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At least 109 records · Page 6Linked to original sources
PubMed1994

[The efficacy of naftidrofuryl on unexpected autonomic symptoms following carpal tunnel surgery].

Symptoms of sympathetic lability occur 30 days after carpal tunnel surgery in about 2.6% cases. A double-blind placebo controlled clinical trial of naftidrofuryl was conducted in 195 patients. It demonstrated that these symptoms occur during the two-week-period after surgery, and that some patients are particularly exposed to an unexpected course (i.e. women and more than 50 years) during the third and fourth weeks after surgery. In this study, patients treated with naftidrofuryl showed a reduction of some symptoms of sympathetic lability, and stabilisation of the unfavourable course observed in patients with placebo; this preventive efficacy of naftidrofuryl could be due to its 5-HT2 receptor blocking action, which is responsible for vasoconstriction and platelet and erythrocytes aggregation. Naftidrofuryl though improves arteriolar haemodynamics, limiting the development of pain and oedema.

Age Factors↗
PubMed1987

Parathyroid imaging: its current status and future role.

The management of autonomous (primary or tertiary) hyperparathyroidism is controversial for two important reasons: (1) Diagnosis of primary or tertiary hyperparathyroidism (as distinct from reactive or secondary hyperparathyroidism) has been revolutionized in the past 20 years as a result of routine inclusion of serum calcium concentration assays in serum multiautomated analysis, now obtained routinely for both hospitalized as well as ambulatory patients. The prevalence of primary hyperparathyroidism in the general population has appeared to rise as a consequence of this assay and the enhanced detection of this disease. This situation has confused the management of hyperparathyroidism since most patients now present with asymptomatic disease, and the need for surgical treatment is controversial in asymptomatic individuals. (2) Primary hyperparathyroidism usually is caused by hypersecretion of parathyroid hormone by an autonomously functioning parathyroid adenoma. In a small percentage of cases, multigland hyperplasia is present. In experienced hands, surgical removal of an adenoma within the thyroid bed cures the hyperparathyroidism 90% to 95% of the time, without performance of a preoperative procedure to localize the adenoma. Approximately 10% of parathyroid tissue is ectopic in location, however. Furthermore, approximately two thirds of "missed" adenomas are within the thyroid bed. Reexploration in the event of a failed operation therefore is not an uncommon occurrence. Parathyroid localization procedures clearly are indicated in patients with primary hyperparathyroidism who have evidence of persistent disease after a failed attempt at surgical cure. In patients first presenting with primary hyperparathyroidism, the need for a localization procedure is less clear, since surgery appears to be successful much of the time without it. Regardless of the nature of the above controversies, surgery for autonomous hyperparathyroidism continues, and localization procedures become more popular. Preoperative localization procedures such as angiography and venography with venous sampling for parathormone are cumbersome and invasive. Noninvasive tests to localize the parathyroid glands have emerged in the past 10 years, including dual tracer radionuclide scintigraphy with 201-thallous chloride and 99m-technetium pertechnetate, high-resolution computer tomography, and fine parts ultrasonography. Dual tracer scintigraphy with thallium and technetium is reported to have a localization sensitivity of 70%-90%. False-negative studies occur primarily in patients with small adenomatous or hyperplastic glands.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1991

Indications, surgical treatment and after-care in juvenile hyperthyroidism.

Between 1974 and 1985, 12 children and adolescents aged 10-18 years were operated on for immunogenic hyperthyroidism resistant to medical treatment. Bilateral, subtotal strumectomies were carried out, leaving a remnant of 2-3 g of thyroid tissue in place. There were no immediate postoperative complications. Hyperthyroidism recurred in two instances. During the same time, 26 children and adolescents up to 18 years of age underwent surgery for autonomous adenoma. Enucleation is the method of choice in adenoma, but is not always possible.

Adolescent↗
PubMed1987

Experience in vibratory and electro-ejaculation techniques in spinal cord injury patients: a preliminary report.

More than 90 per cent of complete spinal cord injury patients have major fertility problems, depending upon the site and type of injury. During the last 5 years 34 patients were treated by vibratory and/or electrostimulation at our center, and semen was produced in all but 5. In 8 patients ejaculation was attempted by vibratory stimulation alone and in 22 electrostimulation also was used. Vibratory stimulation is the easier and less cumbersome of the 2 methods. No major side effects were noted with either technique. Stimulation was performed by a rectal electrode incorporated in a silicone finger glove with a current of 0.1 msec. in duration, a frequency of 30 Hz. and an average of 60 volts. Vibratory stimulation was applied to the frenulum and/or glans penis with a specially constructed vibrator at a frequency of 80 Hz. and a peak-to-peak oscillation of 1.6 to 2.4 mm. Semen obtained during the first 6 months after injury was not of a quality consistent with successful fertilization owing to poor motility. However, semen quality and motility were better in patients who had been injured for more than 6 months. Repeated electro-ejaculation did not improve the quality of semen. The effects of bladder outlet surgery and autonomic blockers were noted in 5 patients.

Adolescent↗
PubMed1980

[Thyreotrophic hypophysial function after surgery for euthyroid goiter or autonomous adenoma].

