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At least 811 records · Page 45Linked to original sources
PubMed1975

[Proceedings: Clinical findings and coronary morphology before and after aorto-coronary venous bypass].

37 patients (mean age 51+/-8 years) were clinically and angiographically investigated before and 11+/-5 months after implantation of an aortocoronary vein graft. The rate of bypass patency was 78%. Postoperatively 57% of the patients were free of symptoms, 35% were improved and 8% unimproved or worse. The reduced incidence of angina pectoris during exercise testing appears to be correlated with graft patency, an improved vascularization index and probably the absence of preoperative myocardial infarction. The systolic time intervals and the lung-ear time at rest are of no value for differentiation of improved and unimproved patients.

Adult↗
PubMed2005

Monitoring for myocardial ischemia.

During the last 20 years, studies using continuous perioperative electrocardiogram (ECG) monitoring in patients at high risk for postoperative cardiac complications have revolutionized our understanding of the pathophysiology, circumstances, timing and possible prevention of perioperative ischemia and postoperative cardiac morbidity and mortality. The present review attempts to provide a comprehensive and practical summary of the current knowledge on perioperative myocardial ischemia. It starts with a description of the conventional definition of myocardial ischemia on exercise stress-testing and continues with a summary of the findings and insights collected from ambulatory Holter monitoring in non-surgical patients with coronary artery disease. It then recaps the variety of studies using perioperative ischemia monitoring to detail the concepts and controversies brought about by this type of monitoring, and tries to portray a general picture of the association of perioperative ischemia and postoperative cardiac complications-including myocardial infarction-and emphasize the importance of postoperative, not just intraoperative, ischemia monitoring.

Electrocardiography↗
PubMed2006

The effect of passive foot flexion on blood circulation in sports and clinical medicine.

UNLABELLED: The aim of the study was to analyze the effect of the passive foot flexion on peripheral and systemic blood circulations in the state of rest of persons adapted to endurance physical loads, and on patients during surgery. METHODS: In the first series of experiments which included 16 males in recumbent supine position adapted to endurance physical loads, the effect of the passive foot flexion by applying a leg muscle activator on the systemic and peripheral blood circulations was analyzed. In the second series of experiments conducted with 6 males and 12 females, the passive foot flexion was aimed at preventing thromboembologenesis during the intraoperative period. RESULTS: After a session of the passive foot flexion applied to persons adapted to endurance physical loads, the venous reserve volume in them increased to 1.68+/-0.3 mL/100 mL (p<0.05). The maximal venous emptying rate increased to 48.3+/-8.8 mL/100 mL/min (p<0.05). After 15 min of the passive foot flexion, the indices of the systemic blood circulation were analogous to the ones before passive foot flexion. The maximal venous emptying rate in the calves of the left and right legs at the end of the surgery decreased to 59.7+/-4.7 mL/100 mL/min (p>0.05) and to 62.9+/-4.0 mL/100 mL/min (p>0.05), respectively. CONCLUSIONS: The passive foot flexion applied to persons adapted to endurance physical loads increases venous reserve volume and maximal venous emptying rate. During the intraoperative period, the passive foot flexion increases maximal venous emptying rate from the triceps muscle of the calf thus decreasing the possible danger of thromboembologenesis.

Adult↗
PubMed1989

A comparison of dipyridamole-thallium imaging and exercise testing in the prediction of postoperative cardiac complications in patients requiring arterial reconstruction.

The individual and combined predictive values of dipyridamole-thallium imaging and exercise testing were compared in a prospective study of 70 patients who had abdominal aortic aneurysms or aortoiliac occlusive disease that required surgical repair. All patients were evaluated clinically by the same cardiologist and had exercise stress testing and dipyridamole-thallium imaging before admission for surgery. Ten patients were excluded from the study because they had evidence of severe ischemia when tested (ST segment depression greater than 2 mm on exercise testing, severe multivessel disease on thallium imaging). The remaining 60 patients were operated on (abdominal aortic aneurysm repair, 40; aortobifemoral repair, 17; femorofemoral graft, 3). The test results were withheld from the surgeon, anesthetist, and cardiologist before surgery. A total of 22 patients experienced major cardiac complications postoperatively (acute pulmonary edema, 17; acute myocardial, infarction, 5; cardiac death, 2). Thallium imaging showed myocardial ischemia in 31/60 patients. Exercise testing was positive (greater than or equal to 1 mm ST segment depression) in 10/60 patients. Dipyridamole-thallium imaging with a high sensitivity and reasonable specificity is the initial test of choice. Exercise testing is a poor screening test because of its low sensitivity. The combination of the two tests gives the highest positive predictive value and the greatest likelihood ratio. Thus patients assessed initially and found to have positive thallium scan results may be further stratified by exercise testing.

Adult↗
PubMed1982

[Harrington's surgical treatment of scoliosis].

