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Biomedical subjects

J Godoy

Publications and source records attributed to J Godoy.

49 records · Page 3Linked to original sources

Malar fractures associated with exophthalmos.

Although fracture of the malar bone is often associated with enlargement of the orbit and subsequent development of enophthalmos, occasionally, a blowin type of orbital floor fracture and exophthalmos occurs. The causes of the injury and the differential diagnosis of the blowin fracture are reviewed. An explanation is offered for the development of the symptoms. Early recognition, open reduction and fixation of the malar bone, and repair of the floor of the orbit defect are important for successful management of the injury.

Adolescent↗

A simplified technique for treating mallet fingers: tenodermodesis.

Tenodermodesis is a useful surgical procedure in cases of mallet fingers where conservative treatment has failed. The results have been satisfactory in 22 of 26 patients. These results all have been achieved within 60 days and with no more than 35 days of permanent splinting of the distal part of the digit. The final range of motion depends on the patient and on the patient's age; this procedure should not be proposed for elderly patients. The operation is not performed until 3 months after the initial trauma and until formal request from a patient who cannot tolerate this small disability. We recommend local anesthesia for this procedure. Thus with a small incision, without hospitalization, and with minimal splinting and immobilization, this procedure provides a simple treatment for a minor lesion, a principle which never should be forgotten.

Adult↗

Significance of sharp waves in routine EEGs after epilepsy surgery.

We retrospectively analyzed the presence of sharp waves in 2-h EEGs performed 6 months after epilepsy surgery in 59 patients. To study the significance of the postoperative interictal epileptiform activity in the tissue remaining after resection, we included only patients with a single epileptic focus (as defined preoperatively by prolonged video/EEG recordings and subdural electrode arrays studies) and no progressive structural lesions. Temporal lobectomy was performed in 51 patients (86%); extratemporal resections were performed in the remainder. The epileptogenic focus was completely resected in 26 patients (44%). The immediate postoperative electrocorticograms (EcoG) showed spikes in 13 patients (22%). At 6-month follow-up, 43 patients (73%) were seizure-free or had auras only and 12 patients (20%) had epileptiform activity on EEG. A significant correlation was noted between presence of sharp waves in the 6-month postoperative EEG and recurrence of seizures (Fisher's exact test p = 0.011) and also with the extent of the resection (complete vs. incomplete p = 0.042). We noted no correlation between postoperative epileptiform activity and location of the resection (temporal vs. extratemporal), presence of spikes in immediate postoperative EcoG, or occurrence of auras only at 6-month follow-up.

Adolescent↗

Intracarotid amobarbital (Wada) test for language dominance: correlation with results of cortical stimulation.

Eighty-eight patients had bilateral intracarotid amobarbital (Wada) testing to determine hemispheric dominance for language in preparation for epilepsy surgery, as well as unilateral extraoperative cortical electrical stimulation using subdural electrode arrays. In none of the patients with left dominance by Wada testing were language areas found with right-sided stimulation, but two patients with right dominance by Wada testing had language areas mapped on the left side. These findings suggest that left dominance by Wada testing is strong evidence for exclusive lateralization of language function in the left hemisphere, but there is concern about the ability of the Wada test to exclude the possibility of some left-sided language function despite apparent right-sided dominance. Patients with left dominance on Wada testing do not need cortical stimulation before extensive right temporal lobectomy, but we believe that patients with right or bilateral dominance on Wada testing should have cortical stimulation for localization of language areas if extensive left or right temporal or frontal resection is planned.

Amobarbital↗

Inferior vena cava catheterization in the neonate by the percutaneous femoral vein method.

Placement of percutaneous femoral venous catheters in neonates is rarely performed for long-term central venous access. We studied 44 neonates (gestational age, 32.4 +/- 48 weeks, postnatal age, 18 +/- 32 days) with lack of other venous access sites. The femoral vein was entered with a 19-gauge introducer needle with placement of a 2F silastic catheter localized at the inferior vena cava-right atrial junction. Catheter-related sepsis, bacteremia, or thrombophlebitis did not occur in any patients. Our findings suggest that percutaneous femoral-vena cava catheters can be safely used when other nonfemoral sites are unavailable.

Catheterization, Central Venous↗