Transient diminished airway protection after transhiatal esophagectomy

Article Abstract:

Patients who have cancer of the esophagus may require esophagectomy, or removal of part of the esophagus. A devastating complication of this surgery is aspiration pneumonia (inflammation caused by the inhalation of foreign material into the lungs). To avoid this complication, various types of diets have been suggested empirically, however, there is little information to support the use of these dietary regimens. A study was undertaken of 15 patients who underwent transhiatal esophagectomy (performed through the diaphragm) to determine the incidence of aspiration, identify predisposing factors and suggest guidelines for postoperative swallowing rehabilitation. Pharyngeal function was evaluated using cinepharyngo-esophagraphy, a well-established method of evaluating swallowing function. These studies were performed prior to surgery, and again one week and one month after the operation. One week after surgery, ten patients (67 percent) showed at least one new abnormal finding in swallowing; one month after surgery these problems had resolved in eight patients and improved in two. None of the patients developed postoperative pneumonia. The most common abnormalities were aspiration or penetration into the larynx (windpipe), occurring in seven patients. In five patients this abnormality was associated with incomplete laryngeal elevation during swallowing, causing decreased protection of the airway. The findings suggest that laryngeal aspiration or penetration occurs commonly after transhiatal esophagectomy, and that these swallowing abnormalities resolve within a month of surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Surgery, Esophagus, Esophageal cancer, Esophageal surgery, Deglutition disorders

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Hurricane's emotional damage is also devastating

Article Abstract:

Survivors of Hurricane Andrew may suffer lasting emotional trauma, say psychiatrists who had planned for such a disaster. People may feel guilty about their reactions to the stress caused by losing their homes, suffering without power in the excessive summer heat and waiting for assistance. Faculty and residents at the University of Miami and Louisiana State University have manned hot lines to assist residents, especially low-income persons who experienced loss of their meager resources.

Hurricanes, Disaster victims, Hurricane Andrew, 1992

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Cultural affirmation and the protection of emotional well-being

Article Abstract:

The effects of the Balkan conflict on the culture and emotional health of Serbian Australians, are examined.

Wars, War

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