ITEMS IN AFP WITH MESH TERM:
Who Should Operate in Carotid Disease? - Editorials
Preoperative Evaluation - Article
ABSTRACT: A history and physical examination, focusing on risk factors for cardiac, pulmonary and infectious complications, and a determination of a patient's functional capacity, are essential to any preoperative evaluation. In addition, the type of surgery influences the overall perioperative risk and the need for further cardiac evaluation. Routine laboratory studies are rarely helpful except to monitor known disease states. Patients with good functional capacity do not require preoperative cardiac stress testing in most surgical cases. Unstable angina, myocardial infarction within six weeks and aortic or peripheral vascular surgery place a patient into a high-risk category for perioperative cardiac complications. Patients with respiratory disease may benefit from perioperative use of bronchodilators or steroids. Patients at increased risk of pulmonary complications should receive instruction in deep-breathing exercises or incentive spirometry. Assessment of nutritional status should be performed. An albumin level of less than 3.2 mg per dL (32 g per L) suggests an increased risk of complications. Patients deemed at risk because of compromised nutritional status may benefit from pre- and postoperative nutritional supplementation.
Nodule Arising in a Surgical Scar - Photo Quiz
ABSTRACT: Laparoscopic adjustable gastric banding procedures have a favorable risk-benefit profile and are increasingly important as part of the overall management of obesity. These procedures are effective at inducing weight loss and improving comorbid conditions, including diabetes mellitus, hypertension, and sleep apnea. Laparoscopic adjustable gastric banding has several typical complications, and family physicians should recognize these as part of a team-based approach to the management of obesity. Gastric band slippage, port or tubing malfunction, stomal obstruction, band erosion, pouch dilation, and port infection are examples of complications that may occur after laparoscopic adjustable gastric banding. Upper gastrointestinal tract imaging is often required to diagnose these complications. Some complications can be managed in the primary care setting through behavioral diet modification or removal of fluid from the band (band deflation); however, other complications require surgical repair or removal of the band.
Common Questions About Vasectomy - Article
ABSTRACT: Vasectomy offers a safe, effective, and permanent method of male contraception, with an overall failure rate of less than 1% in pooled studies. Men older than 30 years in a stable, committed relationship appear to be the best candidates for vasectomy. The no-scalpel technique reduces operative complications, shortens operative time, and hastens resumption of sexual activity. Use of a jet injector instead of a needle to provide local anesthesia (no-needle vasectomy) may reduce pain. Bleeding and infection are short-term complications of vasectomy; long-term complications include sperm granuloma and postvasectomy pain syndrome. One postvasectomy semen analysis demonstrating azoospermia performed after three months and 20 ejaculations is sufficient to establish sterility. Vasectomy reversal is more likely to be successful if performed less than 15 years after vasectomy and in men whose female partner is younger than 40 years.