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Biomedical subjects

M Valle

Publications and source records attributed to M Valle.

At least 109 records · Page 6Linked to original sources
PubMed1988

Treatment of acromioclavicular disruptions: trial of a simple surgical approach.

Following the Allman and the Zlotsky and Ballard classifications, 85 cases of acromioclavicular disruptions (ACD) have been treated. Types I and II have been conservatively managed, while type III was treated by a special surgical technique described in the text. Types I and II were reviewed by a questionnaire form and type III was assessed clinically and radiologically, with good results according to a score rating made for the review.

Acromioclavicular Joint↗
PubMed1988

Fatal encephalitis caused by a bat-borne rabies-related virus. Clinical findings.

The clinical findings are described in the first reported European case of fatal encephalitis of bat origin caused by a rabies-related virus. A bat zoologist developed the symptoms of rabies 51 days after his last exposure to a bat bite. The clinical disease of 23 days duration was a combination of the paralytic and 'furious' forms of rabies. Serial BAEP and EEG recordings, CT and MR scans of the brain, as well as CSF findings, demonstrated severe ascending destruction of the brain. An unusual progression from isolated brainstem death to cortical brain death occurred. Neuropathologically, the brain showed severe lytic changes. The presence of rabies-related virus antigens in brain smears was shown using a panel of fluorescent antibodies. The virus was inoculated into and isolated from suckling mice. The virus had a close resemblance to European bat rabies isolates, which belong to the group of rabies-related viruses. Of particular concern is whether the virus can spread from bats to terrestrial animals and whether the European type of bat rabies constitutes a danger to man.

Adult↗
PubMed1987

Egg-grown and tissue-culture-grown variants of influenza A (H3N2) virus with special attention to their use as antigens in seroepidemiology.

A field strain of influenza A (H3N2) virus isolated in embryonated eggs during the 1984-5 influenza outbreak (A/Finland/13/85E) was compared in an antigenic analysis with virus from the same clinical specimen isolated in MDCK cell cultures (A/Finland/13/85M). The M-virus appeared to be more sensitive to haemagglutination-inhibiting antibodies against heterologous viruses than did the E-virus. The results of propagation and plaque purification experiments support the hypothesis that a single clinical specimen may consist of distinct antigenic variant subpopulations promoted selectively by the host during isolation procedures. Receptor-binding properties are discussed as a possible explanation for this selectivity. A set of 471 paired sera consisting of pre-epidemic and post-epidemic specimens taken from the same subjects in 1984-5 was studied for haemagglutination-inhibiting antibodies to six influenza A (H3N2) virus strains, including the E-virus and the M-virus from A/Finland/13/85. Of the antigens used, the M-virus detected significant antibody increases more frequently than did the E-virus (10.0 v. 5.9%). The superiority of the M-virus may rest primarily in its ability to pick out anamnestic antibody responses. Irrespective of this cross-reactivity, pre-epidemic antibody to the M-virus was fairly well associated with protection. In the set of sera (230 specimens) collected in summer 1985 to represent different age groups, the antibody status against the M-virus was significantly better than the status against the E-virus. The results suggest that, at least in some instances, antibody to MDCK-grown virus is a more accurate indicator of the immune status of a community than antibodies to egg-grown virus variants.

Adolescent↗
PubMed1987

Management of liver trauma.

A ten-year experience with the management of liver trauma is reported. The diagnostic approach is examined, stressing the role of selective arteriography. The management of the 78 observed cases is described. The need for biliary drainage to prevent postoperative leakages, is supported. Overall mortality in this series was 16.6%.

Adolescent↗
PubMed1986

Studies on ergometer exercise testing. I. Significance of the type of ST-segment response, sex, and chest pain.

Ergometer exercise electrocardiographic (EECG) data were surveyed in a series of 328 patients (277 men and 51 women) subjected to coronary arteriography. The sensitivity and specificity of EECG for coronary artery disease (CAD) were 84% and 54%, respectively. The predictive accuracy of a positive test for CAD was 95% in men and 81% in women. The predictive accuracy of a negative test was 25% in men and 62% in women. When slowly ascending ST depression was considered insignificant, the sensitivity of EECG declined to 71%, with an increase in specificity to 64%. CAD was present in 89% of the patients with slowly ascending ST depression and 65% of them had a multivessel disease. Seventy-two subjects had postexercise ST-segment elevation. The predictive value of this sign for CAD was 94%. Exercise-induced chest pain had quite a similar diagnostic significance as EECG. The prevalence of CAD in patients with a history of typical angina was 94% in both sexes. Atypical chest pain was associated with normal coronary arteriography in 59% of males and 100% of females.

Adult↗
PubMed1986

Studies on ergometer exercise testing. II. Effect of previous myocardial infarction, digoxin, and beta-blockade on exercise electrocardiography.

The results of exercise electrocardiography were studied in a random sample of 317 subjects with clinical suspicion of coronary artery disease. In 278 patients with coronary artery disease the rate of false negative tests was 18% with and 12% without previous myocardial infarction. If ST elevation was considered a negative response, the corresponding values were 25% and 13%, respectively, p less than 0.01. The greatest prevalence of negative tests was seen after anterior myocardial infarction: 27% or 42% when ST elevation was not included into positive responses. The sensitivity of exercise-induced ST depression for the presence of multivessel disease was lower after anterior infarction (67%) than in other patients with previous infarction (86%), p less than 0.01. The corresponding specificities were 71% and 22%, respectively, p less than 0.005. If ST elevation was included into positive responses these differences were abolished. In subjects without myocardial infarction the sensitivity was 89% and specificity 43%. Digitalized patients had somewhat higher sensitivity in the exercise electrocardiogram than those without digoxin, 90% vs. 81% (p less than 0.05), but the difference was not seen with exclusion of ST elevation. The specificity was not influenced by digitalis. beta-blockade had no effect on the sensitivity or specificity, but the prevalence of postexercise ST evolution was lower with (11%) than without (30%) beta-blockade. The prevalence of slowly ascending ST depression was reduced by three factors: the presence of digitalis in patients without previous myocardial infarction, infarction itself, and the extent of coronary artery disease. We conclude that exercise electrocardiography has only a limited value in prediction of multivessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1986

Hospital cost development in coronary bypass surgery.

The rapid expansion of open-heart surgery together with steadily rising costs of health services has elicited criticism against uncontrollably expanded costs of coronary bypass surgery. However, critical analyses of the cost structures and the attempts for cost containment can only rarely be found in medical literature. This study emphasizes self-evident surgical principles which have led to surprisingly high cost reductions. Further savings can be obtained by constant financial education of the surgical staff, in spite of some controversial experiences gained elsewhere. The conditions needed are more accurate, up-to-date hospital bookkeeping and closer contacts between the hospital administration and the medical staff.

Coronary Artery Bypass↗
PubMed1985

[Experience in the use of the tumor markers CEA, GICA and TPA in the postoperative monitoring of colorectal neoplasms].

Current use of tumour markers in the followup to malignant digestive tract neoplasias is restricted mainly by the non optimal sensitivity levels and specificity of these markers. These aspects of CEA, GICA and TPA markers used in follow-ups for 23 patients surgically treated for Duke's stage B2 neoplasias of the colon and rectum were examined over the period 1980-1983. Each marker examined displays its own individual characteristics of sensitivity and specificity. An X-ray endoscopic confirmation is required in all cases as no single marker is sufficiently reliable to be used as a diagnostic tool on its own. It is concluded that biological markers should be used as part of a follow-up programme embracing more than one diagnostic procedure.

Antigens, Neoplasm↗