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Biomedical subjects

M Odeh

Publications and source records attributed to M Odeh.

At least 109 records · Page 6Linked to original sources
PubMed1992

[Problems posed by the inferior vena cava in liver transplantation].

On the basis of a 200-case series, we report about the problems posed by the inferior vena cava for liver transplantation, and about the means implemented to solve these problems. Before hepatic transplantation, agenesia of the vena cava, which was encountered once, did not prevent grafting. During transplantation, the inferior vena cava posed problems due to its size or to the approach. These were solved using an extracorporeal venovenous shunt, which we advocate to systematically use for liver transplantation. Following transplantation, in addition to hemorrhages, the problems posed by the IVC included supra- or infrahepatic anastomotic stenoses (2 cases) and infrarenal, retrohepatic or suprahepatic thromboses (2 cases). Their repair again resorted to a venovenous shunt, for which we specify the strategy of use.

Adult↗
PubMed1991

The role of reperfusion-induced injury in the pathogenesis of the crush syndrome.

The crush syndrome consists of the general manifestations that follow prolonged continuous pressure on the limbs. These manifestations are caused by the disintegration of muscle tissue and leakage of the contents of myocytes into the plasma. The morbidity and mortality associated with this syndrome are high. The pathophysiologic process of the derangements associated with the crush syndrome is not fully understood, but the injury induced by reperfusion is likely to be important in its development. The injury due to reperfusion involves many factors, but it is currently ascribed largely to the release of oxygen free radicals, massive accumulation of calcium in ischemic muscles, and the infiltration of neutrophils into reperfused vessels. Since ischemic muscles cannot survive without reperfusion, a strategy to salvage as much of the muscle and kidney tissue as possible in the crush syndrome must include ways of decreasing injury during ischemia and reperfusion. Various pharmacologic agents may attenuate or prevent reperfusion-induced injury to ischemic skeletal muscles and consequently to other organs, particularly the kidneys.

Calcium↗
PubMed1991

Dilated cardiomyopathy associated with Chlamydia trachomatis infection.

A 26-year-old man was admitted to hospital with acute myocarditis complicated by congestive heart failure, and atrial and ventricular arrhythmias. Detailed investigations to determine the aetiological factors involved yielded negative results, except for serological evidence of infection with Chlamydia trachomatis. During the follow-up period, dilated cardiomyopathy developed. To the best of our knowledge a similar case has not been reported previously.

Adult↗
PubMed1991

[En bloc transplantation of liver, stomach, pancreas and small intestine in an infant. Apropos of a case].

The now common practice of joint kidney and pancreas or heart or lung transplantation is being completed by other combinations. This is shown by our case of en bloc liver-pancreas-stomach-duodenum-small bowel transplantation in an 18-month-old infant with small bowen atresia complicated by biliary cirrhosis secondary to total parenteral feeding, after the failure of an intraperitoneal visceral transplant at 1 year of age. The graft was taken from an 8-year-old donor and was not pretreated. Being made of the whole intraperitoneal visceral mass, it had to be adapted to the recipient's size by ex vivo exeresis of the right liver, of the spleen, of the terminal ileon and of the colon. Following intraperitoneal visceral exenteration in the recipient, the graft was inserted in an orthoptic position with a digestive reconstruction by esogastric anastomosis and terminal ileostomy. Immunosuppression combined steroids, azathioprine, ciclosporine, and the biological and immunological follow-up regarded the hepatic and pancreatic functions. The intestinal graft was controlled by repeated biopsies through the stomy. Rectal biopsies and lymphocyte typing in the peripheral blood allowed watching for the occurrence of a possible graft-versus-host disease. The outcome was marked by the persistence of massive lymphorrhea during three months and severe central neurological disorders caused by the difficulties to adapt the level of ciclosporine. The hepatic and pancreatic functions became normal within a few days, and the intestinal function allowed progressively suppressing parenteral feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1990

Transient atrial fibrillation precipitated by hypoglycemia.

