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Biomedical subjects

R Sinatra

Publications and source records attributed to R Sinatra.

36 records · Page 2Linked to original sources
PubMed1991

[THe surgical treatment of aneurysmatic lesions of the ascending aorta: the immediate and long-term results in 40 patients].

From January 1981 to January 1991, 40 patients underwent operation for acute ascending aorta dissection (AAD, 14 patients), chronic ascending aorta dissection (CAD, 9 patients) or aortic ectasia (AE, 17 patients), with simultaneous aortic valve replacement in 30 cases (75%). Average age was 54 years with a 3:1 M/F ratio. In 20 cases (50%) a composite graft bearing a mechanical bileaflet valve was inserted with coronary artery reattachment (Bentall operation). In 16 cases (40%) the ascending aorta was replaced by a woven dacron graft alone (7 cases) or associated with aortic valve substitution (7 cases) or resuspension (2 cases). In 1 case (2.5%) a sutureless ring graft replacement of ascending aorta was carried out and 3 patients (7.5%) underwent aortoplasty with aortic valve substitution. Postoperative mortality rate was 21% for AAD group, 11% for CAD group and 6% for AE group. Non-fatal postoperative complications developed in 36% of AAD patients and in 78% and 29% of CAD and AE patients respectively. These complications occurred in 45% of patients who underwent Bentall operation, in 44% of those who underwent ascending aorta replacement associated with aortic substitution or resuspension, and in 14% of those operated of simple ascending aorta replacement. Average follow-up was 41.6 months (range 1.7-107.4 months). During this period 5 deaths occurred for a long-term mortality rate of 14.2%. Out of 30 survivors 21 (70%) underwent CT-study to evaluate the natural course of the false channel and the risk of redissection or late aneurysm formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The transcatheter ablation of arrhythmias].

The introduction of transcatheter ablation techniques has opened a new era of the management of tachyarrhythmias. The rationale of these therapeutic procedures lies in the induction of an irreversible and limited damage to cardiac tissue involved in arrhythmias. In its original form, the technique involves the delivery of high energy DC discharges (fulguration) to the target area through a temporary catheter electrode. A primary drawback of fulguration, when used for ablation of AV node-His bundle, is the induction of a pacemaker-dependent state; the barotraumatic effect that results from high energy impulses constitutes the major limitation in the case of ablation of accessory pathways or arrhythmogenic areas. Recently, the efficiency of the procedure has been substantially improved by the use of low-power, high-frequency alternating current (radiofrequency), that allows to deliver graded amounts of disrupting energy to selected areas while avoiding undesirable biophysical effects to the surrounding tissue. Remarkable results, with a success rate close to 100%, are reported with radiofrequency ablation of AV node reentry tachycardia, as well as reciprocating tachycardia associated with the preexcitation syndrome, so that this technique can be considered the procedure of choice for both categories of patients. Catheter modification of AV conduction provides a therapeutic tool for treating atrial tachyarrhythmias with rapid ventricular responses. In such cases, however, the risk of AV block with the need for pacemaker implantation must be taken into account. Results of catheter ablation of ventricular tachycardia have been inconstant and generally disappointing, except for ventricular tachycardias due to reentry in the His-Purkinje system, for which a high success rate is reported. Experience with radiofrequency ablation in ventricular tachycardia is very limited, but localization of a critical segment of reentry could improve the efficiency of this technique.

Arrhythmias, Cardiac↗
PubMed1989

An evaluation of morphine and oxymorphone administered via patient-controlled analgesia (PCA) or PCA plus basal infusion in postcesarean-delivery patients.

The analgesic efficacy and adverse effects of morphine and oxymorphone in 32 patients who received traditional patient-controlled analgesia (PCA) following cesarean delivery were compared with those in 32 other patients receiving the same agents via PCA plus basal opioid infusion (PCA + BI). All patients were operated upon during epidural anesthesia with 2% lidocaine and 1:200,000 epinephrine to achieve a T4 sensory level. Upon first complaint of pain in the recovery room, patients were given a titrated iv loading dose of the assigned opioid until comfortable and were then provided with a programmable PCA device. Group I (PCA) consisted of two subsets in which incremental boluses of morphine (1.8 mg, n = 16) or oxymorphone (0.3 mg, n = 16) could be self-administered via conventional PCA. Patients in group II (PCA + BI) received a basal infusion of morphine (0.6 mg/hour, n = 16) or oxymorphone (0.1 mg/hour, n = 16) in addition to self-administered boluses of 1.8 and 0.3 mg, respectively. Patients were evaluated for 24 h following initiation of analgesic therapy, and 10-cm visual analog scales (VAS) were utilized at selected intervals to assess pain at rest, pain during movement, and satisfaction with therapy. The level of sedation and incidence of nausea/vomiting and pruritus were also recorded. Patients utilizing PCA + BI noted significant reductions in resting pain scores with oxymorphone and decreased pain during movement with both opioids when compared with individuals using PCA alone (P less than 0.05). There were no significant differences between treatment groups in 24-h dose requirements or patient satisfaction with therapy (P = ns).(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1989

Verbal/visual processing for males disabled in print acquisition.

