Prevention of thromboembolism in 190 hip arthroplasties. Comparison of LMW heparin and placebo.

Prophylactic efficacy and safety of a low molecular weight (LMW) heparin against postoperative thromboembolic complications were investigated in a double-blind, randomized study. Totally, 210 consecutive patients undergoing total hip replacement were allocated to two groups. Patients in the heparin group received 50 IU anti-Xa per kilo body weight of Logiparin once daily, and patients in the placebo group received one daily injection of saline. Additional prophylaxis in all the patients was thigh-length compression stockings beginning on the day of the operation. Deep vein thrombosis was diagnosed by bilateral ascending phlebography between Days 8 and 10 after the operation. Twenty patients were excluded from the evaluation. Thirty of 93 patients in the heparin group compared with 45 of 97 patients in the placebo group suffered a thromboembolic complication during the study (P = 0.02). The postoperative blood loss and total number of blood transfusions in the heparin group were higher than in the placebo group. However, the observed differences were of no clinical importance. Adverse effects, including bleeding complications and wound hematomas, were observed in 13 heparin patients and 7 placebo patients (NS). One patient in each group died. Thrombo-prophylaxis with LMW heparin once daily was safe and more effective than the placebo in patients undergoing total hip replacement.

[Preoperative evaluation of arteriosclerotic symptoms in the lower extremities by means of intravenous digital subtraction angiography]. / Praeoperativ evaluering af arteriosklerotiske symptomer fra underekstremiteterne ved hjaelp af intravenøs digital subtraktionsangiografi.

Intravenous DSA was performed in 106 patients with symptoms of arterial insufficiency in the lower extremities, requiring treatment according to preceding clinical examination. The examinations were carried out using a 36.5 cm (14 in.) intensifier and a 5.5 F pigtail catheter located centrally. 71% of the examinations were carried out on out-patients. No complications were observed. In 96% of the cases, the intravenous DSA provided sufficient information to make decisions about treatment.

Caecocolic intussusception: a postoperative complication of appendectomy. A case report.

Caecocolic intussusception was found in a 13-year-old boy 17 days after appendectomy. The appendiceal stump was the lead point of the intussusception. The case is presented.

Spontaneous rupture of the diaphragm.

Spontaneous rupture of the diaphragm is rare. A case is presented in which spontaneous rupture of the left hemidiaphragm occurred as a result of physical exercise 4 months before admission to hospital. The patient, a 42-year-old woman, underwent transabdominal repair with uncomplicated postoperative course. The clinical manifestations, diagnosis and treatment of spontaneous diaphragmatic rupture are reviewed against the background of this case and the total of 12 cases in the available literature. All but one of the ruptures were left-sided. The importance of keeping this condition in mind in differential diagnosis is underlined by the fatal outcome in 2 of the known 13 cases.

Electroencephalographic findings during mantra meditation (transcendental meditation). A controlled, quantitative study of experienced meditators.

The EEGs of 13 experienced practitioners of transcendental meditation (TM) were recorded for 5 min preceding TM, during 20 min of TM and until 5 min after, as well as during closed-eyed wakefulness, drowsiness, sleep onset and sleep. Thirteen healthy volunteers matched for age served as control subjects. Computer period-amplitude analysis of F3-C3, T3-T5, P3-O1, F4-C4 and P4-O2 epochs of 50--100 sec duration resulted in a frequency and amplitude spectrum (0.5--28.6 c/sec), and the mean frequency and the mean voltage of each EEG lead. The EEG frequency spectra constituted a continuum with increasing theta and delta activity and decreasing alpha activity as the participants tended to fall asleep. The frequency spectrum during TM corresponded to a spectrum situated between that of wakefulness and drowsiness and remained virtually unchanged during the 20 min of meditation. The EEG mean frequency of the TM group was about 1 c/sec slower than that of the control group. Intra- or interhemispheric differences between quantities of EEG activity remained stable during TM, nor did we observe any theta bursts. There was no consistent EEG patter associated with a successful or unsuccessful meditation, nor did the EEGs of two meditators who stated they had felt drowsy during TM show a different pattern.