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Biomedical subjects

T Schreiber

Publications and source records attributed to T Schreiber.

52 records · Page 3Linked to original sources
PubMed1988

Benign esophagorespiratory fistulas in adults.

Four benign esophagorespiratory fistulas, three secondary to granulomatous disease and one presumed to be congenital, have been diagnosed in adults at the authors' institution in the past year. The patients had symptoms of chronic or recurrent pulmonary infections, and two experienced coughing after swallowing. Chest radiographs demonstrated refractory consolidation, with or without cavitation and frequently accompanied by an air-distended esophagus. Barium studies were diagnostic. All patients responded well to antibiotic and surgical therapy.

Bronchial Fistula↗
PubMed1987

Review of clinical studies of thrombolytic agents in acute myocardial infarction.

Much of the current work in the field of thrombolytic therapy in acute myocardial infarction involves short-term, high-dose infusions of lytic agents. From 1983 to 1986, there were five major trials of these agents in acute myocardial infarction: the Western Washington Intracoronary Streptokinase Trial, the Dutch Interuniversity Group Trial, the Italian Group for the Study of Streptokinase in Myocardial Infarction Trial, the Thrombolysis in Myocardial Infarction Trial, and the Intravenous Streptokinase in Acute Myocardial Infarction Trial. This review considers each of these randomized, prospective trials in terms of design, mean time to therapy, lysis rate, reocclusion and in-hospital reinfarction, bleeding complications, in-hospital mortality, late survival, left ventricular function, and post-infarction morbidity. Findings from these trials indicate that thrombolytic therapy, if given less than four to six hours after onset of symptoms, improves the mortality rate and reduces post-infarction morbidity. Bleeding, a major cause of morbidity, can be managed by careful patient selection and clinical observation.

Clinical Trials as Topic↗
PubMed1987

Radionuclide cineangiography in acute myocardial infarction: role in prognostication.

Radionuclide-based procedures have achieved frequent application in acute myocardial infarction (MI). While these methods can be employed in diagnosis and assessment of therapy, diagnosis usually can be made more easily and with less expense when other methods are employed. Assessment of therapy, while potentially of value, has not been evaluated in a manner which can provide practical guidelines for clinical application. Practical utility has been associated with the use of radionuclide-based techniques in prognostication after infarction; this application is crucial to the formulation and optimization of management decisions. While myocardial perfusion scintigraphy and infarct-avid-agent imaging have been employed in prognostication after infarction, the largest body of prognostic data are available in association with radionuclide cineangiography. When determined in the early hours after infarction, a left ventricular ejection fraction (LVEF) less than 30% indicates a high likelihood of in-hospital mortality, irrespective of the site of infarction. When determined shortly prior to hospital discharge, LVEF less than 30% indicates a high likelihood of posthospital mortality, perhaps as high as 25% during the first year, and reaching 30% by the end of 2 years after infarction. Conversely, LVEF greater than or equal to 30% indicates an 8% 2-year postinfarction mortality risk. While LVEF is a highly potent risk descriptor, considerable evidence suggests the LVEF determined during exercise prior to hospital discharge also provides risk stratification, and may be superior to, or at least additive to, LVEF at rest as a prognostic index.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1980

Measurement of the ohmic electrode-tissue contact resistance and the voltage applied to myocardium.

The electrical impedance of a pulse generator-electrode-heart system is a complex one. By analysis of an equivalent circuit developed for the above, a model was derived to describe the output voltage applied to an implanted electrode. On the basis of the dynamic behavior of the equivalent circuit when a pacing pulse was applied, a method for measuring true ohmic electrode-tissue contact resistance was developed, and a device was constructed to provide an instant digital readout of its value. The value of that risestance varied from 179 to 521 omega in 13 patients. When a variable resistance R, was connected in series with an implanted electrode, and a threshold voltage for every value of R was determined the actual voltage applied to the myocardium was computed for 16 patients.

Cardiac Pacing, Artificial↗
PubMedDate not supplied

Transvenous Fogarty balloon catheter occlusion of an iatrogenic innominate artery to innominate vein fistula.

Transvenous embolization therapy is reported in a patient who developed a fistula from the innominate artery to the innominate vein as a complication of permanent cardiac pacemaker insertion. A transarterial approach at occlusion was unfavorable due to previous difficult catheterizations, and the patient's poor clinical condition precluded alternative operative intervention. The fistula was successfully closed by transvenous placement of a Fogarty nondetachable balloon catheter after coil and detectable balloon placement attempts were unsuccessful.

Aged↗
PubMedDate not supplied

Bronchial mucus transport in chronic smokers and nonsmokers during general anesthesia.

STUDY OBJECTIVE: To compare bronchial mucus transport velocity in smokers and nonsmokers. DESIGN: Prospective consecutive-sample trial. SETTING: University hospital. PATIENTS: 12 smokers and 22 nonsmokers undergoing major abdominal or thoracic surgery with postoperative mechanical ventilation. INTERVENTIONS: After the end of the operation, bronchial mucus transport velocity was measured with a small volume (0.05 to 0.08 ml) of technetium 99-m labeled albumin microspheres with an activity of 1.5 MBq. The radiolabeled bolus was deposited on the dorsal mucosal surface at the distal end of the right and left main bronchus via flexible bronchoscopy. The movement of the microspheres toward the trachea was visualized and recorded using a scintillation camera. Quantitative evaluation was based on the path-time diagram. After determination of bronchial mucus transport velocity, patients were examined daily over 4 days to record pulmonary complications (retention of secretion and nosocomial pneumonia). MEASUREMENTS AND MAIN RESULTS: Smokers were comparable to nonsmokers with respect to age, preoperative lung function tests, body temperature, duration of mechanical ventilation, dose of anesthetics, and intraoperative blood loss. Smokers had a significantly slower bronchial mucus transport velocity compared with nonsmokers: in the left bronchus, 1.3 mm/min (0 to 9.6 mm/min) (median with range) versus 9.7 mm/min (3.7 to 15.3 mm/min) (p < 0.001); in the right bronchus, 2.5 mm/min (0 to 16.0 mm/min) versus 8.3 mm/min (5.5 to 15.3 mm/min) (p < 0.01). Pulmonary complications occurred in 4 smokers and 1 nonsmoker. CONCLUSIONS: When measured during general anesthesia, smokers have a slower bronchial mucus transport than nonsmokers. This may be related to postoperative pulmonary complications in smokers.

Adult↗