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Biomedical subjects

P C Adkins

Publications and source records attributed to P C Adkins.

At least 19 recordsLinked to original sources
PubMed1980

Accentuating the positive.

The Society of Thoracic Surgeons is the largest organization representing our specialty. At this time, escalating costs of medical care and the public demand for accountability have given rise to a number of issues that must be faced. The Society is in a position to lead the medical profession in addressing many of these issues. We must present a united front for our specialty and resolve problems involving our training programs, manpower, federal regulations regarding medical devices, and the Federal Trade Commission's position on advertising. Additionally, the organization must address the issue of a definition of physician competence as it relates to the certifying and recertifying process. Awareness of these problems by all members of the Society with the opportunity for open discussion is essential. It is vital that The Society of Thoracic Surgeons assume a visible positive position on these issues.

Canada↗
PubMed1979

The Society of Thoracic Surgeons manpower survey for 1976: a summary.

The results of a 1977 survey regarding places and types of thoracic surgical procedures performed in the United States are analyzed. Responses gathered from 2,240 thoracic surgeons showed that active thoracic surgeons between 34 and 54 years old performed 195,850 major thoracic or cardiac operations per year. Fifty-four percent of active surgeons responding were in solo practice, 40% practiced in groups of 2 to 5 surgeons, and the reamining 6% were in groups of 6 or more. Community size, regional distribution of services, proportion of professional activities allocated to various procedures, and estimates of additional capacity are also summarized.

Age Factors↗
PubMed1977

The totally occluded internal carotid artery: indications for surgery.

Surgery for treatment of the totally occluded internal carotid artery has been controversial since the first case was reported in 1958. Two cases and a review of the literature are presented to show that complete cerebral angiography should be the determining factor for operating in those patients with symptoms referable to the totally occluded internal carotid artery.

Carotid Arteries↗
PubMed1976

Pulmonary varix regression after mitral valve replacement.

Pulmonary varix is a rare finding; only 35 documented cases have been reported. The first case was described in 1843 as an icidental postmortem finding. The first clinical diagnosis was not made until 1951. In more than half of the 35 cases, the varix was present in the absence of congenital and acquired heart disease. Six patients have had concomitant mitral rheumatic heart disease. This communication describes the second patient with rheumatic mitral regurgitation in whom the pulmonary varix became radiographically invisible after prosthetic mitral valve replacement.

Adult↗
PubMed1976

Indications for early thoracotomy in the management of chest trauma.

Trauma to the thorax represents a significant portion of injuries seen in an inner-city emergency room. Although most of these patients may be successfully managed without thoracotomy, a certain percentage require operative intervention either immediately or within several hours. The records of more than 380 patients with major chest trauma seen in recent years have been reviewed. Three hundred twenty-one of these patients (84%) required only good supportive measures such as correction of hypovolemia, temporary ventilatory support, tube thoracostomy, and careful observation. Forty-four additional patients (12%) required immediate operation following preliminary resuscitative treatment. Indications included hemorrhage, cardiac tamponade, injury to a great vessel, and rupture of the diaphragm. There were 10 deaths in this group. In 15 other individuals (4%) delayed operation was undertaken following careful reappraisal of initial injuries by continued examination, monitoring of vital signs, and appropriate roentgenographic and laboratory studies. Indications for delayed operation included continued or recurrent bleeding, widening of the mediastinum, hemoptysis, and recurrent hemothorax. There was only 1 death in this group. Thus, although it may be clear which patients require immediate operation, only careful and continuous monitoring can identify those who initially appear to be in stable condition but eventually will require exploration.

Adult↗
PubMed1975

Clinical effects of membrane lung support for acute respiratory failure.

Extrapulmonary support in respiratory failure has become possible for prolonged periods with clinical application of the membrane lung oxygenator. The membrane lung may be perfused in a venovenous circuit, in which case it functions by prepulmonary venous oxygenation, or it may be pumped in venoarterial perfusion as partial or total cardiopulmonary bypass. Four patients were placed on venovenous membrane lung (GE-Peirce) perfusion for periods ranging from 6 to 112 hours. In oxygenating blood flows of less than 50% of the cardiac output, a viable PaO2 (mean, 52 mm Hg) was obtained in 2 patients with 60% FIO2, including 1 survivor who was weaned from the membrane lung. The remaining 2 patients had heart failure and insufficient venovenous membrane lung flows to improve systemic oxygenation (mean PaO2, 45 mm Hg on 100% FIO2). Four other patients were placed on venoarterial membrane lung (GE-DuaLung) bypass for 18 to 110 hours. With 40 to 85% of the cardiac output bypassed through the membrane oxygenator, immediate improvement was seen in systemic oxygenation (mean PaO2, 75 mm Hg), effective compliance (mean increase of 75%), and reduction in pulmonary hypertension (mean decrease, 15 mm Hg). These changes during bypass allowed the lungs to be put at rest with a decrease in FIO2 and positive end-expiratory pressures. This clinical experience indicates that venoarterial membrane lung bypass may be both supportive and therapeutic, decompressing the pulmonary circuit and maintaining systemic oxygenation. Membrane lung supported by either mode of perfusion has been shown to be clinically effective in patients suffering acute respiratory failure.

Acute Disease↗