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Biomedical subjects

R E Berry

Publications and source records attributed to R E Berry.

At least 37 records · Page 2Linked to original sources
PubMed1990

Free-floating deep venous thrombosis. A retrospective analysis.

Duplex scan to diagnose deep venous thrombosis is an established technique. As experience accumulated, patients with free-floating thrombi were identified. A retrospective review of 65 patients was performed to study these thrombi, to evaluate treatment regimens, and to analyze patient outcome. A 26% incidence of pulmonary embolus occurred. However patients who had bilateral free-floating thrombi had a 42.8% incidence of pulmonary embolus. Receiving a 7-day course of heparin therapy with a partial thromboplastin time (PTT) at 1.5 times control was 53.2% of patients; 55.4% of the patients underwent follow-up examination, and the mean time to clot attachment was 9.2 days. Patients should receive anticoagulation for 10 days or until clot attachment. Patients with persistent, bilateral free-floating thrombi, or propagation of thrombus are candidates for potential caval interruption. Serial scans should be performed to monitor the thrombus for attachment or alteration.

Aged↗
PubMed1990

Subclavian vein thrombosis: a continuing challenge.

Subclavian vein thrombosis is a relatively uncommon but potentially morbid disease entity. To determine the frequency, cause, and best mode of treatment of this problem, we performed a chart review of all patients with a diagnosis of subclavian vein thrombosis at two major metropolitan hospitals during a 6-year period. A total of 40 patients were identified with subclavian vein thrombosis, which represented 3.5% of all venous thromboses detected during the 6-year period. No side or sex predilection was noted and the majority of patients were outpatients. The cause was fairly evenly divided among intravenous catheters (32%), anatomic abnormalities (45%), and carcinoma with postoperative radiation (22.5%). Despite the increasing use of the subclavian veins for pacemaker leads, hyperalimentation, and permanent intravenous access for chemotherapy, there has not been an increase in diagnosed subclavian vein thrombosis. Anatomic abnormalities with compression of the vein respond well to either heparinization or lytic therapy but require surgery if the venous abnormality persists. Treatment consisted of lytic therapy in 20%, heparinization in 55%, and elevation with removal of the central line in 25% of patients. All patients responded well to treatment, with a decrease in swelling and symptoms; no patient progressed to venous gangrene and only one (2.5%) had a documented pulmonary embolus. Medical treatment provides excellent long-term benefit in most cases unless complicated by an anatomic abnormality.

Adult↗
PubMed1990

Noninvasive detection of deep venous thrombosis. A critical evaluation.

The problems associated with deep venous thrombosis are well established. Correct diagnosis cannot be made by clinical examination; therefore, an objective test for accurate assessment becomes necessary. Contrast venography is recognized as the gold standard examination. However, the disadvantages of venography including radiation, dye exposure, and cost are also well recognized. These disadvantages have led to the development of the noninvasive studies. To evaluate Duplex B-mode ultrasound, Doppler, and air plethysmography, a retrospective review of patients referred to the vascular laboratory for evaluation of deep venous thrombosis was performed. From June 1984 until June 1987, 1,870 patients were examined in the laboratory. Forty eight of these patients underwent all three noninvasive tests as well as contrast venography. There were 16 men and 32 women with a mean age of 60. A total of 50 limbs was examined in these patients. The noninvasive tests had the following sensitivities as compared with venography: Doppler 71 per cent, air plethysmography 71 per cent, and Duplex B-mode ultrasound 95 per cent. These results were statistically significant at P less than 0.05. The specificities for Doppler, air plethysmography, and Duplex B-mode ultrasound were 90 per cent, 83 per cent, and 100 per cent, respectively. These results were also statistically significant at P less than 0.02. Based on these findings, we conclude that Duplex B-mode ultrasound is a superior noninvasive examination as compared with air plethysmography or Doppler, and is a reliable, economical, and efficient substitute for contrast venography.

Evaluation Studies as Topic↗
PubMed1988

Primary lymphoma of the large intestine.

Three cases of primary colonic lymphoma are presented and the literature for this disease is reviewed. Colonic lymphoma occurs in from 0.5 to 2 per cent of all cases of neoplastic disease of the colon, and comprises 15 to 20 per cent of cases of primary gastrointestinal lymphoma. The disease can occur at any age, from 3 years to 89 years; the average age is 50 years. Men are affected twice as often as women. The disease most commonly presents as a painful abdominal mass. The cecum is the area of involvement in 70 per cent of cases. The tumors are usually large, averaging over 7 centimeters. The most common histological types are histiocytic or lymphocytic tumors. Surgery is the principle treatment mode; about half are thought to be potentially curable at the time of surgical exploration. The role of adjuvant therapy has not yet been clearly defined, although data from some studies indicate increased survival in those patients given adjuvant radiation therapy. Survival is decreased in patients with tumors larger than 5 centimeters or with histiocytic cell type. Overall 5-year survival is 39 per cent.

Aged↗
PubMed1986

Transaxillary intra-aortic balloon tamponade in trauma.

A case of exsanguinating intra-abdominal hemorrhage from penetrating trauma in which hypotension was controlled with transaxillary intra-aortic balloon catheter tamponade is presented. Catheter placement without fluoroscopic control through a left brachial arteriotomy with local anesthetics used to control hypotension in exsanguinating abdominal trauma is discussed and compared with resuscitative thoracotomy and descending aortic occlusion in such patients. The efficacy and simplicity of balloon catheter tamponade for abdominal hemorrhage caused by trauma are emphasized.

Abdominal Injuries↗