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Biomedical subjects

M Atik

Publications and source records attributed to M Atik.

At least 19 recordsLinked to original sources
PubMed1981

Exteriorized repair in the management of colon injuries.

In an attempt to reduce septic complications following colonic injury in penetrating abdominal trauma, we tested the efficacy of the exteriorized repair, also known as primary repair and exteriorization of the injured colonic segment. From June 1973 to August 1979, 50 patients with colonic injuries suitable for exteriorized repair were entered into this study. Their ages ranged from 4 to 47 years; 42 were male, eight, female. Thirty-eight had gunshot wounds, 12 had stab wounds. The majority had various associated injuries, but only five were in shock. In 33 patients (66%) the colonic wounds successfully healed and the exteriorized loop was returned into the peritoneal cavity within 14 days. In 17 patients (34%), fecal leakage developed at the repair site and the exteriorized loops were converted into colostomies without sepsis. There was no mortality and a low complication rare (18%). This method of management for selected patients has a special merit in combining the safety of exteriorization with the economy of primary repair.

Abdominal Injuries↗
PubMed1979

The impact of prophylactic measures on fatal pulmonary embolism.

Prompted by reviews showing no significant reduction in the overall incidence of fatal pulmonary embolism in recent years, we examined the incidence of this complication found on autopsy over the 15-year period between 1960 and 1974 in a Veterans Administration Hospital. During the first six years, when no specific prophylactic measures were practiced, 41 patients died of pulmonary embolism on the surgical service; whereas in the last nine years, when dextrans were used prophylactically in high-risk patients, 24 patients had fatal pulmonary embolisms. Of these 24 patients, 21 did not receive the recommended dosages of dextran. There were no significant differences in the average annual number of admissions and major operations, or in the rate of autopsy, between the two periods. We conclude that the prophylactic use of dextran in high-risk surgical patients is a practical, effective, and safe method to reduce the overall mortality from pulmonary embolism.

Dextrans↗
PubMed1979

Evaluation and management of penetrating wounds of the neck: the role of emergency angiography.

With the use of emergency angiography, careful observation, and monitoring, 40 consecutive patients with penetrating wounds were selectively managed. Eleven patients were operated on with one negative exploration and one death. Twenty-nine patients were observed after negative angiography without operation on the neck and were subsequently discharged without' overlooking a significant vascular or visceral injury or amy complication. We believe this policy to be safe and effective. It should reduce the number, the morbidity, and the cost of needless mandatory surgical explorations and should guard against clinically undetected serious injuries. Operations should be reserved for those patients with clinically obvious servere vascular or visceral injury and for those with radiographically demonstrated significant lesions.

Adult↗
PubMed1979

Granulocyte adherence assay in acute infection as a reflection of the host resistance.

The in vitro granulocyte adherence assay was used in six healthy individuals and 14 patients who had acute gram-negative infection to determine whether or not the assay is altered with acute infection and whether or not it adequately reflects the host resistance. The granulocyte adherence values for all patients were significantly lower than those for healthy individuals. In eight patients who recovered, the initial mean value did not differ from that of six patients who died, 7.2 +/- 5.9 and 7.0 +/- 10.9 per cent, respectively, with 50 milligram nylon fiber columns and 53.9 +/- 3.2 and 54.5 +/- 7.2 per cent with 80 milligram nylon fiber columns. However, it was significantly different, p less than 0.001, in both groups of patients from that in the group of healthy individuals, 24.2 +/- 2.5 per cent with 50 milligram columns and 85.7 +/- 4.6 per cent with 80 milligram columns. Subsequently, a significant change in granulocyte adherence, p less than 0.002, occurred in the patients who recovered. Values rose in all of these patients, while they remained low or further declined in those who died. These observations indicate that the in vitro granulocyte adherence capability is reduced in severe acute gram-negative infection and that if reflects the ability of the host to overcome the infection.

Acute Disease↗
PubMed1976

Operative cholangiography and special technical consideration in the management of severe injury of the liver.

The majority of hepatic injuries can be adequately managed by control of bleeding locally at the site, debridement and ample drainage. In some instances, severe blunt trauma and high velocity missile wounds may result in the disruption of intrahepatic structures and significant devitalization of the parenchyma of the liver, necessitating hepatic resection. Operative cholangiography was found to be useful in the evaluation and management of this type of severe injury to the liver. It is simple, practical method to recognize and localize a major disruption of the parenchyma of the liver and bile ducts; to help decide whether or not segmental, sublobar or labor hepatectomy should be performed, and to detect bile leaks from the divided bile ducts after resection of the liver. A modified technique for performing hepatic resection during an emergency situation was suggested to be more suitable than the classic technique. This is based on finger dissection along the line of injury and individual ligation of bile ducts and vessels as they are exposed within the parenchyma of the liver instead of isolation and ligation of the main inflow vessels and of the major ducts at the hilus and retrohepatic ligation of the hepatic veins.

Adolescent↗