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Biomedical subjects

R Jedeikin

Publications and source records attributed to R Jedeikin.

At least 55 records · Page 3Linked to original sources
PubMed1992

Anaesthesia for transthoracic endoscopic sympathectomy in the treatment of upper limb hyperhidrosis.

Renewed interest has been shown in transthoracic endoscopic sympathectomy (TES) for the treatment of upper limb hyperhidrosis. We review our experience and discuss the anaesthetic technique and perioperative problems encountered in 58 patients undergoing TES for hyperhidrosis. Patients were monitored for arterial pressure, heart rate, ECG, pulse oximetry (SpO2), end-tidal carbon dioxide concentration, peak inspired airway pressure and skin temperature. General anaesthesia, with a double-lumen endobronchial tube, enabled the lungs to be collapsed alternately, thereby ensuring easy and clear access to the sympathetic chain. Controlled ventilation with 100% inspired oxygen was necessary to obviate hypoxaemia. In two patients, severe hypotension and bradycardia occurred during insufflation of carbon dioxide into the chest cavity. Four patients required underwater drainage of the pleural cavity for treatment of pneumothorax or haemothorax. The success and safety of the procedure depends on a scrupulous anaesthetic technique.

Adolescent↗
PubMed1992

Spinal epidural anaesthesia. A new combination system.

We present our experience with a new combined spinal epidural system through which regional anaesthesia was performed in 30 male patients undergoing suprapubic prostatectomy. The technique consists of two needles, a 17 G Tuohy needle with a hole in its distal curve (back eye) and a 29 G spinal needle which is passed through the back eye before being introduced into the subarachnoid space. We found the back eye combined spinal-epidural system effective and simple to use. The Tuohy needle with its back eye did not impede insertion of the epidural catheter and was a suitable introducer for the thin 29 G spinal needle.

Aged↗
PubMed1991

[Necrotic pheochromocytoma presenting with shock and abdominal pain].

Pheochromocytoma is a rare tumor, the diagnosis of which is based on a history of hypertension, and symptoms, signs and laboratory data associated with increased release of catecholamines. The combination of pheochromocytoma and shock is uncommon, but when it does occur, is often associated with necrosis of the tumor. We report an unusual case of a patient whose clinical findings suggested fulminating septic shock. Only at postmortem was the diagnosis of pheochromocytoma made.

Abdominal Pain↗
PubMed1990

Disseminated intravascular coagulopathy and adult respiratory distress syndrome: life-threatening complications of hysteroscopy.

A 23-year-old, healthy woman underwent hysteroscopy during which Hyskon solution was injected into the uterine cavity. Soon afterward she developed a bleeding coagulopathy followed by acute respiratory insufficiency and pulmonary edema, necessitating endotracheal intubation and artificial ventilation with positive end-expiratory pressure. This rare complication of hysteroscopy was most probably due to the injection of Hyskon solution.

Adult↗
PubMed1986

Respiratory monitoring with a new impedance plethysmograph.

A new impedance plethymograph respiratory monitor, (AR-8800), was tested on anaesthetised dogs. Decreases in tidal volume and total apnoea were brought about by partial and complete airway obstruction and by partial and total muscle paralysis. The changes in respiration were reliably detected by the monitor and its alarms activated within 15-20 seconds. The misinterpretation of gross body movement as normal breathing did not occur. Our findings suggest that the AR-8800 is a safe and dependable monitor which has distinct advantages and may be of particular use in the monitoring of patients at risk of developing respiratory depression or obstruction, whether in the intensive care unit, the general ward or at home.

Animals↗
PubMed1986

Supraventricular dysrhythmias in the adolescent.

Supraventricular dysrhythmias are the most common cause of rhythm disturbance in the adolescent. With advances in surgical techniques and medical management, more children will be entering adolescence and, as a result, a higher incidence of dysrhythmias will be encountered. Appropriate management of supraventricular tachycardia requires precise determination of the mechanism, symptomatology, and presence or absence of structural heart disease. Antidysrhythmic drugs have a wide spectrum of electrophysiologic effects. An understanding of the mechanisms underlying the different types of supraventricular tachycardia makes management less empiric and more rational. Surgical ablation, as well as endocardial catheter ablation, offer new therapeutic modalities for the management of refractory tachycardias.

Adolescent↗
PubMed1985

Left ventricular hyperkinesia at rest and during exercise in normotensive patients 2 to 27 years after coarctation repair.

