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Biomedical subjects

R Vara Thorbeck

Publications and source records attributed to R Vara Thorbeck.

At least 19 recordsLinked to original sources
PubMed1999

[The behavior of atherogenic indices under the effect of growth hormone in postoperative disease].

OBJECTIVE: It has been studied the effect of the growth hormone (GH) in the atherogenic indexes, during the postoperative period in 28 patients, operated for digestive surgery. METHOD: Patients were divided in: I) control group, patients without treatment, and II) treatment group, patients treated with 8 U.I. of GH during five days after the intervention. RESULTS: Results show that, while in the control group the atherogenic values increased to pathologic levels, in the treatment group, these values stabilized in the physiological limits. CONCLUSIONS: Thus, these results let conclude to the beneficial antiatherogenic effect of growth hormone in the postoperative disease.

Adult↗
PubMed1993

Graves' ophthalmopathy after subtotal thyroidectomy and radioiodine therapy.

Forty-five patients with Graves' ophthalmopathy were studied prospectively. Twenty-one patients (42 orbits; group 1) were treated surgically by subtotal thyroidectomy and 24 (48 orbits; group 2) received radioiodine therapy. All patients underwent tests of thyroid function, ophthalmological examination, and axial and coronal computed tomography before and 12 months after treatment. Patients in group 1 showed significant improvement in the Feldon score (P < 0.001), in proptosis as estimated by Hertel exophthalmometry (P < 0.001) and in proptosis (P < 0.001), maximum diameter of the medial rectus (P < 0.01), lateral rectus (P < 0.05), superior group (P < 0.05) and inferior rectus (P < 0.001) muscles as estimated by computed tomography. Patients in group 2 showed significant improvement only in the Feldon score (P < 0.05). The ophthalmopathy of Graves' disease improves to a greater extent after subtotal thyroidectomy than after radioiodine therapy.

Adolescent↗
PubMed1993

[Minimally aggressive surgery in advanced cancer of the colon].

We evaluated minimally aggressive surgery in the treatment of metastasic cancer of the colon in 6 patients: 2 females and 4 males, with an average age of 71.8. Preoperative studies showed cancer of the colon (right colon = 4; sigmoid colon = 2) with multiple hepatic metastasis. In all cases laparoscopic mobilization and extracorporeal resection with end-to-end anastomosis was performed employing a biofragmentable anastomotic ring. In two patients laparoscopy discovered peritoneal carcinomatosis. One patient was operated using conventional surgery. Intestinal segments with an average length of 21.3 cm were removed, with a mean of 13.5 lymph-nodes per patient, 70.3% of which had metastasis. Eleven of the 12 resection lines were tumor-free (91.6%). Hospital stay averaged 7.8 days, and mean survival has been 4.5 months. Only two patients, those with peritoneal carcinomatosis, had post-operative complications. If an appropriate patient selection is followed: cancer of the colon with hepatic metastasis and no peritoneal spread, laparoscopic surgery is a reliable and effective treatment for advaned cancer of the colon.

Aged↗
PubMed1992

[Xanthogranulomatous cholecystitis].

Ten cases of xanthogranulomatous cholecystitis are presented, 5 women and 5 men, from a total of 439 cholecystectomies (2.2%). In 50% of cases the clinical course was consistent with acute cholecystitis; in 30%, gallbladder cancer was suspected preoperatively; and in 70% of cases cancer was suspected during surgery but intraoperative biopsies showed no malignancy. Definitive pathological findings included early carcinoma of the gallbladder in two patients, and a cholecystocolic fistula in one patient. A perforated gallbladder was found in one patient. The incidence of postoperative septic complications was 18.1%, a figure that doubles that of elective biliary surgery in our hospital.

Aged↗
PubMed1992

Intrathoracic meningocele presenting as a mediastinal mass lesion. Case report.

A routine chest X-ray in a 52-year-old man revealed a widening of the posterosuperior mediastinum and the patient was hospitalized on the suspicion of having a mediastinal mass lesion. Further investigations revealed an anterior cervicothoracic meningocele (intrathoracic meningocele), the dural herniation passing through two large midline congenital openings of the C7-T3 vertebral bodies which appeared partially fused and associated with other regional skeletal malformations.

Humans↗
PubMed1992

[Effect of growth hormone and parenteral nutrition on the catabolic phase following major digestive surgery].

The purpose of the present study was to determine if the administration of a biosynthetic human growth hormone (bGH) was able to enhance the efficacy of total parenteral nutrition (PN). Patients (n = 38) who had undergone major gastrointestinal surgery were randomly divided in two groups. Group I (n = 20) treated only with PN and Group II (n = 18) treated as in Group I plus bGH (4 UI/daily). Our study shows that the administration of bGH produces a significant increase in serum levels of growth hormone and Somatomedin-C. It also caused a positive nitrogen balance from the first 24 hours on (p less than 0.01). In Group II on day 12 after operation a statistically significant increase in transferrin (p less than 0.05), albumin (p less than 0.01) and total proteins (p less than 0.02) was observed. Our study suggest that the administration of bGH produces, perhaps through Somatomedin-C as mediator, an increase in protein synthesis.

