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Biomedical subjects

W R Thoden

Publications and source records attributed to W R Thoden.

30 records · Page 2Linked to original sources

Comparison of continuous and interrupted suture techniques in microvascular anastomosis.

A comparison of the continuous and the interrupted suture techniques, ten procedures each, was performed upon dogs using high frequency pulsed Doppler ultrasonography to monitor blood velocity. No statistically significant differences in the blood velocity profile were found between the two techniques. The pulsatility of the vessels after anastomosis was similar for both techniques. At follow-up examination, mean being 13 weeks, the patency rate was 100 per cent as demonstrated arteriographically for both the continuous and the interrupted techniques with statistically no significant difference in the blood velocity profile. The speed and the ease of completing a continuous anastomosis and its lack of significant hemodynamic differences compared with the interrupted technique speak well for the preferential use of the continuous suture technique.

Angiography↗

Technique of venous impedance plethysmography for quantification of venous reflux.

A study was conducted applying a technique of venous impedance plethysmography for the quantitation of venous reflux to a group of 20 normal persons and five patients with postphlebitic limbs. Results demonstrate a significantly higher reflux refilling rate for those patients with postphlebitic limbs compared with the refilling rate for those in the normal group. It is believed that this technique is a valuable diagnostic tool for detecting venous reflux caused by valve incompetence and that it provides an indication of progression of venous insufficiency in the patient.

Humans↗

Intraoperative anticoagulation during arterial reconstructive procedures.

The technique of thromboelastography was used to monitor the intraoperative administration of heparin during vascular surgical procedures. Interpatient response to 70 units per kilogram of heparin varied widely. There was no need, in any patient, for the use of protamine to reverse the effect of heparin. This, coupled with the absence of hemorrhagic complications, indicates that thromboelastography is a useful method for monitoring the administration of heparin during vascular surgical procedures.

Aged↗

Noninvasive flowmetry in vascular surgery: use of a noninvasive electromagnetic flowmeter.

Using an in vitro model, the measurements made using a noninvasive electromagnetic flowmeter have been validated using standard square wave electromagnetic flowmetry. Clinically, the noninvasive electromagnetic flowmeter provides information as to the functional significance of vascular occlusive disease that is not available through other techniques, gives an accurate, quantitative measurement of the peak pulsatile blood flow through a limb, thus providing an index of tissue perfusion and therefore, the degree of involvement of the disease in the peripheral vascular system.

Arterial Occlusive Diseases↗

Noninvasive detection and prevention of deep-vein thrombosis in the geriatric patient.

Noninvasive methods for the early detection of, and prevention of deep-vein thrombosis can significantly reduce postoperative morbidity and mortality in the elderly due to venous thromboembolism. The technique of venous impedance plethysmography provides a rapid means of assessing the patency of the venous system by detecting changes in venous volume and maximum venous outflow, thus providing for early detection of deep-vein thrombosis. Prevention of deep-vein thrombosis can be accomplished through use of external intermittent pneumatic compression. This technique prevents venous stasis and stimulates the natural fibrinolytic activity of the vein-wall endothelium.

Aged↗

Noninvasive evaluation of peripheral arterial disease in the geriatric patient.

A progressive increase in the incidence of peripheral arterial occlusive disease is being observed in today's steadily aging population. In recent years, a number of simple noninvasive vascular techniques have become available for the diagnosis of peripheral arterial occlusive disease. These techniques provide the physician with physiologic information about the patient's peripheral circulation which permits discrimination between complaints compatible with the aging process and those indicative of an underlying disease state. This article reviews the noninvasive vascular diagnostic techniques that the authors found useful in evaluating the geriatric patient. These include oculoplethysmography. Doppler ultrasound, photoplethysmography, arterial impedance plethysmography, and electromagnetic flowmetry.

Aged↗

Use of noninvasive electromagnetic flowmetry in the assessment of peripheral arterial disease.

The need for noninvasive techniques capable of quantitating peripheral arterial insufficiency is becoming increasingly obvious. We have shown the technique of noninvasive elctromagnetic flowmetry to be capable of distinguishing three relatively discrete clinical zones by quantitating the peak pulsatile flow of blood through the thigh and calf. The obtained peak pulsatile flow values were in close agreement with ischemic index values previously reported as grading the degree of ischemia in a patient. In certain patients, the noninvasive electromagnetic flowmeter has yielded information not readily available from Doppler systolic pressure measurements. With the noninvasive technique of electromagnetic flowmetry and Doppler ultrasound, it is possible to confirm and quantitate patient complaints, follow disease progression and document improvement following arterial reconstructive operations. The noninvasive electromagnetic flowmeter has also been shown to be invaluable in the selection of the operative procedure by providing information about arterial run-on, run-in and run-off.

