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Biomedical subjects

S Tamames

Publications and source records attributed to S Tamames.

At least 19 recordsLinked to original sources
PubMed2000

Laboratory evaluation of the effect of prophylaxis for thromboembolism with fractionated heparin in patients undergoing laparoscopic cholecystectomy.

OBJECTIVE: We studied the effect of prophylaxis for thromboembolism with low-molecular-weight heparin (LMWH) during hospitalization on the biological hemostasis system in patients who had undergone laparoscopic cholecystectomy. METHODS: This was a prospective paired cohort study without a control group (i.e., a before-after study). The subjects were 20 patients operated on laparoscopically for uncomplicated cholelithiasis. All patients received LMWH 2 h before the operation and 24 h after the first dose. Mean duration of surgery was 70 min. Pneumoperitoneum was accomplished at 14 mmHg, and all patients were operated on in the inverted Trendelenberg position (30 degrees). Patients were mobilized within 24 h, and were discharged within 48 h after surgery. As parameters of hemostasis we studied anti-Xa factor activity (anti-Xa), antithrombin III (AT III), partial active thromboplastin time (PTT) and fibrinogen. Samples were taken for laboratory analyses under basal conditions the day before the operation (first determination), 1 h after the first preoperative dose of LMWH was given (second), at the end of the operation (third), 24 h after surgery (fourth), and on postoperative day 7 (fifth). RESULTS: Mean basal values of all parameters were within the normal range. Mean anti-Xa activity was significantly higher in the second and third determinations than in the first and fifth measurements (p < 0.05). Mean PTT was significantly elevated on the second determination and decreased thereafter; however, none of the results differed significantly from the normal value. Mean AT III was significantly lower in the third determination in comparison with the first and fifth measurements. Fibrinogen was significantly higher in the fourth and fifth determinations than in the second and third measurements. Among all parameters and sampling times, the only values outside the normal range were anti-Xa activity on the second, third and fourth determinations. CONCLUSIONS: Plasma anti-Xa factor activity was increased preoperatively, and remained elevated for 24 h after surgery, returning to basal values on postoperative day 7. Partial thromboplastin time was slightly prolonged after the first dose of LMWH, indicating good antithrombotic action.

Adult↗
PubMed1995

[Risk factors of peptic ulcer hemorrhage].

A retrospective analysis is made of the risk factors in 229 patients admitted to hospital with hemorrhage from peptic ulcer. The factors that have been studied are: 1) age. 2) type of ulcer lesion. 3) associated disease. 4) antiinflammatory intake. 5) prior ulcer symptoms. 6) intensity and outcome of the bleeding episode. 7) endoscopic findings. 8) treatment modality. 9) mortality. The analysis of these factors tries to establish, by means of the square chi test with Yates correction, the possible relations between the factors, to determine which ones will have a pronostic value. From the results obtained we conclude that the factors with the highest pronostic importance are: 1) With respect to the severity of the bleeding episode, antiinflammatory intake and duodenal location of the ulcer lesion. 2) With respect to the need for urgent surgical treatment, antiinflammatory intake and prior ulcer symptoms. 3) With respect to mortality, severity, persistence and recurrence of bleeding, and the need for urgent surgical treatment. Finally, it is important to mention the absence of pronostic value, with respect to mortality, of advanced age and the endoscopic findings of active and/or recent bleeding.

Acute Disease↗
PubMed1991

[Hydatid cyst of the diaphragm. Apropos of a case].

We report a case of hydatid cyst of diaphragma in a 70 year-old male, who was admitted to hospital in emergency for right basithoracic pain, aggravated by cough and deep breathing. Laboratory tests were normal. Standard roentgenographs showed a right-sided subpulmonic opacity. Pleural aspiration fluid revealed hemorrhagic pleural effusion. Lung scintigraphy showed and hypoperfused area at the base. Abdominal echography evidenced an hepatic cyst referred to the diaphragma. Thoracoabdominal CT-scans indicated a calcium-loaded mass on the postero-lateral aspect of the right lobe of liver. Surgical exploration revealed an independent hepatic cyst localized in the latero-costal bundles of the diaphragma which was removed en masse.

Aged↗
PubMed1990

[Compensatory reaction of the ascending colon following jejuno-ileal bypass. Experimental study].

