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Biomedical subjects

R Pereiras

Publications and source records attributed to R Pereiras.

At least 19 recordsLinked to original sources
PubMed1985

Comparison of segmental and global ejection fraction in ischaemic heart disease.

In order to evaluate whether segmental ejection fraction (SEF) is a better index of left ventricular (LV) performance than global ejection fraction (EF), 25 patients with significant coronary stenosis and normal EF were studied. SEF was estimated from the LV cineangiogram after dividing the LV into eight segments by means of a long axis and three equally spaced chords perpendicular to it. The area of a given segment was measured in the end-diastole and the end-systole and SEF was calculated by determining the percent decrease in area for each segment. 12 out of the 25 patients presented hypokinesis, akinesis or dyskinesis of at least two segments; the inferior apical and both diaphragmatic segments were the regions most frequently affected. In 7 patients, these abnormalities were compensated by hyperkinesis of two or three other segments, whereas in the remaining 5 patients contraction abnormalities were not accompanied by hyperkinesis in spite of a normal EF. It is concluded that SEF is a more sensitive index of regional LV function than EF in patients with ischaemic heart disease.

Coronary Disease↗
PubMed1983

Segmental ejection fraction in normal subjects.

Following a modification of the area method described by Gelberg et al., left ventricular regional wall motion was studied in 30 normal subject. The left ventricular cineangiograms were filmed in the right anterior oblique projection at 48 frames/s after injection of 76% sodium-meglumine diatrizoate. The end-diastolic and end-systolic frames were each divided into 8 regions using a grid formed by longitudinal axis, which was traced from the midpoint of the aortic valve to the apex, and three equally spaced perpendiculars to the long axis. Segmental ejection fraction was estimated by determining the percent decrease in each segment area in end-systole with respect to the end-diastolic area. The mean values +/- S. D. obtained for each segment were: anterobasal 58 +/- 14%; anterolateral-proximal 59 +/- 6%; anterolateral-distal 58 +/- 4%; apical-superior 59 +/- 8%; apical-inferior 58 +/- 7%; diaphragmatic-distal 58 +/- 9%; diaphragmatic-proximal 55 +/- 6%; and posterobasal 42 +/- 15%. The values obtained are useful for comparison when evaluating left ventricular performance in patients.

Cardiac Output↗
PubMed1982

Diagnosis of pancreatic abscess via percutaneous aspiration.

UNLABELLED: The pre-operative diagnosis of a pancreatic abscess was not considered in a comprehensive review in 1972. However, advances in technology (Ultrasound--US, Computed Tomography--CT) has allowed guided percutaneous needle aspiration (PNA) of suspected pancreatic lesions. The purpose of this study was to evaluate the safety and diagnostic ability of PNA to differentiate acute pancreatic inflammatory masses from pancreatic abscess (PA). Thirteen patients underwent PNA after US or CT revealed an acute pancreatic inflammatory mass (12/13 cystic). One patient underwent a second aspiration. Clinical features T degrees--101.3 degrees F mean (13/13), leukocytosis 14,400 cu/mm (11/13). Aspirated material was gram-stained and examined for bacteria and leukocytes and cultured. RESULTS: PNA was accomplished successfully in all patients. Aspirate revealed bacteria in nine and pancreatic abscess was confirmed at surgery (8) or post-mortem exam (1). Four of five patients in whom no bacteria were visualized had medical resolution, the fifth had continued T degree and underwent a second aspiration which diagnosed a PA. PA contained moderate to large number of PML via aspiration. CONCLUSIONS: PNA provides a potentially important and safe diagnosis adjunct to earlier accurate differential diagnosis of pancreatic inflammatory masses from pancreatic abscess.

Abscess↗
PubMed1981

Therapeutic percutaneous aspiration of pancreatic pseudocysts.

The therapeutic efficacy and safety of percutaneous aspiration of chronic pancreatic pseudocysts was evaluated. Eight patients underwent aspiration a total of ten times. Permanent resolution was obtained in two patients and a third nonsurgical candidate was offered an alternative therapeutic modality. This procedure is simple, rapid, and safe and could become the initial approach to selected patients with a chronic pancreatic pseudocyst.

Adult↗
PubMed1979

Double-ended pigtail ureteral stent: useful modification to single end ureteral stent.

A newly created ureteral stenting catheter of double-ended pigtail design is introduced. The pigtail design at both ends maintains the catheter in place by serving as a solid anchoring device, both intravesically and within the renal pelvis; upward or downward migration of the stent is thus prevented. It is designed also to minimize trigonal irritation. The catheter can be introduced easily either cystoendoscopically or through a percutaneous antegrade route, or by a combination of both methods. It offers the additional advantage of being readily available from an inexpensive stock source; it may be quickly and easily custom made and shaped for any ureter by the physician immediately prior to its insertion. It thus avoids having to have premanufactured, more expensive ureteral stents of different lengths. Open surgery for upper urinary tract decompression can thus be avoided.

