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At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

Randomized placebo-controlled, double-blind trial of ketanserin in treatment of intermittent claudication.

Ketanserin, a selective serotonin (5-HT) antagonist at 5-HT2 receptors, was investigated in a 12-month, double-blind placebo-controlled study in 35 patients with intermittent claudication. Benefit was assessed by repeated treadmill tests, recording claudication distance, and by measurement of Doppler ankle-brachial pressure indices (ABPI) and pulse volume recordings (PVR). Improvement in claudication distance of 42-44% was noted during the 12 months of the double-blind study and this trend continued to 53-67% during an additional 3 month run-out period on placebo. There were no significant differences between the group given Ketanserin and the placebo group. The hemodynamic measurements demonstrated no statistically significant change in either ABPI or PVR throughout the study period, and no significant differences between the two groups. The conclusion of the study indicates that Ketanserin is ineffective in the treatment of intermittent claudication.

Blood Pressure↗
PubMed1991

Biochemical analysis of a human humoral fibroblast inhibitory factor associated with impaired vascular prosthetic graft incorporation.

A specific inhibitory factor was isolated from human serum of a patient who manifested impaired prosthetic graft tissue incorporation. The latter reaction was hypothesized to be related to inhibiting fibroblast proliferation by a specific humoral factor. The crude inhibitory serum was tested against a pool of normal human sera with different cell types in culture. Proliferation of human skin fibroblast and human smooth muscle cell cultures incubated in the presence of 50% inhibitory serum were inhibited up to 58% and 37%, respectively. Proliferation of bovine capillary endothelial cell cultures was stimulated under similar conditions. Isolation and purification of the inhibitory factor from crude serum were initiated by ammonium sulfate precipitation. The pellet was further fractionated by sepharose 6B gel filtration. The inhibitory activity was eluted from the column in a relatively purified form as indicated by gel electrophoresis of the inhibitory fractions, which demonstrated a specific band corresponding to the inhibitory protein, with an apparent relative molecular mass of 230 kDa. The inhibitory factor showed a high affinity to concanavalin A, indicating its nature as a glycoprotein not associated with albumin or immunoglobulin fractions of the serum.

Aged↗
PubMed1991

[Surgery for thoraco-abdominal aortic aneurysm].

12 patients underwent resection of a thoraco-abdominal aortic aneurysm. There were 10 men and 2 women, ranging in age from 54-78 years (mean 65). Aortic arteriosclerosis was the primary etiology in 11, and Behcet's disease in the other 1. Most patients (7/12) presented with Type 3 aneurysm, extending from the distal descending thoracic aorta to the distal abdominal aorta; none had aortic dissection. 11 were operated on for symptoms related to the aneurysm: 3 of these had a contained rupture. The risk factors were chronic obstructive pulmonary disease in 10, hypertension (10), diffuse arteriosclerosis (8), ischemic heart disease (6), chronic renal failure (5) and cerebrovascular accident (1). The surgical technique in 11 was graft inclusion and visceral vessel reattachment. The main complication was acute renal failure, seen in 3 patients. None had spinal ischemia. Operative mortality was 33%. Of the 4 who died, 2 had myocardial infarction and 2 uncontrolled intraoperative bleeding. According to the literature the major complications are spinal cord ischemia and renal failure.

Acute Kidney Injury↗
PubMed1990

[Reflex sympathetic dystrophy in children].

Reflex sympathetic dystrophy (RSD) in children is a clinical syndrome characterized by pain in the extremities associated with hyperesthesia and vasomotor changes. The symptoms frequently result in serious impairment in function of the involved extremity. Treatment should be initiated as soon as possible and include intensive physical therapy; analgesics and transcutaneous nerve stimulation can be added as needed. Compared with the adult, childhood RSD is of unknown etiology and has a better prognosis. RSD has attracted little attention in clinical pediatric practice and in pediatric textbooks and the literature, so the diagnosis may be missed. We report 2 girls with RSD, aged 12 and 15 years, respectively, who were successfully treated with conservative measures; both recovered, with no sequelae.

