[Considerations on the health care fee revision in the pediatric cardiovascular surgery].
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The results of 50 laparoscopic transabdominal pre-peritoneal inguinal hernia repairs are reported with a follow-up of 1-4 years. The patientsage range was 16-75 years. Two recurrences occurred. Only few complications were encountered. The procedure was remarkably pain-free, with 18% requiring no analgesia after the operation and 63% requiring no analgesia after discharge from hospital. There was a rapid return to normal activity, with 55% driving within I week of the operation and 84% within 2 weeks. Sixty-three per cent returned to work within 2 weeks of the operation and 71% within 3 weeks. The results show that laparoscopic hernia repair is remarkably pain-free, allows a rapid return to normal activity and has a low recurrence rate.
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To the Editor: Dr Mehta and colleagues1 reported that patients in the intensive care unit who received diuretics for acute renal failure (ARF) had a higher risk of dying and nonrecovery of renal function than those who did not.
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Aerosolized medications are used as airway clearance therapy to treat a variety of airway diseases. These guidelines were developed from a systematic review with the purpose of determining whether the use of these medications to promote airway clearance improves oxygenation and respiratory mechanics, reduces ventilator time and ICU stay, and/or resolves atelectasis/consolidation compared with usual care. Recombinant human dornase alfa should not be used in hospitalized adult and pediatric patients without cystic fibrosis. The routine use of bronchodilators to aid in secretion clearance is not recommended. The routine use of aerosolized N-acetylcysteine to improve airway clearance is not recommended. Aerosolized agents to change mucus biophysical properties or promote airway clearance are not recommended for adult or pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough. Mucolytics are not recommended to treat atelectasis in postoperative adult or pediatric patients, and the routine administration of bronchodilators to postoperative patients is not recommended. There is no high-level evidence related to the use of bronchodilators, mucolytics, mucokinetics, and novel therapy to promote airway clearance in these populations.
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