Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
Add more filters










Publication year range
1.
Mar Pollut Bull ; 151: 110699, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31780087

ABSTRACT

Bio-accumulation of persistent organic pollutants including polychlorinated biphenyls (PCBs), brominated flame retardants and organochlorine pesticides continue to be of major concern for marine apex predators such as killer whales. The concentrations of 16 polychlorinated biphenyls, 7 poly-brominated diphenyl ethers (PBDEs), 1 poly-brominated biphenyl (PBB) and a range of 19 organochlorine compounds (OCs) was investigated in blubber samples from a mother-foetus pair, an adult female and an adult male killer whale stranded in Ireland between 2010 and 2017. Concentrations ranged from 1.5 mg/kg to 49.3 mg/kg lipid weight and 0.04-1.2 mg/kg lipid weight for Σ16PCBs and Σ7PBDEs respectively. Concentrations of organochlorine compounds were also investigated in the male killer whale; a Σ19OC concentration of 49.4 mg/kg lipid weight was recorded. This study shows high levels of persistent organic pollutants occur in this species of whales stranded in Ireland.


Subject(s)
Environmental Monitoring , Water Pollutants, Chemical/metabolism , Whale, Killer/metabolism , Animals , Female , Fetus , Halogenated Diphenyl Ethers/metabolism , Ireland , Male , Polychlorinated Biphenyls/metabolism
2.
J Emerg Med ; 43(1): e1-3, 2012 Jul.
Article in English | MEDLINE | ID: mdl-19682826

ABSTRACT

BACKGROUND: Considerable controversy exists with regards to the physiopathogenesis of catamenial pneumothorax. The rarity of catamenial pneumothorax makes understanding of its pathophysiology and verification of etiological mechanisms difficult. OBJECTIVE: To contribute evidence to the knowledge base on the pathogenesis of catamenial pneumothorax. CASE REPORT: We describe a case of catamenial pneumothorax with images that substantiate the pore hypothesis as a cause of recurrence of air in the pleural cavity in this patient. CONCLUSION: Our case report contributes evidence that transperitoneal migration of endometrial implants may occur through diaphragmatic fenestrations. Surgical options may be more viable to prevent recurrent pneumothoraces in such patients.


Subject(s)
Diaphragm/pathology , Endometriosis/pathology , Pneumothorax/etiology , Adult , Diaphragm/surgery , Endometriosis/complications , Endometriosis/surgery , Female , Humans , Pneumothorax/surgery , Recurrence
3.
Eur J Cardiothorac Surg ; 39(6): 1047-50, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21041100

ABSTRACT

OBJECTIVE: Operating in a day surgery unit has potential benefits, including lower risk of cancellation, reduced infection rates, cost effectiveness and increased patient satisfaction. We believe that we are the first unit in the UK to regularly perform thoracic surgery in a dedicated day surgery unit, and describe our experience to date. METHODS: Data were collected prospectively from 1 September 2007 to 31 December 2009. Following surgery, patients were observed in a recovery area for 1h before transfer back to a short-stay ward. When chest drains were used, they were attached to an ambulatory drainage device for the patient to be discharged with. All patients were reviewed postoperatively, and were discharged home within 4-6h if appropriate. RESULTS: Ninety-eight patients underwent thoracic surgery in our day surgery unit. Sixty (61.2%) patients were male. The mean age was 53.0 (17-83) years. There were no deaths. Twenty-nine (29.6%) were mediastinal procedures (MED group) such as mediastinoscopy/otomy, 31 (31.6%) were video-assisted thoracoscopic surgery (VATS group) procedures such as lung biopsies and pleurodeses and 38 (38.8%) were a variety of other (OTHER group) procedures such as chest wall interventions and sternal wire removal. Out of the cohort, three (3.1%) patients required admission directly from the day surgery unit, and three (3.1%) were admitted late after discharge with problems relating to their surgery. Our Day Surgery Programme accounted for 12.0% of the total thoracic workload during the time period. CONCLUSIONS: Surgeons are continually trying to fast track increasingly complex procedures and, with good patient selection, thoracic surgery can be performed safely and effectively in day surgery units.


