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Biomedical subjects

R Vara-Thorbeck

Publications and source records attributed to R Vara-Thorbeck.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Preoperative hemodilution for the prevention of postoperative deep venous thrombosis and early infectious complications in colorectal resections].

The effectiveness of heparin DHE and preoperative haemodilution (M.N.H.) for prophylaxis against deep venous thrombosis (D.V.T.) and against early septic complications was investigated in a prospective controlled study on two comparable groups of patients who had undergone colorectal resections for malignant tumours. The results clearly suggested that there was no significant difference between heparin DHE and preoperative haemodilution for prophylactic effectiveness on D.V.T. yet, the percentage of postoperative septic early complications, that is insufficiency of anastomosis and abdominal wall infections, was much lower (p less than 0.001) in patients with moderate normovolaemic haemodilution (haematocrit = 30 per cent). While the number of cases reviewed was as low as 62, the point can be made that less postoperative septic complications occurred to patients with low haematocrit (30 per cent).

Clinical Trials as Topic↗
PubMed1988

[Surgical treatment of echinococcosis of the lung based on 575 personal cases and a study of the literature].

Echinococcosis has continued to be a worrying problem in endemic zones. An account is given in this paper of 25 years of experience in echinococcosis treatment. Reported are 575 patients on whom operations had been performed at the Surgical Clinic of Malaga University under the supervision of Professor Vara López. Fifty-six per cent of these patients were males and the remainder females. The disease was found to occur with regularity to all age groups. Cough, pain, lung bleeding, and geographic origin were characteristic phenomena of the disease and its anamnestic background. Diagnosis was confirmed by these parameters together with eosinophilia, complement fixation reaction according to Weinberg, intracutaneous testing according to Casoni, and radiography. Surgical approaches were pericystectomy in 415 cases, cystectomy in 57 cases, segmentectomy in 64, lobectomy in 34, and pneumectomy in five cases. Postoperative complications occurred to seven per cent of the patients, and the lethality rate amounted to 1.5 per cent. The absence of clinical information in publications is discussed together with lack of analyses of clinical situations, modes of treatment, and complications.

Adolescent↗
PubMed1987

[Stapler versus manual anastomosis in gastrointestinal surgery].

The comparative effectiveness of manual and auto-sutured anastomoses after total gastrectomy (107 cases), low anterior rectal resection (100 cases) and right hemicolectomy (34 cases) is studied. In the stapled series the incidence of anastomotic leakage was somewhat less, although benign stenosis occurred more frequently than with hand-sutured anastomoses. However, this could not be statistically demonstrated. In the authors' view, the main advantages of the use of staplers are the shortening of operating time and the lessening of septic steps.

Gastrectomy↗
PubMed1987

[Vascularization between spleen and liver following splenohepatoplasty. Angiographic studies in cirrhotic rats].

Portocaval shunt is no definite therapeutic solution to portal hypertension. Total bypass of the portal flow, off the liver, is accompanied, in such cases, by sooner liver failure and higher rates of encephalopathy. The view was generally defended that arterialisation of the liver might result in accelerated regeneration of the liver and in an improvement of hepatocellular functionality. Numerous animal experiments and clinical investigations were, therefore, aimed at arterialisation of the hepatic section of the portal vein, following portocaval shunt. Studies were also conducted into splenohepatoplasty. Portal obstruction was found to be avoidable by that technique, and liver arterialisation could be achieved at low pressure. The authors, in their experimental study, succeeded in radiographic representation of neovascularisation which had been achieved between spleen and liver by means of splenohepatoplasty.

Angiography↗
PubMed1987

[Therapy of malignant supratentorial neuroepithelial tumors].

Hopes raised by results published by Leibel and Sheline in "Journal of Neurosurgery" 66 (1987) 1-22 have not been confirmed in our own work. Nevertheless, even our own results, though not statistically significant, have shown a combination of surgery, irradiation, and polychemotherapy to be recommendable for treatment of cases of malignant supratentorial glioma.

Adult↗
PubMed1987

Renal function in patients undergoing major surgery under moderate normovolemic hemodilution.

