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P Spanos

Publications and source records attributed to P Spanos.

11 recordsLinked to original sources
PubMed2005

The supportive value of pre-bypass L-glutamate loading in patients undergoing coronary artery bypass grafting.

AIM: Experimental studies have demonstrated that an exogenous supply of glutamate improves mechanical function and recovery of ischemic myocardium. The aim of the present study was to investigate the effect of myocardial pre-bypass loading with glutamate on myocardial protection during global ischemia and reperfusion of patients undergoing coronary artery bypass grafting (CABG). METHODS: The study was double blinded. Twenty patients undergoing elective CABG were randomized to receive L-glutamate (n = 10) or normal saline (n = 10). Intracellular levels of glutamate, ATP and lactate were measured in left ventricular biopsies collected 10 min after aortic clamp release. Hemodynamic data, and postoperative release of CK-MB and troponin T were also measured. RESULTS: Pre-bypass administration of glutamate resulted in myocardial glutamate loading since glutamate levels were significantly higher in the glutamate group of patients than in controls (18.6 +/- 3.1 versus 8.7 +/- 1.2 microg/g tissue, P < 0.001). In the same group ATP levels were also significantly higher (2.4 +/- 0.7 versus 1.5 +/- 0.4 microg/g tissue, P < 0.05) and lactate levels significantly less than in controls (6.9 +/- 1.9 versus 12.0 +/- 2.1 microg/g tissue, P < 0.001). Glutamate patients had statistically significantly superior post-bypass hemodynamic performance (cardiac index, left ventricular stroke work index, systemic vascular resistance and pulmonary vascular resistance). Statistically significantly lower levels of CK-MB (6 h postoperative), total and peak CK-MB, troponin T (24 h postoperative), and total troponin T were found in the glutamate group. CONCLUSIONS: The results of this preliminary study indicate that pre-bypass intravenous administration of glutamate in patients undergoing CABG has a supportive effect on myocardial metabolism during global ischemia and reperfusion, improves patients' postoperative hemodynamic performance and reduces postoperative cardiac enzyme release.

Adenosine Triphosphate↗
PubMed2003

A comprehensive approach to enhancing sexual health education in the Case Western Reserve University School of Medicine.

We report on the Sexual Health Curriculum Enhancement project at Case Western Reserve University School of Medicine. Using a US dollars 100000 grant from Pfizer Pharmaceuticals, Inc., we have developed and are in the process of implementing a comprehensive, cross-disciplinary and innovative curriculum that is based on three primary objectives for teaching sexual health: attitude change, behavior change, and knowledge acquisition. Five general strategies to incorporate specific sexual health content into the medical school curriculum have been implemented: (1). Faculty Development; (2). Additional Didactics; (3). Cased-Based Learning; (4). Testing and Assessment; and (5). Electronic (Computer/Web-Based Enhancements).

Curriculum↗
PubMed1998

Constrictive pericarditis after coronary artery bypass surgery as a cause of unexplained dyspnea: a report of five cases.

Constrictive pericarditis after coronary artery bypass grafting (CABG) is rare and can present as unexplained dyspnea. We report five consecutive cases of post-CABG constrictive pericarditis seen within a period of 17 months at our institution. All patients presented with heart failure of unknown etiology within a period of 8-84 months after surgery. During the initial post-CABG period, two patients had developed postcardiotomy syndrome that was successfully treated with steroids. They were all assessed noninvasively and invasively. In all patients, the diagnosis of constriction was initially suspected clinically (symptoms, high jugular venous pressure with deep "X" and "Y" descents, pericardial knock). Echocardiography showed transmitral flow typical of constriction in all patients and hepatic venous flow in two. Two patients showed rapid left ventricular relaxation. In all patients, hemodynamic assessment showed diastolic equalization of pressures in all chambers, "W" shape waveform in right atrial pressure, and "dip and plateau" configuration in right and left ventricular pressure waveforms. Diagnosis was confirmed surgically in four patients who were subjected to pericardiectomy-pericardial stripping (three survived, one died). One patient refused surgery. We conclude that constrictive pericarditis, although rare, should be suspected in every case of unexplained dyspnea post CABG. It can appear early or late after surgery, and clinical examination plays an important role in its early recognition. It requires a full noninvasive and invasive assessment in case of clinical suspicion.

Aged↗
PubMed1985

Prophylactic treatment with cimetidine after renal transplantation.

17 consecutive patients who underwent renal transplantation during the period 1979-1981 and were at risk of gastrointestinal hemorrhage were treated prophylactically with the histamine H2-blocker cimetidine without antacids. The incidence of gastrointestinal bleeding, the number of rejection episodes and graft survival were compared with 17 patients, who had received renal transplant during the period 1976-1978 and had not received cimetidine. The incidence of gastrointestinal hemorrhage was not reduced in the cimetidine-treated patients. In addition, cimetidine treatment neither increased the total number of rejection episodes nor changed the long-term graft survival. The results of this study indicate that cimetidine does not appear to be superior to antacids in the prevention of gastrointestinal bleeding in renal transplant recipients.

Adult↗
PubMed1984

The effects of canrenoate K on corticosteroid biosynthesis in nephrectomized dogs.

There is evidence from in vitro experiments that spironolactone not only antagonises the peripheral effects of aldosterone but also inhibits the production of corticosteroids by the adrenals. However relevant data from clinical studies are contradictory probably because spironolactone action on the kidneys also activates other mechanisms, such as renin secretion and potassium retention, which are potent stimulants of the adrenal cortex and thus tend to compensate for the inhibition. To determine the inhibitory effect of spironolactone on the adrenals in isolation, three groups of nephrectomized dogs were studied. Steroidogenesis was stimulated either by angiotensin II, potassium, or ACTH infusion. Potassium canrenoate was administered i.v. bolus at the beginning of the experiment. All the groups showed a similar marked decrease in plasma renin activity (PRA). Plasma aldosterone and cortisol were stimulated by the appropriate stimulus but their increase was blunted after the canrenoate K administration. The altered response between the subgroups was statistically significant (P less than 0.05). Plasma progesterone increased after the administration of canrenoate K. The response difference between the respective subgroups was again statistically significant (P less than 0.05). Canrenoate K was rapidly eliminated from the systemic circulation. These data indicate that canrenoate K causes a partial inhibition of aldosterone and cortisol stimulated secretion but augments the plasma levels of the precursor progesterone, as would be expected following inhibition of specific steps of corticosteroid biosynthesis.

Adrenal Cortex Hormones↗
PubMed1982

[Surgery of pulmonary hydatid diseases in childhood].

Fourteen cases of hydatid cysts of the lung in childhood are reported. The lung organ constitutes the most frequent site of the disease in childhood. The possible pathogenetic factors and the complications such as rupture and suppuration of the cyst are described. Conservative surgical procedures are recommended. The value of prophylaxis against the disease in infants and young children is emphasised.

Adolescent↗
PubMed1982

Inferior vena cava thrombosis due to migration of retained functionless pacemaker electrode.

Thrombosis of the inferior vena cava due to migration of a pacing wire has not been published previously. We describe such a complication due to migration of a retained pacemaker electrode. The distal cut end of the wire was found looped at the level of thrombosis of the inferior vena cava. The patient was treated initially with heparin and placed later on coumadin. Currently, he is doing well without any evidence of thromboembolism.

Electrodes, Implanted↗