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Biomedical subjects

R J Cleveland

Publications and source records attributed to R J Cleveland.

At least 55 records · Page 3Linked to original sources
PubMed1982

The third manpower study of thoracic surgery: 1980 report of the Ad Hoc Committee on Manpower of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons.

An ad hoc committee was appointed by The Society of Thoracic Surgeons (STS) in 1977 in order to determine the available manpower and workload of thoracic surgeons in 1976. This committee conducted a survey of the professional activities and geographic location of all known surgeons certified by the American Board of Thoracic Surgery (ABTS) at that time. A summary of this study indicated the available and projected thoracic surgery manpower. The report also determined the present and projected health care needs of the population of the United States through 1993. Because thoracic surgery needs to continue to meet the health care needs of the United States in an appropriate yet economical fashion, the STS and The American Association for Thoracic Surgery (AATS) undertook a joint review to determine again the available manpower and its workload in calendar year 1980. In addition, this study compared its findings with the 1976 report in order to detect changes in the workload and need for thoracic surgical services. A questionnaire was mailed to 3,584 certified thoracic surgeons. There were 2,675 responses. The material was sent to the Academic Computer Services at George Washington University Medical Center for tabulation and data processing. This report summarizes the results of this survey. It also compares these data with those obtained in the 1976 study and, based on this information, attempts to project the thoracic surgery manpower needs in the next decade by using several hypothetical models.

Forecasting↗
PubMed1980

Atrial pacing during intraaortic balloon pumping.

Intraaortic balloon pumping and atrial pacing are both useful in treating postoperative low output syndrome. However, the electrocardiographic atrial pacing spike can interfere with the electrocardiogram tracking mechanism of many balloon consoles. Bipolar epicardial pacing can avoid this problem and allow simultaneous atrial pacing and intraaortic balloon pumping.

Assisted Circulation↗
PubMed1980

Use of nitroprusside for control of pulmonary hypertension in repair of ventricular septal defect.

After repair of ventricular septal defect (VSD) in a 3-year-old child with markedly elevated pulmonary vascular resistance (PVR), sodium nitroprusside was administered by intravenous infusion at 3.0 microgram per kilogram of body weight per minute. Nitroprusside was effective in reducing pulmonary artery pressure and increasing systemic blood pressure in the intraoperative and early post-operative periods. It is suggested that nitroprusside may facilitate the perioperative management and enhance the early survival in patients with increased PVR secondary to a VSD.

Child, Preschool↗
PubMed1979

Heart surgery.

Explore the source record for details and available documents.

Anxiety↗
PubMed1978

Intermuscular abdominal implantation of permanent pacemakers in infants and children.

Pacemaker implantation in infants and young children presents technical problems because of the relatively large size of the units. Various implantation sites have been employed to avoid the problems of unsightliness, migration, skin necrosis with infection, and patient discomfort. We are presenting a new technique which obviates these difficulties. The pacemaker generator is located in a space developed between the muscles and fascia of the abdominal wall. This site will accept even the largest of demand pacemakers with cosmetically acceptable results.

Abdominal Muscles↗
PubMed1978

Transverse femoral arteriotomy for intraaortic balloon insertion.

A technique for intraaortic balloon placement employing a transverse femoral arteriotomy is described. After balloon removal, the arteriotomy can be closed primarily. Avoidance of retained graft material or use of a vein patch reduces the likelihood of vascular complications.

Assisted Circulation↗
PubMed1978

Warfarin induced necrosis of the skin.

Necrosis of the skin is a rare complication of oral anticoagulation therapy by coumarin congeners. Three males receiving prophylactic warfarin anticoagulation therapy following cardiac valve replacement and one female similarly receiving anticoagulation drugs because of bilateral deep thrombophlebitis associated with carcinoma of the pancreas had typical skin necrosis develop. The lesions passed rapidly through stages beginning with pain, edema, erythema and petechiae. Ecchymoses followed in the localized area with a large bullae containing deep red fluid. Biopsy of the skin revealed involvement of the dermovascular loops with localized necrosis from extensive occlusion of dermal capillaries and venulae by fibrin thrombi. There was red cell extravasation, but inflammatory changes were inconstant. In the patients, in our study, the involvement ranged from small localized lesions of the trunk to extreme extensive skin involvement of both legs with full thickness necrosis in areas. This condition is not dose related nor the result of simple hypoprothrombinemia. It appears to be a conditioned and localized toxicity, although hypersensitivity has not been excluded. Once the diagnosis is made, orally administered anticoagulant drugs must be stopped immediately, and heparinization may be beneficial in confining the process.

Aged↗
PubMed1977

A method of enlarging the distal transverse arch in infants with hypoplasia and coarctation of the aorta.

Immediate operation in infants suffering from severe congestive heart failure and coarctation of the aorta associated with hypoplasia of the distal transverse aortic arch often poses a difficult technical problem. Frequently the anastomosis between the hypoplastic arch and the descending thoracic aorta fails to relieve the gradient across the hypoplastic segment appreciably. A technique of enlarging the lumen of the distal arch and thereby further lowering the gradient has been found effective and is presented.

Aortic Coarctation↗
PubMed1975

The role of intraaortic balloon counterpulsation in patients undergoing cardiac operations.

Intraaortic balloon counterpulsation (IABC) was used to assist 60 patients undergoing cardiac operations for reasons of acute left ventricular failure (18 patients) or electively for indications in high-risk coronary and valvular heart disease (42 patients). Nine of 18 patients achieved hemodynamic stability when treated for acute perioperative or postoperative cardiogenic shock. Four of these died from problems unassociated with postoperative left ventricular failure and 5 were long-term survivors, indicating a potential salvage of 50%. In 42 high-risk patients, IABC was used electively to control preinfarction angina before operation (21 patients) and prophylactically to prevent postoperative low-output failure in another 21 patients with severe coronary and valvular heart disease. Thirty-nine, or 93%, of these patients survived. There were no deaths in the preinfarction angina group, 1 death in the group with coronary disease and ejection fractions less than 30%, and 2 deaths in those with valvular heart disease and congestive failure. Seven patients developed thrombotic or ischemic complications, but no permanent damage resulted. IABC is an important form of assistance for any patient with preoperative, intraoperative, or postoperative left ventricular failure and adds safety and hemodynamic stability for the high-risk patient with preinfarction angina or poor ventricular function.

Assisted Circulation↗