Subject(s)
Ambulatory Surgical Procedures/methods , Hospital Units/organization & administration , Thoracic Surgical Procedures/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Health Services Research/methods , Humans , London , Male , Mediastinoscopy/methods , Middle Aged , Patient Admission/statistics & numerical data , Patient Selection , Prospective Studies , Thoracic Surgery, Video-Assisted/methods , Young Adult
4.
Gen Thorac Cardiovasc Surg ; 58(11): 595-7, 2010 Nov.
Article in English | MEDLINE | ID: mdl-21069502

ABSTRACT

The use of talc for inducing chemical sclerosis in the pleural cavity dates back to 1935. Insufflation (also known as talc poudrage) and instillation have been the techniques used for administering talc. We describe a surgical technique to insufflate talc in the pleural cavity using an ingenious method at no additional cost that ensures effective, widespread talc dispersion and good results.


Subject(s)
Pleural Effusion/therapy , Pleurodesis/methods , Pneumothorax/therapy , Talc/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , London , Male , Middle Aged , Recurrence , Respiration, Artificial , Thoracic Surgery, Video-Assisted , Young Adult
5.
Ann Thorac Surg ; 88(5): 1674-6, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19853136

ABSTRACT

Pulmonary vein stenosis is a known complication of radiofrequency ablation; its incidence ranges from 8% to 50%. However, complete occlusion of unilateral pulmonary veins is uncommon. We report a case with radiofrequency ablation that was complicated by complete occlusion of pulmonary veins along with fibrosing mediastinitis, which we believe has not been previously reported.


Subject(s)
Catheter Ablation/adverse effects , Mediastinitis/etiology , Mediastinitis/pathology , Pulmonary Veno-Occlusive Disease/etiology , Adult , Fibrosis , Humans , Male
6.
Interact Cardiovasc Thorac Surg ; 9(1): 132-3, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19346223

ABSTRACT

We describe a case of posttraumatic diaphragmatic laceration with unusual late sequelae of presentation. Ventilatory and gastrointestinal compromises are known complications of such herniae; but delayed cardiac tamponade without an intrapericardial component of such a hernia has not been reported so far.


Subject(s)
Accidents, Traffic , Cardiac Tamponade/etiology , Hernia, Diaphragmatic, Traumatic/complications , Cardiac Tamponade/surgery , Decompression, Surgical , Fatal Outcome , Gastrectomy , Hernia, Diaphragmatic, Traumatic/diagnostic imaging , Hernia, Diaphragmatic, Traumatic/surgery , Humans , Jejunostomy , Male , Middle Aged , Thoracotomy , Time Factors , Tomography, X-Ray Computed
7.
J Thorac Cardiovasc Surg ; 134(2): 335-41, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17662770

ABSTRACT

OBJECTIVES: Endothelial dysfunction and C-reactive protein play a pivotal role in development of atherosclerosis and act as markers for future adverse cardiac events. Statins reduce C-reactive protein levels and improve endothelial function. However, little information is available on endothelial function and its determinants in veins. We investigated the association between saphenous vein endothelial function and C-reactive protein levels in patients treated with statins undergoing coronary artery bypass surgery. METHODS: Seventy-six patients with optimal low-density lipoprotein cholesterol levels (< or =1.6 mmol/L) secondary to regular treatment with a minimum of simvastatin 40 mg were recruited. Each subject underwent detailed characterization according to anthropomorphic data, saphenous vein endothelial function (assessed ex vivo by measuring acetylcholine-induced relaxation of venous rings), and markers of systemic inflammation (C-reactive protein and tumor necrosis factor-alpha). RESULTS: Despite regular treatment with statins, 26% of patients had C-reactive protein levels in the "high-risk" range (>3.0 mg/L). There was a negative linear correlation between acetylcholine-induced venous relaxation and C-reactive protein (r = -.30, P = .02) and waist circumference (r = -0.21, P = .03). In a multivariate regression model, C-reactive protein (P = .02) was the only independent predictor of acetylcholine-induced venous relaxation. In turn, correlates of C-reactive protein were assessed. There was a correlation between C-reactive protein and coronary atherosclerotic burden (r = .46, P < .0001), body mass index (r = .26, P = .03), fasting glucose levels (r = .31, P = .01), and waist circumference (r = .29, P = .01). Using multivariate analysis, coronary atherosclerotic burden (P < .0001) was the only independent predictor of C-reactive protein. CONCLUSIONS: In our cohort of patients with coronary artery disease, C-reactive protein level was the only independent predictor of saphenous vein endothelial function. In turn, its levels were independently influenced by the extent of coronary atherosclerotic burden.


