Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The triennial Confidential Enquiries into Maternal Deaths in England and Wales report 235 maternal deaths directly due to pregnancy or childbirth in 1973-75. The inquiry covers 94% of maternal deaths, and the figure is 4 times lower than the 1950s report. 37 deaths were attributed to obstetric anesthesia, some of which could have been prevented if the practising house officer had been more knowledgeable. Amniotic fluid deaths numbered 15 and were largely unpreventable. While maternal mortality rates have declined, amniotic fluid embolisms have remained steady since the 1960s. From 1973-75 the causes of death were as follows: hypertensive disease of pregnancy, 47; pulmonary embolism, 61; abortion, 81; sepsis, 70; ectopic pregnancy, 34; uterine hemorrhage, 27.
 ...
PMID:George Stroh. 9 Mar 22

Recent modifications and refinements in the management of patients with renal allografts have diminished the mortality rate at our hospital to 2 per cent and 5 per cent at one year for patients receiving kidneys from related and cadaveric sources, respectively. Of 186 receiving transplants since 1974, seven (4 per cent) have died within one year of operation. The incidence of wound infections has been reduced from approximately 25 per cent in 1972 to 2 per cent since 1976 by the use of a single high dose of broad-spectrum antibiotics administered at the time of induction of anesthesia for any surgical procedure. Risk and limitations of immunosuppression have been better appreciated, ultrasound is used more often in the diagnosis of partial obstruction or perinephric fluid collections, and needle biopsy of the transplanted kidney has reduced the morbidity inherent in open biopsy. The contribution of sepsis as a cause of death has declined. The diminishing hazard of renal transplantation has made it an increasingly attractive treatment for end-stage kidney disease.
 ...
PMID:Factors contributing to the declining mortality rate in renal transplantation. 10 45

300 cases of laparoscopic tubal sterilization using a single entry technique under local anesthesia are described. The routine procedure is described along with figures depicting surgical equipment used. Briefly, the fallopian tubes were cauterized by a 3-burn method and the procedure was performed on an outpatient basis. A 10% failure and complication rate is reported, including 3 cases of wound sepsis, 1 case of vaginal laceration, 2 cases of intraabdominal bleeding, 3 cases of drug allergy, 3 cases of extraperitoneal insufflation, and 1 bowel burn. 1 pregnancy occurred (rate of .5) due to unsatisfactory cautery. 15 failed operations occurred due to inadequate anesthesia, pelvic inflammatory disease, and other technical difficulties. Acceptor characteristics are presented tabularly, and the majority were unmarried; age range was from 23-44 years; and parity ranged up to .12. This procedure used a Wolf 10-mm diameter operating laparoscope attached to fiber optic light.
 ...
PMID:Laparoscopic tubal sterilization: a report on 300 cases. 14 37

To assay the efficiency of cephalothin prophylaxis in open-heart surgery, bacteriological examination of pressure-measurement units, intravenous catheter tips, and urine were made in 211 consecutive patients as well as blood cultures and sputum in suspected postoperative sepsis. Furthermore, cephalothin concentration in serum and tissue was determined in 12 consecutive adults with intact kidney function. Samples were taken before, during, and after the cardiopulmonary bypass, the tissue from the right atrium only before and after cardiopulmonary bypass. A high serum cephalothin level (80.04 +/- 23.35 microgram/ml) was measured 30 min after administration of 2 g cephalothin given as a 15-min-long i.v. infusion on induction of anesthesia. An antibiotic regimen - 4 X 2 g dose of cephalothin daily (first dose on induction of anesthesia) - provides a serum cephalothin level which is significantly higher than the cephalothin minimum inhibitory concentrations for most gram-positive organisms (0.475 microgram/ml) and so ensures an adequate antibiotic coverage throughout the surgical procedure and during the early postoperative phase of open-heart surgery.
 ...
PMID:[Prevention using cephalothin in open-heart surgery]. 30 81

The large mass of devitalized tissue that comprises the burn eschar is gradually becoming recognized as the principal source of complications in the burn patient. Clinical observations suggest that the topical agent silver sulfadiazine does not penetrate the eschar sufficiently to prevent bacterial infection from becoming established in the deeper levels of the wound but does penetrate to a depth of approximately 1.5 mm in bactericidal concentrations. A new technique that takes advantage of this fact, early laminar excision, has been developed at the Children's Hospital of Michigan Burn Center. The eschar is excised layer by layer with the electric dermatome under general anesthesia within the first 72 hr post burn, and the thickness of the devitalized tissue is reduced to a remnant of less than 1 mm. This is less than the depth to which silver sulfadiazine is capable of penetrating in bactericidal concentrations, and greatly enhanced control of burn wound sepsis is achieved. Early laminar excision of the eschar, combined with silver sulfadiazine dressings, aggressive resurfacing of the wound, and increased emphasis on nutrition, is an approach to management of the victims of thermal trauma that should significantly improve survival in patients with burn injuries greater than 60% body surface area.
 ...
PMID:Early laminar excision: improved control of burn wound sepsis by partial dermatome debridement. 36 94

