Biomedical subjects
Publications and source records attributed to J Duarte.
We report a 68 years-old woman with repeated cerebral embolism, secondary to a papillary fibroelastoma of mitral valve, located in its ventricular side. It was detected by two-dimensional echocardiography. Surgical treatment was satisfactory.
1. Analysis of biochemical parameters were carried out on material pooled from 30 female sheep (Ovis aries ligeriensis). 2. The values determined were for the common metabolites and enzymes utilized for specific studies in general metabolism (urea, glucose, cholesterol, lipids, bilirubin, uric acid, creatinine, alkaline phosphatase, GOT, GPT, LDH, LAP, CGT, CK and amylase). 3. Results of these studies were compared with values from normal human adults. 4. The differences obtained in human and sheep ranges can be explained by the different physiology of the two species. 5. This study gives values for the sheep as an experimental animal in biomedical research.
The authors report on their experience with the Sachse urethrotomy procedure performed in 125 patients from 1981-1987, with a minimum follow-up of 12 months and a maximum of 6 years. The etiology was iatrogenic in 46%, trauma in 25%, and inflammatory in 33%. Stricture was frequently localized in the bulbous urethra (63%). Local anesthesia was the most widely used particularly during the latter stage of this period. The authors prefer to use Sylastic-type catheters left indwelling for a short period of time. Their recurrence rate was 15%. Although most of the patients (67%) required one procedure, urethrotomy had to be repeated up to three times (3%) in several patients. Good results were achieved in 57%, fair in 32%, and poor in 11%.
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Between 2 February and 16 April 1985, an outbreak of Serratia marcescens infection involving 10 male patients occurred in a cardiac surgery unit. All the patients had surgical wound infection, five also had osteomyelitis (four sternal, one costal), and another had peritonitis secondary to peritoneal dialysis. Three patients had concomitant bacteremia. All Serratia strains isolated produced a cherry-red pigment, and all had the same biochemical and antibiotic susceptibility pattern. An intensive search for the origin of the outbreak was initially unsuccessful, and it proved impossible to isolate S. marcescens from cultures of numerous samples taken from hospital personnel and from the environment. The fact that all patients were male and had been shaved for surgery by the same team of barbers led us to investigate the shaving procedures. We finally isolated a strain of pigmented S. marcescens, corresponding to that involved in the outbreak, from samples taken from the hands and equipment of the barbers. After suitable action had been taken, the epidemic terminated.
Three cases of fracture of a Carpentier-Edwards ring in tricuspid position are presented. In all three cases the shape of the ring was shown to be abnormal by roentgenogram examination; there was an abrupt bend in the middle portion of each ring. At the time of operation, fracture of the ring skeleton at this midpoint was found in all three instances. Roentgenogram examination seems to be a reliable method of diagnosing this uncommon entity, and tricuspid valve replacement is required for its correction.
The existence of a freely-floating thrombus in the left auricle is a rare finding in mitral pathology. Diagnosis by two-dimensional echocardiography has been described by various authors (1, 2, 3). In our case echocardiographic diagnosis of auricular thrombus was not possible at the beginning, given the bad ultrasonic window. Only when the thrombus floated freely in the left auricle it was detected in the region of the mitral valve, in spite of the bad ultrasound window.
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Injury of the radial nerve produced by external compression during dissection of the internal mammary artery during surgery of ischemic heart disease, is an infrequent event. The use of sternal retractors with only one rod may be the cause of these lesions. We report two cases of radial nerve paralysis produced as a consequence of external compression induced by a sternal retractor during dissection of the internal mammary artery. In the first case the patient showed loss of power of the external muscles of the left forearm and a clear flexion of the left hand. The second patient presented loss of power of the left hand and impossibility to extend the carpus and fingers. In both cases the lesion was reversible.
The aneurysm of subclavian artery is uncommon, and its differential diagnosis is posed with other mediastinal expansive processes in a conventional RX level. A case of right subclavian aneurysm is presented.
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We present the incidence, management and outcome of acute renal failure (ARF) in children who underwent cardiac surgery. Fourteen (9%) from a total of 156 children developed ARF in our hospital in a 3-year period. Patients were aged 2 days to 15 years. Prerenal failure was present in 6 and renal type in the remaining 8 children. Peritoneal dialysis treatment was utilized in 58% of patients. Neurologic and respiratory complications were present. Mortality rate was 58% and related to underlying pathology and to complications in other organs. The management of these patients must be by competent personnel preferably trained in pediatrics.
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