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Biomedical subjects

P Stulz

Publications and source records attributed to P Stulz.

102 records · Page 6Linked to original sources
PubMed1984

Traumatic pulmonary pseudocysts and paramediastinal air cyst: two rare complications of blunt chest trauma.

Traumatic pulmonary pseudocysts and paramediastinal air cysts due to closed chest trauma are very uncommon. Minor clinical symptoms and major radiologic signs are characteristic of this form of injury to the lung parenchyma. Treatment of combined pseudocysts and pneumatocele in a 17-year-old girl is described. Chest X-ray and computed tomography provided the diagnosis. No surgical treatment was required. Intensive bronchial toilet and PEEP-assisted respiration by mask were followed by recovery. This condition must be differentiated from lung abscesses after infected hematomas, specific cavities, or congenital pulmonary cysts.

Adolescent↗
PubMed1983

Traumatic aneurysm of the thoracic aorta simulating bronchogenic neoplasms.

A 70-year-old man was examined in 1977 because of hoarseness and a central opacification in the left hilus. At that time, the diagnosis of a central bronchogenic carcinoma was made based on roentgenographic findings. The patient's condition was reevaluated five years later, when an examination disclosed a chronic posttraumatic aortic aneurysm. Despite severe chronic obstructive pulmonary disease, the patient was successfully operated on.

Aged↗
PubMed1982

Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen.

Twenty-three patients had a painful ilioinguinal and/or iliohypogastric nerve entrapment syndrome following common surgical procedures in the lower portion of the abdomen (appendectomy, repair of inguinal hernia, and gynecologic procedures through transverse incision). The diagnostic triad of nerve entrapment after operation comprises (1) typical burning or lancinating pain near the incision that radiates to the area supplied by the nerve, (2) clear evidence of impaired sensory perception of the nerve, and (3) pain relieved by infiltration with anesthetic for local effects at the site where the two nerves leave the internal oblique muscle. Surgical repair of the scar with resection of the compromised nerve is the most effective treatment. Sixteen patients became symptom free after neurectomy, seven still suffer chronic pain in the scar.

Abdomen↗
PubMed1979

[Management of traumatic rupture of the aorta].

Traumatic rupture of the thoracic aorta is a common injury in automobile accidents. It is the result of a crushing chest injury, most frequently associated with sudden deceleration. Approximately 10 to 20% of the individuals with traumatic rupture of the aorta survive temporarily. Diagnosis may be difficult, but if the lesion is promptly diagnosed, appropriate surgical treatment may be life-saving. 9 patients with traumatic aortic rupture have been operated on at our unit since 1969. 2 died postoperatively from acute respiratory distress syndrome. 7 survived the immediate postoperative period without major complications. 2 of them died later after four weeks because of complications not related to the operation. Based on the literature and on our own experience some directions in the management of the traumatic rupture of the thoracic aorta are presented.

Accidents, Traffic↗
PubMedDate not supplied

Reduction of blood loss and transfusion requirements after coronary artery bypass grafting: similar efficacy of tranexamic acid and aprotinin in aspirin-treated patients.

BACKGROUND: In patients with coronary artery disease, continuation of aspirin may reduce the incidence of unstable angina and preoperative myocardial infarction before surgery, but the risk of perioperative bleeding may be increased. METHODS: The efficacy of aprotinin and tranexamic acid (TXA) was examined in a prospective, randomized, double-blind trial involving 56 patients scheduled for coronary artery bypass grafting and who received aspirin 100 mg/day until the day of the operation. Group I received high-dose aprotinin whereas group II received 10 g of tranexamic acid (TXA) over 20 minutes before sternotomy. Heparinization during cardiopulmonary bypass was controlled with HDTT (high-dose thrombin time) to eliminate interference of aprotinin on ACT (celite activated clotting time). Postoperative blood loss and transfusion requirements were registered during the first 24 hours. RESULTS: The demographics, coagulation, and intraoperative parameters were similar in both groups. Postoperative blood loss (aprotinin 840 mL /24 hours, TXA 880 mL/24 hours, p = 0.481), and transfusion requirements (2.18 units/patient in the aprotinin group, 2.11 units/patient in the TXA group) were not remarkably different between the two regimen protocols. No perioperative myocardial infarction, pulmonary embolism, cerebrovascular event, or other thrombotic events were observed. CONCLUSIONS: In this trial, we were not able to demonstrate any difference in postoperative bleeding in patients pretreated with aspirin after high-dose aprotinin or TXA. From a practical point of view, TXA is safe, less expensive than aprotinin, and easy to handle, and can be recommended in patients pretreated with aspirin to improve postoperative hemostasis.

Antifibrinolytic Agents↗
PubMedDate not supplied

Emergency valve replacement for active infective endocarditis.

During the last 12 years, 14 patients were subjected to emergency heart valve replacement in acute bacterial endocarditis. Operative mortality was 21% (3/14); significant postoperative periprosthetic regurgitation or reinfection occurred in none of the survivors. Risk factors with unfavourable prognosis are: (1) virulent pathogens ("Non-Viridans"-germs); (2) previously normal heart valves; (3) acute aortic insufficiency with premature closure of the mitral valve; (4) floating vegetations shown by echocardiography. Our results provide further evidence for the efficacy of early surgical intervention in patients with bacterial endocarditis with an unfavourable etiology or a complicated course.

Adult↗
PubMedDate not supplied

Candida endocarditis after heart valve replacement (successful management with reoperation and local disinfection).

Two patients with candida infection on prosthetic valves are presented. Both were eventually cured after removal of the prosthesis, sterilization of the prosthetic bed with local iodine solution (Sol. Iodi Aethanolica 6.5%) and insertion of a new prosthesis and the discontinuance of antifungal therapy. This technique has subsequently been applied to 22 patients with bacterial endocarditis with good results.

Administration, Topical↗