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Biomedical subjects

S Kedar

Publications and source records attributed to S Kedar.

13 recordsLinked to original sources

Diode laser trans-scleral cyclophotocoagulation for glaucoma following silicone oil removal.

PURPOSE: To evaluate the effect of trans-scleral cyclophotocoagulation (TSCP) on intraocular pressure (IOP) in eyes with medically uncontrolled secondary glaucoma persisting after intravitreal silicone oil removal. METHODS: Clinical records of 21 eyes of 21 patients who underwentTSCP for medically uncontrolled glaucoma persisting after the removal of intravitreal silicone oil, injected during vitreoretinal surgery for proliferative vitreoretinopathy (PVR), were reviewed retrospectively. Diode laser contactTSCP was applied at a power setting of 1.5-2.5 W, for a maximum duration of 2 s, and a total of 40 spots (10 spots each quadrant). All the patients were evaluated for visual acuity, IOP and number of medications used. RESULTS: The patients were followed up for a mean +/- SD period of 39.9 +/- 4.27 weeks (range 36-48 weeks). The IOP was found to have decreased significantly from a pretreatment value of 34.5 +/- 5.37 mmHg (range 24-44 mmHg) to 20.47 +/- 4.49 mmHg at 6 months of follow up (range 12-30 mmHg, P < 0.01, Student's paired t-test). The total number of glaucoma medications being used reduced from 3.38 +/- 0.5 to 1.08 +/- 0.80 postoperatively (P < 0.01, Wilcoxon's rank sum test). There was no significant difference in the visual acuity before and after the procedure. Thirteen eyes required a second sitting of TSCP, and five of these required a third sitting. For a successful outcome (IOP < 24 mmHg), a mean of 1.56 sittings (range 1-3 sittings) per eye were needed. CONCLUSION: Patients with medically uncontrolled glaucoma persisting after intravitreal silicone oil removal can be treated with TSCP; however, the reduction of IOP is variable. The IOP usually falls after a mean of 2-3 sittings of

Adult↗

The influence of patient positioning on the hemodynamic changes in TURP patients with severe coronary disease.

Hemodynamic changes were studied in 10 patients with severe coronary disease during routine transurethral prostatectomy (TURP) when performed in the lithotomy position with and without elevation of the legs. The patients undergoing the procedure in the lithotomy position with elevation of the legs exhibited significant hemodynamic changes as compared with those undergoing the procedure without elevation of the legs. This leads us to conclude that performing TURP in the lithotomy position without elevation of the legs benefited the patient by stabilizing hemodynamic factors.

Aged↗

Ischemic heart disease precipitated by occult cancer.

The hypothesis was tested that cancer, by virtue of it being a thrombotic diathesis, may enhance ischemic heart disease. Because cancer therapy may precipitate thromboembolism, the authors focused on patients with occult neoplasia before therapy. Occult cancer was defined as a time period of 2 years before a cancer diagnosis was established. Data obtained from the files of patients with the diagnosis of malignant tumors and admitted to a general hospital during a 3-year period were reviewed for coronary risk factors, coronary events, and characteristics of cancer. Indices of coronary instability were studied: the incidence of first coronary events, the incidence of all coronary events, and the coronary events burden. These indices were calculated for 366 patients with cancer (from the Department of Medicine files of 166 consecutive patients with cancer of several primary sites and from the surgical ward files of 100 consecutive patients with colorectal cancer and 100 consecutive patients with cancer of the prostate or bladder) and for 100 patients with benign prostatic hypertrophy. The patients with benign prostatic hypertrophy served as controls. A steep and statistically significant increase in coronary instability indices was observed in all groups of patients with cancer in the 2-year period before cancer diagnosis in comparison with the coronary instability indices of control patients (P less than or equal to 0.05 to 0.0001). Patients with colorectal cancer presented the highest indices in the 2-year period before cancer diagnosis, with unstable ischemic heart disease being reported in 18% and first coronary events in 10%. The coronary events burden was 0.92. The lowest indices among patients with cancer were recorded in those with prostatic and bladder cancer. Unstable ischemic heart disease occurred in 6% and first coronary events in 4%. The coronary events burden was 0.36. The indices were several times lower for control patients than for patients with cancer. Unstable ischemic heart disease occurred in 3% of control patients, and first coronary events in 2%. The coronary events burden was 0.15. Other possible etiologic factors, particularly the known coronary risk factors and anemia, were not statistically related with an increased risk of coronary events in the 2-year period before cancer diagnosis. Based on these epidemiologic data, it appears that there may be an association between occult cancer and coronary events.

Adult↗

Studies on the morphology of human uric acid stones.

Human uric acid acid renal stones are easily distinguished from other urinary calculi by their globular or spherical shape, their colour and their hardness. Investigations of uric acid crystals grown in the presence of a variety of pigments indicate that a disordered layer structure of the uric acid dihydrate is responsible for the colour of such crystals, caused by the inclusion of pigment molecules into the crystal lattice. This in turn may help to explain the other special properties of uric acid stones.

Crystallography↗

Unusual complications of subclavian catheterization.

Infraclavicular subclavian vein catheterization is still a well accepted technique both in operating rooms and intensive care units. Two unusual complications are described: delayed intrathoracic haematoma and severe mediastinal emphysema needing prolonged treatment. The case reports are presented and the complications discussed. The necessity for routine chest x-ray post-operative catheterization and the danger of multiple attempts are stressed.

Aged↗

Enhanced tubular reabsorption of phosphate.

Individual kidney functions were studied during water diuresis in eight patients, following the relief of unilateral ureteral obstruction. Fractional excretion of phosphate was diminished in four of the patients, presumably due to enhanced tubular reabsorption of phosphate in the diseased side. Glomerular underperfusion may be the main factor responsible for the hypophosphaturia in the postobstructive kidney. Fractional excretion of sodium and water was increased in the obstructed side in six of the eight patients. In two of the four patients with hypophosphaturia, there was enhanced fractional sodium excretion, suggesting a dissociation of renal handling of sodium and phosphate in some patients with this condition.

Absorption↗