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Biomedical subjects

N Levi

Publications and source records attributed to N Levi.

At least 37 records · Page 2Linked to original sources
PubMed1998

Percutaneous recanalization of iliac artery occlusions with the Strecker stent.

Within a 3-year period a total of 16 iliac artery occlusions in 16 patients were treated with percutaneous angioplasty and stenting with the Strecker stent without adjunctive thrombolytic therapy. The length of the occlusions varied from 0.5 to 8 cm (mean 4.1 cm). The average stent diameter was 7.6 mm and the average length was 6.1 cm. Reocclusion occurred in 3 patients (two after one month and one after 11 months). One case of dissection and two cases of distal embolization to the external iliac artery were diagnosed during the procedure by an angiogram and were successfully treated by stenting. Two cases of small groin hematoma were treated conservatively.

Acute Disease↗
PubMed1998

Blood transfusion and postoperative wound infection in intracapsular femoral neck fractures.

The relationship between blood transfusion and postoperative wound infection was studied in 695 operations for cervical hip fractures. A total of 156 (22%) patients were transfused with a total of 392 units of blood. A total of 31 (4.5%) patients developed a postoperative superficial or deep wound infection. Cultures identified Staphylococcus aureus as the cause in 71% and E. coli in 9.7% of the infections. A total of 11 out of 156 (7.05%) transfused patients developed a wound infection. In contrast only 20 out of 539 (3.71%) non-transfused patients developed a wound infection (p < 0.05).

Aged↗
PubMed1998

Thoracic disk herniation in an 82-year-old patient. Treatment with the transpedicular approach.

A rare case of thoracic disk herniation in an 82-year-old female is reported. The patient was referred with a 2-month history of weakness and paresthesia of her left leg. On examination she had a severe paresis of the left leg and mild paresis of the right leg. Myelography and magnetic resonance imaging showed a T10-T11 disk herniation. The unilateral transpedicular approach was used and a large prolapse was surgically removed. The patient made an uneventful recovery and her neurologic function recovered to almost normal.

Aged↗
PubMed1998

Anastomotic femoral aneurysms: is an increase in interval between primary operation and aneurysms formation related to change in incidence?

OBJECTIVE: Anastomotic pseudoaneurysms continue to be a late complication of vascular surgery, particulary following prosthetic graft procedures. The purpose of this study was to investigate if a previously reported increase in interval between the original operation and the development of pseudoaneurysm was related to a change in incidence. DESIGN: Retrospective study. METHODS: We reviewed the records of 76 patients who presented with 90 femoral pseudo-aneurysms and underwent reconstructive procedures from January 1989 to June 1994. The median age was 69 years (range: 39-83). In the same time period all femoral artery anastomosis operations were recorded. RESULTS: The incidence of femoral pseudo-aneurysms in Copenhagen was approximately 4.3%. CONCLUSIONS: A previously reported increase in interval between primary operation and aneurysms formation was not related to a change in incidence during the same time period.

Adult↗
PubMed1998

Is preoperative tibial traction responsible for peroneal nerve palsy in patients with a fractured hip?

A study of 456 cervical hip fractures treated with internal fixation was performed to evaluate the incidence of paralysis of the peroneal nerve following hip-fracture treatment. There were no cases of peroneal nerve paralysis in a group of 206 patient treated with a dynamic hip screw without preoperative traction. There were 2 cases of peroneal nerve paralysis in a group of 250 patients treated with 3 parallel screws with preoperative skeletal traction via a tibia pin. This difference was not significant according to Fischer's test (two-tailed P value = 0.5036). We conclude that the incidence of paralysis of the peroneal nerve following hip-fracture treatment is low although preoperative skeletal traction with the injured leg positioned in a Böhler-Braun splint may contribute to this complication.

Aged↗
PubMed1998

Undiagnosed phaeochromocytoma following infrainguinal bypass surgery.

We present a rare case of undiagnosed phaeochromocytoma following infrainguinal bypass surgery. The patient, a 59-year-old lady, had a one year history of hypertension following a first femoro-tibial bypass and presented as a cardiorespiratory emergency in the admission room following her contralateral femoro-tibial bypass. The patient recovered after some days in intensive care despite a delayed diagnosis.

