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At least 343 records · Page 19Linked to original sources
PubMed1999

Early rehabilitation program in postmastectomy patients: a prospective clinical trial.

The purpose of this study was to determine whether 20 patients who received an early postmastectomy rehabilitation treatment program showed more improvement in range of shoulder motion and functional activities than 13 patients who received instruction for exercise only. Data were obtained at preoperatively, three days after operation, at discharge and at postdischarge one month for each patient on parameters such as range of motion of the ipsilateral shoulder joint, upper extremity circumferential measurements, as well as 10 elements of shoulder function. Postoperatively, both groups showed an increased range of motion of the shoulder joint and improved functional activities, but the group that received postoperative rehabilitation management had a better range of shoulder motion and less difficulty in five items for functional assessment. This study also showed that an early rehabilitation program did not increase postoperative complications. We concluded that an early rehabilitation program or intensive instruction program only by a well-trained physical therapist or physiatrist was beneficial to postmastectomy patients in regaining the function and range of shoulder motion, and significantly better in a rehabilitation group.

Adult↗
PubMed1990

[The indications for surgical methods in treating diseases of the coronary arteries].

Included in the study were 236 operations for ischemic heart disease (IHD) aorto-coronary shunt (ACS)--88 patients; ACS + aneurysmectomy--30; ACS + endarterectomy--12, aneurysmectomy--70; skin endocoronary balloon angioplasty--34, heart transplantation--2. The postoperative mortality was 6.5 per cent. Indications for ACS were specified on the basis of the patients state of well-being, the bicycle ergometry [correction of veloergometric] test, the coronarography and ventriculography, the end diastolic pressure and the ejection fraction. Decisive in selecting patients for operative treatment were the data of selective coronarography.

Angioplasty, Balloon, Coronary↗
PubMed1989

[A carotid resection in cervical tumors without a vascular reconstruction].

From 1979 to 1988, 15 cases, consisting of 12 carotid body paragangliomas, 1 vagal body paraganglioma, 1 aneurysm of the internal carotid artery, and 1 recurrent metastatic carcinoma of the neck, were given a simple carotid resection without a vascular reconstruction, since the lesions were fixed to the carotid artery. The collateral cerebral cross-flow was promoted preoperatively with the use of compressing exercises of the carotid artery and controlled by computerized rheoencephalography. There was no operative mortality, though a transient postoperative cerebral complication did occur in one female patient, from which she recovered in one month. Of this series of 15 patients, one died from a malignant lesion and 14 survived for 3 months to 9 years without cerebrovascular complications.

Adolescent↗
PubMedDate not supplied

Preoperative and postoperative study of left ventricular function, hemodynamics and plasma catecholamine concentrations during dynamic exercise in patients with chronic mitral regurgitation.

We studied 7 patients before and after mitral valve replacement (MVR) for chronic mitral regurgitation (MR) and 5 control subjects by echocardiography and right heart catheterization to assess left ventricular function, hemodynamics and plasma catecholamine concentrations during supine bicycle exercise. Left ventricular (LV) end-systolic dimension decreased and LV systolic function increased significantly during exercise in patients and control subjects. LV systolic function (fractional shortening and mean velocity of circumferential fiber shortening) was significantly lower in patients after MVR than before MVR (p < 0.05). Cardiac index at peak exercise was significantly higher in patients after MVR than before MVR (p < 0.05). Significantly greater augmentation in plasma norepinephrine (NE) levels were observed during exercise in patients both before and after MVR than in control subjects (p < 0.05). No significant differences in mean pulmonary artery pressure (PAP) and pulmonary capillary wedge pressure (PCWP) were observed between the patients before and after MVR. Thus, it is concluded that LV systolic and pump function (CI) during exercise were augmented by a compensatory activation of sympathetic nervous system in patients both before and after MVR for chronic MR.

Adult↗
PubMed1993

[Evaluation of the anesthetic risk in patients with coronary disease prior to non-cardiac surgery].

