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Biomedical subjects

A Appelbaum

Publications and source records attributed to A Appelbaum.

70 records · Page 4Linked to original sources
PubMedDate not supplied

Correlation of blood temperature fluctuations with blood pressure waves.

Constant blood temperature in the pulmonary artery is assumed when the thermal dilution method is used for cardiac output determination. In some cases, however, slow temperature fluctuations (2-6 cycles per min.) occur in arterial and venous blood and interfere in the measurement. Those thermal fluctuations were investigated in the pulmonary artery and venae cavae of dogs. The temperature variations were found to be correlated with blood pressure waves: an increase of blood pressure was accompanied by an increase in the blood temperature in the pulmonary artery and a decrease in the blood temperature in the venae cavae. Therefore, measurement of the temperature of the pulmonary artery relative to that of the venae cavae does not rule out those fluctuations, and will not improve the thermal dilution method.

Animals↗
PubMedDate not supplied

Dealing with school violence: how hospitals met this new challenge to emergency preparedness.

This article discusses how hospitals in Jonesboro, AR, and Denver, CO, met the challenge of dealing with school shooting rampages that resulted in multiple casualties and received widespread media coverage. Hospitals need to be well-prepared to implement their emergency disaster plans and handle the physical and emotional trauma of such incidents which, according to a well-known criminologist, may become more frequent.

Adolescent↗
PubMedDate not supplied

The surgical treatment of total anomalous pulmonary venous connection.

Thirty-five patients had complete repair of total anomalous pulmonary venous connection between 1 January 1968 and July 1974. The mean age of the patients was 5.8 months. The hospital mortality rate was 43%; six of seven patients less than one month of age died. There were no deaths in the nine patients over six months of age at the time of operation. Inadequate cardiac performance was responsible for eight of the nine deaths in patients operated on since 1 September 1971. Thirteen percent of the patients who left the operating room alive were reoperated on for bleeding early in the postoperative period. No patient has required tracheostomy since 1 September 1971. Three of the 20 long-term survivors have required reoperation. The late results are good. Ways of improving results in the future are discussed.

Adolescent↗
PubMedDate not supplied

Infant kidnapping: a tragic incident provokes a new HCFA response.

The death of a newborn successfully kidnapped from a hospital nursery overshadowed a recent record of fewer or no abductions compared to prior years. In this case, for the first time in hundreds of fatal or non-fatal kidnappings, HCFA made serious threats to cut off the hospital's Medicare funding.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Delayed sternal closure following cardiac operations.

In 13 patients, sternal closure was delayed at the end of open heart procedures. Seven patients underwent coronary artery bypass surgery (CAB), 5 valve replacements, and one left ventricular aneurysmectomy and closure of post myocardial infarction VSD. In all, primary closure of the sternum was considered impossible or inadvisable. The major indications for delaying sternal closure were: cardiac dilatation with tamponade-like behaviour upon attempted sternal closure (8 patients); intractable bleeding (2); intractable arrhythmia (1); insertion of mediastinal assist devices (3) and intraoperative non-cardiogenic pulmonary edema (1). In all, only the skin was closed. Delayed sternal closure (DSC) was performed 36-120 hours later on 10 of the patients, when their condition had stabilized. Nine patients are long term survivors. None of these patients has developed mediastinitis, wound infection, osteomyelitis or instability of the sternum. The judicious use of DSC in selected situations has several advantages: hemodynamic deterioration from pressure upon the heart may be prevented; a quick access to the heart in case of tamponade or intractable arrhythmia is obtained; insertion of mediastinal assist devices is facilitated. With careful technique the risk of infection is low.

Adult↗
PubMedDate not supplied

Improved functional results following myocardial revascularization in patients with left ventricular dysfunction.

Between February 1978 and October 1982, 40 patients with preoperative ejection fraction (EF) of 0.35 or less underwent aortocoronary bypass. An average of 3.1 saphenous vein grafts per patient were inserted and revascularization was considered complete in 33 (82%) of the subjects in the group. Mean follow-up period was 29 months (range 12-65 months). Early mortality was 5% (2 patients) and there were seven late deaths (3 cardiac and 4 non-cardiac). The five-year cardiac actuarial survival rate was 74% +/- 13% (+/- SEM). Angina has improved in 29 (94%) of the 31 long-term survivors with 23 (74%) being totally asymptomatic. Twenty-two of the long-term survivors performed an exercise test at the end of their follow-up period. These tests revealed that bypass surgery in such patients results in significantly enhanced myocardial oxygen consumption with concomitant increase in effort level and duration. The exercise ability is probably directly related to the degree of revascularization.

Actuarial Analysis↗