lavage. The anterior abdominal wall was stretched and then reduction of the prolapse attempted. Following maximal enlargement of the peritoneal cavity, it was left to the operator to decide whether primary repair was possible and, indeed, permissible in each instance. Staged repairs necessitated the use of silastic pouches. Respiratory and intestinal insufficiency were managed by intermittent positive-pressure ventilation and total parenteral nutrition (TPN). Over one-half of the cases (24 of 42) were under 2.5 kg at birth. Intra-uterine growth retardation was unusual. Ten babies were delivered for obstetrical indications by Caesarean section: 50% were pre-term and in 4 pre-natal diagnosis of a ventral abdominal wall anomaly had been made. The transmural defects were all sited at the umbilicus and were to the right of a consolidated cord in 41 instances. Midgut necrosis due to torsion was encountered in 1 case; 3 further cases with intestinal atresia occurred. Primary closure was obtained in 30 (71%) of the cases reviewed. A prosthetic pouch was used in 12 patients for on everage 10 days in 10 uncomplicated cases. The average length of time in days of tertiary care given to 25 uncomplicated cases treated by primary fascial closure was: ventilatory support 4; intensive care treatment 8; and nutritional source TPN 20. There were 5 deaths (12%): 1 was unpreventable due to prenatal intestinal infarction; 2 were due to abdominal compartment syndrome with renal failure, and, intestinal ischaemia complicating primary and planned staged repairs; 1 caused by intestinal infarction due to torsion of bowel in a pouch; and 1 due to invasive infection. The role played by the strategy taken by the surgeon in the management of gastroschisis is crucial to the outcome. The creation of a compartment-like syndrome produced uncorrectable complications in this series of cases in both primary and staged abdominal wall closures. Minor degrees of this complication proved to be reversible in some patients, which was the reason for the wait-and-see attitude adopted in the management of this problem, often with fatal outcome. Where intra-peritoneal pressure monitoring is not used, the operating surgeon relies on unscientific observations for decision-making at the operating table. The time from birth to operation in 25 of the reviewed cases was on average 5 1/2 h. Of this group, 20 were outborn babies. This is unsatisfactory, but as shown by this review, even in the absence of prenatal management, which should ensure prompt repair, satisfactory results are still possible.
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PMID:The pivotal role of the surgeon in the results achieved in gastroschisis. 2405 22