Three hundred fifty-seven groin hernia repairs were performed under local anesthesia using a long-lasting local anesthetic agent. An ilioinguinal, iliohypogastric, and twelfth intercostal nerve block was carried out initially, followed by regional infiltration of the agent, using a technic first described by Ponka [8] with several modifications. This technic can be employed suffessfully in the majority of groin hernia repairs. It requires careful attention to detail in the administration of preoperative sedation and analgesia and the use of sharp dissection only and greater gentleness in the handling of tissue. We have observed a significant reduction in postoperative discomfort and the virtual elimination of urinary retention, urinary sepsis, atelectasis, and phlebitis in these cases. All patients are fully ambulatory, without assistance immediately after surgery and the majority are discharged the same day or the following morning. This results in a marked reduction in the total cost of repairing a groin hernia.
 ...
PMID:Change in the management of adult groin hernia. 41 25

Before performing vasectomy, the doctor or surgeon should make sure that both husband and wife have been properly counseled as to what vasectomy is all about. Although the operation is normally thought of as minor, both patient and surgeon together should choose the proper anesthesia (general or local) to be used, especially when the patient appears apprehensive about the whole operation. Preoperative preparation should include the patient shaving his scrotum and having a good bath the night before the operation (to get rid of free hairs). Premedication with atropine and a sedative should be considered in the apprehensive patient to prevent vagal stimulation which can lead to cardiac arrest or fainting. 24 hours after the operation, the patient can be advised to return to light work, although it is advisable to take the weekend off. Often, the scrotum feels stiff and uncomfortable. Development of hematoma is the most important and commonest complication of vasectomy. If there is enlargement, the patient should be managed at the hospital; otherwise, a small swelling that is not growing is better left alone. Other possible complications include sepsis, pain and fusiform swelling where the vas was cut, and in some cases, spontaneous recanalization. With respect to reversal of vasectomy, the divided vasa can be reanastamose with or without a splint or assistance of a magnifying loupe. However, although reversal techniques are available and provide some measure of success, couples should be advised that such techniques do not guarantee full restoration of fertility.
 ...
PMID:Vasectomy. 48 35

During 1974 and 1975, five newborn infants weighing between 760 and 1600 g developed severe intraabdominal complications of NEC due to necrotic bowel with perforation and peritonitis. Because these tiny neonates were very ill with sepsis and other severe medical problems, no attempt at laparotomy under general anesthesia was carried out. Instead, using local anesthesia, the contaminated peritoneal cavity was drained via a small incision, usually in the right lower quadrant. This permitted evacuation of air, pus, and stool. In all babies there was improvement evident in the abdomen within one wk, although two of the five newborns died from other causes. The three survivors are well and have normally functioning intestinal tracts 1-2 yr following surgery. One of these surviving babies developed a bowel stricture which subsequently required resection. We feel this method is preferable in the handling of the tiny sick neonate with a bowel perforation from NEC.
 ...
PMID:Peritoneal drainage under local anesthesia for perforations from necrotizing enterocolitis. 59 76

Experiences, with about 1500 cases of intravenous regional anesthesia in outpatient surgery of the limbs over 10 years are reported. In 1975, 158 operations out of 5960 were done using this technique. Intravenous regional anesthesia is suitable for surgery of the limbs, but time of operation should not exceed 90 min, nor should hemostasis be a major problem to consider and the course of surgery should be predictable. Contraindications for this type of anesthesia are hypertonia, lack of accessible veins, heart failure, children, as well as surgery of undefinite extent or for local sepsis. When these rules were followed, no serious complications were seen.
 ...
PMID:[Intravenous regional anesthesia (author's transl)]. 59 9

To compare the risk of death from first trimester induced abortions in hospitals and nonhospital facilities (outpatient clinics and physicians' offices), the death-to-case rates by type of facility were calculated for abortions performed in the U.S. in 1974-1975. Data were derived from the Center for Disease Control's nationwide surveillance of abortion mortality and the Alan Guttmacher Institute's surveys of abortion providers. The data indicated 12 deaths from abortion-related complications in hospitals and 11 deaths in nonhospital settings (crude death-to-case rates of 2.1 and 1.0 deaths/100,000 abortions, respectively). However, 2 distorting factors were found to elevate the hospital rate: preexisting medical conditions, and concurrent sterilization. Adjustments for these factors yielded a hospital death-to-case rate of 1.1 deaths/100,000 abortions, indicating that the mortality risk is similar in both settings. These rates have 2 important limitations: 1) small changes in the already small number of deaths result in relatively large increases in the death-to-case rates, restricting extrapolation from these statistics; and 2) confounding variables influencing abortion mortality, e.g., patient's age and gestational age, cannot be controlled. Causes of death common to both facilities included adverse reaction to anesthesia, sepsis, hemorrhage, and pulmonary embollism, with no one cause disproportionally represented in either setting. Since over 90% of life-threatening complications developed either during the abortion or within 3 days, earlier patient follow-up is advised.
 ...
PMID:Comparative risk of death from legally induced abortion in hospitals and nonhospital facilities. 62 34


1 2 3 4 5 6 7 8 9 10 Next >>