Monitoring cardiac stress using features extracted from S₁ heart sounds.

It is known that acoustic heart sounds carry significant information about the mechanical activity of the heart. In this paper, we present a novel type of cardiac monitoring based on heart sound analysis. Specifically, we study two morphological features and their associations with physiological changes from the baseline state.

Comparison of early outcome from transperitoneal versus transhepatic percutaneous cholecystostomy.

Background/aims: To determine whether there is a statistically significant difference in the short-term clinical outcome in patients undergoing percutaneous cholecystostomy based on the anatomic route of gallbladder puncture that is, transhepatic versus transperitoneal.

Methodology: Our population consisted of 132 patients who: 1) presented with acute cholecystitis, 2) were at high risk for surgery because of comorbid conditions, 3) underwent percutaneous cholecystostomy either using computed tomography guidance or ultrasound guidance and whose anatomic route was known: the transhepatic percutaneous cholecystostomy group comprised 59 patients, the transperitoneal group 73 patients. Demographic characteristics and clinical parameters of the groups were compared statistically, as were postprocedure hospital course, complications and time to hospital discharge.

Evaluation of liver enzymes following elective laparoscopic cholecystectomy: are they really elevated?

Background: Studies made on a small number of patients have demonstrated significant modifications in liver function tests (LFT) following laparoscopic cholecystectomy.

Aim: To assess retrospectively, post-operative LFT in a large group of patients undergoing elective uneventful laparoscopic cholecystectomy.

Methods: Between 1999 and 2007, 1,997 patients were scheduled for laparoscopic cholecystectomy.

Filtered signal-averaged P-wave duration during pneumoperitoneum in patients undergoing laparoscopic cholecystectomy: A reflection of pathophysiological cardiac changes.

Background: Induction of pneumoperitoneum (PP) may lead to adverse cardiac functions secondary to changes such as decreased venous return and hypercarbia. The assessment of cardiac electrical activity by signal averaging may reflect various hemodynamic derangements and serve as a prognostic marker for arrhythmias. The aim of the study is to examine characteristic electrocardiographic changes that may occur during PP, by using signal-averaged P-wave analysis.

Validation and reduction of the oxidative stress following laparoscopic operations: a prospective randomized controlled study.

Objective: To validate ischemia-reperfusion mechanism during laparoscopic cholecystectomy, and to assess the reduction of oxidative stress by an intermittent sequential pneumatic compression (ISPC) device.

Summary Background: Increased intraperitoneal pressure during laparoscopic operations may lead to decreased cardiac output and visceral perfusion, and possible ischemia-reperfusion effects. Using the ISPC device was shown to improve cardiac output and visceral perfusion during pneumoperitoneum (PP).

Fecal impaction in children: report of 53 cases of rectal seed bezoars.

Background: Rectal seed bezoars in children seem to present an uncommon problem that necessitates some operative intervention.

Purpose: Our objective is to determine the occurrence and clinical characteristics of rectal seed bezoars in children with fecal impaction.

Methods: A retrospective review of hospital records of children with discharge diagnosis of fecal impaction was conducted from 1996 to 2005 in a university-affiliated general hospital

Results: The study group is composed 59 children.

Overcoming reduced hepatic and renal perfusion caused by positive-pressure pneumoperitoneum.

Hypothesis: Use of the intermittent sequential pneumatic compression (ISPC) device may improve splanchnic and renal perfusion caused by positive-pressure pneumoperitoneum (PPP) in patients undergoing laparoscopic cholecystectomy.

Design: Prospective controlled study.

Setting: University hospital.

Fecal impaction in adults: report of 30 cases of seed bezoars in the rectum.

Purpose: Seed bezoars in the rectum have been considered an uncommon cause of fecal impaction in adults. Although there have been several reports on sunflower seed bezoars, seed bezoars from the fruit of the prickly pear cactus and watermelon have received little notice. This study was designed to determine the frequency of fecal impaction by seed bezoars in the rectum and their clinical characteristics in adults.

Reversal of adverse hemodynamic effects of pneumoperitoneum by pressure equilibration.

Hypothesis: The creation of positive-pressure pneumoperitoneum during laparoscopic operations can lead to adverse hemodynamic changes, mainly decreased cardiac output. We hypothesized that pneumatic compression sleeves worn on the legs during pneumoperitoneum could abolish the pressure gradient between the abdominal cavity and the legs and so eliminate these adverse hemodynamic changes.

Design: Prospective, randomized, controlled clinical trial with an additional calibration group.

Improving the adverse changes in cardiac autonomic nervous control during laparoscopic surgery, using an intermittent sequential pneumatic compression device.

Background: The creation of positive pressure pneumoperitoneum (PP) may lead to adverse cardiovascular effects during laparoscopic operations. It can also lead to increased sympathetic cardiac activity, that might have serious consequences. We hypothesized that by reversing the hemodynamic effects, the use of intermittent sequential pneumatic compression device (Lympha-press) on the lower extremities would lead to improved cardiac autonomic control.

Laparoscopically assisted approach for postoperative ventral hernia repair.

Background: The laparoscopic approach to incisional hernia repair is already well established because of its advantages. We evaluated the possibility of using a laparoscopically assisted approach whenever conversion to open repair was considered.

Patients And Methods: We operated laparoscopically on 62 patients for postoperative ventral hernia (POVH), seven of whom had undergone laparoscopically assisted repair.

Interposition of a jejunal segment as an alternative one-stage operation for acute left colon obstruction.

Purpose: Much debate surrounds the one-stage surgical management of acute left colon obstruction. Many surgeons are still reluctant to perform primary anastomosis in unprepared bowel fearing the risk of anastomotic dehiscence. Although intraoperative lavage and subtotal colectomy have recently proved effective for preventing fecal loading, both of these procedures have drawbacks and the search for additional alternative surgical procedures continues.