A prospective randomized study on 100 patients with cholelithiasis, who were scheduled for cholecystectomy was carried out. 50 patients were hemodiluted (Hctr. 29-27%). In both groups, hemodiluted and non-hemodiluted patients, the following parameters were studied: renal function as regards glomerular filtration (creatine clearance, etc.) and also with reference to the concentrative capacity of the kidneys (free water and osmolar clearances). The results obtained show that M.N.H. significantly improves renal function. From the practical point of view we can conclude that the improved "performance" of the kidney in hemodiluted patients minimizes the nephrotoxis effects of many drugs and anaesthetic agents.

Blood Volume↗
PubMed1987

[Thoracic epidural analgesia (TEA) with morphine as an alternative to the administration of general anesthesia in thoracotomized patients].

A randomised prospective study was conducted into 60 patients who had undergone thoracotomy for spontaneous pneumothorax or bronchial carcinoma. Pyrazolone was intramuscularly and intravenously injected for postoperative pain relief to some of these patients. Another group received morphine through an epidural catheter (TEA). Postoperative spirometric checks were made on the first, third, and fifth days from surgery. The degree of analgesia was measured by means of the Twycross method. The ventilation parameters recorded from patients with epidural morphine treatment were clearly better than those measured from patients who had received pyrazolone. The amount of pain relief reported by TEA patients were better than that recorded from the pyrazolone group.

Adult↗
PubMed1987

[Assessment of mesenteric anesthesia in abdominal interventions].

This study had been undertaken for the purpose of assessment of mesenteric anaesthesia and its effects on cardiovascular changes during abdominal surgery performed under general anaesthesia (neuroleptanaesthesia). Investigations were applied to 50 patients gastrectomized for gastric ulcer (Billroth II). The patients were subdivided into two comparable groups, with 25 in each of them. Group I had been without mesenteric anaesthesia and Group II with mesenteric anaesthesia according to Finsterer. Average arterial blood pressure, cardiac output, and heart rate were measured prior to anaesthesia and intraoperatively. General anaesthesia, according to our results, led to statistically significant decline of cardiac output (p less than 0.001). Continuous drop in cardiac output was caused also by surgical manipulations in the abdominal cavity of patients without mesenteric anaesthesia. However, mesenteric anaesthesia according to Finsterer resulted in significant rise (p less than 0.001) of cardiac output, as compared to preoperative values. Hence, if undesired circulatory responses are to be avoided in abdominal surgery, mesenteric anaesthesia appears to be just as important as a careful surgical technique which should be tissue-sawing.

Anesthesia, General↗
PubMed1986

[Prevention of deep venous thrombosis in hip surgery].

The prophylactic effectiveness of aggregation inhibitors, low heparin dosage, and preoperative normovolaemic haemodilution was studied by the authors in the context of three comparable groups of patients with deep phlebothrombosis. All patients received hip joint substitutes, including artificial heads of the hip in cases of femoral collum fractures or total hip prosthesis in cases of arthrosis deformans. Patients were monitored by fibrinogen tests and ascending phlebography. Results are likely to produce evidence to the effect that haemodilution is an effective method for treatment of deep phlebothrombosis.

Aged↗
PubMed1986

Modifications of cAMP in plasma and CSF after experimental brain injury.

A dynamic head injury produced by an unconstrained head impact was induced in 30 dogs, out of a total of 45; 15 constituted the control group. Where the energy absorbed by the dog's head is of 59,95 Joules primary brain damage is produced. If the energy absorbed is of 340.31 Joules a severe brain swelling with increase in ICP takes place, leading to the animal's death within 48-96 hours. In the group of animals with a primary brain damage there was no significant change in I.C.P. However, the concentration of cAMP in CSF rose significantly, and this rise continued for 48 hours after impact. In the group of animals with severe secondary brain damage ICP rose significantly from the first post-injury control onwards. The concentration of cAMP in CSF increases significantly after the trauma, but reaches sub-normal levels 48 hours after impact. The plasma concentration of cAMP, on the other hand, is not significantly altered in any of the three groups. The modifications of cAMP in CSF could, in our opinion constitute a good guide for the assessment of the degree of brain damage.