Adolescent↗
PubMedDate not supplied

Multiple tumor emboli after lung resection.

A patient with carcinoma of the lung underwent a left lower lobectomy. For technical difficulties the pulmonary vein was not ligated prior to extensive manipulations of the involved lobe. Following the pulmonary surgery the patient sustained a massive aortic occlusion by a tumor embolus, that was removed by bilateral femoral embolectomies. Three additional documented episodes of peripheral arterial emboli subsequently took place, two of which were tumoral. One tumor embolus into the carotid artery territory eventually caused metastatic spread in the brain. All peripheral emboli were successfully treated by embolectomy. This unique display of multiple tumor emboli, following lung resection for carcinoma, reemphasises the significance of early interruption of the pulmonary vein, in an attempt to reduce the incidence of tumor emboli.

Brain Neoplasms↗
PubMed1989

Errors and pitfalls in intraarterial thrombolytic therapy.

Sixty complications occurred during 138 courses of intraarterial thrombolytic therapy in 122 patients during a 5-year period. These complications were recorded and analyzed prospectively to identify underlying errors in management. There were 31 bleeding episodes, 15 vascular complications, and 14 other complications. Twelve of the bleeding episodes occurred at the puncture site, and 19 occurred at remote sites, accounting for six of the eight deaths in the series. Management errors were clearly identified in 27 of the 60 complications. The three following patterns of errors were recognized: (1) mismanagement of bleeding (12 instances), (2) wrong patient selection (nine instances), and (3) breach of the administration protocol (six instances). The group of 27 complications with underlying management errors included seven of the eight deaths in the present series. Efforts to prevent complications from thrombolytic therapy should concentrate on the specific patterns of management errors identified. This study indicates that low-dose intraarterial thrombolytic therapy is not a low-risk alternative to surgical intervention but should be viewed as a prelude or possible alternative to surgery in selected patients despite the risks involved.

Adolescent↗
PubMedDate not supplied

Complications of saphenous vein harvesting following coronary artery bypass surgery.

Saphenous vein harvesting, though a relatively minor part of the coronary artery bypass operation, can cause complications that may dominate the early and late postoperative course. We describe three groups of complications that are usually given little attention in the literature: complication of vein harvesting in ischemic legs, recurrent cellulitis in vein donor legs, and saphenous neuropathy.

Adult↗
PubMed1989

Behcet disease: long-term follow-up of three children and review of the literature.

Behcet disease is rare in children. There are only two reports of Behcet disease in childhood, describing seven patients. Three pediatric patients are described, in whom the age of onset ranged from 6 to 11 years. Aphthous stomatitis and arthritis were present in all of the patients; genital ulcers, iridocylitis, erythema nodosum, and CNS involvement were present in two patients. Other manifestations included Stevens-Johnson-like eruption, fever of unknown origin, and testicular involvement. All of the patients responded to glucocorticoids; two were also treated with colchicine and one was treated with chlorambucil. In two patients, follow-up of more than 10 years was done, with complete cure in one patient and benign course of illness in the other. Because of the rarity of the disease in childhood and the difficulty in making the diagnosis, there is not enough awareness by pediatricians concerning this disease.

Behcet Syndrome↗
PubMedDate not supplied

Scoring of vascular disease in the lower extremities.

Lack of standardisation in reporting the vascular status of patients leads to difficulties in comparing different series. A method of vascular scoring is presented, integrating symptoms, physical examination, vascular laboratory studies and arteriography. The score is expressed in a concise form by several letters and numbers supplying the relevant information as to the main segment involved, the severity of the ischaemia and the completeness of the examination. The files of 100 candidates for vascular surgery were recorded with the scoring method. Vascular indices were calculated by dividing the sum of points assigned to each item by the maximal available score. The internal consistency of the method was evaluated by computing separate indices for the three components of the scoring--clinical examination (CE), vascular laboratory (VL) and arteriography (AR)--and comparing them with the overall index and with each other. Correlation coefficients with the overall index were for CE 0.90, for VL 0.92 and for AR 0.75. The data on the 200 limbs were reviewed independently by three experienced vascular surgeons and ranked in order of increasing severity of ischaemia; the correlation coefficient between this ranking and one based solely on the scoring method was 0.91. A vascular scoring method may help create a mutual language among practitioners, enabling them to compare results and benefit from accumulating worldwide experience.

