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E MOLKE JENSEN K. A. THIESSEN AA. CHRISTENSEN 《Acta anaesthesiologica Scandinavica》1986,30(2):109-110
The effect of 4 mg oral naloxone on preoperative gastric volume and pH of gastric aspirate was studied in a double-blind, randomized study. Twenty patients received 10 ml of naloxone (4 mg) mixed with 10 ml of orange juice, and 20 patients received 10 ml of isotonic saline mixed with 10 ml of orange juice, 2 h before surgery. Gastric content was obtained immediately after intubation of the trachea. No significant difference in gastric volume and pH of gastric aspirate was found between the two groups. It is concluded that naloxone does not affect gastric emptying and gastric acid secretion to a degree great enough to protect against aspiration of gastric contents into the lungs. 相似文献
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The heart has been regarded throughout history as the central core of life and emotions, of kindness and generosity, courage and grief. Cardiac disease can be overwhelming for both the patient and for the partner, and fear of death is a common and quite normal response. Sexual activity after convalescence is a valuable incentive for patients to undergo rehabilitation. Self-confidence and satisfaction can be greatly enhanced by affectionate closeness, and prolonged foreplay can be savored at any age. Sex play is relaxing and healthful whereas anxious sexual preoccupation, frustration, and avoidance may actually be greater risk factors than the mild physical effort involved for coitus or coital alternatives. Male and female patients with cardiac disease expressed regret that their primary physician, cardiologist, or surgeon had not broached the subject of sexual function before or after the acute illness. They were interested, but both patients and physicians were probably uncomfortable with explicit sexual dialogue. Some common sense reminders to post-MI and post-CABS patients about sexual function may be given verbally or in written form, together with diet and exercise instructions. These should include: a heavy meal or heavy alcohol intake before coitus should be avoided; early morning can be an ideal time for coitus or sex play; moderate room temperature is best; a comfortable sexual position can be found with experimentation; chest pain or palpitations are signals to use appropriate medications; and coital death is rare in a stable, long-standing sexual relationship.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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The role of Harrington instrumentation and posterior spine fusion in the management of adolescent idiopathic scoliosis 总被引:1,自引:0,他引:1
T S Renshaw 《The Orthopedic clinics of North America》1988,19(2):257-267
The Harrington instrumentation system was the first widely used, internationally accepted internal fixation system for the correction of idiopathic scoliosis when combined with a spinal arthrodesis. It has been generally available to the orthopedic surgeon for more than 25 years, and therefore its capabilities and limitations have been identified through this long experience. Its implantation requires minimal invasion of the spinal canal and is associated with a low (less than 0.5 per cent) incidence of neurologic complications. It provides predictable correction of spinal deformity with little subsequent loss of correction. When compared with other newer, more complex internal fixation systems for spinal deformities, the Harrington system has a shorter, less difficult "learning curve"; requires less operating time and blood loss to insert; implants a smaller mass of metal; and in some cases costs substantially less for the implant system. The Harrington system has an extremely low incidence of hook dislodgment and pseudoarthrosis formation in single thoracic curves, being reported as near zero for these curves in two recently published series. Conversely, there are some disadvantages to the Harrington system when compared with other types of fixation. It has limited ability to provide sagittal plane control. It does not effectively and predictably derotate the spine. A recent study showed that at an average of 4 years postoperatively, nearly two thirds of the patients had an actual increase in their rib prominence. The pseudoarthrosis rate is high, up to 4 per cent, in the thoracolumbar and lumbar spine. Hook dislodgment approaches 3 per cent when used below the thoracic region. Another disadvantage is the necessity for postoperative external support. As a result, the Harrington system remains an excellent means of treating single and double thoracic idiopathic curves in a safe and predictable manner, while admittedly having limited derotation and sagittal plane control. Other systems that are more sophisticated at segmental fixation of the spine appear to be more appropriate for scoliotic deformities requiring fusion of the thoracolumbar or lumbar spine and those associated with significant sagittal plane deformities. 相似文献