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Biomedical subjects

A Sternberg

Publications and source records attributed to A Sternberg.

At least 73 records · Page 4Linked to original sources
PubMed1987

Perforation of a benign gastric ulcer into the subdiaphragmatic aorta.

A patient in whom a benign gastric ulcer perforated into the subdiaphragmatic aorta is reported. This is the second such case to be documented and the first to be reported in the English literature. Previous gastroesophageal surgery, regional radiation therapy, ulcerogenic medications, and endocrinopathies seem to be contributing factors to the potential of benign gastric and esophageal ulcers to perforate into the pericardium, left atrium, left ventricle thoracic or abdominal aorta. This complication is almost always lethal. It is concluded that peptic disease in patients with these contributing factors warrants aggressive treatment.

Aged↗
PubMed1986

Contribution of echocardiography to cardiac diagnosis.

In order to quantify information provided by echocardiography for residents in internal medicine and for cardiologists, 150 selected patients were studied by echocardiography, and the ultrasonic diagnosis was compared with the clinical evaluation. Among 144 patients with adequate visualization of the heart, echocardiography provided findings that were totally unexpected to the residents in 13 (9%) and to the cardiologist in 9 (6%) patients. Echocardiography also provided information relevant to the management of the patient in another one-third of the cases. Both the residents and the cardiologist were able to correctly predict the cause of cardiomegaly and the mechanism of heart failure in most patients presenting with these findings. Despite the introduction of cross-sectional echocardiography, the amount of information contributed by echocardiography has not increased since 1978, when a similar study was performed at our institution. This may reflect increased clinical skill among residents, probably due to long-term exposure to echocardiography during their training.

Adolescent↗
PubMed1984

The treatment of primary hyperparathyroidism during pregnancy.

Data on the management of primary hyperparathyroidism during pregnancy are sparse and relatively few parathyroidectomies have been performed during pregnancy. Provided the diagnosis can be established with reasonable certainty, removal of a parathyroid adenoma should be undertaken during the second or at the beginning of the third trimester. Parathyroidectomy in the hands of a surgeon familiar with this operation carries few risks. The complication rate of untreated cases may reach 80 per cent and include spontaneous abortion, fetal death and neonatal tetany. We present two cases of pregnant women who underwent successful parathyroidectomy during the course of gestation.

Adenoma↗
PubMed1984

The pathophysiology of the jejunal conduit syndrome and its exacerbation by parenteral hyperalimentation.

Supravesical urinary diversion using a jejunal conduit may be associated with hyponatremia, hypochloremic-acidosis, hyperkalemia, azotemia, and a clinical picture of nausea, vomiting, dehydration, muscular weakness, elevated temperature, and lethargy. This syndrome is secondary to the loss of sodium chloride into the urine passing through the conduit and absorption of potassium and urea from it. Treatment and prevention of this syndrome consist of adequate supplements of sodium chloride and hydration. Intravenous hyperalimentation as the precipitating factor of a severe form of this syndrome and its successful management are described. The pathophysiology of the jejunal conduit syndrome is also discussed. Great selectivity and extreme caution are recommended with respect to the use of intravenous hyperalimentation in patients with jejunal conduits.

Adenocarcinoma↗
PubMed1984

A combination of 5-fluorouracil and thymidine in advanced colorectal carcinoma.

Concurrent administration of thymidine (TdR) has been shown to increase the antitumor activity of 5-fluorouracil (5-FU) in various experimental models. The clinical response rate, side-effects, and toxicity of 5-FU and TdR were evaluated in 27 patients with advanced colorectal carcinomas. Each 6-day treatment course consisted of an IV loading dose of TdR (405 mg/kg, over 30 min), followed by continuous IV infusions of 5-FU (7.5 mg/kg per day for 5 days), and TdR (216 mg/kg per day for 6 days); courses were repeated every 4 weeks. The overall partial response rate was 4.5%, or 16.7% in patients with no prior 5-FU chemotherapy. Short-lived stable disease was seen at an overall rate of 27.3%, half of these patients with prior 5-FU chemotherapy. Myelotoxicity occurred in 64% of the patients, but this was dose-limiting in only 20%. Gastrointestinal and neurological symptoms were mild and infrequent. There was one case of treatment-related death due to sepsis secondary to leukopenia. It is concluded that the concurrent IV administration of 5-FU and TdR does not improve the response rate over that obtained with 5-FU alone.

