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Biomedical subjects

F Robicsek

Publications and source records attributed to F Robicsek.

At least 217 records · Page 12Linked to original sources
PubMed1978

Mycobacterium fortuitum epidemics after open-heart surgery.

We present the clinical and epidemiological features of Mycobacterium fortuitum epidemics involving 19 patients who underwent open-heart surgery. The source of the infection could not be identified. However, bone wax and homografts utilized at that time have been suspected. The infected patients responded poorly to antibiotic management and their courses in most cases were influenced beneficially by total sternectomy and transplantation of the omentum into the mediastinum. The emergence of M. fortuitum may represent an aggressive bacterial strain resistant to presently used broad-spectrum antibiotic drugs.

Adult↗
PubMed1978

The application of thermography in the study of coronary blood flow.

The technique presented in this paper is based on the authors' previous observations in which they found that artificial decrease of blood flow to a portion of the heart muscle leads to an immediate and proportional drop in the regional myocardial temperature. It appeared to the authors as a logical next step to apply the thermographic camera to a monitor and to record such changes in the human patient during coronary surgery and to use the data to draw conclusions applicable to regional blood supply and to blood flow through surgically inserted vein grafts. They found that, on the normothermic heart, there were well-identifiable "cold" patches corresponding with areas of impaired coronary circulation. By infusion of blood to the ischemic myocardium through individual release of the bypass grafts, the thermogram responded by immediate appearance of "warm" spots corresponding with the areas supplied by the grafts. Even more dramatic demonstration of graft patency and outline of the area supplied by the graft could be performed by injecting cold saline solution into the grafted saphenous veins. In the author's experience this most interesting new method proved to be a useful tool in coronary surgery both as an adjunct in delineating ischemic areas and in proving the patency and efficiency of the grafts inserted.

Blood Flow Velocity↗
PubMed1977

Aneurysms of the abdominal aorta: whether or not, when, and whom?

Recently, those who profess conservative views concerning management of aneurysms of the abdominal aorta argued against operative treatment, saying that the mere presence of an aneurysm is an indication that a patient often suffers from an advanced, terminal stage of diffuse arteriosclerosis and that operation in this patient is futile because it does not prolong life. The experience reported here represents a contrary view. Four hundred and eighty consecutive patients were followed from three to ten years postoperatively. Although the survival rate of these patients was lower than that of the general population of comparable age, it remained significantly higher than that of patients with known aneurysms who did not have the benefit of surgical treatment.

Aorta, Abdominal↗
PubMed1977

Three years' experience with computer-based intensive care of patients following open heart and major vascular surgery.

The authors present their experiences with the Roche-5000 Computer-Based Intensive Care System in the management of 100 consecutive patients who have undergone open heart or major vascular surgery. The system performs the following junctions: (1) numerical and graphic display, out-of-limits alarms, storage and printout of 12 biological and surgical parameters, including chest drainage and urine output, by on-line direct monitoring; (2) display, storage, and printout of all additional laboratory and clinical data by manual input; (3) automatic demand-regulated transfusion and infusion program; (4) a program of medical logic, which includes situation analysis based on the above, two way dialogue with the computer, treatment recommendations to the physician, selective nursing and laboratory orders, acid-base analysis, and instructions for respirator setting. It was found that the computer-monitored patients recovered faster and smoother, with fewer fluctuations in the measured parameters and fewer postoperative complications than did those treated by conventional methods. One additional important effect of the system was that the nurse, relieved of the mechanical tasks of measuring, charting, and recording, was left with a greater amount of time for the care of the patient's personal needs. It seems ironic that such a technical advancement in electronics not only made the recovery faster and safer but also created a more humanistic approach in patient care, through better application of basic nursing techniques.

Cardiac Surgical Procedures↗
PubMed1976

Beneficial metabolic effects of methylprednisolone sodium succinate in acute myocardial ischemia.

The metabolic and hemodynamic effects of methylprednisolone sodium succinate (40 mg/kg body weight) after acute myocardial ischemia were determined in 24 heparinized mongrel dogs. Myocardial ischemia was produced by ligation of the left anterior descending coronary artery. Catheters in the coronary sinus and the vein draining the left anterior descending coronary arterial area were used to collect blood samples from nonischemic and ischemic myocardium. Lactate, pyruvate, glucose, free fatty acids and oxygen were measured in arterial and venous blood from ischemic and nonischemic areas before and 3, 30 and 60 minutes after myocardial ischemia in animals with (Group II) and without (Group I) steroid treatment. In both Groups I and II glucose, lactate, free fatty acids, oxygen and coronary blood flow in nonischemic areas were not significantly changed, whereas glucose uptake in ischemic areas was significantly increased with myocardial ischemia and remained elevated. In Group I lactate uptake in ischemic areas became negative after coronary arterial ligation and remained so; in Group II, it increased after 30 (70%) and 60 (111%) minutes. Free fatty acid uptake in ischemic areas was reduced after myocardial ischemia in Group I, but in Group II it increased after 30 (224%) and 60 minutes (173%), and there was a concomitant increase in oxygen uptake. Pyruvate uptake in nonischemic areas decreased after 60 minutes in Group I, whereas it was reduced after 30 (68%) and 60 minutes (513%) in Group II. The changes were similar in ischemic myocardium. There were no significant changes in hemodynamic indexes. Coronary blood flow in ischemic areas decreased in Group I after myocardial ischemia and further after 30 and 60 minutes, but in Group II it increased after 30 (82%) and 60 minutes (53%). The data indicate that administration of methylprednisolone results in improved collateral blood flow into the infarcted area and a significantly improved metabolic response of ischemic myocardium. The glucocorticoid may also have a direct benefical effect on carbohydrate metabolism and cause the increased pyruvate neccesary to maintain the generation of energy-producing substrates. The results also suggest that methylprednisolone increases cell survival time and results in greater salvage of ischemic myocardium.

Acute Disease↗
PubMed1976

Management of the patient with a prosthetic heart valve.

Approximately 20,000 heart valve prostheses are inserted yearly in the United States. Even after successful heart operations, the patients who receive them cannot be regarded as healthy individuals but are a special group with special problems who need close medical attention for the rest of their lives. They are susceptible to many unusual complications because of their implanted foreign body, and it is a challenge to all physicians in contact with them to be aware of their peculiar problems in order to prevent complications if possible and to treat them immediately if they occur. General therapy, surgical complications, infection, and mechanical problems are reviewed, with means for management outlined. These difficulties can be dealt with only by careful follow-up and well-coordinated teamwork between the family physician and the institution where the operation was performed.

Activities of Daily Living↗