Adult↗
PubMed1989

[Carotid endarterectomy].

Carotid endarterectomy was performed 77 times in 73 symptomatic patients. In 67 of them there had been 1 or more transient ischemic attacks (TIA), in 4 transient atypical symptoms, and in 2 mild persistent neurological deficits. After operation 1 died of a stroke and 1 had a nonfatal myocardial infarction. In 3.3% of 33 low-risk patients (Sundt's classes 1 and 2) there was mild postoperative neurological deficit. The rate of neurological complications was much higher in 40 high-risk patients (classes 2 and 3), including 5 with postoperative stroke. Followup averaged 21.5 months (longest 54 months), the 5-year survival (by extrapolation from a life table analysis curve) was 87%, and there was only 1 fatal stroke. Those who recovered from operation without complications had an 86% chance of having no further neurological problems.

Carotid Arteries↗
PubMed1989

[Occlusive arterial disease after radiation].

A 50-year-old man was treated for occlusion of the superficial femoral artery which had developed 6 years after X-ray therapy to the thigh for a malignant tumor. Occlusive arterial disease is more common after doses of more than 4000 rad and appears more frequently within the first 10 years after doses of 5000 rad or more. Clinical and experimental data suggest that X-radiation predisposes to atherosclerotic change by causing endothelial damage. The clinical approach to symptomatic occlusive disease of arteries that traverse irradiated fields is similar to treatment of other atherosclerotic lesions, except that in some instances an extra-anatomic route should be considered if bypass is required.

Arterial Occlusive Diseases↗
PubMed1989

[Thyroid function disturbances in an infant following maternal topical use of polydine].

A male infant who had symptoms of transient sinus tachycardia and increased concentrations of blood total and free T4 is reported. The mother had used Polydine (P; povidone iodine) for vaginal douching during pregnancy and during the first few weeks after delivery, during which time the infant was fed mother's milk only. Follow-up showed transient elevation of TSH levels in the infant, but with no signs of hypothyroidism. 2 months after the mother stopped using P, the infant's functions had become normal. P should not be used in the perinatal period.

Breast Feeding↗
PubMed1986

Percutaneous transluminal angioplasty. A suggested method for analysis of clinical, arteriographic, and hemodynamic factors affecting the results of treatment.

Sixty-nine percutaneous transluminal angioplasties (PTAs) were performed in the iliac and the femoral arteries of 54 patients. The main factors that might affect the results were reviewed: associated diseases, severity of ischemic symptoms, location and type of lesions (stenosis or occlusion and their length), and presence of disease distal to the site dilated. The vascular status of the patients in our series was more severe than in most others. Improvement at follow-up (average 15 months) was maintained in 74% of 66 radiographically successful PTAs. Poor runoff was the only factor found to affect the outcome deleteriously. Intra-arterial pressure measurements performed during the procedure and vascular laboratory studies were most valuable in assessing immediate and long-term results. Wide variations in results of PTA published in the literature are due to differences in methods of selection, evaluation, and reporting. A plea is made for future presentations of PTA series in an analyzable and comparable way, including and correlating all relevant variables as in the model suggested by the present study.

Adult↗
PubMed1977

Mesenteric lymphadenitis due to Yersinia pseudotuberculosis.

A case of mesenteric lymphadenitis caused by Yersinia pseudotuberculosis is described in a young adult. The diagnosis was suggested by the histological appearance of the lymph nodes, and confirmed by serological tests. This is the first report of mesenteric lymphadenitis due to Y. pseudotuberculosis in Israel.

Adult↗