Evaluation of operative risk in coronary artery disease patients before non-cardiac surgery is a frequent problem concerning 100,000 patients each year in France. Perioperative cardiac morbidity is the first cause of death associated with non-cardiac surgery, with infarction rates of the order of 1 to 2% in coronary disease patients. These infarcts are followed by the death of the patient in 25 to 50% of cases. Evaluation of anesthetic risk is based upon three points: type of surgery, clinical findings and results of investigations. The risk is markedly increased in emergency surgery, and in thoracic, intraperitoneal and above all vascular surgery, in particular when clamping of the aorta is involved. From a clinical standpoint, only a history of infarction and signs of peripheral cardiac failure are independent predictive factors of postoperative complications. Other criteria, e.g. age, uncontrolled hypertension, diabetes and above all the severity of angina are also associated with the onset of perioperative-complications. This evaluation can be refined by electrocardiogram (Q wave, ST segment anomalies, ventricular hypertrophy and left bundle branch block) and chest X-ray. The usefulness and predictive value of exercise tests, when possible in a preoperative context, are particularly precious when the result is positive at low work-load. Many publications have studied the value of myocardial isotope scan, in particular before vascular surgery. They report the excellent negative predictive value (95 to 100%) of this investigation. Furthermore, the predictive value of isotope scan is all the greater when the clinical risk factors seen in the patients and the number of areas with ischemia are taken into account.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1997

[Pleoptic therapy in anisometropic and strabismic amblyopia].

The study aims at describing the current trends in pleoptic treatment with a special attention paid to the practised exercises. On the basis of literature a short review of the pathogenesis of amblyopia with or without strabismus is presented. The need for careful choice of the treatment according to specific conditions in each subject is emphasised. The importance of active pleoptic therapy in cases with or without strabismus is particularly pointed out. In anisometropia contrast sensitivity is decreased, differentiation of optotypes put in line and shape differentiation are worsened, ability to discern figures and to accommodation are impaired. Amblyopia with strabismus leads to decrease in space orientation ability, impairment in following movement, prolongation of saccadic movement and of eye-hand coordination time. The types of visual dysfunction mentioned above determine the exercises which should be recommended in a given case. Examples of exercises are presented and the range of improvement possible to achieve is documented.

Amblyopia↗
PubMed1997

Exercise tolerance in patients with Ebstein's anomaly.

OBJECTIVES: The purpose of this study was to identify the determinants of exercise tolerance in patients with Ebstein's anomaly. BACKGROUND: Patients with Ebstein's anomaly of the tricuspid valve may have exercise limitation that improves after surgical repair. METHODS: One hundred seventeen patients performed cycle ergometry for a total of 124 tests (preoperative test in 76 patients, postoperative test in 23, test but no operation in 18, preoperative and postoperative test in 7). Multiple linear regression analysis was used to identify predictors of maximal oxygen uptake, oxygen saturation and heart rate at peak exercise. RESULTS: Age at the time of exercise ranged from 6 to 60 years (median 15). An atrial septal defect was present in 67 patients (88%) preoperatively. Compared with the preoperative group, the postoperative group had significantly higher maximal oxygen uptake (mean [+/- SD] 20.5 +/- 7.4 vs. 25.3 +/- 7.0 ml/kg body weight per min, p = 0.006). Postoperative rest and exercise blood oxygen saturation was higher than that measured preoperatively (p = 0.0001). Six of seven patients tested before and after the operation showed improved exercise tolerance. Preoperatively, major predictors of maximal oxygen uptake were oxygen saturation at rest (p = 0.01) and age (p = 0.0001). Preoperatively, the major predictor of oxygen saturation at peak exercise was rest oxygen saturation (p = 0.0001), and major predictors of peak exercise heart rate were rest heart rate (p = 0.01) and rest oxygen saturation (p = 0.01). In the postoperative group, predictors of maximal oxygen uptake included age at exercise testing, male gender and heart size. CONCLUSIONS: Definitive operation for Ebstein's anomaly results in improved exercise tolerance. Before the operation, rest oxygen saturation is the major predictor of exercise tolerance, oxygen saturation at peak exercise and peak heart rate. Postoperatively, age, gender and heart size influenced maximal oxygen uptake.

Adolescent↗
PubMed1983

Results of fasciotomy in patients with medial tibial syndrome or chronic anterior-compartment syndrome.

