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Biomedical subjects

D Gozal

Publications and source records attributed to D Gozal.

171 records · Page 10Linked to original sources
PubMed1983

Infective endocarditis in Jerusalem. A comparative analysis of native and prosthetic valve endocarditis.

Thirty patients with prosthetic valve endocarditis (PVE) and 62 patients with native valve endocarditis (NVE) observed during a concurrent period of time (1970-80) were analyzed. Patients with PVE were also compared with 697 patients who underwent cardiac valve replacement in the same period, in an attempt to uncover risk factors for PVE. In the operated patients the overall incidence of endocarditis was 4.3%. There were several significant differences between the NVE and PVE groups. Atrial fibrillation was more prevalent in the PVE group (33.4 vs. 11.5%, P less than 0.05), while infection with gram-positive organisms was more prevalent in the NVE patients (79 vs. 47%, P less than 0.01). The outcome of combined medical and surgical treatment showed a much higher mortality rate (50 vs. 6.4%, P less than 0.01) in the PVE group. Staphylococcal endocarditis resulted in 16% mortality in NVE vs. 100% in the PVE group (P less than 0.01). Careful surveillance may hopefully lead to early detection, treatment and better outcome of PVE.

Adolescent↗
PubMed1982

Hypothesis: new concepts on the pathogenesis of early prosthetic valve endocarditis.

During the years 1970-1980, 697 patients had valve replacement surgery at our institution. Thirty patients subsequently developed prosthetic valve endocarditis (P.V.E.). Reexamination of the native valves of 25 of these patients revealed histopathological evidence of thromboendocarditis in 7, 5 of whom subsequently developed early P.V.E. In 3 out of 25 matched controls in whom P.V.E. was not diagnosed clinically, similar pathological findings were found; these patients all had fever pre- or post-operatively and were treated with a short antibacterial course, but no definite clinical diagnosis was made. We suggest that there is a close relationship between subclinical thromboendocarditis on the native valve and the early development of infective endocarditis on the implanted artificial valve.

Endocarditis, Bacterial↗
PubMedDate not supplied

MR imaging signal response to sustained stimulation in human visual cortex.

The response of signal intensity to transient (on-off) motor and sensory stimulation has been well studied; however, the dependence of signal response on the duration of stimulus requires further characterization. The objective of this study was to determine the time course of signal response in the human visual cortex to prolonged, sustained stimulation and to examine possible contributory physiologic mechanisms. Nine healthy volunteers underwent magnetic resonance (MR) imaging during sustained visual stimulation with light-proof binocular goggles. With photic stimulation, activation was observed in all subjects as an increase in signal intensity of the visual cortex. With sustained stimulation, a gradual decrease in signal intensity was subsequently observed, with progression toward an apparent steady state. Correlation with positron emission tomographic, MR spectroscopic, and visual evoked-potential data suggests that the initial uncoupling of cerebral blood flow and oxidative metabolism with a neuronal activation burst may represent a transient phenomenon. This quick-response phase may proceed to an equilibrium coupling of flow and oxidative metabolism, with a gradual normalization of venous deoxyhemoglobin levels and signal intensity.

Adult↗
PubMedDate not supplied

Combined general and epidural anesthesia for a patient with Takayasu's arteritis. Case report.

BACKGROUND AND OBJECTIVES: The case is presented of a 44-year-old woman with type I Takayasu's arteritis, undergoing total abdominal hysterectomy. METHODS: Her previous symptoms were related to subclavian and vertebral artery lesions that were treated surgically, and to right carotid stenosis (amaurosis fugax 1-year before the operation) that was not treated. Peripheral pulses were present and blood pressure monitoring was not a problem (invasive intra-arterial pressure monitoring was used). Neurologic monitoring was considered to be mandatory in this case and a computerized electroencephalography monitor was used, both to confirm the adequacy of anesthesia and, more importantly, to monitor unilateral cerebrovascular events. RESULTS: The patient underwent surgery with combined epidural and general anesthesia, without any complications. The epidural block was used throughout the early postoperative period for analgesia. CONCLUSIONS: The management of patients with Takayasu's arteritis requires a knowledge of the location and pathophysiology of vascular lesions.

Adult↗
PubMedDate not supplied

Removal of knotted epidural catheters.

BACKGROUND AND OBJECTIVES: An epidural anesthetic was planned for a 24-year-old woman for analgesia during labor and for a 28-year-old woman for an elective cesarean delivery. METHODS: Two cases of inability to remove an epidural catheter due to a knot are reported. The epidural catheter was initially inserted 6 and 8 cm, respectively, into the epidural space. Attempts to remove the catheter by gentle traction remained unsuccessful. RESULTS: In the first case, the catheter was removed successfully by using general anesthesia with succinylcholine, and in the second case the catheter was removed by pulling it out slowly. CONCLUSIONS: To prevent the knotting of an epidural catheter, it should not be inserted more than 3-4 cm into the epidural space. General anesthesia may be one of the options to remove the catheter.

Adult↗