Savannah Health

Archive for August, 2011

Doctors have always known that there is some risk of heart complications associated with major surgery, especially for those who are older or who have preexisting heart problems. There was a study done in the summer of 2008 that looked at the risk factors for cardiovascular problems after total joint replacement (TJR) surgery on the knees and the hips. Two new heart risk factors in TJR surgery were identified: having bilateral joint replacement, replacing joints on both sites of the body during one surgery, and having revision surgery to replace an earlier joint implant.

Researchers looked into the heart risk of TJR by studying the medical records of those who received new or revision total hip or knee replacements over the time of 29 months at a large hospital in New England. From these, the researchers identified the records of patients who, during their hospitalization, had experienced an irregular heartbeat (arrhythmia), heart attack, unstable angina, congestive heart failure, or blockage of an artery in the lung. Records were then matched with those of another group of those who had joint replacement surgery but no documented heart problems. These groups were matched as closely as possible according to surgeon, approximate age of the patient, and year when they had their total joint replacement. Eliminating incomplete records, the researchers had a total of 418 patient records for the study with an average age of 71.4 years; 55% were women; and 51% had knee surgery, 49% were hip surgeries; 20% of the operations were revisions; the rest were initial joint replacements; 11% were bilateral procedures, replacing both knees or both hips in one operation.

The researchers obtained information about any preexisting heart risk factors fro the medical record reviews and fro physical exams, electrocardiograms (EKG), and patient intake questionnaires. Included in these are the well known risks like high blood pressure, diabetes, lung disease, and smoking just for example. Researchers also sifted through data to pick out the factors associated with cardiac problems during the patients’ hospital stays. In 70% of the patients who had some post-surgical heart problems irregular heartbeat was present; 24% had a drop in blood pressure; 8% had unstable angina; 2% had a heart attack; 11% had congestive heart failure and in 1% there was death.

There were many factors had no effect on the risk of heart complications, including gender, being overweight, type of anesthesia, use of NSAIDs, knee versus hip surgery, or having diabetes or high blood pressure are just a few examples of these factors. Some of the traditional factors known to raise heart risk in other types of surgery also hold risk for those who are getting a TJR; age over 75 years; some preexisting heart problems like coronary artery disease, heart attack, congestive heart failure, or diseased heart valves; and irregular heartbeat were confirmed by this study.

A new finding from this study is that patients getting a bilateral joint replacement or revision surgery have 2 to 3.5 times the risk of heart complications during a total joint replacement compared to those getting a single, first time joint replacement.

There were two drawbacks to this study, and they were that it included the data from only one hospital and the results were not typical for other populations where there were TJR’s or hospitals.

Researchers hope that their findings will help doctors to do a better job of weighing the risk and reducing the heart complications that come up in total joint replacement patients. And giving that more than 700,000 total hip or knee replacements were done in the U. S. in 2004, it is essential that there are targeted measures to reduce cardiovascular risks and potentially save many lives.

Cat vaccinations are a great way to protect your cat from contracting feline diseases. Following your local veterinarian on the schedule of vaccinations for kittens and the subsequent vaccinations for booster shots, you will be saving time and money from bringing your cat to the cat clinic more often. This will also lessen your cat’s exposure to the clinic especially if it does not particularly like the place.

Though cat vaccinations are generally helpful, they can also bring risks to your pet. Side effects from these vaccines will go away in time but some can be fatal if not treated. Cats will not be able to tell you when they feel something bad so you have to take the time and observe your pets especially after getting vaccinated. Some of the common side effects are listed below. Read through and be prepared to look out for them when you get your cat vaccinated.

• More often than not, cats will feel discomfort on the vaccination site. They will feel sore on the place injected with the vaccine and redness, irritation or swelling may also be observed. The cat may even limp is the vaccine is administered near the limbs. Vets may prescribe pain relievers to cats that are experiencing severe pain.

• One mild side effect of getting vaccinated is the decrease in appetite and physical activity of your cat. Lethargy accompanied by a slight fever may be expected and will eventually go away on its own after a couple of days. Chlamydia psittaci is a bacterium that causes Chlamydiosis in felines that causes eye and lung problems. The vaccine for it causes lethargy, appetite loss and fever which may last for a few weeks. Some cats manifesting these side effects may need treatment with corticosteroids to alleviate the symptoms faster.

• Cat vaccinations may also result to a type of cancer. Sarcomas or benign lumps may develop in some cats on the area where the vaccine was injected. A sarcoma will invade the deeply into the underlying tissue. Some benign lumps will not be harmful and will eventually disappear, but if a lump grows more than two centimeters and persists for more than three months then you should consult your veterinarian about it. Just like in humans, removal of a sarcoma is surgical and may need chemotherapy or radiation.

• Allergic reactions from cat vaccinations can also be experienced by cats. These include itching, redness, hives, and swelling round the lips, eyes and neck. These moderate signs still need to be checked by a vet. Severe allergic reactions include vomiting, diarrhea, difficulty breathing and a sudden drop in blood pressure that may cause fainting. These symptoms need immediate care from a professional.

• Another risk connected with allergic reactions is an anaphylactic shock. This is an adverse and fatal reaction to cat vaccinations that can result in shock, cardiac failure and ultimately, death. Symptoms of anaphylactic shock include swelling of the face, pale gums, cold limbs, and a fast heartbeat. Immediate care from a physician may include administration of intravenous fluids and epinephrine.

Learn cpr and first aid today for free (or low cost)! Online Free CPR and Free first aid training certification classes are not only fast and convenient, it may be also offered for free or for a very low cost. Online courses, or the virtual class, is designed for those people who want to learn CPR and BFA but may not wish to spend a lot of time or money to do so, and cover the same fundamentals and teach cognitive skills as the more expensive and lengthy classes offered by American Red Cross