Biomedical subjects

D Antonenko

Publications and source records attributed to D Antonenko.

5 recordsLinked to original sources

PubMed1992

Thyroid and thymic malignancy following childhood irradiation.

Synchronous thyroid and thymic malignancy following childhood thymic irradiation has only been reported in two known cases previously, with a third case identified here. A rationale is presented for following these radiated patients as they age with thyroglobulin and thyroid-stimulating hormone (TSH) levels as a measure of risk of the development of nodular thyroid disease and, if such occurs, for an aggressive surgical approach. There exists a growing population at risk attributable to the success of radiation treatment of Hodgkin's and pediatric head and neck tumors. The question is raised regarding the theoretical benefits of thyroid suppressive therapy in this group at risk. With the instructive case presented, radical surgery for either thymic or thyroid carcinoma and careful monitoring for decades-late local recurrences of thymoma are suggested.

Adult↗

PubMed1992

Laser thoracoscopy for pleural effusion.

A potential, new, therapeutic modality for the treatment of recurrent symptomatic pleural effusion in a patient with metastatic carcinoma is presented using "minimal access surgery." Diagnosis at the time of thoracoscopy, as well as treatment using free-beam and contact-tip modalities, is outlined in detail. Also, a complication of inter-costal artery bleeding is presented, as well as its solution using the end-firing endoclip applier. This is an effective and useful procedure that should be particularly of interest to surgeons already using various scope methods. Surgeons currently express strong interest in accomplishing diagnosis and treatment goals in a variety of clinical situations using "minimal access surgery," a phrase coined at the 1989 International Congress of the Society of American Gastrointestinal and Endoscopic Surgeons. Enthusiasm about this procedure is evident across the country by the number of laparoscopic courses offered at a variety of institutions. Similarly, the chest allows certain applications of minimal access surgery resulting in accurate diagnosis and possible definitive treatment by use of the thoracoscope.

Aged↗

PubMed1979

Creatinine clearance in critically ill surgical patients.

Standard tests of renal function (urine output, BUN, and serum creatinine) were compared with creatinine clearance values and with outcome in 131 critically ill surgical patients. There was a strong negative relationship between creatinine clearance and mortality. Of the 23 patients with a severe reduction of creatinine clearance (less than 20 mL/min), 17 died. In contrast, 23 of the 24 patients with a creatinine clearance of 100 mL/min or more survived. Urine output, BUN, and serum creatinine levels correlated poorly with creatinine clearance. A urine output of less than 30 mL/hr, a BUN level greater than 40 mg/dL, and a serum creatinine level greater than 2.0 mg/dL in all instances were associated with reduced creatinine clearances. However, more than half of all the patients with a normal urine output, BUN, or serum creatinine levels also had a reduced creatinine clearance.

Bacterial Infections↗

PubMed1979

Ionized calcium levels in critically ill surgical patients.

Ionized calcium levels measured in 74 critically ill surgical patients averaged 1.97 +/- 0.25 mEq/l, significantly lower than the average (2.26 +/- 0.14) in 34 healthy individuals. The mortality rate increased as ionized calcium levels decreased. Of four patients with ionized calcium levels lower than 1.40 mEq/l, none survived. The average total calcium (4.0u mEq/l) in the critically ill patient was also significantly lower than in controls (4.55 +/- 0.40 mEq/l). The albumin levels were severely reduced (2.80 +/- 0.59 mg/dl) in the patients and significantly lower than in controls (5.31 +/- 0.53 g/dl). There was, however, no correlation between ionized calcium and albumin. Although measured ionized calcium levels correlated with the total calcium level (r = 0.56) and with estimated ionized calcium levels (r = 0.53), it must be emphasized that severe ionic hypocalcemia may occur despite normal total or calculated ionized calcium levels. Consequently, it is hoped that all hospitals with critically ill patients will soon have this analysis available.

Bacterial Infections↗

PubMed1977

Shock and acute respiratory failure after chest trauma.

Shock or acute respiratory failure developing soon after chest trauma are associated with extremely high mortality and morbidity rates. In a study of 1,136 patients with chest trauma admitted to Detroit General Hospital during a 2-year period (1974-1975), it was found that 218 (19%) had shock or acute respiratory failure when first seen in the Emergency Department. Of these patients, 36% (78/218) died and the survivors had a complication rate of 63% (88/140). Shock was associated with a mortality rate of 7.3% (7/96) but the combination of shock and respiratory failure was particularly lethal, with a mortality rate of 73.1% (57/78)overall. No patient over 45 years of age survived this combination. Efforts to improve results following chest trauma must be directed toward earlier and more aggressive management of both these problems

Adolescent↗