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Biomedical subjects

J B Devin

Publications and source records attributed to J B Devin.

7 recordsLinked to original sources
PubMed1990

A pediatric survivor of left ventricular rupture after blunt chest trauma.

The case of a patient with left ventricular rupture as a result of blunt chest trauma from a motor vehicle accident is presented. This is the first reported case of a pediatric survivor of this rare and usually lethal injury and only the fourth report of a survivor. This condition can be treated if the patient survives long enough to reach a trauma center, if the diagnosis is entertained early, and if the appropriate diagnostic studies are obtained in an expeditious manner. We believe that echocardiography is the diagnostic method of choice for pericardial tamponade, whether it is the result of penetrating or blunt trauma, and that early use of this modality may improve survivability.

Accidents, Traffic↗
PubMed1983

Life expectancy and late stroke following carotid endarterectomy.

A review of the UCSD experience with 456 consecutive carotid endarterectomy procedures confirms the acceptably low operative mortality and morbidity associated with this operation. Immediate complications were not different when routine or selective shunting was performed, but the patients with a low internal carotid artery back pressure had higher operative complication rates. The coexistence of atherosclerosis in other parts of the body severe-enough to warrant surgery for them was not associated with either higher early or late carotid surgery complication rates. Following both coronary bypass and carotid procedures, the late mortality was decreased, and the late incidence of stroke was particularly low in comparison to the remainder of the patient group. Late follow-up emphasized the high continuing attrition rate from all causes in these patients. Late strokes continued to occur, particularly in patients with prior strokes and severe preoperative bilateral carotid disease. The late course of patients with posterior circulation transient ischemic attacks treated by carotid endarterectomy was quite similar to that of patients treated for anterior circulation transient ischemia attacks (TIAs). Newer postoperative screening procedures may decrease the incidence of late postoperative stroke by identifying recurrent carotid stenosis while it is still in the asymptomatic stage.

Aged↗
PubMed1982

Transplant renal artery thrombosis. Revascularization after 51/2 hours of ischemia.

Restoration of blood flow to a transplanted kidney following renal artery thrombosis should provide a good model for determining the tolerance of the human kidney to normothermic ischemia. Two cases were seen in which function returned after two and 51/2 hours of occlusion. These, together with two other similar cases reported previously, suggest that attempted revascularization is worthwhile even after several hours of ischemia.

Acute Disease↗
PubMed1982

Is carotid endarterectomy beneficial in prevention of recurrent stroke?

Of 456 consecutive carotid endarterectomies performed at the University of California, San Diego, 127 were in patients who had sustained a previous completed stroke and had recovered with minimal but permanent neurologic deficits (PNDs). Operative mortality for the entire series was 0.9%, but it was 3.1% for the stroke group. A postoperative PND was observed in 2.1% of patients without neurologic deficits but occurred in 3.9% of the patients after stroke. A 97% one-to-ten-year follow-up was obtained. The total early and late serious morbidity and mortality in this surgically treated series of patients after stroke was 24% at five years. We conclude that carotid endarterectomy for the prevention of recurrent stroke carries a high risk and may not be superior to nonoperative treatment.

Adult↗
PubMed1981

Nonaneurysmal suppurative aortitis.

Two patients had nonaneurysmal suppurative aortitis. In one, the aortic ruptured and the patient died. The second patient had Salmonella sepsis and occlusion of the infrarenal aorta. He was treated with aortic resection and extra-anatomic bypass, but died 20 months later of an unrelated illness. Patients with Salmonella sepsis who are over 50 years of age or who are suspected of having aortic atherosclerosis should be evaluated carefully for aortitis since rupture or aneurysm formation is associated with a dismal prognosis.

Aged↗
PubMed1975

Bovine graft arteriovenous fistulas for maintenance hemodialysis.

Modified bovine carotid artery grafts have been used for maintenance hemodialysis in 44 patients during an 18 month period. The technique of constructing an arteriovenous fistula in the leg and in the forearm is described. The common femoral artery and saphenous vein in the leg and the radial artery and basilic vein in the forearm are the preferred vessels. The complication rate has been low, consisting primarily of thrombosis and false aneurysms at the dialysis needle puncture site. Oversized grafts should be avoided because of resultant turbulent flow and the tendency of thrombosis. Bleeding after withdrawal of the hemodialysis needle must be properly controlled to minimize complications. Eighty-two percent have various problems and 18 per cent have failed. Bovine graft arteriovenous fistulas provide excellent vascular access in patients undergoing chronic hemodialysis.

Animals↗