Surgery Consultatons Archive

Aspirin and clopidogrel after coronary bypass surgery

What are the current evidence-based recommendations for aspirin and clopidogrel (Plavix) use following coronary artery bypass graft (CABG) surgery (both on- and off-pump procedures)?

How to treat lymphedema

What are the most effective therapies available to treat lymphedema?

Stopping warfarin before cataract surgery

Does an individual undergoing cataract surgery with standby or local anesthesia need a full workup if he or she has been stable on current medications, regardless of medical history?

Treating chronic esophageal reflux

What treatment options are available for chronic esophageal reflux? Is surgery ever preferable to long-term treatment with a proton-pump inhibitor?

Recurrent bouts of biliary colic

A gastroenterologist and surgeon have recommended cholecystectomy for a patient with recurrent biliary colic and a 3% biliary ejection fraction on CCK-HIDA scan. Is this advisable?

Surgical clearance guidelines

Many dentists, optometrists and other specialty providers are sending adult patients to our primary-care clinic for surgical or procedural clearance. Are there standards of practice for such patients?

Are certain antidiabetes drugs better than others after gastric bypass?

Following gastric bypass surgery, many patients will still need metformin or glipizide (Glucotrol). Is there any evidence that one class of hypoglycemic agents is better absorbed than another?

Post-splenectomy vaccination recommendations

What vaccines and vaccination schedule are recommended for splenectomy patients?

How serious is latex allergy?

Do I really need to worry about vials with latex tops or BP cuffs with latex bladders? Can't rash be treated symptomatically, or is escalation to anaphylaxis a major concern?

Hyponatremia on the rise

I seem to be seeing a lot more hyponatremia. Some of these patients are taking diuretics, while others have psychogenic polydipsia or syndrome of inappropriate antidiuretic hormone secretion (SIADH). Others have no known cause. Is there an explanation for this increase?

Outdated warning against using epinephrine in digital blocks

Do the benefits now outweigh the risks of using lidocaine with epinephrine in digital blocks?

Gallbladder mystery

Should a patient with a negative abdominal ultrasound be referred for cholecystectomy?

Fallout from a ruptured inclusion cyst

What causes an inclusion cyst to come to a head and rupture, and what effect does this have?

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