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Pneumoperitoneum causes intracranial pressure elevation and blood stasis at lower extremities. This study investigates cerebral oxygen saturation changes during laparoscopy and the effects of intermittent sequential compression (ISC) of the lower extremities in patients during elective laparoscopic cholecystectomy. Sixty patients were randomly divided into two groups according to the application of ISC to the lower extremities. Group I served as control group whereas ISC was applied to group II. Cerebral oxygen saturation, peripheral blood oxygen saturation, heart rate, mean blood pressure, and associated changes have been recorded during the operation. Peripheral blood oxygen saturation and mean blood pressure values did not change significantly after pneumoperitoneum. Cerebral oxygen saturation levels of the group II patients were higher in than the group I patients and the difference between the groups was statistically significant ( p = 0.0001). The difference became more prominent following the 35th minute of the operation. Mean heart rate of the patients in group II was lower than the patients in group I and the difference was also statistically significant ( p = 0.0001). In this study, it was found that the decrease in cerebral oxygen saturation was recovered with ISC application. This simple and reliable technique helps to restore cerebral oxygen saturation levels while increasing blood return from the lower extremities. [ABSTRACT FROM AUTHOR]

Aim: Today, in inguinal hernia repair, postoperative pain and costs are regarded as equally important issues as technique and recurrence rates. Postoperative pain is thought to vary according to the applied anesthesia method. As local anesthesia is reported to inflict less pain, its effects on early period post-operative complications should also be evaluated.Methods: Two hundred patients, on whom Lichtenstein tension free hernia repair had been performed due to unilateral inguinal hernia between March 2004 and July 2005, were prospectively examined. The patients were randomized according to the anesthesia applied. They were divided into two groups: local anesthesia (LA) and spinal anesthesia (SA). The early post-operative complications, post-operative pain scores, and operation durations of the patients, were evaluated.Results: Local anesthesia was found not to increase the post-operative complications; on the contrary, it was shown to prevent the complications of spinal anesthesia. Although visual analogue pain score (VAS) values at 4, 8, 12, and 24 h post-operation were found to be lower than the SA group, the difference between was not significant. Also, it was discovered that LA did not retard the operation duration.Conclusion: Local anesthesia reduces post-operative pain and facilitates patients' mobilization and discharge along with decreasing the early post-operative complications. Thus, LA is a safe and advantageous method to be applied in inguinal hernia repair. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MS) is the term that encompasses metabolic risk factors that may lead to atherosclerotic cardiovascular disease. This study was undertaken to investigate the prevalence of MS in patients with ischemic cerebrovascular disease (CVD), according to National Cholesterol Education Program/Adult Treatment Panel III (ATP III) criteria. A total of 40 patients who were referred to the emergency department and given a diagnosis of CVD were included in this study. Detailed medical histories, physical examination findings, heights, weights, and waist circumferences of patients were recorded. Fasting blood glucose levels and lipid profiles of patients were evaluated. Those with hypertension, diabetes, or hyperlipidemia were regarded as meeting at least 1 of the ATP III criteria. Study results were compared, especially between females and males. In all, 55% of patients were female, and 70% were older than 65 y. Blood pressure over 130/85 mm Hg was assessed in 60% of patients. Among female patients, 81.8% had a waist circumference greater than 88 cm; 50% of male patients had a waist circumference over 102 cm. A fasting blood glucose level above 110 mg/dL was identified in 57.5% of patients. Serum triglyceride levels in 30% of patients were above 150 mg/L. It was noted that 33.3% of male patients had a high-density lipoprotein (HDL) level below 40 mg/L, and in 68.2% of female patients, an HDL level below 50 mg/dL was recorded. According to these findings, 14 of 22 female patients (64%) and 13 of 18 male patients (72%) were identified as having MS. High rates of stroke associated with MS reveal the importance of forthcoming preventive approaches. [ABSTRACT FROM AUTHOR]

Adult intussusception occurs infrequently and differs from the childhood condition in its presentation, cause, and treatment. Nonspecific symptoms can delay diagnosis; most cases are diagnosed at emergency laparotomy. Increased use of computed tomographic scanning to evaluate patients with abdominal pain can enhance reliable preoperative diagnosis. Treatment entails simple bowel resection in most cases. Reduction is controversial, especially in cases of colonic intussusception. This report describes the diagnosis and management of a case of adult ileal intussusception caused by an inflammatory fibroid polyp-a rare lesion of the gastrointestinal tract. [ABSTRACT FROM AUTHOR]