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Biomedical subjects

J Gintautas

Publications and source records attributed to J Gintautas.

At least 37 records · Page 2Linked to original sources
PubMed1993

Incompatibility of Isovue 370 and papaverine in peripheral arteriography.

Complete thrombotic occlusion of the arterial blood flow in the upper extremity was produced after mixture of Isovue 370 (iopamidol) and papaverine hydrochloride during routine angiography. Bolus and then continuous infusion of urokinase failed to dissolve the thrombus. The patient required a surgical thrombectomy and recovered uneventfully. This case report demonstrates that caution should be exercised when Isovue 370 and papaverine are used in angiography.

Angiography↗
PubMed1993

Surgical management of pediatric renal trauma: an urban experience.

This study was undertaken to review our operative experience in the management of pediatric renal trauma. Over a 2-year period (August 1988 to August 1990) 25 of 60 children undergoing celiotomy sustained renal injuries. There were 22 boys and three girls ranging in age from 5 to 18 years. Eighty-four per cent were victims of gunshot wounds, 12 per cent were stabbed, and 4 per cent sustained blunt trauma. The 25 injured children sustained a total of 45 individual organ injuries. Only 16 per cent required a nephrectomy, while the great majority (84%) were managed with renal sparing procedures. When we compared survivors to nonsurvivors, there was more thoracic and vascular injury along with more blood transfusion requirements in nonsurvivors. There was no statistical difference in Pediatric Trauma Score (PTS) between survivors and nonsurvivors (9.8 +/- 0.26 vs 9.5 +/- 1.5). Preoperative intravenous pyelographies (IVPs) performed in 52 per cent of all patients demonstrated the site of injury, presence of contralateral function as well as the anatomic position of the kidneys. We conclude that renal injury is common following penetrating abdominal trauma in childhood, however, these injuries can be managed by early operation with renal sparing procedures. There is a high incidence of associated intra-abdominal injury in those who have sustained penetrating renal trauma, but mortality is more common in patients sustaining associated thoracic and vascular injuries. An IVP should be performed, even in the absence of hematuria, when trauma trajectory strongly suggests urologic injury. This study also illustrates the sharp rise in drug-related urban violence with an associated increase in pediatric renal trauma.

Abdomen↗
PubMed1991

Clinical assessment of gestational age: a comparison of two methods.

The ratio of fundal height (FH) to maternal abdominal length (MAL) was defined as percentage of maternal abdominal length (PMAL) and compared to FH alone in 100 consecutive uncomplicated pregnancies from the 18th week of gestation to delivery at term. Reference graphs for fetal growth evaluation were developed using these two clinical methods. The predictive value of each technique was assessed by comparing gestational age estimates in 29 additional patients at various gestational ages. The correlation coefficient between the known gestational ages and estimates by the PMAL method was .86, and between known gestational ages and estimates by the FH method, .94. Twenty more patients were evaluated by three obstetricians in a double-blind fashion to determine gestational ages by each technique. The average deviation from the real gestational age varied from 2.07 to 3.14 weeks using the FH method, and from 2.82 to 3.97 weeks using the PMAL graph. It was concluded that FH measurement correlates better with gestational age than its ratio to the MAL.

Abdomen↗
PubMed1990

Endovaginal sonography for the early diagnosis of intrauterine and ectopic pregnancies.

Endovaginal sonography, together with beta-HCG titre, was used to diagnose ectopic pregnancy in 58 patients. Transabdominal ultrasound failed to conclude this diagnosis. The data from endovaginal sonography revealed the presence of a gestational sac in all 15 patients with normal pregnancies at a beta-HCG level of 1042 mIU/ml. Of the 23 patients with pathological pregnancies only 61% had an intrauterine gestational sac. Only 15% of the 20 patients with ectopic pregnancies showed an increase in beta-HCG greater than 66% in 48 h, while in normal pregnancy, this increase was found in 71% of the patients. The endovaginal findings of the ectopic gestation revealed a complex adnexal mass in 55%, a cystic mass in 30% and fluid in the cul-de-sac in 20%. The diagnostic indices of adnexal and cul-de-sac sonographic findings in the ectopic group further improved specificity and positive predictive accuracy. The detection of ectopic versus intrauterine gestation showed a high sensitivity of 95%, a specificity of 100%, a positive predictability of 100% and a negative predictability of 97%. The data confirm the value and reliability of endovaginal and cul-de-sac sonography, combined with measurement of the beta-HCG level in the early diagnosis of ectopic pregnancy. This combined approach not only makes the differentiation between normal and extrauterine gestation more accurate but also helps to avoid unnecessary diagnostic laparoscopy and hospitalization.

Chorionic Gonadotropin↗
PubMed1990

A rare malposition of the central venous catheter.

The left pericardiacophrenic vein was accidentally cannulated during an attempt to establish central venous catheterization through the left internal jugular vein. Chest roentgenograms and intravenous contrast material confirmed the position of the catheter. Although our patient developed no problems during a five-day cannulation, based on published information, it is advisable to reposition the catheter to avoid perforation of the pericardiacophrenic vein and possible cardiac tamponade.

Adult↗