In spite of intensive conservative treatment of scoliosis operation is almost necessary. Indication for operation is given by progression of scoliosis by angles over 50 degrees. In our hospital the method according to Harrington combined with the Cotrel transverse compression device is carried out. We report on our experiences over 13 years. Complications were exactly put to record.

Adolescent↗
PubMed1994

[Exercise therapy].

Explore the source record for details and available documents.

Exercise Therapy↗
PubMed1996

[Coronary assessment and surgery for aortic aneurysm: a pragmatic attitude].

High prevalence of coronary artery disease in patients with AAA leads to a high rate of peri-operative cardiac complications. Coronary insufficiency is thus the cause of 40 to 60% of post-operative deaths after aortic surgery. Demonstration of coronary insufficiency depends on the clinical history, electrocardiographic evidence, non-invasive examinations and coronarography. Diagnosis is based on non-invasive tests, and of primary importance exercise tests, which have a high sensitivity. Specificity for predicting post-operative cardiac complications remains low but can be improved by combining with other tests (for example exercise test and Holter recording) or with other clinical parameters. Coronarography provides a precise map of the coronary status but gives little information on functional impairment of encountered lesions. Finally, besides the cost and a certain degree of morbidity, coronarography increases the number of indications for revascularizations with the inconvenience of its intrinsic mortality and also retards the operation increasing the risk of rupture. The evaluation of cardiac risk before surgery must be based on correct use of non-invasive tests, limiting coronarography to cases with frankly positive tests.

Aged↗
PubMed2003

Outcome of surgical treatment of medial tibial stress syndrome.

BACKGROUND: Medial tibial stress syndrome is a common chronic sports injury characterized by exercise-induced pain along the posteromedial border of the tibia. The reported outcomes of surgical treatment of this condition have varied. METHODS: Of seventy-eight patients who underwent surgery for medial tibial stress syndrome, forty-six (thirty-one men and fifteen women) returned for follow-up. The outcomes of the surgery were determined by comparing preoperative and postoperative pain levels as indicated on a visual analog pain scale and ascertaining the ability of the athletes to return to presymptom levels of exercise. RESULTS: The mean duration of postoperative follow-up was thirty months (range, six to sixty-three months). Surgery significantly reduced pain levels (p < 0.001) by an average of 72% as indicated on the visual analog pain scale. An excellent result was achieved in 35% of the limbs; a good result, in 34%; a fair result, in 22%; and a poor result, in 9%. Despite the success with regard to pain reduction, for a variety of reasons only nineteen (41%) of the athletes fully returned to their presymptom sports activity. CONCLUSIONS: Surgery can significantly reduce the pain associated with medial tibial stress syndrome. Despite this reduction in pain, athletes should be counseled that a full uninhibited return to sports is not always achieved.

Adolescent↗
PubMed2000

Lung volume reduction surgery for the treatment of severe emphysema: a study in a single Canadian institution.

OBJECTIVE: To evaluate lung volume reduction surgery (LVRS) and its effectiveness in improving pulmonary function, exercise capacity and quality of life in a population of emphysema patients referred to and screened in a single centre. DESIGN: A prospective case series. SETTING: A Canadian tertiary care hospital. PATIENTS: Patients with severe emphysema, significant dyspnea and impaired exercise capacity interfering with quality of life. INTERVENTIONS: Bilateral LVRS was performed through a median sternotomy. MAIN OUTCOME MEASURES: Pulmonary function tests (preoperative forced expiratory volume in the first second [FEV1], residual volume [RV]), 6-minute walk (6 MW) distance, quality of life (Medical Outcomes Study 36-item short-form health survey) and degree of dyspnea (Medical Research Council of Great Britain dyspnea scale and the baseline and transitional dyspnea indices) were assessed before LVRS and at 6 and 12 months after. RESULTS: Fifty-seven patients were assessed for LVRS, of whom 10 were selected for surgery. Homogeneous distribution of disease was the most common reason for exclusion. Of the 10 patients operated upon, 1 died of acute cor pulmonale on the fourth postoperative day and 1 died of recurrent exacerbations of chronic obstructive pulmonary disease and chronic respiratory failure at 315 days postoperatively. In the surviving patients, the mean preoperative FEV1 increased from 0.70 L before surgery to 0.90 L at 1 year, with a mean relative increase of 33.4%. The mean RV decreased from 5.57 L to 4.10 L, with a mean relative decrease of 27.6%. The 6 MW distance increased from 302.7 m to 356.9 m at 1 year, with a mean relative increase of 21.6%. Quality of life and degree of dyspnea were improved significantly at 1 year after LVRS. Of the 5 patients on oxygen at home before surgery, 4 were able to reduce their requirements but not to discontinue oxygen. CONCLUSIONS: LVRS is an effective palliative treatment for dyspnea and poor exercise tolerance in highly selected patients. Although the duration of palliation is unknown, our results show that improvements in pulmonary function, exercise, quality of life and degree of dyspnea are preserved over the first year. Only a minority of the patients screened were eligible for surgery. The 2 deaths in our series emphasize the need for even further delineation of selection criteria.

Aged↗