Animals↗
PubMed1986

[Echinococcosis of the liver. Its surgical treatment based on 178 personal cases].

Reported in this paper are 178 patients who had received surgical treatment for echinococciasis of the liver, among them 144 at the Surgical Hospital of Madrid University, between 1962 and 1970, and another 34 at the Surgical Hospital of Granada University, between 1971 and 1982. All of them had been carriers of Echinococcus cysticus. Echinococciasis of the liver usually is not diagnosed until the hydatid cyst begins to cause conspicuous symptoms or complications on account of its own growth. Diagnostic clues are obtainable from laboratory findings (eosinophilia in excess of four per cent), immune reaction, complement fixation reaction according to Weinberg, and intracutaneous test according to Casoni. Diagnosis of the authors' cases had been preceded by scintiscanning. Surgical removal of echinococcus cysts from the liver calls for an undogmatic approach. From among all surgical methods applicable to cyst removal the authors have most frequently used closed marsupialisation, according to Posadas-Dew (65.8 per cent of all cases). Drainage marsupialisation was applied to 25.8 per cent of all cases. The postoperative lethality amounted to 2.3 per cent. Morbidity was low.

Adolescent↗
PubMed1986

[Cysts of the parathyroid glands].

Cysts of epithelial bodies are rare causes of hyperparathyroidism. Reported in this paper are 2 patients with clinical symptoms of hyperparathyroidism, high blood calcium levels and established hormones in their epithelial bodies. Cysts of epithelial bodies were diagnosed by means of angiography, computed tomography, and sonography. Various aetiological factors behind cyst formation in epithelial bodies are discussed.

Adenoma↗
PubMed1986

[Peritoneal echinococcosis].

Secondary peritoneal echinococcosis was recorded from 50 in 312 patients (16 per cent) who had been hospitalised for liver echinococcosis. Hydatido and peritoneal hydatidiosis were recorded from 34 of these patients and thus accounted for the two most common pathological forms of secondary peritoneal echinococcosis, according to Dévè. Peritoneal echinococcosis usually is not diagnosed until conspicuous symptoms grow manifest due to cyst growth or other complications. Positive responses were recorded from all the above cases to laboratory tests (eosinophilia in over five to nine per cent) and were also established on the basis of immune reactions, including the complement fixation reaction according to Weinberg, the intracutaneous test by Casoni, and latex echinococcus reaction. Surgery, at present, is the only promising therapeutic approach to the problem. Surgical intervention could not even be avoided by application of mebendazol. Postoperative lethality amounted to four per cent and morbidity to ten per cent. They were comparatively low, measured by the generally poor prognosis of the disease.

Adolescent↗
PubMed1985

Hemodynamic response of elderly patients undergoing major surgery under moderate normovolemic hemodilution.

Moderate normovolemic hemodilution (MNH) is used in general surgery not only when major blood loss is anticipated but also as a prophylactic measure for the prevention of postoperative deep vein thrombosis. The hemodynamic effects of MNH (hematocrit value 27-29%) with dextran 70 as diluent were evaluated in 50 patients undergoing major surgery (cholecystectomy or total hip arthroplasty). They were divided into two groups according to age: I less than 60; II greater than 60 years. Comparison of the results obtained in the two groups shows no significant difference between them, either before or after hemodilution. Our study shows that MNH is a safe procedure, not only in young patients but also in those over 60 years.

Adult↗
PubMed1984

[Preoperative hemodilution as prophylaxis of deep vein thrombosis].

In a clinical study the effectiveness of aggregation limiters (Dextran and acetyl-salicylic acid) and preoperational normovolaemic haemodilution as prophylaxis for deep vein thrombosis (D.V.T.) was assessed on the basis of experimental work in 404 surgical patients. Our patients were monitored by means of the fibrinogen test and ascending phlebography. Our results show that haemodilution is a very effective preventive for D.V.T. Therefore, moderate normovolaemic haemodilution can be applied as an effective prophylactic measure for postoperative deep vein thrombosis.

Adult↗