Medication-induced acute esophageal necrosis: a case report.

Background: Acute esophageal necrosis or Gurvits syndrome is a rare clinical condition characterized by necrotic esophageal mucosa with an abrupt end at the gastroesophageal junction. Its etiology is multifactorial, but mainly related to low-flow states. We describe a case in which a patient accidentally took the wrong medication, with clozapine and olanzapine most probably being the cause of his subsequent acute esophageal necrosis.

[Emergency craniotomies at the North Karelia Central Hospital in 2006 to 2014].

Traditionally, acute evacuations of traumatic intracranial hematomas are performed by neurosurgeons in university hospitals. However, most patients with traumatic brain injury are initially transported to regional hospitals that lack neurosurgical expertise. Thus, a trauma surgeon in a regional hospital may encounter a patient with an expanding hematoma that must be operated without delays.

[Thoracic lavage and open cardiac massage as treatment of hypothermic cardiac arrest--case report].

Cardiopulmonary bypass is the treatment of choice for a severely hypothermic patient with cardiac arrest. However, the treatment is not always available. We describe a successful three-and-a-half hour resuscitation of a hypothermic cardiac arrest patient with manual chest compressions followed by open cardiac massage and rewarming with thoracic lavage.

Randomized Multicenter Trial Comparing Glue Fixation, Self-gripping Mesh, and Suture Fixation of Mesh in Lichtenstein Hernia Repair (FinnMesh Study).

Objective: Three different mesh fixation techniques were compared to find out how to perform a safe and cost-effective open inguinal hernioplasty in day-case setting with the best outcomes with regard to chronic pain.

Summary Background Data: Mesh fixation method may influence on the incidence of chronic pain after Lichtenstein hernioplasty.

Methods: Lichtenstein hernioplasty was performed under local anesthesia in 625 patients as day-case surgery in 8 Finnish hospitals.

Vascular comorbidities and demographics of patients with ruptured abdominal aortic aneurysms.

Background: The results of previous studies reporting the epidemiology of ruptured abdominal aortic aneurysm (RAAA) are highly heterogeneous. Furthermore, although RAAA and the preceding abnormal dilation of the abdominal aorta (AAA) are associated with other cardiovascular comorbidities, the demographic profile of all patients with RAAA has not been thoroughly investigated.

Objective: To document accurately the epidemiology, survival, and demographic data (including vascular comorbidities and previous use of health care services) in RAAA-patients.

The prevalence of abdominal aortic aneurysm is consistently high among patients with coronary artery disease.

Objective: Emerging evidence suggests high prevalence of abdominal aortic aneurysm (AAA) among patients with coronary disease. Accurate characterization of the association between coronary disease and AAA and of the actual prevalence of AAA among patients with angiography-verified coronary artery disease (CAD) is needed to evaluate the possible benefits of systematic screening for AAA.

Methods: We searched for studies that reported the association between AAA and CAD or coronary heart disease (CHD; wider phenotype definition) in the general population (randomized controlled trials, prospective population cohorts) and those that reported the prevalence of AAA among patients with angiography-verified CAD through PubMed, Embase, and reference lists for the period between 1980 and 2014.

Screening Men with Coronary Heart Disease for Abdominal Aortic Aneurysm: A Prospective Cohort Study.

Background: The prevalence of abdominal aortic aneurysms (AAA) is higher among patients with coronary heart disease (CHD) compared with control population.

Objective: To assess and determine the prevalence of non-diagnosed AAA in men with CHD.

Materials And Methods: A total of 438 active male out-patients with CHD were screened for AAA by abdominal ultrasound (US) examination.

Open Mesh Repair for Inguinal Hernia is Safer than Laparoscopic Repair or Open Non-mesh Repair: A Nationwide Registry Study of Complications.

Background: Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-mesh (OS) repairs and laparoscopic (LAP) repairs using retrospective nationwide registry data.

Rewarming a patient with accidental hypothermia and cardiac arrest using thoracic lavage.

The optimal treatment for severe accidental hypothermia is cardiopulmonary bypass because this offers the most rapid rate of rewarming. However, cardiopulmonary bypass therapy is not available in every hospital. In these circumstances, rewarming has to be achieved with other methods.

[Epiglottitis and necrotizing mediastinitis in a middle-aged man].

Acute epiglottitis is nowadays a rare bacterial infection. Airway management and promptly started antimicrobial medication are essential in the treatment. Descending necrotizing mediastinitis is a life-threatening bacterial infection that typically spreads from an odontogenic, pharyngeal or neck infection.