Adult↗

Topical application of povidone-iodine in the management of decubitus and stasis ulcers.

The efficacy of topical applications of povidone-iodine (Betadine solution and ointment) for the control of infection associated with decubitus and stasis ulcers was evaluated in 18 male outpatients (age range, 33--68 years). Dressings were changed twice daily over a period of 42 days. Statistically significant improvement was noted in the following signs and symptoms: edema, pain, erythema, ulcer size, and ulcer depth. All patients experienced some degree of symptomatic relief and clinical improvement within two weeks after starting therapy. At the end of the study, 67 percent of the ulcers were clinically cured and 33 percent showed improvement. Acceptance by the patients was excellent, with no reported side effects or sensitization reactions. Povidone-iodine used in a daily regimen of ulcer care can reduce the level of infection and promote healing.

Administration, Topical↗

Acebutolol: a review of its pharmacology, pharmacokinetics, clinical uses, and adverse effects.

Acebutolol is a new hydrophilic, cardioselective beta-adrenergic-blocking agent that possesses partial agonist and membrane-stabilizing activities. In the treatment of mild to moderate essential hypertension, once-daily acebutolol as monotherapy provides effective control in a large majority of patients and produces a further reduction in blood pressure when used concomitantly with diuretics. Acebutolol is as effective as other beta-blocking agents, and in a large, double-blind, parallel study against propranolol was found to cause less reduction in heart rate, and fewer neurologic side effects and patient withdrawals due to adverse effects. Oral acebutolol is also effective in suppressing premature ventricular contractions, and in small numbers of patients generally beneficial results were obtained in supraventricular and ventricular arrhythmias with intravenous administration. These salutary effects are attributable to beta blockade. Controlled clinical trials documented the antianginal actions of oral acebutolol in chronic stable angina pectoris; its efficacy in this regard is comparable to that of other beta-blocking agents. The drug produces smaller decreases in heart rate and cardiac output and alterations in peripheral vascular hemodynamics than beta-blocking drugs without partial agonist activity, and because of its cardioselectivity, it may be used cautiously in patients with bronchospastic disease. Acebutolol has minimal metabolic effects and does not elevate levels of blood lipids during long-term therapy; high-density-lipoprotein cholesterol increased with acebutolol in a small number of patients.

Acebutolol↗

Brompheniramine maleate: a double-blind, placebo-controlled comparison with terfenadine for symptoms of allergic rhinitis.

This was a double-blind, randomized, placebo-controlled, multicenter, parallel study comparing the effectiveness, at recommended doses, of an extended-release formulation of brompheniramine maleate and terfenadine in the treatment of allergic rhinitis. Subjects with symptoms of seasonal and/or perennial allergic rhinitis received brompheniramine 12 mg (n = 106), 8 mg (n = 105), terfenadine 60 mg (n = 106), or placebo (n = 53) twice daily for 14 days. On treatment days 3, 7, and 14, symptom severity ratings (i.e., rhinorrhea, sneezing, nasal congestion, itchy nose, eyes or throat, excessive tearing, postnasal drip) were completed by the physician; subjects and physicians each completed a global efficacy evaluation. Brompheniramine 12 mg and 8 mg and terfenadine were more effective than placebo (p < or = 0.05) on the physicians' global: brompheniramine 12 mg was more effective than terfenadine (p < or = 0.05) on days 7 and 14 and brompheniramine 8 mg on day 3. On the subjects' global evaluation, brompheniramine 12 mg and 8 mg and terfenadine were more effective than placebo (p < or = 0.05); brompheniramine 12 mg was more effective than terfenadine (p < or = 0.05) on days 7 and 14 and brompheniramine 8 mg on day 3. In general, brompheniramine 8 mg was comparable to terfenadine. On days 3 and 7, the total symptom and total nasal symptom severity scores for subjects receiving brompheniramine 12 mg were significantly more improved than for placebo (p < 0.05); terfenadine was not different from placebo; brompheniramine 12 mg was significantly better than terfenadine on day 7 (p < 0.05) for reducing total symptom severity and on days 3, 7, and 14 for reducing total nasal symptom severity. Adverse experiences were reported by 155 (41.9%) of the 370 subjects enrolled in the study. The overall rate of adverse experiences in the brompheniramine 12 mg treatment group (57.5%) was significantly greater (p < 0.05) than for brompheniramine 8 mg (38.1%), terfenadine (31.1%), and placebo (39.6%). In conclusion, an extended-release formulation of brompheniramine 12 mg or 8 mg bid alleviates allergic rhinitis symptoms and brompheniramine 12 mg provides significantly better relief of these symptoms than terfenadine 60 mg bid.

Administration, Oral↗