The series of physiopathologic consequences and the adaptive response that appears in the residual intestine following intestinal by-pass surgery has been widely studied. The same is not true for the ascending colon. Having demonstrated the adaptive changes this organ undergoes after a massive enterectomy, we carried out the present study to evaluate the compensatory reaction after an intestinal by-pass. A total of 115 Wistar rats weighing 350-550 g were used. Twenty animals made up group 0 (control), 30 underwent intestinal section (group II) and 65 received a jejuno-ileal by-pass (group III), with latero-lateral anastomosis. After weight control was performed the animals were sacrificed at 15, 30, 45 and 60 days, and samples were taken from the ascending colon for optical microscopy (OM), scanning electronic microscopy (SEM) and transmission electronic microscopy (TEM). All objective data were quantified and statistical studies carried out. The by-pass animals showed statistically significant ponderal drops (p less than 0.001), an expression of the malabsorption disorder the by-pass produced. Groups 0 (control) and I (IS) showed no macroscopic, microscopic or ultrastructural changes. The by-pass animals, however, manifested colic dilatation with a significant increase in thickness, to the detriment of the muscularis and mucosa, and greater crypt depth with a relative decrease in the number of goblet cells. Enterocytes increased in number and size. These changes were statistically significant in relation to groups 0 and I. The above findings were confirmed ultrastructurally. In the scanning electronic microscopy after 30 days, the colic mucosa had an irregular appearance, with elevations but no foliated appearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Carcinoma of the gastric stump after resection of benign disease (32 cases)].

Gastric stump carcinomas have a poor prognosis; the etiology, diagnosis and treatment are not well-defined. The authors analyze their experience with 32 patients with carcinoma of the gastric stump after gastric resection for peptic ulcer; the age of the patients was 44-72 years. The period of latency, since the previous resection, was 28 years. At the time of diagnosis, all patients were symptomatic. The radiological study was positive in 69% of cases and endoscopic exploration and biopsy in 100%. 47% of patients could be resected but the surgery was considered radical only in 4. The tumors were always adenocarcinomas; the muscular layer was infiltrated in 86% of cases and to adjacent organs in 52%. 76% of cases presented lymph node metastases and 31% distant metastases. There were 8 postoperative deaths (28%). The five years survival was 4.2%. The poor prognosis of this lesion emphasizes the importance of early diagnosis and treatment as well as that of periodic follow-up of gastrectomized patients older than 50.

Adult↗
PubMed1989

[Extrahepatic biliodigestive anastomoses. Analysis of 227 cases].

The authors analyze their experience with 227 biliodigestive anastomoses to compare the early and late results. Choledocholithiasis (49%) and cancer of the pancreas (25%) were the most common processes. Choledochoduodenostomy (48%), cholecystojejunostomy (22%), sphincteroplasty (18%) and hepaticojejunostomy (9%) were the techniques most often used. In 61% of cases (90% of the malignant tumors) there was an emergency indication. Twenty-one percent of the patients presented serious complications in the postoperative period (14% of the benign tumors), half of which depended on the bypass. Postoperative peritonitis (2%), external biliary fistula (4%) and acute pancreatitis (2%) were the most significant surgical complications. Hepaticojejunostomy induced the largest number of bypass-dependent complications. There were 12 deaths due to medical causes (5%), these being most numerous in subjects with neoplasms and cholecystojejunostomy, and 8 of surgical origin (4%), half of them in carriers of a hepaticojejunostomy. There was a clear decline in the morbidity of patients operated on in recent years. In the long term, 91% of the patients remained free of discomfort or had minimal symptoms. Choledochoduodenostomy or sphincteroplasty produced the best results. It is concluded that biliodigestive anastomoses yield the best early and late results with minimal secondary effects.

Adolescent↗
PubMed1984

Compound grafts of xenopericardium and Dacron fabric for repair or replacement of great vessels: a method to avoid interstitial and suture hole bleeding.

Compound grafts constructed by wrapping pericardial xenografts around fabric grafts were used for replacement or repair of the great vessels. After cardiopulmonary bypass (CPB), bleeding through the compound graft is nil. Nine patients had the intrathoracic aorta replaced with a compound graft, and eight patients had patch repair of the ascending aorta or the right ventricular outflow tract. Bleeding in all patients was minimal because the nonporous nature of the xenopericardium avoids interstitial and suture hole hemorrhage until normal hemostasis is obtained.

Adolescent↗