I studied the results of fasciotomy of the affected muscle compartment in eight patients with chronic anterior-compartment syndrome (involvement of the anterior tibial compartment) and in nine patients with medial tibial syndrome (involvement of the deep posterior compartment), all of whom had pain with exercise. In the patients with chronic anterior-compartment syndrome, the preoperative intramuscular pressure in the anterior tibial compartment, as measured by the wick-catheter method, was increased ten minutes after exercise to 52 +/- 36 millimeters of mercury. After fasciotomy this pressure was significantly lowered to 4 +/- 6 millimeters of mercury (p less than 0.01). In the patients with medial tibial syndrome, the preoperative intramuscular pressure in the deep posterior compartment was normal ten minutes after exercise (8 +/- 4 millimeters of mercury) and did not significantly change after the fasciotomy (5 +/- 6 millimeters of mercury). The clinical results after fasciotomy were good in both groups of patients. There was complete relief of pain in all of the patients with chronic anterior-compartment syndrome and in five of the nine patients with medial tibial syndrome. The other four patients considered their condition to be improved in spite of some remaining symptoms.

Adolescent↗
PubMed2003

[Clinical outcome of patients after transmyocardial laser revascularization alone and combined with coronary artery bypass grafting].

The aim of the study was to assess the effect of transmyocardial laser revascularization (TMLR) alone and in combination with coronary artery bypass grafting (CABG) on the angina score (CCS--Canadian Cardiovascular Society class), exercise tolerance and left ventricular function 6 months after the procedures. Sixty two patients were subjected to revascularization, 38 to sole TMLR procedure and 24 to combination CABG and TMLR (CABG/TMLR group). The angina score and exercise stress test together with radionuclide ventriculography were performed before and 6 months after the operation. The angina class and exercise tolerance were similar in both groups preoperatively. After the operation the improvement was seen in both groups with no statistical difference. The left ventricular ejection fraction were 61 +/- 8% and 54 +/- 8% (p < 0.05) before operation and after 6 months respectively. Transmyocardial laser revascularisation alone and in combination with coronary artery bypass grafting may relieve the angina and improve the exercise tolerance. However the left ventricular ejection fraction may drop significantly.

Coronary Artery Bypass↗
PubMed1989

[Arrhythmia during extraction of the third molars under intravenous sedation. A case report of postoperative tetralogy of Fallot].

Extraction of the third molars [formula: see text) was done under local anesthesia with intravenous sedation using diazepam in a 14 year-old girl. She had the history of radical operation for tetralogy of Fallot at 4 years of age. During extraction procedure, this patient showed many multifocal premature ventricular contraction in ECG. These arrhythmias were able to control with intravenous lidocaine. In this case, the preoperative evaluation of her cardiac function was not pertinent possibly due to the judgment by her ability of physical exercise in the past history. We reflect that inadequate preoperative evaluation of cardiac function may result in inadequate management.

Adolescent↗
PubMed1988

Improvement in cardiac performance and exercise tolerance after left ventricular aneurysm surgery--a prospective study.

Forty two patients were studied prospectively by rest and exercise radionuclide ventriculography before and after (10 +/- 4 months) left ventricular aneurysm resection. Functional classification (NYHA) improved from 3.0 +/- 0.6 to 2.3 +/- 0.5 (p less than 0.0001) with an increase in double product (p less than 0.01) and total exercise workload (p less than 0.04) over preoperative values. End-diastolic volume was significantly reduced (p less than 0.0001) and resting global left ventricular ejection fraction (LVEF) improved significantly (p less than 0.03) after surgery, as did regional ejection fractions of the lateral/inferior wall (p less than 0.01). Cardiac index (CI) at rest, however, remained unchanged. Under exercise, improvement of global (p less than 0.0003) and regional ejection fractions (p less than 0.02) was more pronounced and a significant increase was also observed for CI (p less than 0.003). Improvement in left ventricular performance occurred both in patients with single and multiple vessel disease, but was more distinct in the latter group who additionally received coronary artery bypass grafts. These patients were furthermore postoperatively able to increase global LVEF at exercise (p less than 0.05). We conclude that aneurysm resection with or without coronary bypass relieves cardiac symptoms and improves exercise tolerance and left ventricular function at rest and on exercise in most patients.

Adult↗