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Biomedical subjects

S Mandell

Publications and source records attributed to S Mandell.

13 recordsLinked to original sources
PubMed2004

Intraoperative fluid management of living donor versus cadaveric liver transplant recipients.

Living donor liver transplantation has increasingly become an alternative to cadaveric donor liver transplants for select adult patients. Because these cases can be performed electively, living donor recipients may have better compensated liver disease at the time of surgery than cadaver donor recipients. However, it is unknown if this difference would have a significant effect on their intraoperative course. Therefore, we compared the intraoperative fluid management of patients receiving liver grafts from either living or cadaveric donors (n = 25, each group). Patient groups did not differ in demographics or baseline laboratory values. The duration of anesthesia and anhepatic phases were significantly longer in living donor cases (651 +/- 80 minutes vs 409 +/- 20 and 55 +/- 14 vs 45 +/- 6, P < .05). Adjusted for anesthesia time and patient weight, fluid administration (crystalloid and albumin) was not different between the two groups. Intraoperative transfusion requirements were also not significantly different in recipients from living donors versus cadaveric donors with regard to red blood cells, fresh frozen plasma, platelets, and cryoprecipitate. However, arterial oxygenation was better preserved in recipients from living donors. The PaO2/FiO2 (P/F) ratio at the end of the procedure was significantly better in patients receiving livers from living rather than from cadaveric donors (P/F ratio 335 +/- 114 mm Hg vs 271 +/- 174, P < .05). Our results indicate that while intraoperative fluid and transfusion requirements are similar, the impact of transplantation on pulmonary gas exchange is more pronounced in patients receiving organs from cadaveric donors. This difference may arise from longer cold ischemia times present in the cadaveric donor group.

Cadaver↗
PubMed1985

Carcinomatous meningitis from transitional cell carcinoma of bladder.

The following case report presents a patient with transitional cell carcinoma of the bladder referred to this medical center after carcinomatous meningitis developed. Previously he had undergone surgical resection of the primary lesion and had received cis-platinum chemotherapy for lung metastasis. This unusual presentation of metastatic disease (carcinomatous meningitis) seems to alert the surgical and medical communities to new complications.

Carcinoma, Transitional Cell↗
PubMed1976

From heroin to methadone--social role changes and reinforcement differentials in relation to outcome on methadone. Part I. The study of reinforcement differentials.

This study examines the relevance of reinforcements available to the addict in five critical stages of his career to his success on methadone maintenance. In-depth focused interviews were held with 30 addicts who had completed a program of methadone induction and who were characterized by social worker's evaluations as Successful, Marginally Adjusted, or Failures. The Successful group showed a higher initial negative reinforcement followed by higher positive reinforcement on methadone. The Moderately Successful group showed more negative reinforcement before treatment but continued to show negative reinforcements afterwards. The Failures were low on negative reinforcements earlier but negative reinforcements were high after treatment.

Adult↗
PubMed1976

From heroin to methadone-social role changes and reinforcement differentials in relation to outcome on methadone. Part II. The study of social role changes.

The life-styles of addicts who are Successful, Marginally Successful, and Failures in a methadone maintenance program are examined by in-depth interviews in five time periods-early family life, the preheroin period, late heroin, premethadone, and methadone maintenance. The hypothesis is confirmed that the more the methadone patient has managed to develop a new and more conventional set of peer group, familial, and occupational roles, the greater the likelihood of his success on methadone maintenance. The in-depth view of the groups over time suggests that the pattern of alternation of positive reinforcements and punishing situations may be associated with outcome.

Employment↗