Mycobacterium fortuitum Infection Occurring After a Punch Biopsy Procedure

Abstract: Mycobacterium fortuitum is a rapidly growing atypical mycobacterium frequently reported as a postsurgical wound complication from a major surgical procedure. We present a unique case of M. fortuitum infection occurring in a 4-year-old boy after a minor punch biopsy surgical procedure. As far as we know there has been no published case of M. fortuitum occurring after a punch biopsy procedure.     

Fiberoptic colonoscopy: Complications of colonoscopy and polypectomy

Summary Members of the American Society of Colon and Rectal Surgeons were polled regarding complications of colonoscopy and polypectomy. Sixty per cent of the members responded. One hundred sixty-two surgeons were found to be performing colonoscopy, and this paper presents the accumulated data on complications. A total of 20,139 colonoscopies were performed, with 12,746 diagnostic procedures and 7,393 polypectomies. The overall complication rate was 0,4 per cent with diagnostic colonoscopy and 1.8 per cent with polypectomy. Based upon these complications, guidelines in regard to history, preparation, and technique of colonoscopy and polypectomy are discussed.     

Therapeutic Modalities for the Prophylactic Management of Postoperative Nausea and Vomiting

The occurrence of postoperative nausea and vomiting (PONV) remains one of the most common complications after general anesthesia. The causes of PONV are multimodal, involving several physiologic pathways that stimulate the vomiting center, including the chemoreceptor trigger zone, the gastrointestinal tract, the vestibular system, the cerebral cortex, and the midbrain. Significant research has been published focusing on the use of different pharmacologic agents and varying anesthetic techniques to prevent and manage PONV. The addition of therapeutic modalities to the arsenal of prophylactic management techniques may decrease patient incidence of PONV by directing treatment to various pathways that stimulate the vomiting center. The purpose of this article is to review briefly the literature and discuss three therapeutic modalities for preventing PONV: perioperative oxygen administration, perioperative intravenous fluid administration, and differing fasting protocols.     

Further consideration of the minimum dose of histalog necessary to provoke a maximal secretory response

The purpose of the study was to determine the minimal dose of intramuscular Histalog necessary to evoke a maximal gastric acid response. A brief review of some of the reported side effects of Histalog was made. Analysis of previous studies led to the conclusion that the proper dose of Histalog was in the range of 1.5–2.0 mg/kg body weight. Some possible reasons for the discrepancy in dose recommendations are pointed out. Ten subjects were tested with intramuscularly administered alternate doses of 1.5 and 2.0 mg Histalog per kilogram body weight. The results were expressed in terms of maximal acid output per hour. There was no statistical difference in the results. It was concluded that the proper dose of intramuscularly administered Histalog for the augmented Histalog gastric analysis is 1.5 mg/kg.Supported by funds allocated to Work Unit MR005.20-0212A by Bureau of Medicine and Surgery, Department of the Navy.The authors wish to express their appreciation to CFR B. D. Stout, MC, USN, for the performance of statistical analysis of the data, and to Capt. J. William Cox, MC, USN, Chief of Medicine and Director of Research, for his helpful comments and criticism, and for help in obtaining necessary equipment.The opinions expressed herein are those of the authors and cannot be construed as reflecting the views of the Navy Department or of the naval service at large.     

Satisfaction and use of a spiritually based mantram intervention for childbirth-related fears in couples

This study assessed patient satisfaction with the use of a spiritually based (mantram/sacred word) intervention in expecting couples. A mixed-methods design, experimental repeated measures with interviews at 6-month follow-up was conducted. Satisfaction was moderate to high. Mantram was used for labor pains and uncertainty. Implications include scheduling flexible classes earlier in pregnancy. A larger randomized study is needed to assess intervention effectiveness.