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Biomedical subjects

J Avram

Publications and source records attributed to J Avram.

17 recordsLinked to original sources
PubMed1999

Radiation therapy of metastatic spinal cord compression. Multidisciplinary team diagnosis and treatment.

PURPOSE: To evaluate the effectiveness of a multidisciplinary approach to spinal cord compression (SCC) in accordance with prospective protocol, providing a uniform approach to diagnosis, decision making concerning optimal treatment modality in any particular case of SCC, treatment performance and evaluation of treatment results. The SCC patients treated by radiation therapy are described. MATERIALS AND METHODS: Patients with SCC were examined and treated by a multidisciplinary team consisting of a neurologist, radiologist, oncologist, orthopedic surgeon, and neurosurgeon. Seventy-nine patients for whom radiation was recommended received a 30 Gy radiation dose to a compression-causing mass and course of high dose dexamethasone. Three fractions of 5 Gy and 5 fractions 3 Gy each were delivered by Co60 or 8 MV photon beam in 12 days. Treatment outcome was essentially evaluated by ambulation capabilities which were considered to be the main problem of SCC. Changes in other neurologic motor, sensory and autonomic disturbances were also evaluated. RESULTS: Seventy-two percent of the patients were already non-ambulatory at diagnosis. The first symptom was motor deficiency in only 33% of them while in all other cases it was pain. Ambulation capability was the main prognosticator of treatment outcome; 90% of patients who were ambulatory before treatment remained so while 33% of the non-ambulatory patients regained their ability to walk. The grade of motor disturbance was also an important variable: among the non-ambulatory patients, 50% of the paretic but only 14% of the plegic ones became ambulatory. Overall, 51% of the study patients were ambulatory after undergoing radiation. The ambulatory state after treatment was the main predictor for survival. CONCLUSION: Close cooperation of a multidisciplinary team in diagnosis and treatment according to the above protocol enabled the achievement of good results of radiation treatment in SCC. Early diagnosis and early treatment should further enhance therapeutic outcome.

Adult↗
PubMed1994

[The indications for surgical treatment in venous malformations of the lower extremities].

The venous congenital anomalies are diseases with a low frequency to compare with the great number of the acquired venous diseases, but that present interest specially through their disabled evolution and through the insufficient standardisation and limited treatment. The paper present the experience of the First Surgical Clinic of Timişoara, with 76 venous congenital abnormalities of the lower limbs. We studied 48 patients with syndrome Klippel-Trénaunay, 12 with syndrome Parkes Weber and 16 venous hemangiomas. The surgical treatment was performed to 6 patients with syndrome Klippel-Trénaunay; in 3 cases we have do phlebolysis. The operation realized in syndrome Parkes Weber was in 1 patient the Malan operation and in another one an embolisation. 13 patients with venous hemangioma were operated on (81%) performing in 12 cases the complete excision and in 1 case the transcutaneous ligature followed by sclerotherapy. The indications of the surgical treatment in the venous congenital abnormalities require a good judgment, a precise lesion diagnosis and a competent evaluation of the therapeutics venous.

Arteriovenous Malformations↗
PubMed1993

Nosocomial acinetobacter meningitis secondary to invasive procedures: report of 25 cases and review.

The medical records of 25 patients with nosocomial meningitis due to Acinetobacter baumannii were retrospectively reviewed. Most cases occurred in the neurosurgical intensive care unit over a 5-year period, with an increased rate during summer. The majority of infections were associated with indwelling ventriculostomy tubes or CSF fistulae in patients receiving antimicrobial therapy. Repeated environmental cultures failed to reveal a source of the microorganism, and control measures had no apparent effect on the outbreak. However, no further cases appeared following a sharply reduced total intake of antibiotics in the neurosurgical department. Forty-one cases of acinetobacter meningitis, secondary to invasive procedures, were found in the English-language literature and were compared with the cases presented. To our knowledge, our series is the largest of acinetobacter meningitis reported hitherto. Although not one of the most common pathogens in hospitals, Acinetobacter constitutes an increasing threat for patients, especially those receiving antimicrobial therapy in intensive care units who are being maintained by various life-support systems.

Acinetobacter↗
PubMed1988

Infratentorial epidermoids.

