Biomedical subjects

P Jaques

Publications and source records attributed to P Jaques.

10 recordsLinked to original sources

PubMed1992

Noninvasive detection of iliac artery stenosis in the presence of superficial femoral artery obstruction.

In patients with superficial femoral artery obstruction, iliac disease may be difficult to diagnose by commonly used noninvasive techniques. We studied common femoral artery acceleration time (onset of systole to peak systole), as measured from a Doppler spectral display and expressed in milliseconds. Previous work has suggested that an acceleration time of 144 msec or greater is abnormal and is associated with iliac stenosis (greater than or equal to 75% diameter reduction) or occlusion. During a 2-year period, in 139 limbs with superficial femoral artery obstruction, acceleration times were measured immediately before angiography. The overall test accuracy was 94.2% (131/139). In the 112 sides with normal angiograms, the acceleration time correctly identified no disease in 109 patients (97.3% specificity), and in the 27 iliac stenoses or occlusions the test detected disease in 22 patients (81.5% sensitivity). This appears to be a good test that can be done with equipment usually available in most vascular laboratories.

Angiography↗

PubMed1991

Transcatheter management of pseudoaneurysms complicating pancreatitis.

Hemorrhage from rupture of an arterial pseudoaneurysm is a potentially fatal complication of pancreatitis. Seventeen patients underwent transcatheter embolization of 23 arteries for the treatment of 20 arterial pseudoaneurysms secondary to pancreatitis. Their records were reviewed retrospectively to evaluate the clinical benefit of transcatheter therapy. At presentation, 15 of the 17 patients had gastrointestinal, intrasplenic, retroperitoneal, intraperitoneal, or postoperative wound bleeding. Transcatheter embolotherapy was the sole treatment for 16 (80%) of the 20 pseudoaneurysms in 13 patients. Four pseudoaneurysms (20%) in four patients were treated prior to splenectomy. Transcatheter therapy was clinically beneficial in all patients. Three patients had procedural complications without significant clinical sequelae. Transcatheter embolotherapy should be the initial treatment of choice in patients with arterial pseudoaneurysms secondary to pancreatitis. Treatment may be definitive or facilitate subsequent surgery.

Acute Disease↗

PubMed1986

CT features of intraabdominal abscesses: prediction of successful percutaneous drainage.

Fifty-three patients with 71 intraabdominal abscesses identified on computed tomography (CT) and treated with percutaneous abscess drainage were evaluated for the possible predictive value of any particular CT feature in relation to the outcome of percutaneous drainage. Features analyzed included the presence of a "rind," sharp exterior margin, air-fluid level, scattered internal gas bubbles, and internal septations, as well as size, site, and the presence or absence of fistulas as determined by sinography. Statistical analysis revealed that only site has predictive value; liver and subphrenic abscesses were more likely to have a successful outcome than abscesses in other locations (84% vs 47% complete cure). The presence of a long air-fluid level denoted communication with the gastrointestinal tract, which led to significantly longer drainage times and larger drainage volumes. Since there are no CT features that can strongly predict a poor outcome, all intraabdominal abscesses should be considered candidates for percutaneous drainage.

Abdomen↗

PubMed1982

Diagnosis of mycotic abdominal aortic aneurysm using 67-gallium citrate.

Mycotic aneurysms of the abdominal aorta are uncommon, but potentially lethal problems. Clinical subtleties may suggest their presence, but in the past, definitive diagnosis has been dependent on surgical exploration or autopsy findings. A case is presented in which 67-gallium citrate abdominal scanning localized the site of sepsis in an abdominal aortic aneurysm and allowed for prompt and successful surgical therapy. This noninvasive technique is recommended as a adjunct in the diagnosis of mycotic abdominal aortic aneurysms.

Aged↗

PubMed1980

Lung folding simulating peripheral pulmonary neoplasm (Blesovsky's syndrome).

