Diagnosis The classic history is of the patient who begins his or her symptoms by awakening at night with numbness and pain in the median nerve distribution of his or her hand(s). This progresses to daytime symptoms that are often aggravated by activities.1,2 The occurrence of “dropping objects” in carpal tunnel syndrome patients is an index of elevated disease severity.3 Carpal tunnel symptoms...

Approximately 100 million people undergo noncardiac surgery annually worldwide. It is estimated that around 3% of patients undergoing noncardiac surgery experience a major adverse cardiac event. Although cardiac events, like myocardial infarction, are major cause of perioperative morbidity or mortality, its true incidence is difficult to assess. The risk of perioperative cardiac complications d...

Despite several advances in the understanding of the pathophysiology of achalasia, treatment remains palliative as the neuronal defect of the disease seems to be irreversible. Currently, the most effective treatment options are graded endoscopic pneumatic dilation and laparoscopic Heller myotomy with partial fundoplication. Although both treatments seem to have similar efficacy in the short-ter...

More than 90 percent of all amputations are now due to the complications of chronic disease. Because most amputations can be anticipated, the preoperative period allows the opportunity for psychological preparation of the patient. This article highlights the important contribution family physicians can make before patients undergo amputation. Common patient reactions before and after amputation...

Echocardiographic studies of the mitral valve were performed in 57 patients with pure or predominant mitral stenosis who subsequently underwent surgery (30 commissurotomy, 27 valve replacement). Mitral valve calcification was graded heavy (thick, conglomerate echoes), light (multiple, discrete linear echoes) or none (thin, single or duplicate signals). Valve mobility, measured as the excursion ...

Preoperative cardiac evaluation is aimed at evaluating the patient's current medical status, making recommendations concerning the risk of cardiac problems in the perioperative period, and providing a clinical risk profile that the patient, primary physician, consultants, anesthesiologist, and surgeon can use in making treatment decisions. Patients can be stratified on clinical grounds into low...

In the linked study by Coura and collaborators , it is reported that acupuncture the day before surgery can reduce postoperative pain (see article on page 16). 1 Although the study is small and there are gender differences between the groups, the fi ndings are novel, suggesting that acupuncture may be used the day before surgery rather than given in the immediate preoperative period. This sugge...

This study aimed to investigate the prognostic value of the preoperative neutrophil to lymphocyte ratio (NLR) in resectable gastric cancer (GC). This was a retrospective review of 1030 patients with resectable GC managed between 2005 and 2011. Patients were stratified into 2 groups, those with a preoperative NLR >3.44 and those with a preoperative NLR ≤ 3.44. Clinicopathological data affecting ...

conclusions administration of albumin compared to hes in patients with a normal renal function results in a lower drop of gfr and platelet count, less bleeding and lower rise of serum creatinine. background the ideal strategy to prime the cardiopulmonary bypass (cpb) circuit in adult cardiac surgery is still a matter of debate. objectives in this retrospective study, we examined albumin solutio...