Fourteen males disabled in print acquisition were studied over time to determine their patterns of verbal and spatial processing. Comparing results of WISC-R and WAIS scales using a Bonferroni correction for t-values, it was found that the Similarities subtest scores significantly increased while the Vocabulary subtest scores and Acquired Knowledge category significantly decreased. Hemispheric specialization was suggested as a possible cause for differences in verbal and nonverbal processing.

Adolescent↗
PubMed1986

Learning style and intelligence of reading disabled students.

This study examined the relationship between elements of the Learning Style Inventory and various scales of the WISC-R for reading disabled students. Previous research generally suggests that reading disabled students have preferences that tap the visual-spatial domain and have higher WISC-R Performance Scale and subtest scores than Verbal Scale and subtest scores. Subjects with IQs of 90 or better on either the Verbal or Performance Scales of the WISC-R and a consistency score of 75 or better on the inventory were selected. Contrary to what might be expected, data generally showed a nonmeaningful pattern of correlations between scales of the Learning Style Inventory and WISC-R Performance-type functioning. However, as an important part of the validation of the inventory, lack of association between the two can be interpreted as support for its construct validity.

Arousal↗
PubMed1984

Use of three writing tasks at an adolescent treatment center.

Adolescent residents placed in a state youth facility for crimes, misdemeanors, and anti-social behavior were presented with three writing modes during their language arts instruction. The modes required that they write a composition based on viewing a slide arrangement (Visual Composition), on imagery generated while the teacher provided sensual impressions (Imagery Composition), and on embellishing and rearranging a list of sentence fragments (Report Writing). The mean of a composition holistically scored prior to the writing treatment was significantly lower than the means of Report, Imagery, and Visual Composition writing for 14 subjects present for all writing tasks. While no significant differences emerged among the writing modes the percent gain over baseline was highest for Visual Composition (50%), a technique in which no printed language cues were available to the writer. Perhaps for problem adolescents with low literacy skills, direct emphasis on traditional and non-traditional, nonverbal approaches to composition may increase writing proficiency.

Adolescent↗
PubMed1983

Hemispheric routing of tactilely delivered words for dyslexic males.

This investigation sought to determine the effect of delivering unknown spelling words via a tactile modality to the left and right cerebral hemispheres of 10 dyslexic boys of about 14 yr. of age whose vision was occluded during word palpation. More words were learned through either condition of right- and left-hand delivery than control words. Spelling meaningful words when vision is occluded can be accomplished by either hand delivery for older dyslexic boys.

Adolescent↗
PubMed1983

Iliac arteriovenous fistula complicating lumbar laminectomy.

An iliac arteriovenous fistula may rarely complicate lumbar laminectomy, particularly at the L4-L5 level. We present such a complication in a 45-year-old man who presented in our institution with a postlaminectomy iliac arteriovenous fistula and severe congestive heart failure. Repair of the fistulous orifice and tubular reconstruction of the iliac artery were successfully performed.

Journal Article↗
PubMed1981

[Hyperbaric oxygenation in cerebral air embolism occurring during open-heart surgery (author's transl)].

Hyperbaric oxygenation was used in two patients with extensive neurologic damage from cerebral air embolism occurring during open-heart surgery. One patient made a full recovery. The use of hyperbaric oxygenation produces the most direct relief of the mechanical obstruction and provides the definitive treatment for cerebral air embolism. First consideration must be given to the prevention of this complication, but once an embolus has occurred, hyperbaric treatment should be instituted promptly and early. Therefore every team engaged in open-heart operations should be familiar with the diagnosis and the therapy of air embolism.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Long-term histologic features of synthetic chordal replacement for mitral valve repair: a case report.

Expanded polytetrafluoroethylene (e-PTFE) sutures have been used with increasing frequency to replace chordae tendineae in mitral valves prolapsing because of myxoid change. A case is reported where fibrosis and calcification of the endocardial overgrowth covering the synthetic chordae led to severe mitral regurgitation 7 years after plastic repair and required mechanical prosthetic valve implantation.

Calcinosis↗
PubMedDate not supplied

Sterility of epidural solutions--recommendations for cost-effective use.

BACKGROUND AND OBJECTIVES: Specific recommendations or guidelines for duration of use or "hangtime" for epidural solutions have not been established. Presently, most hospital policies limit expiration dating of these solutions to 24 hours at room temperature. Extending expiration dating would reduce or eliminate the manipulation of the epidural system during the course of therapy. The objective of this study was to assess the bacteriologic status over time of pharmacy-prepared epidural solutions to determine if longer expiration dating could be safely instituted. METHODS: Samples from both previously administered and nonadministered bags of epidural infusate solutions were retrieved for bacteriologic testing and maintained at room temperature. These solutions were tested every 5 to 7 days beginning 24 to 48 hours after preparation. RESULTS: Samples of 54 infusion bags were tested for a median duration of 63 days. One hundred fifteen samples were tested. Only 5 samples of 4 solutions reported positive cultures; no growth was reported for multiple subsequent cultures of these solutions. CONCLUSIONS: Samples of pharmacy-prepared epidural solutions remained sterile for greater than 42 days. A change from epidural solution expiration dating of 24 hours to 48 or 72 hours would translate into a cost savings of $36,375 to $48,450 at our institution.

Analgesia, Epidural↗