Six cases are reported in whom the diagnosis of benign pleural thickening with lung folding simulating peripheral pulmonary neoplasm was made. Three patients presented with chest pain, two were asymptomatic, and the abnormality was a chance finding in one patient with asthma. The radiographs in all cases showed similar appearances--a peripheral opacity appearing to lie within the lung, usually the lower lobe, and characteristic curvilinear shadows extending from the opacity to the hilum. At thoracotomy, predominantly visceral pleural thickening had caused the underlying lung to fold. Hyaline plaques were present on the parietal pleura elsewhere and pleural adhesions were usually absent. Adequate removal of the thickened visceral pleura in five patients allowed the folded lung to re-expand, with reversion of the chest radiograph to normal. One patient in whom the underlying lung folding was not appreciated at operation still has chest pain and the chest radiograph is unchanged. The radiographic appearances of this non-malignant condition, especially the appearances on lateral tomography, are diagnostic, and recognition may obviate the need for operation in asymptomatic patients. For those patients with chest pain, thoracotomy with removal of the visceral pleura and release of the folded lung appears to be effective in relieving this symptom.

Adult↗

PubMed1980

Tenckhoff peritoneal dialysis catheter: cannulography and manipulation.

The Tenckhoff catheter is a permanently implanted peritoneal access cannula widely used for acute or chronic peritoneal dialysis. Failure of the cannula is usually due to the development of blocking adhesions or malposition. In 14 of 18 patients with inadequately functioning Tenckhoff catheters, catheter manipulation resulted in restoration of function. There were no complications.

Adolescent↗

PubMed1979

Aneurysm rupture secondary to transcatheter embolization.

False aneurysms of the pancreatic and peripancreatic arteries are a well recognized complication of chronic pancreatitis due to proteolytic enzymatic digestion of the arterial wall. These false aneurysms can be a source of life-threatening hemorrhage. Three cases are reported in which attempted embolizations of these bleeding aneurysms resulted in rupture into the gastrointestinal tract. Special precautions should be taken in such a procedure because of the inherent weakness of the aneurysmal wall.

Adult↗

PubMed1977

Hepatic angiography in hereditary hemorrhagic telangiectasia.

Three patients presenting with gastrointestinal bleeding and characteristic radiologic findings of hereditary hemorrhagic telangiectasia are described. Emphasis is placed not only on the angiodysplasia evident from abdominal angiography, but also on the demonstration by the chest radiograph of a chronic mild hyperdynamic state.

Adult↗

PubMedDate not supplied

An automated sequential sampling system for particulate acid aerosols: description, characterization, and field sampling results.

An automated sequential sampling system for the measurement of particulate acid aerosols was developed in order to allow the routine collection of daily samples with only once-per-week site visits. The system's design, operation, and associated quality assurance (QA), quality control (QC), and data validation procedures are described. Results from a multi-year field application of this system in the Buffalo, Albany, and New York City metropolitan areas are reported, as well as from external audits and interlab analytical intercomparisons. It is found that the system successfully collected 94% of all possible samples in these three cities between May 1988 and December 1989. Weekly QA field blanks and positive control filters indicate that these data were collected with negligible acid contamination or neutralization. Peak aerosol acidity levels at these sites were found to be highest during the summer months, with peak 24-hr average levels in the 300-400 nmol/m3 range. It is concluded that this system represents a more convenient means of collecting extended daily records of valid particulate acid aerosol concentrations than has been possible in the past.

Acids↗

PubMedDate not supplied

Quantitative digital fluorography. Computer vs. human estimation of vascular stenoses.

Digital subtracted images of iodinated rods, incorporating accurately measured areas of eccentric stenosis were obtained. The average subjective estimations of fractional area reduction (211 readings each) by three experienced angiographers were compared with values obtained using an interactive computer algorithm using the densitometric data. Results were analyzed to identify major influences on accuracy, including iodine concentration, vessel width, absolute severity of the stenosis, and vessel orientation. While no single factor appeared to seriously affect human accuracy, computer readings were significantly influenced by the tilt of the vessel in relation to the x-ray beam. Various potential sources of error including beam hardening, stenosis geometry, and scattering are discussed and appropriate algorithm corrections suggested. The importance of the availability of a reliable and accurate method to quantify vascular stenosis and volume of stenotic material is stressed.

Absorptiometry, Photon↗