Biomedical subjects

R J Luchi

Publications and source records attributed to R J Luchi.

At least 73 records · Page 4Linked to original sources

PubMed1976

Vertebral osteomyelitis. Still a diagnostic pitfall.

Vertebral osteomyelitis is still a diagnostic problem. Nonspecific symptoms (low-grade fever, malaise, and weight loss) may dominate. Specific infections may be suggested by the history, and the diagnosis may be reinforced by a transient response to antibiotics. The patient may have symptoms resulting from a secondary paravertebral abscess. Even with fever, back pain, and point tenderness over the vertebral column, the correct diagnosis may not be considered. Predisposing conditions include drug addiction, instrumentation of the infected urinary tract, bacteremia from other causes, or previous back surgery. Diagnosis is made by roentgenographic studies and isolation of the causative organism from blood cultures or from the infected area. Staphylococcus aureus is the most common pathogen, although other microorganisms may be responsible. Intensive intravenous antibiotic treatment appears to be curative, without surgical debridement, external stabilization, or porlonged oral administration of antibiotics.

Adult↗

PubMed1975

Surgical treatment for stable angina pectoris. Prospective randomized study.

To evaluate the role of coronary bypass treatment of stable angina, 72 patients were randomly divided into surgical and medical groups. They were followed with treadmill tests and repeat catheterization. Anginal symptoms decreased or disappeared in 89 per cent of those operated on and 65 per cent of those not operated on, but more of the former than of the latter became asymptomatic: 69 vs. 11 per cent respectively (p smaller than 0.01). Exercise tolerance time improved significantly (p smaller than 0.001) in both groups, but more in the group operated on, plus 78 per cent vs. plus 48 per cent, p smaller than 0.05. During a 28-month follow-up period, fewer cardiac complications occurred in the patients operated on--14 vs. 34 (p smaller than 0.02). Mortality was 9 per cent in the patients operated on and 14 per cent in those not operated on; this difference is not significant. The results indicate that improvement, though demonstrable in both groups, is greater with surgery, and quality of life during the first 28 months is better in patients who are operated on.

Angina Pectoris↗

PubMed1975

Coronary arterial spasm in classic angina pectoris.

A 47-year-old black male who presented with classical angina pectoris and positive exercise test developed spasm of the right coronary artery in the vicinity of an atherosclerotic lesion resulting in transient total occlusion of the vessel. It seemed unlikely that spasm was catheter induced in this case, and the vessel relaxed promptly following nitroglycerin administration. The occurrence of severe spasm in proximity to atherosclerotic narrowing of coronary artery may contribute to stable and unstable angina, myocardial infaction, and sudden death in patients with these conditions coexisting. The awareness of such a phenomenon is necessary to avoid serious errors in the interpretation of coronary angiograms.

Angina Pectoris↗

PubMed1975

The incidence and clinical implications of coronary artery spasm.

The total incidence of coronary artery spasm during coronary angiography has been reported to be between 0.26% and 0.93%. The rarity of this phenomenon has been invoked to minimize its clinical significance. Review of a one-year experience in our catheterization laboratory showed that coronary spasm occurred in eight of 274 coronary angiograms (2.93%). In three instances, spasm could not be ascribed to catheter tip irrigation, and was considered to be spontaneous. Since multiple factors during coronary arteriography might inhibit the occurrence of coronary spasm, it is believed that the incidence of spontaneous spasm may be higher than can be documented during angiography. Coronary spasm may have important clinical significance in various chest pain syndromes and greater methodical attention should be directed toward this phenomenon.

Adult↗

PubMed1975