Two noninsulin-dependent diabetic patients developed transient atrial fibrillation precipitated by hypoglycemia that reverted to sinus rhythm after administration of IV dextrose. Atrial fibrillation as a complication of hypoglycemia in diabetic patients has been reported in only two patients with insulin-dependent diabetes mellitus.

Aged↗
PubMed1990

Termination of intractable hiccups with digital rectal massage.

A 60-year-old man with acute pancreatitis developed persistent hiccups after insertion of a nasogastric tube. Removal of the latter did not terminate the hiccups which had also been treated with different drugs, and several manoeuvres were attempted, but with no success. Digital rectal massage was then performed resulting in abrupt cessation of the hiccups. Recurrence of the hiccups occurred several hours later, and again, they were terminated immediately with digital rectal massage. No other recurrences were observed. This is the second reported case associating cessation of intractable hiccups with digital rectal massage. We suggest that this manoeuvre should be considered in cases of intractable hiccups before proceeding with pharmacological agents.

Hiccup↗
PubMed1990

The role of tumour necrosis factor-alpha in acquired immunodeficiency syndrome.

Tumour necrosis factor-alpha (TNF) is a primary mediator in the pathogenesis of infection, tissue injury and inflammation. It is synthesised by various activated, phagocytic and non-phagocytic cells, and a wide variety of infectious or inflammatory stimulae are capable of triggering TNF biosynthesis. Recent studies indicate that overproduction of TNF in septicaemia is a critical step in triggering septic shock and multiple organ damage. Intravenous administration of recombinant human TNF induced the same types of derangement in cardiovascular homatologic, inflammatory and metabolic homeostasis that are found with endotoxic or septic shock. Chronic TNF production causes a potentially lethal syndrome of cachexia, anaemia, and protein and lipid wasting. Several investigators have recently demonstrated elevated levels of serum TNF in patients with acquired immunodeficiency syndrome (AIDS), these levels being closely correlated with the severity of the disease. This review discusses the role of TNF in the pathophysiology of AIDS and of several disorders associated with the latter. In addition, it discusses the interactions between TNF and several agents used in AIDS therapy, and suggests the use of TNF-antagonists in combination as a therapeutic regimen for AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Is Trendelenburg's procedure still useful in 1990? Apropos of 3 cases of massive pulmonary embolism surgically treated successfully in a general surgery department].

The authors report about 3 cases of massive pulmonary embolism operated successfully in a context of general surgery. As they discuss the data given by the literature, they establish the remaining indications of Trendelenburg's procedure, as well as the problems encountered today to perform it without the help of extracorporeal circulation.

Emergencies↗
PubMed1990

[Experience in hepatic transplantation. Report of 118 cases].

From February 1978 to November 1989, 118 orthotopic liver transplantations were performed in 106 patients, including 100 adults and 6 children; 11 of these grafts were performed before 1984. The study of this series emphasizes the casuistical peculiarities, with high incidence of alcoholic cirrhosis, 24/106 (22.6%) and of fulminating hepatitis, 17/106 (16%). The study of the results yields a real survival rate of 61% in the total series, 78% for the recent period including the past 3 years, and 86% if excluding the emergent cases. The comments also deal with the changes in the procedure and in postoperative complications, with some immunological issues and with the peculiar features connected with the insertion of this operation into a combined medical and surgical program of multi-organ transplantation.

Adult↗
PubMed1990

Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease.

We describe 13 patients who developed erosive gastritis with overt gastrointestinal bleeding while receiving 75-250 mg nonbuffered aspirin per day for the secondary prevention of cardiac or cerebrovascular events. The bleeding occurred despite good initial tolerance to aspirin for several months or years. All patients were elderly and had severe atherosclerotic cardiovascular disease. Our data suggest that, contrary to common belief, very low doses of nonbuffered aspirin are attendant with clinically apparent gastrointestinal complications.

Aged↗
PubMed1989

Effect of hypercapnia on upper airway resistance and collapsibility in anesthetized dogs.

