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Biomedical subjects

I Papo

Publications and source records attributed to I Papo.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Heart valve replacement].

From 1965 to 1980, the authors accumulated vast experience by operating on 2500 diseased heart valves. Some of these patients had one, two, or three valves replaced. Among the two/three patients, there was a monovalvular problem in III, and more than half the patients with multivalvular problems in IV functional group NYHA. In group II there were only one/three patients with stenosis of the aortic valve. Because of the advanced stage of the disease among the group II patients, the following conditions were often present: heart insufficiency, manifest lung hypertension, cardiomegaly, and pronounced arrhythmia with damage to the kidneys. The risk in such cases is significantly greater. In total, 2941 valves were built. 74% had a normal postoperative recovery, 9,2% died; and 14,2% suffered complications that were remedied. Among the complications were insufficiency of the heart, arrhythmia, hemorrhage, transitory cerebral damage, and tracheobronchial infections. Thus, it can be seen that valve replacement as a treatment for significant hemodynamic disturbances is an effective method of surgical treatment. Improved results, reduction of complications, and few fatalities signal the advancement in such treatment.

Heart Valve Diseases↗
PubMed1980

Intracranial hypertension in severe head injuries.

Long-term ICP monitoring was carried out in a series of 124 patients with severe head injuries admitted to the Intensive Care Unit. Forty-nine percent of patients were admitted within six hours of injury. Most of them were referred by Community Hospitals. Only patients with diffuse brain lesions or patients operated on for mass lesions and remaining in a coma state after operation are taken into account. Altogether, 46 patients survived, but 15 of them remained severely disabled or in a vegetative state, and 78 died. Twenty-four percent of the whole series succumbed to fulminationg intracranial hypertension. The average survival in this group was 5.1 days. Twenty-nine percent died after exhibiting different levels of intracranial hypertension ranging from 20 to 50 mm Hg. In this group the role of extracerebral complications as a cause of death should not be underestimated. Death caused by cerebral lesions with ICP not exceeding 15 mm Hg was exceedingly rare in the first 72 hours. Normal or fairly raised ICP does not rule out the risk of devastating intracranial hypertension: reliable and harmless P/V tests are needed. All patients who survived after showing sustained intracranial hypertension exceeding 50 mm Hg were under 20 years of age. In the present series the results of treatment of intracranial hypertension were, on the whole, rather disappointing.

Adolescent↗
PubMed1980

Intrinsic third ventricle craniopharyngiomas with normal pressure hydrocephalus.

Two observations of intrinsic third ventricle craniopharyngiomas, both involving males in the fifth decade, are reported. Histologically, the tumours, one entirely solid and the other one chiefly cystic, were composed of squamous epithelium with microcysts and no calcifications. In the literature primary third ventricle craniopharyngiomas are considered to be exceedingly rare. However, if a more precise preoperative diagnosis, using computerised axial tomography, were made as a matter of routine, to verify third ventricular masses, it might demonstrate that these tumours are more common than previously believed. In both cases striking clinical pictures of normal pressure hydrocephalus were observed. The relations between intracranial pressure, CSF circulation and ventricular size are discussed. On mechanical grounds, it is very difficult to explain the poastoperative reduction in ventricular size, since there was no significant change in intracranial pressure.

Autopsy↗
PubMed1980

Traumatic cerebral mass lesions: correlations between clinical, intracranial pressure, and computed tomographic data.

After surveying the different phases of their previous experience with the diagnosis and management of traumatic cerebral mass lesions, the authors analyze the correlation between clinical, computed tomographic (CT), and intracranial pressure (ICP) data in 29 patients with traumatic intracerebral hematomas and/or brain lacerations. Clinically, the patients are classified in three groups: (a) deeply comatose patients (Glascow coma scale (GCS), 4 to 5); (b) patients with intermediate disturbances of consciousness (GCS, 6 to 10); and (c) patients with minor impairment of consciousness (GCS, more than 10). Sixteen patients were operated upon. Operation was ineffective in the patients who were already deeply comatose in the first hours after injury, even though elevated ICP was definitely reduced after operation in some of them. Conversely, patients with well-limited lesions, moderate disorders of consciousness, and persisting intracranial hypertension despite medical therapy seemed to be good candidates for delayed operation by limited procedures. In patients with intermediate disturbances of consciousness and no tendency to improvement or deterioration, ICP monitoring correlated with CT scan appearance may be of practical use for making the decision to operate. However, most cases diagnosed on CT scan have a benign course; the patients recover uneventfully with conservative management. In such patients careful clinical observation is usually sufficient. (Neurosurgery, 7: 337-346, 1980).

Adolescent↗
PubMed1979

Intracranial pressure time course in primary intracerebral hemorrhage.

The course of intracranial pressure (ICP) over time was studied in 66 hypertensive and/or altherosclerotic patients harboring intracerebral hematomas. Patients with no disturbance of consciousness showed normal or only slightly elevated pressure. Conversely, most patients in deep coma exhibited high pressure with a tendency to rise further no matter what treatment was used. In the remaining patients with intermediate disturbances of consciousness, no definite correlation was found between ICP, clinical condition, and outcome. In all of the patients who underwent operation, the postoperative course of ICP over time was also studied and seemed to depend to a certain extent on the timing of the operation.

Adult↗
PubMed1978

The reliability of computerized axial tomography in the diagnosis of infratentorial mass lesions. A neurosurgical appraisal.

The accuracy of CAT in the diagnosis of infratentorial expanding lesions is analysed on the basis of 224 personal cases. The posterior fossa lesions are classified in four groups according to the reliability of CAT as the only pre-operative examination. The present indications for conventional neuroadiological procedures are also outlined. Particular emphasis is laid on the information supplied by CAT in postoperative follow up to detect both immediate and delayed complications.

Adult↗
PubMed1977

Long-term intracranial pressure monitoring in comatose patients suffering from head injuries. A critical survey.

On the basis of a series of 75 patients, the practical use of Icp continuous long-term recording in severe head injuries without mass lesions or remaining deeply comatose after surgical procedures is critically analyzed. ICP monitoring alone seems to be not essential for prognosis. Conversely it is of much greater use as a guide to management (respirator treatment, osmotics, CSF drainage). If the pros and cons of the procedure are carefully weighed, it would appear that, for the time being, ICP long-term monitoring is justified only in comatose patients on intensive care.

Adolescent↗