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Biomedical subjects

S Patel

Publications and source records attributed to S Patel.

At least 775 records · Page 43Linked to original sources
PubMed1981

Noninvasive assessment of load reduction in chronic congestive heart failure patients.

Therapy with phentolamine can improve the condition of patients with congestive heart failure due to the inotropic effect of this drug as well as its vasodilating action. Therefore, 8 patients with volume-overloaded left ventricles due to aortic insufficiency and mitral insufficiency received 50 mg of phentolamine 4 times a day for 2 weeks. Peak and end systolic wall stress were estimated using a noninvasive echocardiographic technique. The peak systolic wall stress in this group was 133 X 10(3) dynes/sq cm, which is similar to the reported normal value. However, the end systolic wall stress was 89 X 19(3) dynes/sq cm, which is much higher than the reported normal values. After PO administration of phentolamine, the end systolic stress was normalized while the peak systolic stress was reduced below normal. As a result of therapy with phentolamine, the ejection fraction, the percentage of change in the minor axis, and the velocity of circumferential fiber shortening significantly increased. Thus, PO administration of phentolamine can improve left ventricular function in patients with mitral insufficiency and aortic insufficiency.

Adult↗
PubMed1981

Results of gastric neutralization with hourly antacids and cimetidine in 320 intubated patients with respiratory failure.

In a retrospective analysis massive upper gastrointestinal (GI) hemorrhage, defined as blood loss requiring more than two units of blood transfusion over a 24-hour period, occurred in 40 (9.5 percent) of 420 intubated, mechanically ventilated patients with respiratory failure, irrespective of the etiology of the respiratory failure. In a prospective study hourly antacid gastric neutralization, maintaining the gastric pH over 5, the incidence of massive gastric bleeding was reduced to 3 (1.4 percent) of 210 patients. In 110 additional patients, cimetidine, a histamine H2 receptor blocker, was used to prevent gastric acid secretion; 3 (2.7 percent) of 110 patients had massive upper GI bleeding; all three had solitary chronic pyloric ulcers. We conclude that gastric neutralization, either with hourly antacids or with cimetidine, is effective in reducing the incidence of massive gastric hemorrhage in intubated, mechanically ventilated patients during respiratory failure. We recommend the use of either in all intubated patients with respiratory failure. In addition, in 17 patients who had gastric bleeding at the time of transfer to the respiratory intensive care unit, gastric neutralization with hourly antacids in 14 patients and with cimetidine in three patients stopped the bleeding in all 17 patients within 24 to 48 hours.

Aged↗
PubMed1981

Preoperative liver biopsy and survival after portasystemic shunting.

The value of preoperative liver biopsy in predicting the outcome of portasystemic shunting was investigated. Using coded slides, the authors examined liver biopsy specimens from 41 patients with alcoholic cirrhosis who underwent portasystemic shunting. The degree of fatty change, alcoholic hyalin, alcoholic hepatitis, central hyalin sclerosis and the activity and severity of the cirrhosis were assessed and possible correlations were noted with the preoperative Child's classification, postoperative encephalopathy and with early and late mortality. A correlation was found between the presence of alcoholic hyalin in more than 10% of hepatocytes and early mortality; all of the six patients who died within 30 days of operation had this finding in the liver biopsy specimen. Early mortality correlated better with alcoholic hyalin than with the Child's classification. There was some correlation between late mortality and the degree of hyalin sclerosis and with the activity and severity of cirrhosis. The authors conclude that the findings of a liver biopsy done preoperatively are valuable in indicating prognosis and operative mortality in alcoholic cirrhosis.

Biopsy↗
PubMed1981

Carcinoembryonic antigen estimation in cerebrospinal fluid in patients with metastatic breast cancer.

Cerebrospinal fluid (CSF) and plasma levels of carcinoembryonic antigen (CEA) have been measured in 39 patients with disseminated breast cancer, 22 of whom had metastases involving the central nervous system (CNS). CSF CEA was also measured in 13 patients without cancer who had non-malignant disorders. Thirteen of the 22 patients with CNS metastases had elevated CSF CEA, together with 4 of 17 patients with disseminated breast cancer without neurological involvement. These 4 patients were shown to have extensive dorso-lumbar spine deposits. CSF CEA was not detected in any of the 13 patients without cancer. Estimation of CEA in the cerebrospinal fluid may be a useful adjunct in the diagnosis of disseminated breast cancer involving the CNS, provided that spinal metastases are absent.