The short- and long-term results of effective surgical repair of coarctation of the aorta on left ventricular mass and function in 48 patients were evaluated using echocardiography and stress-gated radionuclide angiography. Thirty-two of the 48 patients who had no additional cardiac problems and had technically adequate radionuclide angiograms form the basis for this report. Among these, three had mild systolic hypertension and none had significant aortic valve dysfunction. Age at the time of study ranged from 6.5 to 59 years (mean 27). Age at the time of surgery ranged from 3 months to 34 years (mean 12 years). Duration from surgery to the time of noninvasive study ranged from 2 to 29 years (mean 15). In the 32 patients, left ventricular mass was 120 +/- 20 g/m2, compared with a control value of 87 +/- 10 g/m2. Mean left ventricular ejection fraction was elevated to 69.2 +/- 1.6% at rest (control 60 +/- 1.3%) and 78.8 +/- 1.3% during exercise (control 70 +/- 1.7%) (p less than 0.01). The systolic ejection rate was significantly increased (p less than 0.01) and end-systolic volume significantly decreased (p less than 0.01) compared with values in control patients. There was no correlation between ejection fraction and either age at the time of surgery or years since surgery. These findings of hyperdynamic left ventricular function and increased left ventricular mass without apparent cause many years after coarctation repair raise important questions as to mechanisms, extension to other forms of afterload stress that have been surgically or medically relieved and long-term outcome.

Adolescent↗
PubMed1985

Myocardial ischaemia in asphyxia neonatorum. Electrocardiographic, enzymatic and histological correlations.

Serial electrocardiograms and creatine kinase (CK) isoenzyme activities were studied prospectively in 20 asphyxiated term newborn infants and 43 normal neonates. By adapting a previously described grading system for ischaemic changes, a degree of electrocardiographic ischaemia was defined which occurred almost solely in asphyxiated infants. Infants with this degree of abnormality had significantly higher mean CK-MB and MM activities than other asphyxiated infants at 0, 8 and 28 hours. Histological changes of peripartum myocardial necrosis were seen in 4 of the 5 infants on whom an autopsy was performed, and either electrocardiogram or CK-MB was abnormal in all four. It is concluded that myocardial injury in the newborn period is often associated with CK-MB release, but in view of the lack of cardiac-specificity of CK-MB in newborn infants, caution is urged in the interpretation of elevated isoenzyme activity in the neonate.

Asphyxia Neonatorum↗
PubMed1985

Prolonged respiratory center depression after alcohol and benzodiazepines.

A male patient was admitted to the hospital in coma and acute respiratory failure following the oral intake of benzodiazepines and alcohol. On the fourth day after admission, the patient was conscious, results of clinical examination of the respiratory system were normal, and pulmonary ventilation tests and blood gas measurements were within normal limits. However, mouth occlusion pressure and ventilatory response to CO2 were found to be markedly reduced. In the period of weaning the discrepancy between the normal clinical picture and blood gases and the laboratory findings of respiratory depression implies that there is a slowing in recovery of the respiratory center in this type of intoxication.

Adult↗
PubMed1984

Ductal origin of the left pulmonary artery in severe tetralogy of Fallot: problems in management.

Cardiac catheterization in a neonate demonstrated tetralogy of Fallot and absence of anatomic origin of the left pulmonary artery from the main pulmonary artery. A central aortopulmonary shunt was performed in order to increase pulmonary blood flow. Because of the concern that the left pulmonary artery was actually being supplied by a ductus arteriosus, repeat catheterization was performed and this revealed closure of the ductus arteriosus with obliteration of arterial supply to the left pulmonary artery. A left Blalock-Taussig shunt was subsequently performed and this reestablished blood supply to the left pulmonary artery. This case report describes problems in management of congenital heart disease with absence of anatomic origin of the left pulmonary artery from the main pulmonary artery.

Blood Vessel Prosthesis↗
PubMed1983

Effect of ouabain on the anterograde effective refractory period of accessory atrioventricular connections in children.

The anterograde effective refractory period of the accessory connection was determined before and after the administration of ouabain (0.015 mg/kg intravenously) during electrophysiologic studies in 21 patients with Wolff-Parkinson-White syndrome. The mean age (+/- standard deviation) was 10 +/- 2 years (range 1 month to 31 years). Each patient had stopped taking all cardiac drugs for more than 36 hours. Determination of the anterograde effective refractory period of the accessory connection was made using the atrial extrastimulus technique. A change in the anterograde refractory period of the accessory connection was defined as an increase or decrease of greater than 10 ms from the value before ouabain administration. The post-ouabain anterograde effective refractory period of the accessory connection increased in 2 (9%) of the 21 patients, decreased in 9 (43%) and was unchanged in 10 (48%). This study demonstrated a decrease in the anterograde effective refractory period of the accessory connection of 43% of patients with Wolff-Parkinson-White syndrome after the administration of ouabain.

Adolescent↗
PubMed1983

Serial electrocardiographic changes in healthy and stressed neonates.

Serial changes in T-wave vector and polarity were assessed in 162 electrocardiograms, 117 from 44 healthy term neonates and 45 from 17 stressed neonates. Records were taken at 5 to 8 hours, 24 to 33 hours, and 71 to 96 hours after birth. Sequential changes in both T-wave amplitude and frontal and horizontal axes were found in both groups. A lag period was noted between healthy and stressed infants when comparing changes in T-wave amplitude, with greater flattening of T-waves for longer periods of time after birth in the stressed group. The normal changes in T-wave axis over time in the horizontal and frontal planes showed a similar lag in the stressed group. Alterations of T-wave amplitude and axis alone may be markers of myocardial ischaemia in neonates but are only reliable signs after the first 24 hours of life.

Apgar Score↗