Biomedical subjects

V M Bernhard

Publications and source records attributed to V M Bernhard.

112 records · Page 7Linked to original sources

PubMedDate not supplied

Supraorbital Doppler evaluation in vascular surgery.

Directional Doppler examination of the supraorbital vessels is an effective, noninvasive method of evaluating patency of the internal carotid artery. In the presence of occlusive disease in the internal carotid artery, flow in the superficial temporal and frontal artery is reversed so that blood flows in a retrograde fashion into the orbit, providing valuable collateral circulation to the brain. Using these basic anatomical and physiological facts, the direction of arterial flow in the supraorbital vessels and the response to compression of the superficial temporal and facial arteries were measured with the directional Doppler. Evaluation of 125 carotid arteries in 63 patients by both arteriography and Doppler examination established an overall accuracy of 87 percent by the Doppler supraorbital test. This study demonstrated the value of carotid Doppler examination in the evaluation of extracranial cerebral circulation.

Arterial Occlusive Diseases↗

PubMedDate not supplied

Heparin induced platelet aggregation: in vitro confirmation of thrombotic complications associated with heparin therapy.

Eleven patients who developed thromboembolic complications while receiving heparin were studied for a possible adverse reaction to heparin as the cause of their progressive thrombosis. Fifteen additional patients who were receiving heparin for recurrent thromboembolism, but who did not develop signs of thrombotic complications, were studied as patient controls. The most significant finding was an abnormal in vitro aggregation response to heparin alone in all of the patients who developed complications who were tested for it (64 percent). None of the patient controls demonstrated this abnormality. In addition, thrombocytopenia was noted in all of the former but in only one of the latter. Results of prothrombin times, fibrinogens and fibrin split products eliminated disseminated intravascular coagulation as the cause of the thrombocytopenia in the majority of cases. Finally, an approach to the early detection of the abnormal heparin response is presented and guidelines for its therapeutic management are recommended.

Adenosine Diphosphate↗

PubMedDate not supplied

Reliability of Doppler and impedance techniques for the diagnosis of thrombophlebitis.

The accuracy of Doppler ultrasound and impedance diagnostic techniques for identifying deep venous thrombosis was determined by comparison with patient venograms. Those patients suspected of having deep venous thrombosis were tested by ultrasound, impedance, and venography, with venography the standard for establishing the accuracy of the noninvasive methods. The deep inspiration, the Valsalva and abdominal pressure maneuvers, and the pneumatic cuff technique were employed with the impedance tests. The incidence of false negative and false positive results were determined for each noninvasive method separately and for both methods used concurrently. When both methods were considered, the number of false positives was high; however, all cases with major thrombosis were detected in the group of patients examined. A positive result with ultrasound or impedance tests should be considered an indication to perform venography, or if venography is contraindicated, to perform other noninvasive tests.

Blood Flow Velocity↗

PubMedDate not supplied

Noninvasive assessment of toe systolic pressures with special reference to diabetes mellitus.

Toe and ankle systolic blood pressures were measured noninvasively in asymptomatic volunteers and in patients with peripheral arterial obstructive disease. The measurement of ankle pressure was falsely elevated in 23% (51/219) of the diseased limbs studied, as a consequence of partial or total vessel incompressibility caused by arterial calcification and rigidity. Eighty percent (41/51) of limbs with erroneous ankle pressure readings were from patients with diabetes mellitus. Toe pressure was the most reliable indicator of occlusive disease, and was able to assess disease distal to the ankle. Five groups were separated using the ankle-brachial and the toe-ankle systolic pressure ratios: normal, claudication, limb salvage, claudication/incompressible arteries, and limb salvage/incompressible arteries. Insulin dependent and orally-medicated diabetics predominated in the two groups with incompressible arteries. The toe-brachial systolic pressure ratio was an accurate hemodynamic indicator of total peripheral arterial obstructive disease.

Ankle↗