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Biomedical subjects

C B Rosoff

Publications and source records attributed to C B Rosoff.

17 recordsLinked to original sources
PubMed1983

Shorter length of stay for simple cholecystectomy: cost-effectiveness of alternative strategies.

Patients undergoing simple cholecystectomy during a 12-month period at a Boston teaching hospital were retrospectively divided into two groups: short stay surgery (SSS) patients had a hospital length of stay (LOS) of 5 or 6 days; conventional stay surgery (CSS) patients were hospitalized for more than 6 days. After matching for sex, age, preoperative LOS, and secondary diagnoses, 18 pairs were identified. None of the patients had major complications after the hospital discharge. One to 2 years after surgery, health status was identical in the two groups. Patients in the SSS group reported a larger number of minor complications after hospital discharge and less satisfaction with the adequacy of their length of stay. Shortened length of hospital stay for a subgroup of simple cholecystectomy patients is a promising means of reducing cost with minimal, if any, sacrifice in quality of care and deserves further evaluation.

Adult↗
PubMed1979

Reduced incidence of cerebral ischemia following rupture of intracranial aneurysms.

A randomized study was carried out to determine if the administration of reserpine and kanamycin to lower the concentration of vasoactive biogenic monoamines would reduce the incidence of cerebral vascular ischemic complications and death following the rupture of intracranial aneurysms. Twenty-six treated and twenty-eight control (untreated) patients were studied. In the preoperative period, eight control (untreated) patients developed symptomatic cerebral ischemia as opposed to one treated patient. There was no correlation between the preoperative clinical findings of ischemia and angiographic evidence of vasospasm. In the post-operative period four control and one treated patient developed symptomatic cerebral ischemia; vasospasm, as demonstrated by cerebral angiography, paralleled these findings.

Cerebral Infarction↗
PubMed1978

Intermediate syndrome of platelet dysfunction.

We studied eight patients with intermittent bleeding episodes usually following trauma and associated with the ingestion of medicine known to interfere with platelet function. All patients had a normal or minimally prolonged baseline bleeding time. All had a normal platelet count, glass bead retention test, and platelet serotonin content and a variable pattern of abnormalities in prothrombin consumption and platelet factor 3 availability. However, all showed abnormal platelet aggregation reactions using epinephrine, adenosine diphosphate, and collagen. Following the administration of 975 mg aspirin, our patients' bleeding times became prolonged to a greater extent than the bleeding times of normal controls (range 13 to greater than 20 min). Review of the literature showed approximately 5% of "normal" controls had findings similar to those we report. We believe we are describing a group of individuals with an intermediate form of platelet dysfunction. Although their bleeding diathesis is not as severe as that of patients with platelet dysfunction syndromes previoulsy described, they do bleed significantly when subjected to trauma following the ingestion of drugs such as aspirin. We propose that this defect is common and should be screened for. The aspirin tolerance test is a simple test for detecting these patients.

Adolescent↗
PubMed1976

Effect of dehydration and cardiac tamponade on superior mesenteric artery flow: role of vasoactive substances.

The role of serotonin, catecholamines, and angiotensin in the pathogenesis of mesenteric low flow states was investigated in anesthetized dogs by measurement of blood flows with electromagnetic flow meters. During dehydration or cardiac tamponade, a disproportionate decrease in superior mesenteric artery flow was demonstrated, compared with aortic flow, but renal artery flow was relatively better maintained. Depletion of serotonin and catecholamines by pretreatment with reserpine or blocking serotonin's action with methysergide did not alter the disproportionate reduction in mesenteric flow. Disproportionate superior mesenteric artery flow during dehydration and tamponade was associated with increased levels of circulating angiotensin and virtually was abolished by bilateral nephrectomy, by inhibition of enzymatic conversion of angiotensin I to II by Bothrops nonapeptide, and by competitive inhibition of angiotensin II with 1-sar, 8-ala angiotensin II. Exogenous angiotensin administered intravenously to dogs not protected by drug treatment disproportionately decreased superior mesenteric artery flow with less effect on renal artery flow. These results are compatible with the hypothesis that increased circulating levels of angiotensin during dehydration and tamponade contribute to the disproportionate reduction in superior mesenteric artery flow in the anesthetized dog.

Angiotensin II↗
PubMed1975

The influence of aspirin on postoperative platelet kinetics and venous thrombosis.

Several parameters of platelet kinetics were followed in 105 middle-aged and elderly postoperative patients, half of whom were randomly allocated to receive aspirin. A significantly lower incidence of venous thrombosis, as detected by 125I-fibrinogen scanning, was found among patients receiving aspirin when compared with the control group. Platelet survival was shortened in the postoperative state, an effect that was inhibited by aspirin. The development of deep vein thrombosis did not shorten platelet survival, nor did fibrinogen survival discriminate patients with venous thrombosis. Treatment with aspirin reduced urinary excretion of 5-hydroxy indole acetic acid--presumably by inhibiting in vivo platelet release of serotonin, reduced postoperative consumption of platelets, and reduced the mean corpuscular volume of the platelet population. These studies suggest that platelet function is important in the pathogenesis of postoperative venous thrombosis.

Adult↗