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Biomedical subjects

T O'Donnell

Publications and source records attributed to T O'Donnell.

26 records · Page 2Linked to original sources

Treatment of cardiogenic shock by emergency aortic balloon valvuloplasty.

We used aortic balloon valvuloplasty to successfully treat two patients who had cardiogenic shock associated with calcific aortic stenosis. In both patients, the resulting reduction in mean aortic valve gradient and increase in calculated aortic valve area allowed prompt discontinuation of treatment with pressors and a return to near normal renal function. Both patients were discharged within 10 days after valvuloplasty and showed significant, long-lasting clinical improvement. Aortic balloon valvuloplasty can reverse cardiogenic shock associated with calcific aortic stenosis.

Aged↗

Relation between postphlebitic changes in the deep veins and results of surgical treatment of venous ulcers.

41 patients with venous ulceration, investigated by ascending phlebography, had operations to ligate incompetent calf perforating veins. Recurrent ulceration developed within five years of operation in all 23 patients with evidence of deep-vein damage on the initial phlebograms. Only 1 of the seventeen patients with normal deep veins had a recurrent ulcer during the same period of follow-up. Thus local surgery to the perforating veins in postphlebitic limbs was shown to be ineffective.

Adult↗

Intravascular ultrasound estimation of arterial stenosis.

The evaluation of the degree of reduction in the cross-sectional area of an artery has important pathophysiologic and therapeutic implications. Currently, no technique can easily provide this information. In this in vitro study we evaluated the potential of a new imaging technique, intravascular high frequency ultrasound angioscopy, in the estimation of percentage of cross-sectional area stenosis of an artery. To do this, we compared intravascular high frequency ultrasound to previously-validated external high frequency ultrasound and to anatomic estimation of arterial stenosis. Using a prototype intraluminal imaging catheter with a 20 MHz ultrasound transducer at its tip, we imaged 20 arterial segments of various size (15 to 90 mm2 lumen area by anatomy) in the control state and after experimental stenosis. These arterial segments were also imaged by external high frequency ultrasound. Lumen areas were measured from calibrated ultrasound images in the control state and after stenosis, and percentage of cross-sectional area stenosis was calculated. These data were compared to the percentage of area stenosis derived from calibrated anatomic photographs of the arteries taken in the control state and after stenosis. Both intravascular ultrasound angioscopy and external high frequency ultrasound yielded high-resolution, two-dimensional, circumferential images of the arteries. Alterations in vessel area and shape were apparent after creation of stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗

Morphine-Infused silver sulfadiazine (MISS) cream for burn analgesia: a pilot study.

Pain is considered the most distressing symptom of a burn wound, with analgesia usually provided via oral or parenteral medications. Use of systemic opioids can be complicated by fluctuations in bioavailability, absorption, and clearance of drugs caused by the burn. There has been little research done in the area of topical medications for burn analgesia. The following is a double-blind, placebo-controlled pilot study assessing the safety (side effects) and efficacy (pain ratings and medications administered) of morphine-infused silver sulfadiazine cream for burn pain. Four patients are reported on (2 in each group). Only participants taking placebo reported side effects related to morphine and necessitated anxiolytic medications. Pain ratings in the treatment group ranged from 0 to 7 with a mean of 2.1, whereas the placebo group's ratings ranged from 2 to 8 with a mean of 5.6. The placebo group averaged 55.3 mg oral morphine per half day, whereas the treatment group averaged 42.9 mg.

Administration, Topical↗

Tibial hemimelia of a different class.

A variant of tibial hemimelia, previously undescribed in the literature and not classifiable by either of the established classification systems, is described. The features of this condition include a short, deformed tibia; proximal subluxation of the fibula at the knee; a normal knee joint and an ankle joint that may look abnormal but falls short of true diastasis of the joint. Treatment of two cases by differential lengthening of the tibia and fibula using the Ilizarov device is described. This form of tibial hemimelia should be recognised as a separate variant as preservation of the foot and ankle with expected excellent function should be possible, unlike the more severe forms of this condition.

Age Factors↗

The Medicare Catastrophic Coverage Act of 1988 and its impact on employer-sponsored retiree medical plans.

The Medicare Catastrophic Coverage Act of 1988 (MECCA) significantly enlarges the scope of federally funded health care benefits for elderly Americans. Since Medicare's inception in 1965, several inadequacies have become apparent, especially the absence of coverage for catastrophic illnesses. Now MECCA inhibits the potential financial ruin of elderly Americans faced with overwhelming, extended medical costs. The Act is budget-neutral and can reduce employers' Social Security payroll tax costs. However, the costs and complications of the maintenance-of-effort provision refunds and potential employee resistance to raised Medicare premiums, which could force some beneficiaries to cancel Part B participation and increase reliance on employer-sponsored plans, do pose problems for employers. Options and alternatives to these new opportunities and concerns are detailed herein.

Aged↗