Fifty Percent Reduction in Narcotic Use After Minimally Invasive Cardiac Surgery Using Liposomal Bupivacaine.

Objective: Minimally invasive cardiac surgery via a right minithoracotomy (RMT) is a common approach to different valve pathologies, tumor resection, and atrial septal defect (ASD) closure. We studied intraoperative field block using liposomal bupivacaine (LB) in these operations.

Methods: Consecutive 171 minimally invasive RMTs (fourth intercostal space) were studied, and patients in cardiogenic or septic shock, intravenous drug abuse, and those re-explored were excluded ( = 12).

Evidence of altered homocysteine metabolism in chronic renal failure.

The fasting serum concentrations of total homocysteine and metabolites of transsulfuration (cystathionine, cysteine, methylmalonic acid, 2-methylcitric acid) and remethylation (methionine) were determined by gas chromatography-mass spectrometry in 40 nondialyzed patients with chronic renal disease and in 50 patients with end-stage renal disease requiring chronic maintenance hemodialysis. The nondialyzed patients and 28 of the dialysis patients did not receive additional vitamin supplementations. Twenty-two of the dialysis patients received daily oral vitamin preparations containing 10 mg pyridoxine (vitamin B(6)), 6 microg cyanocobalamin (vitamin B(12)), and 1 mg folic acid.

Hyperhomocysteinemia and the risk for vascular disease in hemodialysis patients.

The objective of this study was to examine if hyperhomocysteinemia is associated with occlusive vascular disease in hemodialysis patients. The study design included risk factor analysis and determination of serum homocysteine in hemodialysis patients. Fifty chronic uremic patients on regular hemodialysis treatment were studied.

A new central supply system as alternative source for bicarbonate dialysate.

Bicarbonate dialysis is mandatory for high efficiency treatment. In most cases bicarbonate is delivered either as prepacked powder or as a stable liquid concentrate in 6-10 I plastic containers. With a newly designed central supply system (CSS) using 800 I tanks of custom-made sterile and pyrogen free concentrates, we investigated the risk of bacterial contamination of dialysate in a 30-bed dialysis unit.

[Parathyroid sonography in long-term dialysis].

In a prospective study the prevalence of sonographically enlarged parathyroid glands in patients on maintenance hemodialysis was investigated and correlated with clinical and laboratory findings of secondary hyperparathyroidism. We examined 97 unselected patients with a 5 MHz probe. In 34% (33/97) a total of 69 parathyroid glands were detected with a statistically significant correlation between the period of dialysis and the incidence of parathyroid enlargement; 47.