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Biomedical subjects

C Born

Publications and source records attributed to C Born.

At least 37 records · Page 2Linked to original sources
PubMed2000

Tertiary survey of the trauma patient in the intensive care unit.

The issues surrounding the arrival of trauma patients to the ICU have been defined. By necessity, many of these topics are dealt with elsewhere in greater detail. The basic framework within which this phase of care could be optimized has been provided. Pitfalls related to patients' mode of arrival to the ICU affect subsequent management and should direct specific clinical activity. The tertiary survey is a complete summation and cataloguing of a patient's injuries. The need for ongoing resuscitation determines how much attention can be paid to the tertiary survey. Clinical suspicion based on mechanism and pattern of injury and thorough, repeated, complete physical examination are the essential elements of the tertiary survey. The survey is affected by factors that alter patients' mental status because examination is most reliable in patients who can localize pain. Medications, intoxication, and head injuries are common factors that interfere with the reliability of the tertiary survey for variable periods. Radiographic assessment is used to identify injuries suspected on the basis of mechanism of injury, injury pattern, and findings on physical examination. Some studies may be done portably; others require transport within the hospital. The intensivist must prioritize these ongoing diagnostic studies based on patient stability and the need for ongoing resuscitation.

Alcoholic Intoxication↗
PubMed1998

Efficiency of video-assisted thoracic surgery for primary and secondary spontaneous pneumothorax.

BACKGROUND: The objective of the study was to analyze the efficiency of video-assisted thoracic surgery (VATS) for the treatment of primary (PSP) or secondary (SSP) spontaneous pneumothorax in an initial series of 99 patients. METHODS: From April 1992 to December 1995, 74 men and 25 women with a median age of 31 years (range, 17 to 85 years) were treated by VATS for persistent (n = 40) or recurrent (n = 59) PSP (n = 65) or SSP (n = 34). Postoperative parameters such as use of analgesics, length of hospital stay, and duration of drainage were compared with those of a control group of 100 patients treated by lateral thoracotomy between January 1988 and December 1991. RESULTS: Conversion to lateral thoracotomy was necessary in 6 (9.2%) patients with PSP and in 10 (29.4%) patients with SSP, in most cases because of adhesions. Postoperative complications occurred in 1 (1.7%) patient with PSP and in 6 (25%) patients with SSP. There were no operative deaths. After a median follow-up period of 29 months, 4 (4.8%) recurrences were noted. All recurrences occurred in patients with PSP and during the first year of our experience. Compared with lateral thoracotomy, treatment by VATS resulted in a significantly shorter hospital stay and drainage duration in patients with PSP but not in patients with SSP. The use of analgesics was reduced in all patients treated by VATS independent of the type of pneumothorax. CONCLUSIONS: Surgical treatment by VATS is a viable alternative to lateral thoracotomy in patients with PSP. The usefulness of VATS in patients with SSP remains to be defined.

Adolescent↗
PubMed1998

[Minimally invasive thoracic surgery--evaluation after 5 years].

A prospective study documented all minimally invasive operations performed in the department of thoracic surgery between 1992 and 1996. The most frequent indications were: lung biopsy (n = 181, 30.9%), coin lesions of unknown origin (n = 179; 30.5%), pneumothoraces (n = 133; 22.7%), pleura effusions (n = 19; 3.2%), and pleura empyema (n = 13; 2.2%). The majority (82.6%) of the minimally invasive procedures were completed without conversion; in 6.0% an extension (< 5 cm) of one of the trocar incisions was necessary and in 11.5% an anterolateral thoracotomy. It is demonstrated that a wide spectrum of thoracic operations can be performed by the minimally invasive approach.

Adolescent↗
PubMed1997

[Efficacy of minimally invasive thoracic surgery in diagnosis of pulmonary coin lesion].

AIM OF THE STUDY: With only a few exceptions every pulmonary nodule of unknown dignity has to be clarified by biopsy. Aim of the present study was to analyze the usefulness of minimal invasive thoracic surgery in patients with indeterminate pulmonary lesions. METHODS: In the study included were 121 patients (67 male/54 female), who were primarily treated by minimal-invasive surgery during the period 1992-1995. Preoperatively, a single pulmonary nodule was diagnosed in 89 patients. 32 patients had two or more lesions. RESULTS: Using the minimal invasive approach a pulmonary nodule was successfully localized and resected in 83 (68.5%) patients. In 33 patients the operation was classified as diagnostic, in 36 patients benign or inflammatory tumors were completely resected and in 14 patients palliative resections of malignant tumors were performed. Overall, an extension of the operative approach was necessary in 38 (31.5%) of the patients. In 23 patients a "mini-thoracotomy" (< 5 cm) was used to localize the nodule. A standard thoracotomy was performed in 15 patients, mostly because of massive adhesions. CONCLUSIONS: The minimal invasive approach has become a routine procedure in thoracic surgery and is extremely useful in the diagnosis of indeterminate pulmonary nodules.

