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Biomedical subjects

A Odero

Publications and source records attributed to A Odero.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Diagnostic problems in traumatic rupture of the thoracic aorta. Observations on 8 surgically treated cases].

The authors report their experience concerning the diagnosis of traumatic rupture of the thoracic aorta, based on a review of eight surgically treated cases. They emphasize the importance of the immediate performance of an aortography which, providing highly specific findings, permits the diagnosis of this serious lesion, which is often misrecognized. The diagnostic value of the standard chest roentgenogram is discussed, with special attention to mediastinal enlargement which (especially if associated with a CT finding of a periaortic haematoma) must lead to the performance of an aortography, even in those cases with atypical or absent symptoms. Following this diagnostic approach, an early surgical treatment of the aortic lesions, with favorable results in five out of eight cases was obtained.

Adolescent↗
PubMed1979

[Selective arterial perfusion with antienzymes in experimental acute pancreatitis. Preliminary experience].

Authors analyze some results obtained treating, with selective arterial perfusion (using antienzymes), experimental acute pancreatitis in dogs (fifteen). The first dogs' group was used to perform several experimental acute pancreatitis; the second group was treated by selective arterial perfusion and was related to group of dogs treated by i.v. antienzymes drugs. Histological and biochemical data are discussed. The results obtained with arterial perfusion are preliminary referred as better than classic i.v. antienzymes drugs therapy.

Acute Disease↗
PubMed1979

[Surgical treatment of massive pulmonary embolism. Personal cases].

5 cases of pulmonary embolism are reported. 3 of these were subjected to pulmonary embolectomy with complete success; repeated controls bear witness to the good long-term cardiorespiratory condition. Two patients died, one following angiography, the other at anaesthetic induction; this fact shows the desirability of submitting patients to partial support extracorporeal circulation prior to angiography and, in any cases, before submitting them to anaesthesia. This surgical success obtained in treatment of the three cases shows that embolectomy continues to play a decisive role.

Adult↗
PubMed1978

[Hyperplasia of the adrenal medulla].

A case of arterial hypertension due to suprarenal medulla hyperplasia is reported. Having accepted the existence of this form, the problem of its recognition is stressed, in the presence of catecholamine pathology, even though the type or site of its anatomo-pathological substrate cannot be identified, explorative surgery and possible removal of the suprarenal glands can be indicated.

Adrenal Gland Diseases↗
PubMed1978

[Massive pulmonary embolism. Clinical aspects and treatment].

The frequency of pulmonary embolization seems to be increasing. Venostasis, intimal damage and hypercoagulability of blood are the more recognized causes of pulmonary thromboembolism. It is especially threatening to the elderly, obese, immobilized (for an accident or an operation) patients. Pulmonary isotopic scans or angiograms are most often relied upon to establish the diagnosis. A properly performed pulmonary angiography is necessary to establish or refute the diagnosis in almost every case. With the exception of the patients suddenly dying for a massive pulmonary embolism, the period of time between onset of symptoms and death is usually adequate for substantiating a diagnosis and promptly beginning a fit anticoagulation therapy using continuous intravenous heparin or fibrinolytic agents infusion. Although it is not proper to separate surgical and medical treatment of thromboembolism, the Authors, on the ground of their experience on 5 patients affected by massive pulmonary embolism, in 3 of whom was performed a successful embolectomy, think that heparin anticoagulation treatment is at any rate to apply for treating pulmonary embolism, but in patients in whom the shock is unresponsive to vasopressors or in whom anticoagulation therapy is controindicated, the surgical removal of pulmonary emboly, with the support of a pump oxygenator, is the treatment of choice for the acute massive pulmonary thromboembolism.

Anticoagulants↗
PubMed1977

[Behavior of the local lymphatic system after aorta-iliaco-femoro-popliteal reconstruction].

As a result of the observation of oedemas of the lower extremities and lymphorrhoea in the immediate postoperative course of surgical reconstruction of the aorto-iliaco-femoro-popliteal arterial axis (and on the basis of similar cases in the literature), the participation of the lower extremity return circulation in this facet of vascular surgery has been documented. The venous system was never impaired whereas the local lymphatic system was always damaged by surgical aggression on the arterial vessels. However, the extensive anatomical lesions shown up by lymphography are not reflected in evident clinical signs; whenever oedema or lymphorrhoea of the surgical wounds are observed, these symptoms are always of slight importance and easily and quickly resolved. At long-term follow-up, no clinical evidence of impairment ot the venous and lymphatic venous return circulation was ever encountered. For prophylactic purposes the lymphatic structure encountered during the operation should be carefully ligated to counteract another dangerous complication: infection.

Aorta↗
PubMedDate not supplied

Aortic graft infections: treatment with arterial allograft.