Adult↗
PubMed1984

Self-inflicted ocular injuries. A rare form of self-mutilation.

Two unusual patients with chronic, undifferentiated schizophrenia committed acts of ocular self-mutilation. The types of patients who perform acts of self-inflicted ocular injuries are described, with particular emphasis on individuals suffering from post-traumatic stress disorder (PTSD). A discussion of these cases, as well as a review of the literature on the more common forms of self-mutilation, is presented.

Adult↗
PubMed1984

Duodenal diverticula occurring in a family--chance or inheritance?

The incidence, aetiology and possible inheritance of duodenal diverticula remain controversial. These aspects are discussed through the presentation of a family, in which duodenal diverticula occurred in a man and his two sons. To the best of our knowledge, this is the first such family documented in the medical literature. This familial occurrence may be attributed solely to the high incidence of duodenal diverticula in the general population (set by various authors at up to 14.2%), and, therefore, of no hereditary significance at all. We believe a screening study of the families of individuals with proven duodenal diverticula is most desirable, for it could shed light upon the controversial questions of incidence, aetiology, and inheritance patterns of duodenal diverticula.

Aged↗
PubMed1983

One-stage subtotal colectomy with anastomosis for obstructing carcinoma of the left colon.

Fourteen cases of severe obstructing carcinoma of the left colon were treated by emergency subtotal colectomy and ileorectal or ileosigmoid anastomoses. There was one death after two months and a further two septic postoperative complications. Follow-up stretched from two to 39 months (an average 13.7 months). One patient died of a myocardial infarction after 11 months and another of liver metastases after 21 months. Two patients were lost to follow-up at 12 and 25 months, and nine patients remain alive and well, free of disease. The last nine cases were consecutive, and two additional patients with obstruction had only colostomy performed due to their poor conditions. A staged approach to treatment reduces long-term survival as well as inducing a high cumulative mortality and morbidity rate. Colostomy also reduces the quality of life for the elderly patient. Results of this form of treatment are surprisingly good, and it is advocated as the treatment of choice for the vast majority of patients.

Aged↗
PubMed1981

'Malignant' macroscopic appearance of an inflammatory testicular lesion--a reminder for surgeons.

Inflammatory changes in the tunica vaginalis testis may assume a misleading appearance which is highly suggestive of malignancy. Obviously, histological examination is crucial for establishing the corrent diagnosis. This phenomenon has been described in texts dealing specifically with testicular pathology, but is not emphasized in standard text books of urology, surgery or pathology. An illustrative case serves as the basis for discussing this entity, for the purpose of familiarizing it to surgeons, urologists and pathologists who are yet unaware of it.

Adult↗
PubMed1979

Restoration of muscle-pump function in chronic venous insufficiency.

The direct venous pressure profile was recorded before and after treatment in 15 patients suffering from chronic venous insufficiency. Patients were treated conservatively, first by tight elastic support and walking exercises, then by eliminating the points of blood shunting by sclerotherapy of the incompetent perforators. The average venous pressure drop during tiptoeing was increased from 31.6% to 50.9% (P less tan 0.01), and the time required for return to the resting venous pressure level increased from an average 6 seconds to 12.9 seconds (P = 0.01). These values indicate a significant improvement in the functioning of the muscle pump of the calf, and are paralleled by clinical and subjective improvement. Wr recommend this method of treatment in cases of chronic venous insufficiency. We also wish to point out the importance of repeated direct venous pressure profile recording as a means of assessing the effectiveness of treatment in cases of venous disorders.

Bandages↗