Adult↗
PubMed1997

[Results of minimally invasive surgery in patients with recurrent or persistent primary pneumothorax].

BACKGROUND: The objective of the study was to analyse the efficiency of video-assisted thoracic surgery (VATS) in the treatment of primary spontaneous pneumothorax (PSP) in an initial series of 65 patients. METHODS: From April 1992 to December 1995 47 male and 18 female patients with a median age of 28 years (range 17-53) were treated for persistent (n = 20) or recurrent (n = 45) spontaneous pneumothorax by VATS. In most patients a stapling of bullae using an endostapler was performed followed by parietal pleurectomy or pleural abrasion. Postoperative parameters, like use of analgetics, length of hospital stay and length of drainage were compared with a control group of 57 patients treated by lateral thoracotomy between January 1988 and December 1991. RESULTS: Conversion to lateral thoracotomy was necessary in 6 (9.3%) patients. Postoperative complications occurred in one patient (1.7%) consisting of a persistent air leak for more than 7 days. No second intervention was necessary. There were no operative deaths. 4 recurrences were noted after a median follow-up of 29 months. All recurrences occurred in the first 18 months after surgery. Compared to lateral thoracotomy the treatment by VATS resulted in a significantly shortened hospital stay (mean: 8 vs. 11 days; p < 0.001) and drainage time (mean: 4 vs. 5 days; p < 0.001). The use of opioid analgetics was 3.7 days (mean, range 1-11 days) after VATS and 6.5 days (mean, range 2-20 days) after conventional therapy. CONCLUSIONS: Surgical treatment by VATS is a viable alternative to lateral thoracotomy in patients with recurrent or persisting PSP.

Adolescent↗
PubMed1997

[Cost comparison of minimal invasive surgery vs. standard operation exemplified by primary pneumothorax].

In patients with primary spontaneous pneumothorax, the costs for a minimally invasive operation were retrospectively compared with the costs for a standard operation using lateral thoracotomy. The calculations were based on the direct costs for the operation, the expenditures for the in-hospital stay, and the socioeconomic costs in terms of working disability. The results demonstrate that the high expenses for the minimally invasive operation are compensated by the reduction in costs due to a shorter in-hospital stay and a shorter recovery time in patients treated by minimally invasive surgery.

Adult↗
PubMed1990

[Clinical problems in postpartum psychoses].

The authors analyzed post-partum psychoses treated at the Psychiatric Clinic of the Faculty Hospital in 1985-1986. The group comprised 41 patients. Post-partum psychoses are not considered a separate nosological unit nor symptomatic mental disorders but are classified as endogenous psychoses, provoked by childbirth. As to endogenous psychoses, most frequently manic depression is involved, as suggested by the clinical picture and course. Schizophrenia is found less frequently, as compared with manic depression, the cca 1:10. In rare instances post-partum symptomatic psychosis may develop.

Adult↗
PubMed1988

Pelvic crush injuries with occlusion of the iliac artery.

During a 1-year period, three patients presented with acute traumatic thrombosis of the common or external iliac artery concomitant with a massive crush injury to the pelvis. All had vascular compromise of the involved extremity on initial physical examination, but in two patients with open pelvic trauma, exsanguination, major visceral injury, hypothermia, and a coagulopathy precluded emergency vascular reconstruction. Both required hindquarter amputation for adequate debridement. The third patient presented without exsanguination or visceral trauma. Angiography and vascular reconstruction were undertaken, but myonecrosis compounded the initial vascular compromise, and eventually required a hip disarticulation for debridement. It was concluded that: exsanguination and/or major visceral injury takes priority over emergency vascular reconstruction; soft-tissue injury may preclude limb salvage despite vascular reconstruction. If a cadaveric limb exists, early radical amputation, including hindquarter amputation, should be undertaken.

Adult↗
PubMed1981

The stability of teletherapy-beam symmetry with gantry angle.

The authors describe a rapid means of evaluating the stability of beam symmetry as the gantry angle is varied. Two radiation detectors, a ratio circuit, and an X-Y recorder are used. The teletherapy machine is operated in the rotational mode, and the ionization-current ratio is recorded as a function of the gantry angle. This test can provide an early warning of beam-symmetry instabilities.

Particle Accelerators↗