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Biomedical subjects

J D Durham

Publications and source records attributed to J D Durham.

At least 19 recordsLinked to original sources
PubMed1991

Planned delayed nephrectomy after ethanol embolization of renal carcinoma.

Planned delayed nephrectomy after preoperative ethanol infarction was done in 6 patients with renal carcinoma. Three patients had intracaval extension of tumor, 2 had renal vein but no vena caval extension and 1 had no renal vein or vena caval involvement. Nephrectomy was delayed 22 to 44 days after embolization. In the patients with inferior vena caval extension shrinkage of tumor thrombus after embolization allowed for easier surgical resection. Furthermore, delay of nephrectomy after preoperative infarction was of value in improving the clinical status of high risk patients.

Adult↗
PubMed1991

Popliteal artery entrapment: findings at MR imaging.

Magnetic resonance (MR) imaging can noninvasively demonstrate the anatomic relationships between the popliteal artery and the muscles within the popliteal fossa, making it an ideal screening test for popliteal artery entrapment prior to angiography or surgery. The authors describe a patient with bilateral type II popliteal artery entrapment in whom the anomaly was diagnosed in the asymptomatic extremity with MR imaging.

Adult↗
PubMed1991

Renal artery stenosis during pregnancy: a review.

Renal artery stenosis in pregnancy may present as chronic hypertension with superimposed preeclampsia or as recurrent isolated preeclampsia. Renal angiography is the most sensitive and specific diagnostic technique available for this lesion, and therapeutic percutaneous transluminal angioplasty may be carried out in conjunction with angiography. We report a patient with renal artery stenosis diagnosed and treated with percutaneous transluminal angioplasty at 26 3/7 weeks gestation. The literature on renal artery stenosis in pregnancy is reviewed.

Adult↗
PubMed1990

Dieulafoy disease: arteriographic findings and treatment.

Dieulafoy disease is an unusual cause of massive and frequently fatal gastrointestinal tract hemorrhage that results from the erosion of a submucosal artery. Although the lesion has been found throughout the gastrointestinal tract, it most commonly occurs in the proximal stomach. Nine patients with this condition have been treated at the authors' institution during the past 5 years. The bleeding lesion was located before surgery with selective visceral arteriography in three patients. Rapid extravasation was demonstrated from an eroded but otherwise normal-appearing artery in all three cases. Hemorrhage was controlled successfully in one patient with selective embolization of the involved left gastric artery branch. The remaining eight patients were treated with surgical ligation.

Adult↗
PubMed1990

Proximal fallopian tube occlusion: diagnosis and treatment with transcervical fallopian tube catheterization.

Transcervical fallopian tube catheterization (TFTC) was performed in 22 infertile patients with bilateral fallopian tube obstruction and a mean duration of infertility of 3.3 years. A high prevalence of previous ectopic pregnancy (n = 8, 36%), tubal ligation and/or reconstruction (n = 5, 23%), spontaneous or therapeutic abortion (n = 6, 27%), and previous intrauterine device use (n = 14, 64%) was noted. The authors successfully catheterized 40 (98%) of 41 tubes without serious complication and visualized the distal tube in 36 (88%) of 41 tubes. Free spill in at least one tube was seen in 17 (77%) of 22 patients. Nineteen patients had a history of previous laparoscopy or laparotomy for tubal disease, in 16 of whom laparoscopic results were available for review. Retrospectively, in 15 (94%) of 16 patients all clinically relevant abnormalities would have been detected by means of TFTC alone. Five patients conceived, three with intrauterine and two with ectopic pregnancies. Patients with intrauterine pregnancies had normal-appearing tubes after TFTC, while those with ectopic pregnancies had residual tubal abnormalities after recanalization. TFTC is a safe, accurate diagnostic procedure that provides more information than hysterosalpingography and, in most cases, as much or more information about the fallopian tubes than laparoscopy.

Adult↗
PubMed1990

Direct catheterization of the mesenteric vein: combined surgical and radiologic approach to the treatment of variceal hemorrhage.

Minilaparotomy and direct catheterization of the mesenteric vein for variceal embolization was attempted in 15 patients in whom medical and endoscopic treatment of variceal hemorrhage had failed. Hemorrhage was controlled immediately after the procedure in 11 patients. The 30-day survival rate was 60% (n = 9). The cause of death in six patients was variceal bleeding (n = 2), liver failure (n = 3), and respiratory failure (n = 1). The 6-month survival rate was 33% (n = 5), and the 1-year survival rate was 27% (n = 4). Bleeding recurred in 67% of surviving patients; however, fatal variceal bleeding occurred in only 22% (n = 2). Direct mesenteric vein catheterization allows simplified entry into the portal vein for embolization of bleeding esophageal or gastric varices. Early experience suggests that the results are similar to those of percutaneous transhepatic embolization, without the complications and technical demands of a transhepatic approach.

Adult↗
PubMed1989

Regional infusion of urokinase into occluded lower-extremity bypass grafts: long-term clinical results.

The initial outcome, long-term patency rate, and rate of limb salvage were studied in patients after regional urokinase infusion for treatment of thrombosed lower-extremity grafts. Seventy-one infusions were performed in 53 patients. Complete clot lysis occurred in 75% of grafts, with establishment of antegrade blood flow in 66%. Variables that favorably influenced clot lysis and the reestablishment of antegrade blood flow through the graft were a short duration of occlusion and a suprainguinal graft position. The median duration of patency after infusion and adjunctive therapy was 162 days, with 75% limb salvage at 301 days. No statistically significant variables that influenced the length of patency were identified. These long-term patency results are inferior to the reported results in suprainguinal grafts after reoperation. They appear similar to reported results for occluded infrainguinal grafts treated with thrombectomy and patch grafting.

Female↗
PubMed1985

Nurse psychotherapists' experiences in obtaining individual practice privileges.

Nurses who function as primary care providers often want direct access to hospitalized clients. Individual practice privileges provide one means by which such providers can admit and treat their clients in institutional settings. This article describes a study in which nurse psychotherapists report their experiences in obtaining individual staff privileges. Findings of the study have implications for other primary care nurses seeking such privileges. The authors conclude that current conditions within the health care system may be favorable in facilitating individual practice privileges for nurses.

Adult↗
PubMed1985

Sex chromosome variations in school-age children.

Current evidence suggests that some school-age children are born with a sex chromosome variation. Large chromosome surveys of newborns indicate that 0.5% to 0.6% have chromosome errors, with sex chromosome variations accounting for 35% of them. The four most frequently occurring sex chromosome variations are Turner Syndrome (45,X), Klinefelter Syndrome (47,XXY), Polysomy X or Triple X (47,XXX), and Polysomy Y or XYY (47,XYY). Though many individuals with sex chromosome variations can live functionally normal lives, others may experience developmental, physical, psychological, behavioral, and learning impairments. New information has dispelled myths and biases previously associated with these disorders. By becoming knowledgeable about sex chromosome variations and their effects upon children, school health personnel can assist affected children, their families, and teachers.

Adolescent↗
PubMed1985

Klinefelter syndrome.

Explore the source record for details and available documents.

Adaptation, Psychological↗