Since its reintroduction by Kieffer in 1991, many authors have used arterial allografts for surgical management of vascular prosthetic graft infection. During a decade, 25 patients with aortic graft infection were treated using in situ revascularization with arterial allograft. There were 23 male and 2 female patients of mean age of 65.7 +/- 8.8 years (range, 43-78). Antibiotic therapy was administered for a mean time of 26 +/- 5 days (range, 21-45) in the postoperative period. The mean follow-up time was 2.3 +/- 3 years (range, 22 days-8.7 years). The mean in-hospital postoperative stay was 29.6 +/- 14 days (range, 9-68). An aorto-enteric fistula (AEF) was present in 11 patients (44%), producing gastrointestinal bleeding. The overall mortality rate was 13 of 23 (56.5%) patients. The allograft-related mortality rate was 5 of 23 (22%). The overall allograft-complicated patient rate was 15 of 23 (65%); we observed 18 allograft ruptures in 12 patients and 8 allograft thromboses in 6 patients. The overall amputation rate was 8.7% (2 of 23). Age of the recipient older than 69 years (P = .02), positive preoperative marked-leukocyte scanning (P = .04), and persistent postoperative leukocytosis (P = .03) were significant variables associated with an increased risk of allograft-related complications. The use of arterial allografts for aortic graft infections represents an interesting alternative for the treatment of graft infection. Nevertheless, there are some problems related to the durability of this type of graft, which can still be considered as a "bridge transplant."

Aorta↗
PubMedDate not supplied

Treatment of Buerger's disease with electrical spinal cord stimulation--review of three cases.

Buerger's disease or obliterating thromboangiitis is an inflammatory pathologic condition affecting the distal vascular segments; it strikes young adults, especially males and heavy smokers. Medical and surgical treatment often fail to heal these patients, especially considering the frequent relapse of this disease linked with tobacco abuse--definitive healing often involves limb amputation. Electrical spinal cord stimulation is evaluated in this study with an analgesic aim and for improvement in skin microcirculation, with the goal of long-term healing of diseased limbs.

Adult↗
PubMedDate not supplied

[Indications for the use of vascular homografts].

Homografts were first mentioned in scientific literature at the beginning of the 1900s in articles by Yamanouchi and Carrel who were the first to demonstrate the possibility of substituting segments of artery by transplanted homologous segments of vein. Since then homografts have been considered a possible surgical treatment for stenotic and aneurysmal diseases of the aortic-iliac-femoral vasculature. Meanwhile much research has been carried out in an attempt to perfect the treatment that the biological prothesis undergoes once explanted. This treatment is aimed at providing the best possible conservation of the biological and mechanical characteristics of the graft while eliminating the highly antigenic components. The introduction in the 1950s of synthetic prostheses and their immediately encouraging short-term and long-term results, clearly better than those of the homografts, led to the use of these latter being temporarily abandoned. They came back into the spotlight some years later with completely different indications from those for which they had originally been proposed. The natural resistance to bacterial colonization makes the homograft an ideal candidate for treatment of infected prostheses or of patients at high risk of infection (immunosuppressed patients). Furthermore the low thrombogenicity and the case with which they can be sutured are important advantages for use in pediatric heart surgery and oncologic surgery in the treatment of associated vascular lesions. Nevertheless, large scale use of homografts cannot be recommended for a variety of reasons: 1) the need for ministerial authority; 2) the need for a tissue bank where the certification and cryopreservation of the homografts could be carried out; 3) the still unsettled doubts about immunological aspects associated with homografts.

Aneurysm, Infected↗
PubMedDate not supplied

[Proximal abdominal aortic aneurysms after infrarenal aortic reconstruction].

The failure of infrarenal aortic open reconstruction due to sterile sovranastomotic abdominal aortic aneurysm (SS-AAA) is a rare and complex long-term complication. Even if they undergo the same treatment, is necessary to distinguish between true aneurysmal degeneration of proximal aorta and chronic proximal aortic anastomosis sterile rupture with consequent false aneurysm formation: we call proximal para-anastomotic abdominal aortic aneurysm (PPA-AAA) the first and proximal anastomotic false abdominal aortic aneurysm (PAF-AAA) the latter. The etiology of this complication is exclusively degenerative and it occurs in the absence of infection, which has totally different features. SS-AAA have been reported in 1 to 4% patients, but the available studies differ about patient selection and diagnostic methods. According to these considerations we can suppose the real incidence greater and near to 25% in over 10 years follow-up patients. Clinical findings of PPA and PAF-AAA before rupture are poor and this consideration emphasizes the necessity of a long term ultrasound follow-up. Best diagnostic tools after echographic detection of SS-AAA are spiral TC scan and MR imaging. Due to image accuracy, the short time necessary to take the images and availability spiral TC has taken the place of standard TC and arteriography. Scar tissue field and visceral vessels involvement with consequent proximal clamping are the main problems in open repair of SS-AAA. Elective open repair mortality rate varies from 0 to 17% and increases dramatically after rupture. Endovascular repair at the present is suitable only for hardly selected cases, because of frequent visceral involvement. We report our 17 patients series (8 PPA and 9 PAF-AAA), which we have observed friom 1991 to 2003 in a total amount of 1363 abdominal aortic aneurysms treated. All the patients have been treated with elective open repair with a global perioperative mortality of 6% (1/17).

Aged↗
PubMedDate not supplied

Neoplastic thrombosis of the inferior vena cava and right atrium due to kidney cancer. Three surgically treated cases.

Extension into vena cava and right atrium of tumor thrombus from a renal cell carcinoma presents a surgical challenge. The use of cardiopulmonary by-pass, hypothermia and cardiac arrest with temporary exsanguination has allowed the successful surgical excision of this tumor. During 1986 and 1987 3 patients with cancer of kidney invading the vena cava were operated on with this surgical technique. No deaths occurred. The possibility of curing this type of cancer with minimal operative risk and good results is discussed.

Aged↗