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A C Rao

Publications and source records attributed to A C Rao.

5 recordsLinked to original sources

Prophylactic nasogastric tube decompression: is its use justified?

To evaluate the need for routine prophylactic nasogastric tube decompression following gastrointestinal surgery, we retrospectively reviewed the cases of 177 patients. The patients were classified as those not receiving nasogastric tubes, those whose tubes were removed within 48 hours postoperatively, and those whose tubes remained for more than 48 hours. No significant differences were noted in duration of hospital stay, time for return of adequate bowel function, or time before beginning an oral diet. Further, there were no differences in the frequency of wound complications, anastomotic leakage, or mortality. Patients without tubes had no greater incidence of vomiting, and despite a more frequent occurrence of abdominal distention and nausea, only 8% required insertion of a tube for persistent symptoms. Intubated patients had a greater frequency of respiratory complications. The results indicate that routine prophylactic use of nasogastric decompression is unnecessary and may be safely eliminated in patients having gastrointestinal surgery.

Adult

Clinical experience with a new lead combining active fixation with steroid elution.

The Medtronic lead engineering model number 10335A represents a new concept in lead design combining active fixation with steroid elution. It aims for immediate stability and low chronic thresholds. Twenty-one leads, 9 atrial and 12 ventricular, were implanted in 13 patients (10 males, mean age 68; range 22-91 years). The atrial leads showed no rise in pulse width threshold at a voltage of 1.6 volts (mean thresholds at implant, 1, and 26 weeks; 0.1 +/- 0.09 msec, 0.15 +/- 0.04 msec, and 0.1 +/- 0.03 msec, respectively). The ventricular leads had a small but significant rise between implant and 1 week at an output of 1.6 volts (0.07 +/- 0.03 msec increasing to 0.11 +/- 0.04 msec; P < 0.02) but no significant later rise (0.1 +/- 0.04 msec at 2 weeks and 0.1 +/- 0.05 msec at 6 months). These low chronic thresholds would allow early reprogramming of the unit to low voltages resulting in a battery saving with prolongation of the unit's life. There were no significant changes in the P and R wave amplitudes, but there was a fall in lead impedance in the ventricular leads between implantation and 1 week (P < 0.02) but none subsequently, and there was no significant change in atrial impedance. There were no sensing failures and no lead displacements. Despite impressive pacing characteristics, the study was suspended because of a high level of mechanical complications. Of the 96 patients implanted worldwide with 136 leads there were eight helix deformations, which will require redesign.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Polymyositis.

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Adolescent

Apolipoprotein profile in type II diabetic patients with and without coronary heart disease.

Diabetes mellitus is frequently associated with lipid metabolism abnormalities. In the present study the lipid and apolipoprotein profiles have been compared in type II diabetic subjects with (n = 30) and without (n = 30) coronary heart disease (CHD). All subjects were studied after good metabolic control had been achieved. Significant differences in plasma lipids and apolipoproteins were seen in diabetic patients with CHD in comparison with diabetics without CHD. Patients with CHD presented higher total cholesterol, triglyceride, LDL-cholesterol, apo B, apo CII and apo CIII levels and total cholesterol/HDL-cholesterol and LDL-cholesterol HDL-cholesterol ratios and lower HDL-cholesterol values and apo A1/apo B ratio than the patients without CHD. The same findings were found in females; while male subjects with CHD had significantly increased total cholesterol, LDL-cholesterol and apo B levels and total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios and significantly decreased apo A1/apo B ratio compared with males without CHD. These findings support the concept that the apolipoprotein profile plays a remarkable role as risk factor for CHD in type II diabetes mellitus.

Aged