Subject(s)
C-Reactive Protein/analysis , Coronary Artery Bypass , Coronary Disease/surgery , Endothelium, Vascular/drug effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Saphenous Vein/transplantation , Simvastatin/therapeutic use , Vascular Patency , Aged , Biomarkers/blood , Coronary Disease/blood , Endothelium, Vascular/physiopathology , Female , Humans , Inflammation/blood , Male , Predictive Value of Tests , Regression Analysis , Risk Factors , Saphenous Vein/drug effects , Saphenous Vein/physiopathology
8.
J Heart Valve Dis ; 15(5): 716-8, 2006 Sep.
Article in English | MEDLINE | ID: mdl-17044380

ABSTRACT

Hemostatic physiology involves a complex interlinking of blood and endothelial factors. Its pharmacological manipulation invariably impacts at multiple molecular sites. Herein is reported an unusual case of coexistent warfarin-induced skin necrosis and heparin-induced thrombocytopenia following mitral valve replacement for thromboembolic phenomena associated with marantic endocarditis and bronchial adenocarcinoma. Thrombophilia in the face of endocarditis should be treated with a suspicion of underlying cancer.


Subject(s)
Anticoagulants/adverse effects , Endocarditis/surgery , Heart Valve Prosthesis Implantation , Heparin/adverse effects , Mitral Valve/surgery , Skin/pathology , Thrombocytopenia/chemically induced , Warfarin/adverse effects , Adenocarcinoma/complications , Adenocarcinoma/pathology , Bronchial Neoplasms/complications , Bronchial Neoplasms/pathology , Fatal Outcome , Heart Valve Diseases/surgery , Humans , Intracranial Embolism/drug therapy , Intracranial Embolism/etiology , Male , Middle Aged , Necrosis/chemically induced , Postoperative Complications/etiology , Skin/drug effects
10.
Ann Thorac Surg ; 80(5): 1765-72; discussion 1772, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16242453

ABSTRACT

BACKGROUND: Bilateral internal thoracic artery (BITA) bypass grafts have advantages over single internal thoracic artery (SITA) bypass grafts in the medium term, particularly in diabetics. However, the perceived higher sternal complication rates seen in diabetics have led many surgeons to avoid the use of BITA surgery. The aim of our study was to assess the validity of this approach by assessing the incidence of sternal infections over a 10-year period in one institution. METHODS: A retrospective analysis was made of our coronary artery bypass graft (CABG) patients over a 10-year period (7,581 patients). Nine hundred and twenty-two of the patients were diabetics (261 insulin-dependent diabetes mellitus [IDDM]). Of the insulin-dependent diabetics, 166 had SITA, and 95 had BITA grafts. RESULTS: There was no significant difference in this subgroup in terms of gender, preoperative angina, dyspnea class, left ventricular function, and number of distal anastomoses. Comparing the rates of sternal wound complications of SITA and BITA in IDDM are the following: (1) superficial sternal infection, 6.6% in SITA, 1.1% in BITA (p = 0.04); (2) deep sternal infection, 1.2% in SITA, 3.2% in BITA (p = 0.27); (3) sternal dehiscence, 1.2% in SITA, 3.2% in BITA (p = 0.27). CONCLUSIONS: Our data do not support the perception that BITA grafting increases the risk of sternal complications in insulin-dependent diabetic patients.


Subject(s)
Diabetes Complications , Infections/etiology , Mammary Arteries/surgery , Postoperative Complications/epidemiology , Sternum/pathology , Surgical Wound Infection/classification , Aged , Female , Humans , Incidence , Infections/epidemiology , Male , Middle Aged , Postoperative Complications/pathology , Risk Factors
SELECTION OF CITATIONS
SEARCH DETAIL
...