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Biomedical subjects

T Paes

Publications and source records attributed to T Paes.

10 recordsLinked to original sources
PubMed2004

Randomised controlled trial to evaluate the efficacy of TachoComb H patches in controlling PTFE suture-hole bleeding.

OBJECTIVE: Suture-hole bleeding is a considerable problem in vascular procedures using polytetrafluoroethylene (PTFE) grafts. This study aimed to study the efficacy of TachoComb H patches in controlling suture-hole bleeding. DESIGN: Prospective randomised controlled trial. Materials and methods. Patients undergoing femoral anastomosis and femoral or carotid patch angioplasty with PTFE grafts were prospectively randomised to TachoComb H patches or standard compression with surgical swabs. RESULTS: Twenty four patients were randomised (12 patients in each treatment group). The median time to haemostasis was 300 (range 180-600)s in patients treated with TachoComb H and 660 (range 180-1200)s in the control group. The log rank test of equality over treatments based on the 22 patients with assessment of time to haemostasis showed statistical significance (p=0.0134). There were no serious complications associated with use of TachoComb H patches. CONCLUSION: TachoComb H patches were found to be safe and effective for the control of suture-hole bleeding in patients undergoing vascular reconstruction with PTFE grafts.

Aged↗
PubMed2001

Quality of life evaluation following endoscopic transthoracic sympathectomy for upper limb and facial hyperhydrosis.

In this prospective cohort study, the outcome of bilateral endoscopic transthoracic sympathectomy (ETS) was assessed using the Dermatology Life Quality Index (DLQI) questionnaire. 10 consecutive patients who underwent two-stage bilateral ETS for primary hyperhydrosis were assessed. Two patients had concomitant facial blushing. Symptomatic improvement was achieved in all patients. Statistical analysis (one-tailed Wilcoxon rank test) demonstrates a significant (p < 0.05) step-wise improvement in quality of life after each stage. This has not previously been described for two-stage bilateral ETS and confirms the suitability of this technique in the definitive management of refractory primary hyperhydrosis.

Adolescent↗
PubMed1991

Acquired venous aneurysms.

A case is reported of acquired venous aneurysms in the superficial forearm veins of an oarsman. The aetiology, presentation and complications are discussed.

Adult↗
PubMed1986

The influence of DDAVP infusion on the coagulation and fibrinolytic response to surgery.

The response of components of the coagulation and fibrinolysis systems to infusion of DDAVP has been examined in patients undergoing elective surgery. In the DDAVP treated group there was a significant increase, compared to control, in plasminogen activator (by fibrin plates p less than 0.005, ECLT p less than 0.0125, by Student's t test) before operation. No difference between groups was seen by either methods in the activator levels in samples 24 h postoperation, whereas a significant drop (p less than 0.002) in protein C concentration was observed at this stage in the treated group. Levels of factor VIII components were significantly higher (p less than 0.005) than control at all stages of operation and a significant shortening (5 sec p less than 0.05) of the APTT was seen at all stages (apart from 24 h samples). DDAVP infusion therefore may exacerbate the hypercoagulable state observed in surgical patients without preventing the (post-operatively) fibrinolytic shutdown. Instead, infusion tends to produce fibrinolytic depletion at the key mid-operative stage.

Adult↗
PubMed1985

The influence of LMW heparin on the coagulation and fibrinolytic response to surgery.

The response of components of the coagulation and fibrinolytic systems has been examined in patients undergoing minor and major elective surgery and receiving or not receiving subcutaneously administered prophylactic low molecular weight (LMW) heparin. Blood samples were withdrawn pre-operation (PO), post-anaesthesia (PA), during operation (DO) and 24 hours post-operation. Release of plasminogen activator occurred post anaesthesia at a time when factor VIII components were unchanged or decreased. Induction of anaesthesia decreased plasminogen (p less than 0.005) fibrinogen (p less than 0.02) ATIII (p less than 0.002) and fast a2-antiplasmin (p less than 0.005). During operation plasminogen activator release reached a peak in association with a moderate increase in factor VIII components. Heparin treatment produced a prolongation of APTT at DO (p less than 0.05) and at 24hr (p less than 0.002) stages, this prolongation being apparently unrelated to its concentration but did not prevent the rise of factor VIII components observed at 24 hr (p less than 0.02). Prekallikrein (p less than 0.05) and antithrombin III levels (p less than 0.05) were significantly higher whereas fast a2-antiplasmin (p less than 0.002) was significantly lower at 24 hours in patients undergoing major operation and treated with heparin. Protein C levels fell significantly at 24 hours in the untreated patient (p less than 0.014) and in the heparin treated group the fall was greater than the control group (p less than 0.007). At 24 hours other haemostatic and fibrinolytic components were unaffected by heparin treatment.

Adult↗
PubMed1985

Heparin and dihydroergotamine prophylaxis against thrombo-embolism after hip arthroplasty.

A prospective study involving 500 consecutive patients undergoing hip replacement was performed to find out whether a combination of heparin and dihydroergotamine was effective in preventing postoperative fatal and non-fatal emboli. Deep-vein thrombosis was demonstrated in 131 cases (26.2%), in 99 of whom thrombi were confined to the ipsilateral (operated) limb and in 13 to the contralateral limb; 19 patients developed bilateral thrombi. Nine patients (1.8%) died during the first four weeks after operation, before they were discharged from hospital; in one, major emboli were demonstrated in the right pulmonary artery. Three of the 500 patients developed non-fatal pulmonary emboli. Excessive bleeding occurred in 21 (4.2%) and in 19 of these prophylaxis was discontinued. Wound haematomas developed in 25 patients (5.0%); only six required evacuation but in none of these six did deep infection occur while in hospital; in three patients, however, the wound haematoma prolonged the stay in hospital. Thus the combination of heparin and dihydroergotamine proved an effective prophylaxis against pulmonary embolism in patients undergoing total hip replacement. The risk of bleeding complications is wholly acceptable when balanced against the advantages of the therapy.

Aged↗