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The article examines the long-term outcomes of post-operative hypocalcemia by reviewing the management protocol for post-thyroidectomy hypocalcemia at the Hospital del Mar in Barcelona, Spain. It reports that 37.9% of 222 patients who contracted hypocalcemia after undergoing total thyroidectomy between 1993 and 2007 further developed protracted hypoparathyroidism (HPP). It also observes that patients with higher serum calcium levels one month after surgery are more likely to recover parathyroid functions within the first postoperative year.

Aim To assess the pathophysiology and treatment of neurogenic dysphagia. Methods 46 patients with brain damage, 46 with neurodegenerative diseases and eight healthy volunteers were studied by videofluoroscopy while swallowing 3–20 mL liquid (20.4 mPa s), nectar (274.4 mPa s) and pudding (3931.2 mPa s) boluses. Results Volunteers presented a safe and efficacious swallow, short swallow response (≤740 ms), fast laryngeal closure (≤160 ms) and strong bolus propulsion (≥0.33 mJ). Brain damage patients presented: (i) 21.6% aspiration of liquids, reduced by nectar (10.5%) and pudding (5.3%) viscosity ( P < 0.05) and (ii) 39.5% oropharyngeal residue. Neurodegenerative patients presented: (i) 16.2% aspiration of liquids, reduced by nectar (8.3%) and pudding (2.9%) viscosity ( P < 0.05) and (ii) 44.4% oropharyngeal residue. Both group of patients presented prolonged swallow response (≥806 ms) with a delay in laryngeal closure (≥245 ms), and weak bolus propulsion forces (≤0.20 mJ). Increasing viscosity did not affect timing of swallow response or bolus kinetic energy. Conclusions Patients with neurogenic dysphagia presented high prevalence of videofluoroscopic signs of impaired safety and efficacy of swallow, and were at high risk of respiratory and nutritional complications. Impaired safety is associated with slow oropharyngeal reconfiguration and impaired efficacy with low bolus propulsion. Increasing bolus viscosity greatly improves swallowing function in neurological patients. [ABSTRACT FROM AUTHOR]

Background: The prevalence of enterococcal isolation and factors associated with postoperative enterococcal infection remain ill defined. Methods: A prospective longitudinal observational study was conducted of consecutive patients with a first episode of intra-abdominal infection and a positive microbiological culture who did or did not develop a postoperative septic complication involving enterococci. The prevalence of initial enterococcal isolation was determined for each focus of infection. Postoperative enterococcal infections were related to whether appropriate (piperacillin–tazobactam), suboptimal (carbapenems) or inappropriate (cefotaxime plus metronidazole) antienterococcal therapy had been administered empirically. Results: Enterococci were isolated in 42 (21 per cent) of the 200 patients investigated. The isolation rates were 11 per cent for community-acquired peritonitis, 50 per cent for postoperative peritonitis and 23 per cent for intra-abdominal abscesses of both origins. No enterococci were isolated from 49 patients with perforated appendicitis. Independent factors for postoperative enterococcal infection were type of intra-abdominal infection (P = 0·006), Acute Physiology And Chronic Health Evaluation (APACHE) II score greater than 12 (P = 0·04) and inappropriate empirical antibiotic cover (P = 0·05). Postoperative enterococcal infections were associated with a high mortality rate (21 versus 4 per cent; P < 0·0007). Conclusion: Enterococci are frequently isolated from intra-abdominal infections of non-appendiceal origin and are often involved in postoperative infectious complications, particularly peritonitis. Empirical antibiotic therapy covering Enterococcus faecalis should be contemplated in some circumstances. [ABSTRACT FROM AUTHOR]

An abstract of the article "Accuracy of ultrasound in the diagnosis of molar pregnancy," by S. Cano and colleagues, is presented.