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Biomedical subjects

K J Brouwer

Publications and source records attributed to K J Brouwer.

8 recordsLinked to original sources
PubMed2001

Randomized clinical trial of patient-controlled versus fixed regimen feeding after elective abdominal surgery.

BACKGROUND: Although studies have shown that early oral feeding after abdominal surgery is feasible, many surgeons still advocate a careful, slow introduction of postoperative oral feeding. This study was conducted to investigate whether patient-controlled postoperative feeding is possible in patients undergoing colonic or aortic surgery. METHODS: A randomized clinical trial compared patient-controlled postoperative oral feeding (PC group) with a fixed regimen (FR group). Patients in the PC group (n = 56) received oral feeding when they requested it; patients in the FR group (n = 49) started a normal diet on day 5. Endpoints were time to tolerance of a diet similar to the preoperative diet, reinsertion of a nasogastric tube, complications and duration of hospitalization. RESULTS: Median time to resumption of a normal diet was 3 days in the PC group and 5 days in the FR group (P < 0.001). Reinsertion of a nasogastric tube was required in nine patients in each group (P not significant). The incidence of complications was similar in both groups: 12 of 56 in the PC group and 13 of 49 in the FR group. There was no significant difference in duration of hospital stay between the groups. CONCLUSION: Most patients tolerate a normal diet on the third day after operation. Patient-controlled postoperative feeding is safe and leads to earlier resumption of a normal diet.

Aged↗
PubMed1998

[Topical corticosteroid injection for 'trigger finger': good short-term results, but fairly high risk of recurrence].

OBJECTIVE: To determine the short and long term results of trigger fingers treated with a local injection of corticosteroid. DESIGN: Prospective analysis. SETTING: 'Zuiderziekenhuis', Department of General Surgery, Rotterdam, the Netherlands. METHOD: In 55 patients with 62 trigger fingers the affected flexor sheath was injected with a long-acting corticosteroid. All patients were followed up for at least one year. RESULTS: With one or two steroid injections 60 of the 62 trigger fingers were treated successfully. During the follow-up period the cumulative recurrence rate was 33% after one year. CONCLUSION: The treatment of trigger fingers with a local injection of steroids is a simple and safe procedure but the risk of recurrence in the first year is considerable.

Administration, Topical↗
PubMed1996

Gas explosion during colonic surgery.

Explosions of the colon as a result of the use of diathermy in the presence of gas mixtures of oxygen, hydrogen and/or methane have been previously described in the literature. This danger is present during colonoscopic polypectomy as well as during colonic surgery. The following case is presented to alert to the potential hazards of bowel gas during electrosurgery.

Adult↗
PubMed1994

[Toxic epidermal necrolysis, a life-threatening skin disease].

Toxic epidermal necrolysis (TEN; Lyell's disease) was diagnosed in three patients: an 8-year-old boy and two women aged 39 and 25. Treatment consisted of daily sterile wound care using a synthetic wound covering, oral as well as tube feeding and administration of fluid, electrolytes and albumin. Sepsis developed in 2 patients, and was treated with specific antibiotics. Irreversible sight loss developed in 1 patient. A burns centre offers optimal conditions for treatment because of the combined availability of both nursing and medical expertise and of the required infrastructure needed for antisepsis, climate control and intensive care.

Adult↗
PubMed1981

Rotational deformities after femoral shaft fractures in childhood. A retrospective study 27-32 years after the accident.

Fifty femoral shaft fractures sustained in childhood and for the most part treated conservatively were studied in retrospect 27-32 years after the accident, with special reference to rotational deformity. Femoral rotation was measured by means of so-called anteversion X-rays according to Dunn-Rippstein, and the same radiological examination was carried out in a control group of 100 adult volunteers. The L/R differences in femoral rotation were studied in the patient group in comparison with the control group. Persistent rotational dislocation was found in only one case, and had had no demonstrable untoward consequences. The established view that rotational dislocation is incapable of spontaneous correction is refuted with aid of clinical and experimental data from the literature and personal observations. It is concluded that, in the patients studied, good results have been obtained by the conventional traction methods of Bryant and Russel. The use of the so-called "Weber Bock" to replace these methods is therefore not recommended.

Adolescent↗