Biomedical subjects

M R Evasovich

Publications and source records attributed to M R Evasovich.

3 recordsLinked to original sources

PubMed1998

Perioperative vasopressin secretion treated by demeclocycline.

The purpose of this study was to evaluate the perioperative effects of demeclocycline on vasopressin (VP) in patients undergoing surgery, specifically coronary artery bypass grafting (CABG). This was a prospective, double-blind placebo-controlled clinical study using human subjects in a 575-bed tertiary care teaching community hospital. Thirty patients (20 males and 10 females) undergoing elective CABG over a 6-month period were randomized preoperatively to receive either demeclocycline or a placebo. Each patient received either a total of 1200 mg daily of demeclocycline or a placebo beginning 5 days preoperatively and continuing through postoperative day 2. Urine and serum osmolality, electrolytes, and VP levels were measured daily. Perioperative VP levels were significantly higher (P = 0.05) in the demeclocycline group despite decreased VP activity. The postoperative serum sodium and osmolality remained normal in the demeclocycline group and significantly decreased in the placebo group (P < 0.01). The urine osmolality increased significantly in the placebo group (P = 0.04) on postoperative day 1. We conclude that perioperative administration of demeclocycline reliably inhibits the effects of increased VP secretion commonly seen in patients undergoing CABG procedures. Applying these findings to surgical patients who are at increased risk of complicated fluid and electrolyte problems requires further study.

Adult↗

PubMed1997

Colorectal carcinoma and the relationship of peritoneal cytology.

BACKGROUND: This study was designed to investigate the frequency of the association between colorectal cancer and peritoneal cytology as well as the impact of surgical resection on conversion of cytology from benign to malignant cells being present. Furthermore, increasingly frequent reports of port site recurrences with laparoscopic colectomy for limited stage colon carcinoma prompted us to evaluate the incidence of tumor cell spillage with traditional "open" colonic surgery. METHODS: Fifty random patients undergoing surgery for colorectal carcinoma were prospectively evaluated with peritoneal washings prior to and following colon resection. RESULTS: Five patients (10%) were found to have malignant cytology, with no patients converting from negative to positive cytology. All five positive cytologies were associated with stage IV disease and poorly differentiated colon cancer. CONCLUSION: Intraoperative peritoneal cancer dissemination could not be demonstrated by cytologic washings of the abdominal cavity before and after colorectal resection utilizing standard cytomorphological criteria.

Adenocarcinoma↗

PubMed1996

Does pneumoperitoneum during laparoscopy increase bacterial translocation?

BACKGROUND: To evaluate the impact of laparoscopy in the presence of peritonitis, this study was designed to assess bacteremia caused by E. coli-induced peritonitis with a carbon dioxide pneumoperitoneum in a rat model. METHODS: Sixty Sprague-Dawley rats were divided into inoculum groups (no E. coli, 10(6) colony-forming units [CFU] E. coli, and 10(8) CFU E. coli), followed by induction of a carbon dioxide pneumoperitoneum or no pneumoperitoneum. Fifteen-minute-interval blood cultures were obtained to determine time of bacteremia development. Statistical assessment to determine significant differences among groups was done using ANOVA and t-test analysis. RESULTS: A total of 20 animals with E. coli introduced into the peritoneum and a carbon-dioxide-induced pneumoperitoneum had more frequent positive blood cultures at all time intervals compared to identical inoculum subgroups without a pneumoperitoneum. ANOVA revealed a significant difference in bacteremia within the same concentration inoculum groups in animals receiving a pneumoperitoneum vs none (p < 0.01). Bacteremia increased significantly as inoculum concentrations increased (25% with 10(6) E. coli inoculum vs 80% with 10(8) E. coli), especially among the insufflated subgroups (45% with 10(6) E. coli vs 100% with 10(8) E. coli) over 180 min (p < 0.01). CONCLUSION: Carbon dioxide pneumoperitoneum increases the incidence of E. coli bacterial translocation from the peritoneum into the bloodstream in this rat model.

Animals↗