Postoperative convalescence after inguinal hernia surgery: Prospective randomized multicenter study of laparoscopic versus Shouldice inguinal hernia repair in 1042 patients

Interest in inguinal hernia surgery has increased significantly with the introduction of new operating techniques during the past decade. This multicenter study compared short-term results in patients treated by the laparoscopic transabdominal preperitoneal patch technique (TAPP; n=518) and the Shouldice technique (n=524). We evaluated demographics, operative data, complications, hospital stay, postoperative pain, use of analgesics, functional status, sick leave, and complaints up to 3 months postoperatively. The median operating time was shorter in the Shouldice group (55 vs. 65 min), but there were no significant differences in complication rates, and major complications were rare. The hospital stay was 1 day or less in over 98% of cases in both groups, but more operations were performed on outpatient basis in the Shouldice group. In the TAPP group postoperative pain and analgesic consumption were less, postoperative functional status was better, and sick leave was shorter (10 vs. 14 days). These results show that the two methods are equally safe and have few major complications. The TAPP operation is associated with less postoperative pain, better postoperative functional status, and shorter sick leave, but at the price of a longer operating time. Electronic Publication     

Studying the Composition of Salmus Preparation

Salmus is a product of Salvia sclarea technology that is widely used in balneary practice. It is established that the analytical characteristics of salmus substance, as stipulated in the temporal pharmacopoeial article VFS 42-1530-85, are not objective and should not be used for evaluating the quality of the ready-to-use preparation and for monitoring the process of its manufacturing. TLC data show that salmus contains all components of sage oil (Russian State Standard GOST 3171-76) except for linalyl acetate. Qualitative specific color reactions on Silufol TLC plates showed for the first time the presence of flavonoids such as kaempferol, quercetin, juglanin, quercitrin, and rungioside and revealed one previously unknown substance, probably, of a flavonoid nature. The TLC data also showed the presence of condensed tannins and chlorophylls. It is suggested to perform quantitative analysis and identification of biologically active substances in salmus using methods for determining the content of reducing sugars (carbohydrates) and oxidizable components. New procedures for determining the sum of essential oils and flavonoids using the total content of extractable components have been developed and verified. It is suggested that these substances are among the main therapeutic components of salmus. __________ Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 8, pp. 33 – 36, August, 2005.     

Tc-99m HMPAO SPECT imaging of the central nervous system in tuberous sclerosis

Tc-99m HMPAO was used to evaluate cerebral perfusion in a patient with tuberous sclerosis. The SPECT images demonstrated reduced HMPAO uptake in regions corresponding with MRI-confirmed locations of cortical tubers. These results indicate that the lesions are characterized by vascular perfusion deficits and support the hypothesis that cortical tubers result from developmental abnormalities of the embryonic central nervous system.     

Esophageal pH monitoring for gastroesophageal reflux: a United Kingdom study

Esophageal pH monitoring is the accepted standard for the investigation of gastroesophageal reflux (GER) in adults. A postal questionnaire was sent to 912 United Kingdom paediatric physicians & surgeons. Five hundred forty-seven (61%) replied, with 124 (22.7%) currently using the technique, mostly in conjunction with barium swallow and/or esophagoscopy. The use of pH monitoring to quantify GER was also accepted in principal as being the best determinant of reflux by a further 186 (34%), but as yet was unavailable in their hospitals. Pediatricians were also questioned as to their management of children with GER. The majority were treated medically with a variety of antireflux medication, with only 237 (42%) referring cases for surgery.     

Selective anorexigenic effects of corticotropin releasing hormone in the rhesus monkey

1. Rhesus monkeys were equipped with a novel intracerebroventricular (i.c.v.) cannula system and trained to respond under operant schedules of food presentation or termination of stimuli associated with the delivery of shock (escape). 2. CRH decreased food-maintained behavior in a dose-related manner over the range of (0.3-10 micrograms/kg) but did not affect escape responding, demonstrating a selective effect on food-maintained responding. 3. This selective effect was related to the tendency for responding to stop after delivery of a food pellet when higher doses of CRH were given, consistent with the notion that a conditioned aversion to food was established in the presence of CRH. 4. This may suggest that in hyperaroused clinical states such as depression and anorexia nervosa, focus is shifted away from appetitive tasks as a result of increased levels of CRH.     

Primary and secondary lymphomas of the brain: an MRI study

Three types of lymphoma of the central nervous system are known: primary non-Hodgkin's malignant lymphoma (NHML), secondary NHML and neurological lesions of Hodgkin's disease. NHML's are rare tumours, often associated with immunodeficiency and presenting predominantly as neuropsychological disorders. In this study 8 patients were explored by CT and MRI, with pathological confirmation. None of our patients had AIDS. The most typical neuroradiological image of this type of tumour is that of a large and intensely contrast-enhanced tumoral mass which is often multifocal and periventricular with infiltration of the subarachnoidal spaces and leptomeninges. Mass effect and perifocal oedema are less pronounced than expected with tumours of that size. NHML's may totally regress under corticosteroid therapy. This tumour of obscure aetiology must be recognized as it is now increasingly frequent.