Effects of growth hormone in patients receiving total parenteral nutrition following major gastrointestinal surgery.

The purpose of the present study was to determine whether the administration of a biosynthetic human growth hormone was capable of enhancing the efficacy of total parenteral nutrition. Patients (n = 38) who had undergone major gastrointestinal surgery were randomly divided into two groups. Group I (n = 20) treated only with PN, and Group II (n = 18) treated as in Group I plus human growth hormone (4 IU daily). Our study shows that the administration of human growth hormone produces a statistically significant increase in serum levels of growth hormone, somatomedin-C, transferrin, albumin and total proteins. It also causes a positive nitrogen balance from the first 24 hours onward. These findings suggest that the administration of human growth hormone produces an increase in protein synthesis, perhaps through somatomedin-C as mediator.

Phenol treatment of pilonidal sinuses.

Pilonidal disease of the natal cleft is a common condition responsible for much morbidity. The results of phenol injection used in 67 patients treated in our Department of Surgery between 1986-1988 are reviewed. Our study shows that this procedure is an effective treatment. Phenol injection of pilonidal sinuses is a simple operation and produces results which are similar those achieved by surgical procedures but has the advantages of a shorter inpatient stay (1-3 days) with a prompt return to work (1-2 weeks).

[Prevention of thromboembolic disease and post-transfusional complications using normovolemic hemodilution in arthroplasty surgery of the hip]. / Prévention de la maladie thrombo-embolique et des complications post-transfusionnelles par l'hémodilution normovolémique en chirurgie arthroplastique de la hanche.

A prospective randomized study was conducted to evaluate the effect of moderate normovolemic haemodilution in arthroplastic surgery of the hip, to prevent postoperative deep vein thrombosis and the need for postoperative transfusion. The patients (n = 151) were divided into three groups: 48 patients received Dextran + Acetylsalicylic Acid as a prevention of the thromboembolic complications (Group I). 57 patients received a low dose of Heparin according to the Kakkar protocol (Group II). 52 patients were operated under Haemodilution (Group III). In Group I and II homologous blood transfusions were necessary in 83% of the cases, and in two cases posttransfusional hepatitis were observed. In Group III haemodilution avoided the use of homologous blood. Therefore of the three methods this study showed that haemodilution is the best way to prevent postoperative thrombo-embolism, significantly more effective than Heparin and Dextran, in arthroplastic hip surgery.

[Is appendiceal surgery performed by residents safe?]. / Es segura la cirugía apendicular realizada por residentes?

An evaluation was made of the participation of residents in appendicular surgery as compared to staff surgeons, the evolution of results over the residency period and the influence of the presence of experienced surgeons together with residents during the emergency operation. Seven groups were made according to the surgeons involved. Parietal, intraabdominal and general complications of each group were quantitated, as well as postoperative hospitalization and mortality. Statistical study revealed similar results for the different groups.