INDEX surgery

In 1996, Chmell et al. [57] published a retrospective review of 143 patients implanted with Hylamer acetabular inserts after a follow-up period of at least 2 years. The index surgeries were performed between 1991 and 1992, and thus all of the Hylamer components in this study were gamma irradiated in air. Seventeen patients in the series were implanted with matched femoral components from the same manufacturer as the liner the remaining patients were implanted with mismatched femoral components from a different manufacturer. Overall, the revision rate due to excessive wear was 4.8%, with all six of the revisions occurring within the group of 126 patients with mismatched components. The authors judged the wear-related failure rate to be unacceptable and discontinued use of Hylamer acetabular inserts. 

Only two short-term prospective studies on the effect of soy on the breast have been performed to date. The first reported the effects of two weeks of soy supplementation on the breast of women who were due to have surgery for either benign or malignant breast disease (Hargreaves, 1999). Soy had no adverse effects on any histological index of proliferation. However, a rise of pS2 protein and lowering of apolipoprotein D was observed in the nipple aspirate of women taking soy compared with controls. (A similar effect has... 

Lithium is used in the prophylaxis and treatment of mania and in the prophylaxis of bipolar disorders and recurrent depression. Lithium should be stopped 24 hours before major surgery but the normal dose can be continued for minor surgery, with careful monitoring of fluids and electrolytes. After major surgery, renal function is reduced and this may compromise clearance of lithium. Lithium is a drug with a narrow therapeutic index and it should be avoided if possible in patients with renal impairment. Renal function should be tested before initiating treatment. If lithium is given to patients with renal impairment, a reduced dose should be used and serum lithium concentrations should be monitored closely. 

Forty healthy participants, 25 female and 15 males, aged 19-33 years with a body mass index between 18 and 24 kg/m took part in the study. Excluding criteria were smoking, current dental surgery, illness of the pharynx or the cavity of the mouth, malabsorption, long-time medication, use of a toothpaste with vitamin A during the last 2 months prior to the study, pregnancy, and metabolic diseases. 

Two studies evaluated the effects of lipid-lowering therapy on clinical endpoints in the leg. The Program on the Surgical Control of the Hyperlipidemias was a randomized trial of partial ileal-bypass surgery for the treatment of hyperlipidemia in 838 patients (9). After five years, the relative risk (RR) of an abnormal ankle-brachial index value (ABI) was 0.6 (95% Cl, 0.4 to 0.9, absolute risk reduction, 15% points, p < 0.01), and the RR of claudication or limb-threatening ischemia was 0.7 (95% Cl, 0.2 to 0.9, absolute risk reduction, 7% points, p < 0.01), as compared with the control group. 

Index functional status 30 d after stroke. The results showed that only the severity of neurological deficit predicted greater 30-d mortality in these patients. Patients with hyperthermia on the first day of hospitalization had increased mortality and worse functional status at 30 d, but increased temperature was not an independent predictor of mortality 30 d after PICH. In a study to assess typical early onset complications following ischemic stroke, Weimar et al. (5) looked at a cohort of 3866 patients from 14 neurology departments with an acute stroke unit. In the first week following admission, increased intracranial pressure (ICP) and recurrent cerebral ischemia were the most frequent complications, along with fever, severe hypertension, and pneumonia. Similar concerns are also found in cardiac surgery patients in whom perioperative stroke occurred (6). 

Figure 9.3 Inhibition of intimal hyperplasia by resveratrol in rabbits subjected to endothelial injury by denudation. Groups of eight New Zealand white rabbits, weighting 2.2 to 3.6 kg, were assigned randomly to control (untreated) (M), low (2 mg/kg/d) (L), and high dose (4 mg/kg/d) (H) resveratrol treatment, which was administered intragastrically for 5 weeks beginning 1 week before surgery. A 2-cm segment of injured iliac artery was excised, fixed in 4% paraformalin, embedded in paraffin, and sectioned at5-mm intervals from the proximal to the distal end. Representative sections were stained with hematoxylin/eosin. The external and internal elastic lamina were manually identified. Intimal proliferation index (IPI) was defined as the ratio of intimal area to [intimal+medial] area relative luminal area (RLA) was defined as the ratio of luminal area to [luminal+intimal+medial] area.

In acromegaly, excess growth hormone causes diabetes, hypertension and arthritis. The former two lead to a 2-fold excess in cardiovascular mortality. Surgery is the treatment of choice. Growth hormone secretion is reduced by octreotide and other somatostatin analogues and to a lesser degree by bromocriptine (see Index). 

Nelskyla KA, Yh-Hankala AM, Puro PH, Korttila KT. Sevoflurane titration using bispectral index decreases postoperative vomiting in phase II recovery after ambulatory surgery. Anesth Analg 2001 93(5) 1165-9. 

Examples of chemoprophylaxis in the non-surgical arena include the prevention of endocarditis with amoxicillin in patients with valvular heart disease undergoing dental surgery, and the prevention of secondary cases of meningococcal meningitis with rifampicin among household contacts of an index case. 

Buzby GP, MuUen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am J Surg 1980 139 160-7. 

Riker, R.R. Fraser, G.L. Simmons, L.E. Wilkins, M.L. Validating the sedation-agitation scale with the bi.spcctral index and visual analog scale in adult ICU patients after cardiac surgery. Intensive Care Med. 2001, 27, 853-858. 

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