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Biomedical subjects

E W Pollak

Publications and source records attributed to E W Pollak.

At least 37 records · Page 2Linked to original sources
PubMed1979

Short-term femoral vein catheterization. A safe alternative venous access?

Results of femoral vein catheterization were compared with those of subclavian and antecubital vein catheterization in 2,345 combat casualties during treatment of hypovolemic shock. Femoral vein catheterization was successful in 95.5 per cent of cases. Accidental arterial puncture occurred in 6.3 per cent, hematomas in 1.3 per cent, and infection in 1.4 per cent. Subclavian vein catheterization was successful in 92.4 per cent. Arterial puncture occurred in 0.4 per cent, hematomas in 0.3 per cent, infection in 1.1 per cent, pneumothorax in 1.4 per cent, and hydrothorax in 0.4 per cent. Antecubital vein catheterization was successful in 77.6 per cent, infection developed in 3.3 per cent, and phlebitis occurred in 5.6 per cent. No clinically detectable phlebitis occurred after either femoral or subclavian vein catheterization. The low morbidity of femoral vein catheterization in this series suggests that this approach be considered when short-term massive intravenous fluid administration is indicated in the treatment of circulatory collapse or cardiac arrest.

Blood Transfusion↗
PubMed1979

Massive spontaneous hemoperitoneum due to rupture of visceral branches of the abdominal aorta.

Review of 153 cases of massive spontaneous hemoperitoneum following visceral arterial rupture showed that 94% of all young women and 100% of all pregnant women had ruptured congenital splenic artery aneurysms at the time of hemorrhage, whereas young males bled from a variety of sources. Individuals who were 45 years old or older bled either from lesions of the celiac axis or its branches (66%) or from arterial mesenteric system lesions (34%). Only 22% of the older individuals of either sex bled from splenic artery sources. Arterial hypertension was present in 40% and previous or simultaneous intracranial hemorrhage occurred in 9% of the older patients. There were no survivors among those in whom the bleeding source was not operatively controlled. With operation, 79% of the younger patients and 57% of the older ones survived. Results emphasize the high mortality of visceral artery rupture with intraperitoneal bleeding. Prophylactic excision is advised for all complicated aneurysms regardless of age and all uncomplicated aneurysms in healthy individuals, especially in fertile or pregnent women.

Adult↗
PubMed1978

Pancreatic pseudocyst: management in fifty-four patients.

The management of pancreatic pseudocyst was reassessed in fifty-four patients: only sixteen (30 per cent) regressed with nonoperative management; six (11 per cent) died of septic complications; and thirty-two (64 per cent) eventually required operation. Most pseudocysts did not regress with nonoperative therapy, thus emphasizing the need of serial clinical and ultrasonic examination at frequent intervals to detect nonresolution or complications requiring earlier operation than previously advocated.

California↗
PubMed1978

Inflammatory carcinoma of the breast. A therapeutic approach followed by improved survival.

Disappointing results of radical mastectomy for treatment of inflammatory breast carcinoma led to its abandonment and the use of alternative therapeutic methods without improvement of survival rates. Results of radical mastectomy combined with other therapeutic modalities have not been fully evaluated so far. In a series of nine patients with proven inflammatory breast carcinoma and no distant metastases, two underwent radiotherapy, oophorectomy, and adrenalectomy (group A) and seven underwent preoperative irradiation, radical mastectomy, postoperative irradiation, and chemotherapy (group B). There were no local recurrences in either group. Group A patients survived five and eight months (mean, 6.6+/-2.1) and patients of group B survived 45.5+/-26.2 months (p less than 0.05). Results show no rational basis for withholding radical mastectomy, but suggest that improved survival may be obtained when radical mastectomy is an integral part of a rational sequential therapeutic schedule.

Adenocarcinoma↗
PubMed1978

The effect of fluid infusions upon serum protein concentrations during hemorrhagic shock.

Of 24 dogs subjected to hemorrhagic shock, 12 resuscitated with intravenous infusions containing 2.5 per cent human serum albumin maintained significantly higher, p less than 0.05, serum albumin levels than did 12 others treated with Ringer's lactate solution, with or without 50 per cent dog plasma. These differences persisted for as long as six weeks after hemorrhage. Dogs resuscitated with Ringer's lactate solution and 50 per cent dog plasma had significantly higher serum globulin levels than did the dogs receiving 2.5 per cent albumin containing infusion during the first three days after hemorrhage. The simultaneous addition of 5 per cent glucose, potassium chloride and hydrocortisone sodium succinate to the infusion of dogs receiving 2.5 per cent albumin in Ringer's lactate solution did not provide significant alterations in the serum concentration of protein and protein fractions when compared with those of dogs receiving only 2.5 per cent albumin in Ringer's lactate solution. These findings corroborate the suggestion of a capillary leak of serum albumin into the interstitial space during hemorrhagic shock that persists for at least one week after hemorrhage. The administration of albumin containing solutions during the initial stages of hemorrhagic shock counteracts this albumin loss.

Animals↗
PubMed1977

Volvulus of the spleen.

Volvulus of the spleen in absence of malarious splenomegaly is rare. Most reported instances occur in young and middle-aged women and are related to a congenital abnormality of the mesogastrium, pregnancy, and multiparity. In this reported case of splenic volvulus in a young, multiparous woman, posterior mesogastrium malformation was the cause. Certain preoperative findings could suggest this infrequent diagnosis in future cases.

Adult↗
PubMed1977

Detection of anticoagulation therapy failures in patients with venous thrombosis.

Results of ultrasonic monitoring of venous patency and fibrinogen uptake testing were evaluated in ten patients with venous thrombosis receiving heparin therapy. Two propagating venous thromboses were detected 24 to 48 hours before massive pulmonary embolism developed, thus emphasizing the usefulness of these methods for detection of anticoagulation therapy failures.

Adult↗
PubMed1977

Serum protein concentration during hemorrhagic shock.

Early changes in serum protein concentration during hemorrhagic shock were evaluated in a series of 20 dogs, following massive bleeding. The serum protein concentration fell faster than did the hematocrit value, with significant changes becoming apparent 15 minutes after hemorrhage, p less than 0.05. After this initial fall, a less marked descent occurred. The most remarkable changes were in the serum albumin fraction. Changes of the globulin levels were less evident. These findings of an early albumin loss, occurring within 15 minutes following acute massive hemorrhage in the dog, probably are due to a leakage of albumin into the interstitial space, secondary to increased capillary membrane permeability. Larger molecules, such as the globulin fraction, did not consistently decrease during the first 45 minutes following shock, a possible indication that loss of this protein into the interstitial space did not occur in a consistent manner. The aforementioned findings support the early use of intravenous infusions containing macromolecules, larger than albumin, during hemorrhagic shock, to re-establish an oncotic gradient, which is diminished due to a loss of albumin from the circulation.

Animals↗
PubMed1977

Fibrinogen uptake test. Criteria for interpretation of results in patients with venous thrombosis.

Accurate detection of active deep venous thrombosis with the fibrinogen uptake test (FUT) requires adherence to rigid criteria for interpretation of results of the tests. In a series of 56 patients, only detection of serial increase of per cent uptake at the same position correlated with presence of active venous thrombosis in all cases. Other investigated criteria, which were based on the analysis of single FUT results, showed a 21% incidence of false positive results. Accordingly, active venous thrombosis investigation by FUT requires performance of serial tests and analysis of the curve of uptake at each position to detect serial increasing per cent uptake.

Fibrinogen↗