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Biomedical subjects

J Zelingher

Publications and source records attributed to J Zelingher.

9 recordsLinked to original sources

One-stage coronary angiography and angioplasty.

The combination of diagnostic angiography and angioplasty as a single procedure is becoming common practice in many institutions, but the feasibility and safety of this strategy have not been reported. This report describes 2,069 patients who underwent coronary angioplasty over a 3-year period at an institution where combined angiography and angioplasty is the norm. All patients were prepared before angiography for potential immediate angioplasty. In 1,719 patients, angioplasty was performed immediately after the diagnostic angiogram, while separate procedures were performed in 350 patients. Of those 350 patients, 254 were referred for angioplasty after diagnostic angiography at other hospitals. One thousand one hundred ninety-seven patients were admitted electively for treatment of stable angina pectoris, and 872 underwent procedures during hospitalization for unstable angina or acute myocardial infarction. One thousand nine hundred seven patients (92.2%) had successful angioplasties; in 130 patients (6.3%) the lesion could not be dilated, but no complication occurred, and in 32 patients (1.5%) angioplasty ended with a major complication (0.8% death, 1.0% Q-wave myocardial infarction, 0.5% emergency coronary artery bypass surgery). There was no difference between the combined and staged groups with regard to success, major and minor complication rates or in length of hospitalization after angioplasty. We conclude that routine combined strategy for angiography and angioplasty is feasible, safe, easier for the patient, and more cost-effective than 2 separate procedures.

Angina Pectoris

The effects of continuous operation in a chemical protective ensemble on the performance of medical tasks in trauma management.

Treating casualties in a chemically hazardous environment constitutes a unique problem. Physical protection of the medical personnel may impair their performance and potentially affect patients' prognoses. The present study examined the effect of prolonged physical protection on the accomplishment of medical tasks related to trauma management. Sixty one emergency medical technicians, acclimatized to operating in protective gear, underwent four rounds of testing during eight hours of continuously wearing either a chemical protective suit or regular fatigues. The quality of the designated medical tasks, including sterility, was maintained throughout the study. A significant reduction in speed of performance was noted (approximately 30% slowing, p < 0.0001 in multivariate analysis) because of protective clothing. There was no additional decrement in performance following a prolonged stay in the protective gear. We conclude that in a chemically contaminated area, fully protected medical personnel are capable of treating trauma patients reasonably well, and for a relatively long period of time. The importance of pretraining and proper instruction is emphasized.

Acclimatization

Liver failure and the sea-blue histiocyte/adult Niemann-Pick disease. Case report and review of the literature.

Niemann-Pick disease is a metabolic disorder resulting in accumulation of sphingomyelin in visceral organs. The adult form (type B) is characterized by the sparing of brain involvement, allowing those affected to have a relatively benign course. Although the abnormal lipid accumulation in the liver is commonly recognized, hepatocellular compromise is extremely rare. We describe a patient with adult Niemann-Pick disease who over the course of over 35 years developed hepatic failure and portal hypertension, and we review the literature regarding hepatic involvement in this rare disease.

Adult

An interactive microcomputer program for calculation of combined parenteral and enteral nutrition for neonates.

A responsive, iterating program is described (available on diskette from first author), which enables the physician to formulate a balanced, total parenteral nutrition (TPN) for low-birth-weight and sick newborns. The program allows for the possibility of TPN or simultaneous intravenous, intraarterial, and oral feeding. It calculates the overall balance of fluids, nutrients, calories, electrolytes, minerals, trace elements, and vitamins. It features the integration of algorithms and limit tests of nutritional balance, to produce a feeding program that can be modified by clinical considerations of the physician, specific for each patient. The entire procedure can be accomplished, and a record of the entries and orders to the pharmacy and to the ward staff printed, within about 4-5 min. The program, which is written in BASIC, can be accommodated within and operated with a 16K byte microcomputer, equipped with a monitor, a printer, and a diskette or other program storage device.

Computers

The Virtual Hospital.

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Computer Communication Networks

HyperDOC.

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Computer Communication Networks

Exploring the Internet.

The Internet is a vast network connecting smaller networks of computers in the United States and overseas. The chief existing structure that will support the proposed information superhighway, the Internet has grown exponentially in recent years. It is now a major tool for sharing computer resources, research issues, and communication with groups or individuals. This review will describe the history of the Internet, the various ways of connecting to it, and some of the tools that are particularly useful for medical researchers and clinicians.

Computer Communication Networks