PubMed Health⌕ Search

Biomedical subjects

M Findler

Publications and source records attributed to M Findler.

29 records · Page 2Linked to original sources

Dental treatment in very high risk patients with active ischemic heart disease.

A new method of predental treatment and management for patients with active ischemic heart disease is reported. Patients with unstable angina pectoris or who have just had a myocardial infarction underwent full treatment for pain-induced dental problems, with the use of an incremental three-level antiangina and antianxiety medication: before dental treatment; in the waiting room, and c) during dental treatment. The setting was a tertiary referral oral medical service and hospital dental clinic. Twenty-six patients were treated, 16 men, 10 women, ranging in age from 45 to 68 years. Ten patients with unstable angina pectoris and 16 patients less than 3 months after a myocardial infarction. All patients underwent comprehensive dental treatment. Good cardiovascular control was achieved, and all the procedures were uneventfully completed. This study indicates the need to reconsider the absolute versus relative contraindications for dental treatment in patients with active ischemic heart disease and recommends the use of a gradual three-level therapy.

Aged↗

Intrapericardial extralobar pulmonary sequestration in a neonate.

A huge pericardial effusion was diagnosed during fetal ultrasound examination performed in the 42nd week of pregnancy on a healthy 25-year-old woman. Immediately after the birth, a two-dimensional echocardiogram confirmed this finding in the infant, and an intrapericardial kidney-shaped solid mass measuring 45 x 56 x 15 mm, completely surrounded by pericardial effusion, was visualized to the left part of the heart. The heart was normal. No signs of cardiac tamponade were seen. At the age of two days, the mass was surgically resected and the pericardial fluid evacuated. Microscopic examination revealed that the mass was formed totally of normal lung tissue surrounded by normal pleura. To the best of our knowledge, this is the first case of intrapericardial extralobar sequestration consisting of an accessory lung with completely normal lung tissue.

Adult↗

Dissecting aortic aneurysm in pregnant women without Marfan disease.

Dissection of the young women without Marfan disease is related, in most instances, to pregnancy. The structural changes in the arterial wall that occur during pregnancy may predispose women to this complication of pregnancy. In this study, two young women, who had none of the characteristics of Marfan's syndrome, were operated upon for dissection of the ascending aorta. The first patient was in the 35th week of gestation and a cesarean section was performed prior to replacement of the ascending aorta. In the second patient, diagnosis of dissection and severe aortic regurgitation occurred in the postpartum period. Knowledge of this albeit relatively rare complication of pregnancy may assist the clinician in diagnosing and referring patients early for surgical treatment that, in most instances, may save the lives of both mother and fetus.

Acute Disease↗

Surgical revascularization following failed percutaneous transluminal coronary angioplasty.

Percutaneous transluminal coronary angioplasty (PTCA) was performed on 200 patients and failed in 36, 12 of whom underwent myocardial revascularization within 3 hours after the angioplasty attempt. Elective operations were performed without complications in the other 24 cases. The 12 emergency operations were necessitated by major complications during or after PTCA, viz, coronary occlusion (6 patients) coronary dissection (2) and failed catheter passage or dilation with severe myocardial ischemia (4). Three of these 12 patients had signs of acute myocardial infarction preoperatively, and new infarction appeared postoperatively in two cases. All eight patients with ST-segment elevation preoperatively had raised levels of myocardial enzymes postoperatively, and two of them had new Q-waves. Three of the 12 patients required inotropic drugs following revascularization. There was one postoperative death. When complications arise in PTCA, emergency operation should be undertaken. When PTCA fails, but without complications, surgery can be electively performed.

Aged↗