Adult↗
PubMed1990

[Prevention of thromboembolic disease and post-transfusional complications using normovolemic hemodilution in arthroplasty surgery of the hip].

A prospective randomized study was conducted to evaluate the effect of moderate normovolemic haemodilution in arthroplastic surgery of the hip, to prevent postoperative deep vein thrombosis and the need for postoperative transfusion. The patients (n = 151) were divided into three groups: 48 patients received Dextran + Acetylsalicylic Acid as a prevention of the thromboembolic complications (Group I). 57 patients received a low dose of Heparin according to the Kakkar protocol (Group II). 52 patients were operated under Haemodilution (Group III). In Group I and II homologous blood transfusions were necessary in 83% of the cases, and in two cases posttransfusional hepatitis were observed. In Group III haemodilution avoided the use of homologous blood. Therefore of the three methods this study showed that haemodilution is the best way to prevent postoperative thrombo-embolism, significantly more effective than Heparin and Dextran, in arthroplastic hip surgery.

Aged↗
PubMed1990

[Intraoperative autotransfusion in massive hemorrhage after thoracic-abdominal trauma].

In the University Hospital of Granada (Spain), 359 trauma surgical patients underwent intraoperative autotransfusion. Patients from group I (blood loss less than 2000 ml) did not requiere homologous blood transfusion. So the high risk involved in the type of transfusion was avoided. With patients from group II, however, that is, those with a blood loss of more than 2000 ml, we had to fall back on homologous transfusion in addition to retransfusing autologous blood. The main indication for intraoperative autotransfusion is without doubt abdominal and thoracic trauma which lead to high blood loss.

Abdominal Injuries↗
PubMed1989

[Is appendiceal surgery performed by residents safe?].

An evaluation was made of the participation of residents in appendicular surgery as compared to staff surgeons, the evolution of results over the residency period and the influence of the presence of experienced surgeons together with residents during the emergency operation. Seven groups were made according to the surgeons involved. Parietal, intraabdominal and general complications of each group were quantitated, as well as postoperative hospitalization and mortality. Statistical study revealed similar results for the different groups.

Acute Disease↗
PubMed1986

Non-chromaffin paraganglioma of the orbit. Case report.

The non chromaffin paraganglioma of the orbit is a relatively rare tumor. To our knowledge only 25 cases have been reported in the world literature. We report on the case of a 39-year-old woman who was treated surgically for the removal of an orbital paraganglioma 10 years ago. She had complained of proptosis and her right eyeball was slightly displaced upwards and laterally. A transcranial operation was performed and the tumor, located medically and weighing 9'5 grs., was completely removed; it was encapsulated. 10 years after this total excision there was no evidence of recurrence. From a histological point of view the tumor cells closely resembled those of paragangliomas of the carotid body and glomus jugulare.

Adult↗
PubMed1985

[Diagnosis and treatment of malignant struma (based on 82 personal cases)].

The treatment of undifferentiated thyroid cancers differs in no way from that of other malignant tumours. An oncological resection has to be performed. As far as well-differentiated thyroid carcinomas are concerned, we have divided our cases into two groups ('low risk' and 'high risk') according to factors of age, sex and pathological type. In low-risk patients we recommend lobectomy; together with a limited homolateral neck dissection in cases of papillary carcinoma. In the high-risk group we performed a subtotal thyreoidectomy which is complemented by treatment with radioactive ioidine until a total thyreoidectomy is achieved. By following this method, nearly all our patients (77 out of 82) were still at life after 7-4 years; the exceptions were five cases of patients with anaplastic carcinoma who died within the year. In our view, such positive results justify a conservative surgical procedure.

Adenocarcinoma↗
PubMed1984

[Normal and pathologic semiology of the anterior choroidal artery].

In the normal individual, the anterior choroidal artery (ACA) has a rather fixed angiographic trajectory, but in patients with intracranial tumors it almost invariably has a modified course, the nature of the modification being dependent on the topography of the lesion. Authors employ the parameters used up through the present for objectivating the course of the anterior choroidal artery, and add others of theirs own, especially in regard to the relative location of various points on the vessel (rather than their isolated positions). A total of 28 measurements were taken for each of the 132 angiographic series studied: 31 normal individuals and 101 with diverse intracranial lesions. Every value was entered into a computer along with (by numerical coding) personal data, incidental factors and, in the pathological series, the topography of the preferrent (primary) lesion and secondary lesion (tumoral extension), as well as the possible coexistence of hydrocephaly and/or transtentorial herniation. This procedure allowed for an exhaustive analysis of each factor involved, which could be studied individually or in combination within each of the groups and subgroups established. In this way the extensive results could be readily interpreted.

Arteries↗
PubMed1984

New parameters in the radioanatomy of the deep cerebral venous system. Angiographic classification of intracranial tumors with respect to the phleboaxial line.

The usually observed modifications of the deep phlebogram in the entire pathological series are: transmedial displacement of the internal cerebral vein (more or less evident but always significant), straightening of the superior arch of the internal cerebral vein, an important ventricular dilatation in most cases. The most reliable parameters are: Fisher's bisecting line and two of the parameters proposed by the author's: Monro-Phleboaxial-Line and Monro-Glabella-Bregma-Angle.

Adult↗