Anastomotic Pseudoaneurysms: Our Experience with 49 Cases

We investigated the factors implicated in the pathogenesis of anastomotic aneurysm formation and the postoperative course of patients with such a complication. Forty-five patients with 49 anastomotic aneurysms were diagnosed and treated in two vascular surgery departments in Athens, Greece, during an 8–year period. Emergent complications occurred in 15 cases, rupture in 11, and thromboembolic episodes in another four. Preoperative diagnostic workup in the remaining elective cases (n = 34) included color duplex scan, computed tomographic scan, and angiography. All patients underwent operation, and cultures were obtained during the surgical procedures. Histological examination of the host artery wall adjacent to the aneurysm was also performed. Aortobifemoral bypass was the original operation performed in the majority of cases (71%), and the femoral anastomosis was the most frequent site involved (85.7%). Emergent procedures were associated with increased mortality (46.6%), whereas elective operation resulted in high patency rates and no mortality. In an attempt to isolate predisposing factors that contributed to aneurysm formation, we concluded that the etiology was multifactorial in approximately one-third of the cases and degenerative host artery disease was the main cause (40%). Arterial degeneration is the leading cause of anastomotic aneurysm formation, and emergency arterial reconstruction in cases of aneurysm complication is associated with a poor prognosis.     

A comparative evaluation of the neurotoxic properties of ketamine and nitrous oxide

The general anesthetics, nitrous oxide (N₂O) and ketamine, are NMDA antagonists which, like other NMDA antagonists such as MK801, induce a neurotoxic reaction in the rat brain. For MK801 neurotoxicity, both age and sex are important variables (adult rats are more sensitive than immature rats and females are more sensitive than males). In this study we found that ketamine has this same age and sex dependency profile, and N₂O has the same age but not sex dependency. Male and female rats are equally sensitive to N₂O neurotoxicity.     

ABO血型不合红细胞输注的临床转归

在过去的30年中,输血安全有了巨大的进步,大部分感染性风险下降,然而,输血仍然有致病和致死的潜在风险.对于受血者来说,最大的风险之一是来自于差错导致输入了不正确的血液成分.