Surgery case study

The Study on the Efficacy of Nosocomial Infection Control (SENIC) analyzed more than 100,000 surgery cases and identified abdominal operations, operations lasting more than 2 hours, contaminated or dirty procedures, and more than three underlying medical diagnoses as factors associated with an increased incidence of SSI. When the NRC classification described in Table 48-1 was stratified by the number of SENIC risk factors present, the infection rates varied by as much as a factor of 15 within the same operative category. 

Neurological Effects. Neurological effects in hrnnans after acute inhalation exposure to chloroform are well documented because chloroform has been used as an anesthetic for surgery. Inhaled chloroform acts as a depressant on the central nervous system. Chronic inhalation exposure to chloroform resulted in exhaustion, lack of concentration, depression, and irritability in occupationally exposed people (Challen et al. 1958). In a case study, chloroform inhalation for 12 years resulted in psychotic episodes, hallucinations, and convulsions (Heilbmnn et al. 1945). Central nervous system toxicity was observed in humans after oral exposure to chloroform, which suggests that the effects of inhalation and oral exposure are similar. In case reports of patients who intentionally or accidentally ingested several ounces of chloroform, deep coma with abolished reflexes occurred within a few minutes (Piersol et al. 1933 Schroeder 1965 Storms 1973). 

For discussions concerning informed consent and medical experimentation on prison populations, see Mark, Vernon H, Neville, Robert, (1977) Brain Surgery in Aggressive Epileptics Social and Ethical Implications. Ethical Issues in Modern Medicine, (eds, Robert Hunt John Arras). Veatch, Robert M, (1977). Case Studies In Medical Ethics, pp, 267-71 Bernier, Barbara L, (1994) Class, Race, And Poverty Medical Technologies And Socio-Political Choices. 11 Harv. BlackLetter J. 115,... 

This chapter contains three case studies. The first one on climbing rope illustrates the technology of fibre production and rope construction to meet specific mechanical property targets. There are some similarities between rope and the much smaller scale braided sutures used in surgery. Further sport case studies, on polymer foam protective gear and materials in running shoes, are mentioned in the Further Reading section. 

Veillon F (1993) CT and MR imaging versus surgery of recurrent cholesteatoma in the post-operative middle ear a 72 case study. Radiology 185 (S) 248... 

A recently developed bibliographic database of papers on fibrin sealant revealed that more than 700 animal studies including about 25,000 individual animal procedures have been published (Fairbrother, 1995). Controlled clinical trials are described in 85 papers, but the majority of the 1400 clinical papers describe case reports and anecdotal, uncontrolled studies. One fibrin sealant, Tissucol or Tisseel, has been utilized in applications involving more than 2 million patients, 41 % in reconstructive surgery and 14% in cardiothoracic surgery, and studies using it have been reported in more than 2000 papers. 

Hypersensitivity reactions of the skin and respiratory system have been reported in a study made at random of 750 orthopaedic surgery cases, who received 5 different plasma substitutes preceding anaesthesia. Side effects, especiahy erythema and urticaria, itching and oedemata, rhinorrhoea and asthmatic conditions, were observed in 21.3% with gelatin derivatives, 3% with Macrodex... 

In other study,79 Samuelsson and coworkers (Sweden) investigated the efficacy of either ECT or radiotherapy or a combination of the two in destroying experimental colon carcinoma tumor in rats. The combined treatment resulted in tumor growth inhibition, and, total regression was obtained in 75% of the cases with radiotherapy alone, 75% of the tumors remained. As mentioned above78 with ECT alone, the regression rate was 50%, the same as surgery alone. 

Patients suspected of having sleep apnea should undergo a sleep study. If sleep apnea is diagnosed, these patients should be treated with weight reduction, a continuous positive airway pressure (CPAP) machine, and, in extreme cases, surgery. Sleep apnea patients in general should not be prescribed sedative-hypnotics. 

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