Female↗
PubMed1997

The incidence of Achilles tendon rupture in Copenhagen.

The incidence of Achilles tendon rupture in Copenhagen during an 18 year period, from 1978 to 1995 was studied. A total of 209 patients sustained 213 Achilles tendon ruptures (55 in women and 158 in men). The median age was 41 years. The overall incidence was 13.4/100000 inhabitants/year.

Achilles Tendon↗
PubMed1997

Femoral pseudoaneurysms in drug addicts.

OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five patients who had a primary vascular reconstruction. Two out of two patients who had a triple ligation of their aneurysms had claudication postoperatively. One patient presenting with thrombosis had a hip-exarticulation following an unsuccessful thrombectomi. No death occurred in this series. CONCLUSION: Revascularisation at the time of resection of the pseudoaneurysm offers better prospects for limb function.

Adult↗
PubMed1997

Avulsion fracture of the calcaneus: report of a case using a new tension band technique.

We report a case of avulsion fracture of the calcaneus in an 83-year-old woman. Nonoperative treatment was not considered satisfactory. However, the os calcis was osteoporotic, and internal fixation therefore was performed with a transverse Kirschner pin through the os calcis, securing a figure-of-8 metal tension band wiring to the fragment. We suggest that this technique provides a strong internal fixation in selected cases.

Aged↗
PubMed1997

Surgical infections with Mycoplasma: a brief review.

Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma.

Cross-Sectional Studies↗
PubMed1997

Arteriosclerotic femoral artery aneurysms. A short review.

True arteriosclerotic aneurysms of the femoral artery are rare but they are dangerous lesions that may thrombose, embolise or rupture. They are often bilateral and frequently the patient has other aneurysms in the abdominal aortic or popliteal artery. True femoral aneurysms were originally classified by Cutler and Darling in 1973 as type 1 and type 2 according to their relationship to the common femoral bifurcation. Case reports of isolated superficial and profunda femoral artery aneurysms have been published, but these are exceedingly rare although isolated aneurysms of the profunda femoris artery may be more common in Denmark. True femoral artery aneurysms are attributed to weakening of the arterial wall due to atherosclerosis. True femoral artery aneurysms are relatively rare and are found in elderly smoking men. Aortic aneurysms are approximately 10 times more common. Distal embolization occurs in 0-26% of cases. Acute thrombosis occurs in around 15% of cases. Rupture is uncommon and varies between 10% and 14%. Aneurysmal dilatation of the profunda femoris artery is uncommon and occurs in only 1% to 2.6% of all femoral artery aneurysms. Individualized operative approaches are based on aneurysmal involvement of the superficial femoral or profunda femoris arteries, as well as the presence or absence of coexisting extremity occlusive disease. Aneurysm excision and interposition or bypass graft reconstruction are favored over direct end-to-end reanastomosis.

Aneurysm↗
PubMed1997

Mycoplasma in urine and blood following catheterisation of patients undergoing vascular surgery.

OBJECTIVES: The purpose of this investigation was to determine if mycoplasmas enter the bloodstream after urinary tract catheterisation in patients undergoing vascular surgery in order to evaluate the efficiency of the routine prophylactic antibiotic treatment. DESIGN: Prospective study. MATERIALS AND METHODS: A total of 100 patients (63 men and 37 women) undergoing elective vascular surgery had urine and blood cultures performed for mycoplasmas. Blood cultures were taken preoperatively after urinary tract catheterisation and the urine was collected during catheterisation. The median age of the patients was 67 years (range 42-87). RESULTS: A total of 12 (12%), 5 men and 7 women, had a positive urine culture for mycoplasmas (One patient had Mycoplasma hominis and 11 had Ureaplasma urealyticum isolated). Their median age was 60 years (range 42-76). No blood cultures were positive for Mycoplasma. CONCLUSIONS: Mycoplasmas do not enter the blood-stream after catheterization in sufficient amounts and sufficiently often to be detected by blood-cultures in this small patient sample. The number of vascular patients harbouring mycoplasmas in the urine was low and we found no indication for changes in the prophylactic antibiotic treatment based on these findings.

