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Biomedical subjects

J A Pastena

Publications and source records attributed to J A Pastena.

6 recordsLinked to original sources
PubMed1994

Surgical prophylaxis for pulmonary embolism.

The trauma patient population is at special risk for fatal pulmonary embolism. We experienced 11 fatalities in one 12-month period. Specific risk factors for both deep venous thrombosis and pulmonary embolism can be identified among trauma patients. The latter usually cannot be offered prophylactic anticoagulation, and the nature of their injuries (e.g., long bone fractures) makes not only bedside surveillance difficult but also precludes use of pneumatic compression, etc. We have developed a protocol for prophylactic inferior vena caval filtration for our trauma patients deemed at particular risk for pulmonary embolism. Since 1986 we have inserted 205 Greenfield filters in 201 patients. Two hundred were inserted prophylactically. There was no mortality, and morbidity was minimal. No patient with a Greenfield filter sustained a fatal pulmonary embolism during this period. Four patients died from pulmonary embolism before vena caval filters could be inserted. We believe that the trauma patient, at risk for pulmonary embolism, should be offered a Greenfield filter prophylactically as soon after hospitalization as logistically possible.

Adult↗
PubMed1993

Women in surgery. An ancient tradition.

The heritage of women in surgery goes back to the dawn of Western civilization, to that strip of land lying between the banks of the Tigris and the Euphrates. This 5500-year history of women surgeons can be divided into three epochs: ancient history, the Middle Ages, and modern times.

Female↗
PubMed1990

Trauma recidivism.

Surgeons have long recognized that a proportion of hospitalized trauma patients present with a history of a previous admission for trauma, termed by the authors as "trauma recidivism." The incidence of trauma recidivism was addressed by a review of 150 consecutive admissions to a level I Trauma Center. This study identifies this subset of trauma patients, establishes their magnitude, and analyzes mechanisms of injury and hospital courses. The implications for those who care for trauma patients is discussed.

Adolescent↗
PubMed1989

Prediction of clinical course in diabetes using a simple coagulation test.

Peripheral vascular complications in diabetic patients are extremely variable. It has been suggested that they are related, in part at least, to accelerated blood coagulation. However, a simple test to monitor these changes in coagulability has not been previously described. This article reports that a test in which citrated blood, when incubated with either saline (control) or with endotoxin (to activate the extrinsic pathway) and then subjected to the determination of the recalcification time, can detect minute changes in coagulability. This technique showed that the recalcification times of both saline and endotoxin-incubated blood samples were significantly shorter in a majority of diabetic patients than in controls. These studies substantiate the significant incidence of hypercoagulability in diabetics.

Adult↗
PubMed1988

Recalcification time in breast disease.

Hypercoagulability in malignant disease can be attributed, in part, to excess generation of tissue factor (thromboplastin) by the monocyte. Incubation of anticoagulated venous blood with endotoxin (a cellular activator) enables the generation of tissue factor by monocytes. The quantity of this procoagulant generated is determined by a simple recalcification time (a marker for cellular activation). Individuals with breast cancer have significantly shorter endotoxin-activated recalcification times than patients with cystic hyperplasia, who have, in turn, significantly reduced recalcification times when compared with those of healthy volunteers.

Adult↗