Infratentorial epidermoids are rarely seen in the lifetime of a neurosurgeon. Most published series consist of a dozen or so cases. In a period of 20 years we operated on only 6 such patients. Five are doing excellently, one patient died two and a half months after operation of a fulminating infection. The follow-up is of 20 years, 9 years, and 3 years of the first three patients, while the remaining three were operated during the last year. Such an accelerated pace of epidermoid incidence in our department during the last year may be fortuitous, but may also be an indication that, many patients with vague complaints who had an epidermoid, had been missed in the past. Undoubtedly, the CT scan has greatly facilitated the diagnosis of epidermoid cysts, whether infra- or supratentorial. Diagnosis, however, hinges on suspicion or awareness on clinical grounds of the possibility of an infratentorial epidermoid. The analysis of the clinical presentation in our 6 cases, seems to allow the division of infratentorial epidermoids into those that are posteriorly located, which uniformly manifested at some stage of illness raised intracranial pressure, and the anterior epidermoids in the cerebello-pontine angle characterized by the insidious involvement of cranial nerves. Computerized tomography, in some cases with the adjunct of Metrizamide cisternography, confirms the diagnosis and delineates the spread of the lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Diseases↗
PubMed1988

The in-vivo-nerve response to direct low-energy-laser irradiation.

To study the in-vivo effects of direct Low-Energy Laser Irradiation (LELI) on the Peripheral Nervous System, the sciatic nerve in rats was surgically exposed, crushed and then subjected to the direct irradiation of either of two continuous-wave HeNe lasers--0.3 mW or 17 mW. We found that the 0.3 mW laser significantly boosts the electrical activity in both the injured and non-injured nerves. The temperature changes of the nerve were measured during irradiation, and no thermal effect was detected. These findings could have direct therapeutic applications in various surgical situations.

Animals↗
PubMed1982

Carbon dioxide laser surgery of basal meningiomas.

This preliminary report summarizes our results with laser surgery in patients with basal meningiomas (8 basilar and 1 intraventricular extending also into the third ventricle). Illustrative preoperative and postoperative CT scans are included. The advantages and limitations of this surgical technique are discussed briefly.

Bone Neoplasms↗
PubMedDate not supplied

[Subfascial endoscopic perforating veins section].

AIM: Subfascial endoscopic perforating veins section (SEPS) is a modern surgical method used in the treatment of chronic venous insufficiency. The paper presents the postoperative results using SEPS technique at the patients with chronic venous insufficiency of the inferior limbs of different etiologies. MATERIAL AND METHOD: We followed 26 patients, 16 women and 10 men, with ages between 16-75 years, with chronic venous insufficiency at the inferior legs. 20 patients had only one inferior limb affected by the disease and 6 patients had both limbs involved. They were, after CEAP clinical criterion, in C4, C5 and C6 classes and they had three different etiologies as primary varices with an evolutive period of 20 years, postthrombotic syndrome and congenital varices. We performed 32 SEPS operations in the 1-rst Clinic of Surgery, University of Medicine and Pharmacy "Victor Babeş" Timişoara. RESULTS: The time of healing and postoperative complications were reduced after SEPS procedures. The healing is 100% at three months after surgery. The check up after 12 months showed a rate of 87.5% of healing. We recorded 4 unilateral relapses at patients that had postthrombotic syndrome. DISCUSSIONS: The study realized in our clinic comparing with other studies from the literature, shows that our results are similar to that recorded in medical centers from other countries demonstrating the superiority of SEPS methods comparing with the classical Linton or Felder methods of perforating veins ligation.

Adolescent↗
PubMedDate not supplied

The effect of prolonged dextran administration in guinea pigs.

Dextran 70 6% in 0.9% NaCl solution, injected intraperitoneally in guinea pigs, 10 ml/kg b.w./day, during a period of 27 days brought the lowering of the plasma proteins level, whie the total colloid osmostic pressure (due to Dectran and proteins) remained close to that of the control group. The concentration of typhus 0 antibodies and the number of precipitation lines assayed during immunodiffusion in gel were lower than in thd control group. The diminishing of the red blood cells number and of the amount of hemoglobin corresponds to the decreasing proportion of the erythroblastic series (in the bone marrow). Histological changes in the liver and in the kidney are minimal and could be explained by the effort made by these depurating organs to eliminate Dextran from the body.

Animals↗