Aged↗
PubMed1978

Jaundice, choledocholithiasis, and a nondilated common duct.

In two cases of jaundice due to choledocholithiasis, the biliary tree was not dilated on skinny-needle transhepatic cholangiography. Visualization of the biliary tree before arriving at a diagnosis in certain cases of jaundice is needed.

Cholangiography↗
PubMed1978

Portosystemic communications studied by transhepatic portography;.

The experience of collecting 120 transhepatic portograms, performed in patients with different degrees of portal hypertension, affords the opportunity for discussing the anatomical and hemodynamic features of portosystemic communications. Multiple pathways of decompression were found. The coronary-gastroesophageal collateral formed pathways in 108 cases, other major collaterals in 41, and minor collaterals in 2. This multiplicity of communications suggests that no one vessel is indispensable as a collateral pathway.

Collateral Circulation↗
PubMed1978

Rapid diagnosis of obstructive jaundice due to pancreatic abscess with pancreaticobiliary fistula.

A case of pancreatic abscess with pancreaticobiliary fistula manifesting as obstructive jaundice of occult etiology is presented. Diagnosis was made preoperatively by skinny needle percutaneous transhepatic cholangiography. In addition, a communication between the biliary tree and the pancreatic abscess cavity was demonstrated in the absence of previous biliary surgery or primary biliary tract disease. We feel this is the procedure of choice for emergency visualization of the biliary tree in a jaundiced patient where a surgically approachable lesion is suspected.

Abscess↗
PubMed1977

New techniques for interruption of gastroesophageal venous blood flow.

Enlarged gastroesophageal veins were successfully obliterated in 41 patients using embolization with modified autogenous clots and/or Gelfoam, balloon occlusion, iatrogenic perivenous hematoma, sclerosing agents (Sotradecol and Keflin), or a combination of these methods. Thirteen patients were actively bleeding when studied, and the site of bleeding was detected in 4. Surgical exploration of 16 patients and autopsy study of 5 showed persistent obliteration ranging between three weeks and seven months. No major complications requiring reparative surgery were encountered. Gelfoam soaked with Sotradecol is the preferred agent because it provides persistent obliteration of the embolized veins. Patients who are acutely bleeding or have done so previously are candidates for selective obliteration of the gastroesophageal veins.

Catheterization↗
PubMed1977

Pitfalls in transhepatic portography.

Difficulties commonly encountered in transhepatic catheterization of the portal vein and interpretation of portograms are discussed. A long-sleeved trocar is recommended. Curved guide wires and deflector assemblies may assist in superselective catheterization of the tributaries of the portal vein. The judicious use of embolic material (small volumes, slowly injected) should guarantee the success and safety of this technique. Transhepatic obliteration of the gastroesophageal veins is a relatively simple and usually successful form of palliative treatment for actively bleeding and stable gastroesophageal varices. Thoroughness of the embolization procedure and of interruption of blood flow in the gastroesophageal veins is necessary to prevent early recurrence of bleeding.

Catheterization↗
PubMed1977

Transhepatic obliteration of gastroesophageal varices: results in acute and nonacute bleeders.

Seventy-three patients with hepatic cirrhosis and bleeding gastroesophageal varices underwent transhepatic portal vein catheterization and variceal obliteration. Gastroesophageal varices were successfully obliterated in 32 patients actively bleeding and in 35 patients with stabilized bleeding gastroesophageal varices. The remaining six were technical failures. Follow-up examinations in 10 patients from 1 month to 3 years later showed persistent obliteration of embolized veins. Recurrence of variceal bleeding occurred in nine patients. This method should be considered as a palliative, effective adjuvant to the medical treatment of patients with bleeding gastroesophageal varices.

Acute Disease↗
PubMed1977

Percutaneous transhepatic cholangiography with the "skinny" needle. A rapid, simple, and accurate method in the diagnosis of cholestasis.

One hundred thirty-one cases of cholestasis were evaluated by "skinny" needle percutaneous transhepatic cholangiography. The biliary tree was seen in 129 patients (98.5%). When the biliary tree was dilated, a success rate of 100% was obtained. In the 45 patients with nondilated ducts, visualization was achieved in 95.6%. There was no mortality, early operation, or transfusion requirement associated with the procedure. This form of cholangiography is a simple, reliable, and extremely high-yield technique for evaluating patients with cholestasis.

Aged↗