Adult↗
PubMed1997

Preoperative ultrasound mapping of the saphenous vein: prognostic value on early post operative results, a prospective study.

A prospective series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. Sixteen (17%) bypass procedures thrombosed within the first week postoperatively. A naturally occurring optimal vein diameter was discovered: 3.5-4.2 mm at mid-thigh level and 0-1.5 mm less at mid-calf level. It was significantly correlated with higher one week patency: thrombosis occurred in 11% in veins with this optimal diameter combination and in 19% in all other combination (P < 0.05). These results confirm and expand a retrospective study.

Aged↗
PubMed1997

Blood transfusion requirement in surgery for femoral artery aneurysms.

BACKGROUND: Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion requirement in patients undergoing surgery for femoral artery aneurysms. METHODS: The blood transfusion requirements of 120 patients undergoing surgery for femoral artery aneurysms were studied. All patients underwent routine pre-operative and postoperative haemoglobin measurement. Operative blood loss was also assessed. RESULTS: The transfusion requirements were correlated with the type of aneurysms, the existence of preoperative anaemia and intraoperative blood loss. A total of 62 (52%) patients were transfused with a total of 144 units. Out of 90 patients with anastomotic femoral aneurysms, 42 patients were transfused with a total of 89 units. The average measured intraoperative blood loss was 635 ml. Out of 17 patients with atherosclerotic femoral aneurysms, 13 patients were transfused with a total of 34 units. The average measured intraoperative blood loss was 1107 ml. Out of 13 patients with traumatic or mycotic femoral aneurysms, 7 patients were transfused with a total of 21 units. The average measured intraoperative blood loss was 536 ml. CONCLUSIONS: Patients with a preoperative haemoglobin < 7 mmol/l should be cross-matched 3-4 units. When the preoperative haemoglobin is between 7 and 9 mmol/l, patients should be cross-matched 1-2 units, whereas it should be safe to group and antibody screen patients with a preoperative haemoglobin > 10 mmol/l.

Adult↗
PubMed1996

Early mortality after cervical hip fractures.

A total of 59 (13.5 per cent) of 437 patients with cervical hip fractures died within the first 3 months, compared with an expected mortality rate of 2.6 per cent in the comparable general population (P < 0.05). The average age at death was 86 years (range, 62-98). The 3-months mortality rate among patients admitted from institutions was 24/105 = 23 per cent compared with 35/332 = 10.5 per cent for patients admitted from their own homes (P < 0.05). The 3-months mortality rate for patients with Garden 1 + 2 fractures was 9.4 per cent compared with 14 per cent for Garden 3 + 4 (P < 0.05). This series seems to suggest that non-cemented hemi-arthroplasty may be associated with an increased 3-months mortality rate of 21 per cent compared with 13.9 per cent (P < 0.05) for patients with the same age distribution. This may be due to a relatively high deep-infection rate following non-cemented hemi-arthroplasty.

Adolescent↗
PubMed1996

Blood transfusion requirements in intracapsular femoral neck fractures.

The blood transfusion requirements of 445 patients undergoing operation for intracapsular fractures of the femoral neck were studied. These requirements were correlated with the type of operation carried out, the existence of pre-operative anaemia, and intra-operative blood loss. A total of 127 patients (29 per cent) were transfused with a total of 321 units.

Adolescent↗
PubMed1996

Anastomotic femoral aneurysms: increase in interval between primary operation and aneurysm formation.

OBJECTIVE: Anastomotic pseudoaneurysms continue to be a late complication of vascular surgery, particularly following prosthetic graft procedures. The purpose of this study was to investigate if a previously reported increase in interval between the original operation and the development of pseudoaneurysm was still valid. DESIGN: Retrospective study. MATERIAL AND METHODS: We reviewed the records of 76 patients who presented with 90 femoral aneurysms. The median age was 69 years (range: 39-83). The commonest previous vascular surgery was a aortofemoral bypass in 61 cases. RESULTS: The interval between the original operation and the repair of the pseudoaneurysms was 9 years (range 1 month to 26 years). CONCLUSIONS: This study confirms the previously noted trend of an increasing time to aneurysm formation from 3 years before 1975, 5 years between 1976 and 1980, and 6 years between 1981 and 1990.

Adult↗