The upper airway (UAW) is intrinsically unstable and susceptible to collapse when the negative inspiratory intraluminal pressure exceeds the stabilizing forces which prevent obstruction. In the present study we evaluated mechanisms by which UAW patency is maintained in the presence of increased inspiratory flows when respiration is stimulated. In seven anesthetized dogs breathing spontaneously through a low tracheostomy, the UAW was isolated by a second tracheostomy directed rostrally. UAW pressure-flow relationship and stability against collapse were evaluated during steady flow in the inspiratory direction while the animals were breathing 100% O2 or a hypercapnic gas mixture. The pressure-flow curves of the isolated UAW demonstrated the characteristic pattern of collapsible tubes. Steady state hypercapnia resulted in lower UAW resistance during both inspiration and expiration. UAW resistance decreased linearly as PCO2 and ventilation increased over the course of CO2 rebreathing. In addition, during hypercapnia the critical negative intraluminal pressure required to induce UAW collapse and obstruction increased from -4.3 +/- 0.9 to -8.5 +/- 1.5 SE cm H2O (p less than 0.01), indicating increased stability of the UAW. Since hypercapnia is known to stimulate UAW muscles, our findings suggest that increased UAW muscle activity improves UAW patency both by decreasing their resistance to airflow, and by increasing UAW walls rigidity and stability against collapse.

Airway Resistance↗
PubMed1989

Effect of salicylate on upper airway dilating muscles in anesthetized dogs.

It is well documented that salicylate given in large doses stimulates ventilation. As increased ventilatory drive is often associated with augmented upper airway dilating muscle activity, we evaluated in anesthetized dogs the effect of salicylate on the electrical activity of three upper airway muscles, the alae nasi, the genioglossus, and the posterior cricoarytenoid. The electromyograms of these muscles were compared with those of the diaphragm before and at 15-min intervals after intravenous salicylate administration (250 mg/kg). Salicylate induced a gradual increase in ventilation and in the electrical activity of all muscles examined (p less than 0.001). Compared to baseline activity, salicylate increased the electrical activity of the genioglossus more than that of the diaphragm (p less than 0.01). The increase in upper airway muscle activity was observed also in vagotomized dogs, and was not accounted for by changes in arterial blood gases or pH. Increases in upper airway muscle electrical activity were associated with a significant decrease in upper airway resistance to airflow (mean reduction of 62 +/- 7% SE, p less than 0.01). The preferential increase in genioglossus electrical activity and the decrease in upper airway resistance observed in this study with salicylate suggest that salicylate, and possibly other pharmacologic agents that stimulate ventilation, may improve upper airway patency.

Airway Resistance↗
PubMed1989

Effect of salicylate on upper airway stability and pressure flow: relationship in anesthetized dogs.

Previous studies have shown that upper airway muscle activity is augmented in response to increased respiratory drive, thereby improving upper airway patency. In the present study we evaluated the effect of salicylate, a well-known respiratory stimulant, on upper airway stability and pressure-flow relationship. Multiple levels of airflow were used to assess pressure-flow relationship in the isolated airways of anesthetized dogs and to calculate the coefficients of Rohrer's equation P = K1V + K2V2. In addition, we measured the negative intraluminal pressure needed to collapse the upper airway. These measurements were repeated after intravenous administration of sodium salicylate, 250 mg/kg. Salicylate-induced hyperventilation was associated with increased alae nasi electrical activity. Resistance to airflow and K2 decreased significantly (p less than 0.01), suggesting dilation of the upper airway lumen. The intraluminal pressure under which upper airway collapse occurred became more negative in all dogs (from -5.0 +/- 0.8 to -8.5 +/- 1.3 cm H2O, p less than 0.01), indicating improved stability of the upper airway walls. These findings suggest that salicylate, and presumably other pharmacologic agents that stimulate ventilation, can improve both upper airway patency and upper airway stability.

Airway Resistance↗