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Biomedical subjects

V L Modesto

Publications and source records attributed to V L Modesto.

9 recordsLinked to original sources
PubMed2000

Avoiding hypothermia in trauma: use of the flameless heater pack, meal ready to eat, as a field-expedient means of warming crystalloid fluid.

Forward-deployed medical units do not have the capability to warm intravenous (i.v.) fluids before their administration. We intend to demonstrate a field-expedient means of warming i.v. fluids and preventing hypothermia using the flameless heater available in the Meal, Ready to Eat (MRE). Room-temperature and refrigerated lactated Ringer's solution were organized into three data collection groups using either one or two MRE heaters. The temperature change of the fluid was recorded. Average temperature increases ranged from 15.8 to 31.2 degrees C in times ranging from 8 to 20 minutes. Therefore, we conclude that the flameless MRE heater provides a simple, field-expedient means of warming i.v. fluids before their administration.

Cooking↗
PubMed1999

Isolated splenic metastasis from colorectal carcinoma: report of a case and review of the literature.

In general, surgical resection for metastatic colorectal adenocarcinoma rarely benefits more than a small percentage of patients long term. In the case of isolated splenic metastasis without evidence of other metastatic disease, splenectomy may increase survival times in patients with previously resected colorectal adenocarcinoma. Currently there are only five case reports involving isolated splenic metastases in the English-language literature. This article presents a sixth case and a review of the previous five cases in the literature, with a discussion on the possible diagnostic and therapeutic approaches to these rare but important cases and the apparently significant survival advantage of early diagnosis and treatment.

Adenocarcinoma↗
PubMed1997

Surgical debridement and intralesional steroid injection in the treatment of idiopathic AIDS-related anal ulcerations.

BACKGROUND: The treatment of idiopathic anal ulcerations in AIDS patients is still evolving. These patients suffer with severe incapacitating anal pain. PATIENTS AND METHODS: Relief of pain was achieved with the use of intralesional steroid injections. Twenty-one patients from 1990 to 1993 presented with severe anal pain of 4.5 months average durations (range 3 weeks to 2 years). The average CD4 count was 52.1 (range 0 to 150). Fourteen (67%) patients had a solitary ulcer, while 7 (33%) had complex ulcerations. RESULTS: All patients were treated by debridement of the ulcer, biopsy, and intralesional injection of steroids. Microscopic evaluation revealed nonspecific inflammatory changes, without histopathologic evidence of viral infection or malignancy. Viral tissue cultures were negative. Fifty-seven percent of patients required only one injection to achieve dramatic relief of pain. Forty-three percent necessitated additional injections at 2-week intervals. The average patient was injected 1.9 times (range 1 to 7), with 20 of 21 patients (95%) reporting good to excellent pain relief. CONCLUSION: AIDS anal ulcerations should be treated aggressively with surgical debridement, biopsy and intralesional steroids. The efficacy of this therapy suggests that symptoms are partially due to inflammatory mediators.

Acquired Immunodeficiency Syndrome↗
PubMed1996

The crochet hook method of stab avulsion phlebectomy for varicose veins.

Excision of varicose veins through ministab incisions is currently the choice for the removal of varicose vein clusters. The crochet hook technique of stab avulsion phlebectomy is described in this paper. This surgical method for the treatment of varicose veins has been widely utilized in a residency training environment during the last twelve years and has been used by the senior author for more than 20 years. The technique is easily mastered, cost effective, and has excellent therapeutic and cosmetic results.

Humans↗
PubMed1994

Laparoscopic gastrostomy using four-point fixation.

Percutaneous endoscopic gastrostomy (PEG) has become an effective alternative to surgical gastrostomy in patients who require enteral access or gastric decompression. Technical considerations, however, limit the application of PEG in selected patients and those who have contraindications to PEG. Laparoscopic gastrostomy tube placement has been introduced as an alternative to PEG. A technique for laparoscopic gastrostomy tube placement that emphasizes four-point fixation of the anterior gastric wall is presented.

Gastrostomy↗
PubMed1994

Sexually transmitted diseases and anal manifestations of AIDS.

During the past 20 years, there has been an increased use of the anorectum for erotic pleasure. Consequently, this has led to an overwhelming rise in sexually transmitted diseases (STDs) of the anus and rectum. It is important that surgeons involved with the care of colon and rectal disorders be familiar with each of these diseases. The recent AIDS epidemic has been a challenge to the medical community. Equally as challenging is the management of common anorectal disorders in the AIDS patient. AIDS not only influences the manner in which STDs present but is associated with its own spectrum of anorectal disorders. Discussion and management of STDs and anorectal disorders of AIDS patients are presented.

AIDS-Related Opportunistic Infections↗
PubMed1992

A mass casualty while in garrison during Operation Desert Storm.

In the theater of operations, rear echelon hospitals by doctrine receive patients who have been stabilized by forward hospitals. Occasionally, mass casualties will occur in the rear area, but rarely from combat causes. This report documents a mass casualty occurring in garrison from an anti-tank weapon misfiring. All rear echelon hospitals, regardless of their mission, must be prepared for the acute care of combat mass casualties.

Accidents↗