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Biomedical subjects

T Bross

Publications and source records attributed to T Bross.

At least 19 recordsLinked to original sources

[Changes of selected immunological parameters after cardiopulmonary bypass in postop period].

The aim of the study was to evaluate the influence of changes of chosen immunological parameters on postoperative course patients after cardiopulmonary bypass operation. Complement components C3, C4 and immunoglobulins IgA, IgG, IgM were taken into account. The group consisted of 70 patients, 51 men at mean age 52.6 +/- 10.8 years and 19 women at mean age 50.7 +/- 11.0 years. All patients were operated in moderate hypothermia 26-32 degrees C with use of crystalloid cardioplegia. We used membrane oxygenators: Safe II (Polystan), Monolyth (Sorin), Maxima (Medtronic) and Bentley (Baxter). In 36 patients with multivessel coronary artery disease the internal thoracic artery and saphena vein grafts were performed. 27 patients underwent the valve prosthesis implantation procedure and 7 correction of the congenital heart dis-ease. The mean extracorporeal perfusion time was 127.5 +/- 51.0 min. The mean aortic cross-clamping time was 65.6 +/- 26.9 min. 6 blood samples were taken in the time periods called from 0 to 5: 0--before the operation, 1--right after the operation, 2--1 day after the operation, 3--3 days after the operation, 4--7 days after the operation, 5--14 days after the operation. All the immunological parameters were measured at the Technicon RA-1000 System device using plasma antibody serum of Behring Company. We compared two groups: 1) 21 patients extubated at operation day with 42 patients extubated at 1-th postoperative day, 2) 38 patients with postoperative organ failure with 32 patients without organ complications. The intubation time was shorter in patients with higher levels of C3 (to 7-th day) and C4 (at 1-th postoperative day). The postoperative organ failure were more frequently in patients with lower postoperative C3 (to 3-th day) and with lower C4 at 1-th postoperative day. The postoperative changes of immunoglobulins IgA, IgG, IgM were similar in patients with complicated and uncomplicated postoperative course.

Aged↗

[Echocardiographic assessment of pathologic geometry in the left left ventricle with aneurysm before and after endoventricular plasty].

UNLABELLED: Large LV aneurysm (LVA) leads to progressive distortion of ventricular geometry. Endoventricular plasty (EVP) maintains LV original shape and size and may restrain this process. AIMS: Echocardiographic estimation of LVA size. Assessment of the results of EVP regarding operative technique. Assessment if the initial parameters of LV function and LVA size could predict the choice of surgical technique. MATERIAL AND METHOD: 33 patients with LVA underwent EVP: 18 with patch (group A), 15 without patch (group B). Echocardiography was performed before and after surgical procedure. LVA-area, LVA-volume, its proportion to LV area and volume (LVA-area/LV-EDA, LVA-volume/LV-EDV) were determined apart from routine parameters of LV function. RESULTS: Mean LVA-area was 15 cm2, LVA-volume was 50 mL. Mean LVA-areal LV-EDA was 0.38 LVA-volume/LV-EDV was 0.35. LVA exceeding 0.4 of LV area/volume was considered as a large. After surgery LV-EDV diminished +/- 40 mL, LVLd decreased +/- 1.5 cm. EF improved from 44% to 54%. Patients in group A had larger LVA-volume (60 vs 39 ml, p = 0.02) as well as LV-EDV (160 vs 120 ml, p = 0.03), and lower EF (41% vs 51% p = 0.002). Only 2 patients with LVA-volume greater than 56 ml were operated on without patch. After surgery echocardiographic parameters did not differ between the groups: in group A operation was much more extensive. SUMMARY: 1.) Echocardiographic parameters concerning size (LVA-area, LVA-area/LV-EDA) and volume (LVA-volume, LVA-volume/LV-EDV) of LVA provides information about disturbances in LV geometry, are valuable in planning operative method. 2.) EVP with or without patch provides significant improvement of LV geometry and function in echocardiographic investigation.

Adult↗

[Difficulties in distinguishing left ventricular aneurysm from pseudoaneurysm. Case report].

A case of 51-year old female with large inferior left ventricular aneurysm developed 3 months after myocardial infarction is presented. The patient demonstrated advanced congestive heart failure and angina. Coronarography revealed amputation of the distal part of 3 coronary vessels without possibility of revascularisation. In ventriculography large inferior wall aneurysm was found. Echocardiography strongly suggest the presence of pseudoaneurysm. During the operation very large real aneurysm arising from inferior wall and apex was found. Postoperative period was complicated by many cardiac and non cardiac events. Authors discuss the problems of proper diagnostic and its influence on decision about surgical management.

Aneurysm, False↗

Mentorship experiences in a group of occupational therapy leaders.

OBJECTIVES: The development of occupational therapy leaders is a long-held goal of many members of the American Occupational Therapy Association and of state associations. The initiation of mentor programs is a common means to accomplish this goal. These programs take time and effort, and, although occupational therapists have described how mentorship programs work in the literature, there are few articles that describe the actual mentorship experiences of occupational therapy leaders. METHOD: To study the experiences of elected occupational therapy leaders, a 30-item questionnaire was distributed at the annual meeting of the Committee of State Association Presidents and completed by 53 respondents. Results were analyzed, and cross tabulations were run between selected items. RESULTS: Respondents were frequently exposed to role models, were assisted by sponsors, were mentored by other occupational therapists, and served as mentors themselves. There was little evidence that the respondents were mentored by high-powered individuals who helped launch their careers. CONCLUSION: More than half of the respondents were mentored by other occupational therapists, and only 29% of the respondents reported that they surpassed the status and position of their mentors. Plans to initiate mentorship programs should include activities that promote powerful leaders who move beyond the status and position of their mentors, so that occupational therapists can represent the interests of the profession to others.

Adult↗

[A case of perforation of the pericardial sac by Seldinger's catheter guide].

This is a case report of perforation by Seldinger's catheter leader into pericardial sack. The leader was inserted contrary-wise++ to the subclavian vein with the sharp end in front. The leader moved forward toward the venous system and perforated into the pericardial sack. The preceding steroid therapy which the patient had undergone due to asthmatic status resulted in mediastinitis after the primary surgery. Right technique of reoperation and intensive postoperative care led to patient recovery.

Bronchodilator Agents↗

Success in NCLEX-RN: identifying predictors and optimal timing for intervention.

This ex post facto study was designed to identify predictors of success in the NCLEX-RN and determine the optimal point in time for identifying students at risk. The convenience sample consisted of 407 graduates of an integrated, upper division, baccalaureate nursing program, 1984-1987. Prematriculation (total lower division GPA, science GPA, type of lower division College, age, and sex), junior year (three Nursing theory course grades) and pre graduation variables (three senior year nursing theory course grades and Mosby ASSESSTEST) were analyzed for predictive value. Nursing theory courses at the junior and senior year and the Mosby ASSESSTEST strongly correlated (p less than .0001) with NCLEX performance. Discriminant analysis enabled successful classification of 62% of the sample at prematriculation, 81% at the end of the junior year, and 86% at the end of the senior year. The study indicates that students at high risk can be identified at the end of the junior year so that enrichment and support programs can be introduced at that time.

Adult↗

Treatment of cerebral embolism in heart surgery.

The results in the treatment of air embolism in open heart surgery are presented. Two cases of gaseous cerebral embolism are described. One of the patients had a period of unconsciousness of 54 hours, the other of 17 days. Therapy included administration of vasoactive drugs (xanthinol nicotinate 1500 mg 2 times daily as an intravenous drip) combined with superficial hypothermia (32 degrees C). In both cases complete recovery was achieved.

Adolescent↗