Fatal surgical or procedure-related complications: a Finnish registry-based study.

Introduction: In Finland, all healthcare personnel must be insured against causing patient injury. The Patient Insurance Centre (PIC) pays compensation in all cases of malpractice and in some cases of infection or other surgical complications. This study aimed to analyze all complaints relating to fatal surgical or other procedure-related errors in Finland during 2006-2010.

Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report.

Introduction: A blunt thoracic trauma may cause arterial bleeding requiring operative treatment or endovascular embolization or endovascular aortic stenting. A novel damage control technique to stop such bleeding is presented.

Case Presentation: We present the case of an 82-year-old Caucasian man who experienced rib fractures I-VII on the left side and bleeding from damaged intercostal arteries after a blunt thoracic trauma.

Effect of triclosan-coated sutures on the incidence of surgical wound infection after lower limb revascularization surgery: a randomized controlled trial.

Background: Surgical wound infection (SWI) is a common complication after peripheral vascular surgery. In a prospective study, triclosan-coated sutures were reported to decrease the incidence of surgical site infection after various surgical procedures. The aim of our study was to test the hypothesis that use of triclosan-coated sutures decreases the incidence of SWI after lower limb vascular surgery.

Supplemental postoperative oxygen in the prevention of surgical wound infection after lower limb vascular surgery: a randomized controlled trial.

Background: Surgical wound infection (SWI) is a common complication after peripheral vascular surgery. Infections increase morbidity and costs of treatment. The aim of the present study was to test the hypothesis that supplemental postoperative oxygen decreases the incidence of SWI after lower limb revascularization.

Metoprolol versus amiodarone in the prevention of atrial fibrillation after cardiac surgery: a randomized trial.

Background: Current guidelines recommend β-blockers as the first-line preventive treatment of atrial fibrillation (AF) after cardiac surgery. Despite this, 19% of physicians report using amiodarone as first-line prophylaxis of postoperative AF. Data directly comparing the efficacy of these agents in preventing postoperative AF are lacking.

[Gas in the abdominal cavity--due to cholecystitis caused by gas-producing bacteria].

In most cases, gas in the abdominal cavity indicates perforation of the gastrointestinal wall. We describe a patient, in whom the cause of abdominal gas detected in computed tomography turned out to be emphysematous cholecystitis caused by gas-producing bacteria. It is a rare disease characterized by accumulation of gas into the gall bladder or its wall.

Right-sided Bochdalek hernia in an adult: a case report.

Introduction: Bochdalek hernia is a type of congenital diaphragmatic hernia that typically presents in childhood - the clinical manifestation of symptoms and diagnosis in adults is extremely rare. There are fewer than 20 cases of right-sided Bochdalek hernia reported in adults in the literature.

Case Presentation: We review a case of a 38-year-old woman with a right-sided Bochdalek hernia who was experiencing abdominal pain and pleural effusion.

Lichtenstein hernioplasty versus totally extraperitoneal laparoscopic hernioplasty in treatment of recurrent inguinal hernia--a prospective randomized trial.

Objective: To compare the Lichtenstein hernioplasty with a totally extraperitoneal preperitoneal laparoscopic technique (TEP) in treatment of recurrent inguinal hernias.

Summary Background Data: Only a few studies thus far have compared an open and laparoscopic approach with the treatment of recurrent inguinal hernia in a prospective randomized study setting.

Methods: Ninety-nine patients undergoing surgery for recurrent inguinal hernia were prospectively randomized into having either open or laparoscopic mesh repair.

Preoperative alterations in correlation properties and complexity of R-R interval dynamics predict the risk of atrial fibrillation after coronary artery bypass grafting in patients with preserved left ventricular function.

Introduction: We evaluated whether there are constant preoperative alterations in nonlinear R-R interval dynamics that associate with the risk of postoperative atrial fibrillation in patients with preserved left ventricular function.

Methods: We analyzed mean normal-to-normal R-R intervals, short-term scaling exponent of detrended fluctuation analysis (DFA alpha(1)), approximate entropy and entropy of symbolic dynamics (SymDyn En) from 10-minute ECG recordings during rest, paced breathing, and passive tilt performed 1 day before surgery in 67 elective coronary artery bypass grafting patients.

Results: Nineteen patients developed postoperative atrial fibrillation.