44 euthyroid patients with nodular goiter and 23 patients with autonomous adenomas were treated by hemithyrectomy or subtotal thyrectomy. Thyroid function was followed over 6 weeks post-operation by TRH tests, which were performed before and at the 5th, 14th, 28th and 42nd day after operation. Bilateral subtotal thyrectomized patients with euthyroid goiter showed a continous increase of basal and TRH stimulated TSH level into the hypothyroid range. 19 of 25 patients were hypothyroid 6 weeks after operation. In contrast, 14 of 19 hemithyrectomized patients with euthyroid goiters remained euthyroid during the time investigated; 5 patients showed a transient TSH increase into the hypothyroid range but were euthyroid again after 6 weeks. TSH levels obtained from patients operated for autonomous adenoma may not yet reflect thyroid function during the time interval investigated here. We conclude that all patients with euthyroid goiter after bilateral subtotal thyrectomy should receive hormone substitution because they are at high risk to develop recurrency. However, we propose that in patients hemithyrectomized for euthyroid goiters the decision of long term hormone substitution should be cased on the result of a TRH-test 3--4 month after operation. Substitution with thyroid hormone should be preferred to iodide because it is unclear yet how far a failure in iodide organification and hormone synthesis is the reason for goiter recurrency.

Adenoma↗
PubMedDate not supplied

Avoiding long-term disturbance to bladder and sexual function in pelvic surgery, particularly with rectal cancer.

Urinary and sexual dysfunction are common problems after rectal cancer surgery, and the likely cause is damage to the pelvic autonomic nerves during surgery. In recent years, attention has been focused on preserving the autonomic nerves through a technique which is usually combined with total mesorectal excision or radical pelvic lymphadenectomy. The autonomic nerves consist of the paired sympathetic hypogastric nerve, sacral splanchnic nerves, and the pelvic autonomic nerve plexus. We will demonstrate the anatomy of the pelvic autonomic nerves and the relation of these nerves to the mesorectal fascial planes, and review the medical literature on sexual and urinary dysfunction after rectal cancer surgery with and without autonomic nerve preservation.

Autonomic Nervous System↗
PubMed2004

Impairment of cardiovascular autonomic control in patients early after cardiac surgery.

OBJECTIVE: Impairment of the baroreceptor reflex activity reflects an alteration of the autonomous regulation of the cardiovascular system and has proven to predict fatal outcome in patients after acute myocardial infarction. The following study was performed to analyse the baroreceptor sensitivity, heart rate variability and blood pressure variability in patients early after coronary surgery. METHODS: Twenty-five male patients undergoing coronary artery bypass were examined in a prospective study; normal values were obtained from healthy volunteers. Arterial pressure signals were recorded from a radial artery catheter for 30 min preoperatively and in short intervals after surgery. Mechanical manipulations and pharmacological interventions were avoided during the sampling periods. Baroreflex function was calculated according to the dual sequence method, heart rate variability and blood pressure variability were calculated including nonlinear methods. RESULTS: Initial values of the patients did not differ from healthy volunteers. The strength of baroreflex sensitivity (increase in blood pressure causing a synchronous decrease of heart rate) is low 2 h postoperatively. The number of delayed tachycardic changes of heart rate, which are caused by sympathetic activation, is only moderately reduced as compared to values obtained from healthy volunteers. Heart rate variability is widely unchanged as compared to preoperative values; blood pressure variability showed an increase of low-frequency components, again indicating sympathetic predominance. Nonlinear analyses revealed reduced system complexity at the beginning of the postoperative course. CONCLUSION: Obviously, there is a vagal suppression 20 h after surgery, while the sympathetic tonus works in a normal range. This unbalanced interaction of the autonomous systems is similar to findings in patients after myocardial infarction. The predictive value of these markers has to be elucidated in further clinical studies.

Aged↗
PubMed1991

[Alprazolam for patients with psychotic symptoms or autonomic imbalance symptoms after breast cancer surgery].

Effectiveness of alprazolam in daily dosages of 0.8-1.2 mg was studied in 28 patients who showed psychotic symptoms or autonomic imbalance symptoms after operation for breast cancer. Psychotic symptoms included depression, anxiety, tension, and restlessness, and symptoms of autonomic imbalance included sleep disorder, anorexia, and pains. All of these symptoms were improved at high ratios by alprazolam. The drug was very useful in 16 cases (57.1%), useful in 11 cases (39.3%), and slightly useful in one case (3.6%). The only adverse reaction reported was unsteady gait in one case.

Adult↗
PubMed1998

Success of surgery for primary aldosteronism judged by residual autonomous aldosterone production.

Since February 1996 we have prospectively assessed residual adrenal autonomy by the fludrocortisone suppression test (FST) in 23 patients 3 months after unilateral adrenalectomy for Conn syndrome and in 45 patients after a longer interval. In regard to blood pressure, 36 (53%) patients were cured of hypertension and the remaining 32 (47%) patients had improved hypertension control at the time of their latest postoperative clinical assessment. In regard to the outcome of surgery, patients who achieved normal suppressibility of aldosterone were regarded as cured, and those who had greater suppressibility after surgery were considered improved. Time since surgery for the whole group averaged 26 months. By these biochemical criteria, 42 patients (62%) were cured by surgery, and the rest improved; 16 (76%) of 21 women were cured, and 26 (55%) of 47 men. The women (mean +/- SD age 47 +/- 11 years) were significantly (p < 0.05) younger than the men (52 +/- 9 years). Preoperative aldosterone levels before and after FST were similar in the cured and improved groups and fell significantly (p < 0.01) in both groups following surgery. After surgical reduction of autonomous aldosterone production, mean plasma renin activity levels increased sixfold in the cured group and threefold in the improved group. Surgical mortality in this group of 68 patients with Conn syndrome was zero.

Adult↗