Bone Neoplasms↗
PubMed1981

Vitamin C utilization status in chronic alcoholic patients after short-term intravenous therapy.

Blood (leukocytic) ascorbic acid (vitamin C) levels were estimated in 25 chronic alcoholics (M = 21; F = 4; Age: mean +/- S.D. = 46.28 +/- 8.78; range 28-61 years) on admission before starting any treatment and on the sixth day following intravenous therapy with vitamin C -- 500 mg daily for 5 days. Twenty-four out of 25 patients (96%) were found to be deficient in blood vitamin C (mean +/- S.D. = 68.44 +/- 28.13; range = 28-148; normal range for control population = 120-300 nmol/10(8) W.B.C.). The status of blood vitamin C was significantly improved after the replenishment therapy with I/V vitamin C 500 mg daily for 5 days (mean +/- S.D. = 108.32 +/- 34.98 nmol/10(8) W.B.C.: range = 54-282.5; t = 3.76; P = less than 0.001). Still the levels did not return to within the normal range in 16 patients out of 25 (64%). In view of the biochemical deficiency of vitamin C in chronic alcoholics, it is suggested that conventional detoxification therapy for ethanol withdrawal syndrome should include polyvitamins including ascorbic acid. It is further suggested that more prolonged replenishment therapy with vitamin C, preferably by intravenous route, may be needed to normalize its blood levels in some chronic alcoholic patients.

Adult↗
PubMed1980

Multiple sclerosis and serial computerized tomography. Delayed contrast enhancement of acute and early lesions.

By demonstrating periventricular contrast-enhanced lesions cranial computerized tomography (CT) supported the diagnosis of multiple sclerosis in a patient with recurrent transient hemiparesis. These abnormalities were present only on delayed films taken one hour after contrast injection and probably represented acute and early demyelinating plaques. Areas of contrast enhancement evolved to isodensity with and without corticosteroid treatment. Brain scan findings mirrored cranial CT abnormalities, and both could be correlated with the clinical status and the course of the disease.

Acute Disease↗
PubMed1980

Computed tomography of hepatic fracture: a case report.

A case of hepatic fracture is presented in which computed tomography (CT) played a major role in the diagnosis. The fracture, which was suggested on scintigraphy, was easily demonstrated on CT as a low-density hematoma. The advantages and potential use of CT in this clinical setting are discussed.

Child↗
PubMed1980

A theoretical model for predicting parameter changes in soft contact lenses due to bending.

Equations are presented for the theoretical determination of back vertex poser changes in soft contact lenses due to bending. The main assumption is that the volume of the lens remains unchanged. A description of changes in other lens parameters, namely, central thickness, overall diameter, and anterior radii, is presented for both spherical and toric lenses. In general, power changes predicted by the proposed model are less than those suggested by previous workers in this field. Changes however occur in other parameters which have previously been regarded as remaining constant such as the central thickness of the lens. These changes are of small degree but have significant bearing on back vertex power.

Contact Lenses, Hydrophilic↗
PubMed1980

Eucalyptus oil poisoning.

Accidental ingestion of eucalyptus oil by a 3-year-old boy caused profound central nervous system depression within 30 minutes, but he recovered rapidly after gastric lavage. The extreme toxicity of eucalyptus oil is emphasised.

Child, Preschool↗
PubMed1979

Renal failure in the respiratory intensive care unit.

The development of renal failure during respiratory failure is of grave prognostic significance. In 686 patients with respiratory failure, 74 developed renal failure; these had a mortality of 80%. The leading predisposing factors are: 1) gastrointestinal bleeding with hypovolemic shock; 2) sepsis with shock; 3) drug induced nephrotoxicity; and 4) hypotension. With antacid gastric neutralization, judicious use of nephrotoxic antibiotics, the incidence of renal failure can be reduced. Once renal failure occurs, early dialysis may increase the chances of recovery in these critically ill patients.

Acute Kidney Injury↗
PubMed1979

Case report. The iron rim sign.

A chronic cystic cerebral hematoma occurred in the frontal lobe and mimicked both clinically and radiographically a frontal sinus mucocele. A rim seen on multidirectional tomography and unenhanced computed tomography was presumed to be composed to calcium. However, electron microscopic analysis revealed the rim to be composed almost entirely of iron from hemosiderin breakdown products. This is the first such report of an "iron rim" that we could find in the literature.

Adult↗