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Biomedical subjects

A Z Najem

Publications and source records attributed to A Z Najem.

6 recordsLinked to original sources
PubMed1989

The Muir-Torre syndrome: a disease of sebaceous and colonic neoplasms.

The Muir-Torre syndrome of sebaceous neoplasms of the skin, with or without keratoacanthomas, and multiple low-grade visceral malignancies with prolonged survival is a rare disorder. Colonic polyps are frequently present, and the syndrome appears to be familial. We report 2 unrelated patients with the Muir-Torre syndrome. Each case exhibited sebaceous adenomas. Gastrointestinal findings included colonic adenocarcinomas and a tubulovillous adenoma. Although an unusual disease, the Muir-Torre syndrome requires recognition because these patients are at risk for multiple primary malignancies and may have family members also at risk.

Adenocarcinoma↗
PubMed1988

Comparative study of cefotetan and cefoxitin in the treatment of intra-abdominal infections.

One hundred eighty-eight patients were enrolled in a multicenter, randomized clinical trial to compare the safety and effectiveness of 1 to 2 gm cefotetan every 12 hours with those of 1 to 2 gm cefoxitin every 6 hours in patients with intra-abdominal infections. Most of the infections were community acquired, were associated with gastrointestinal tract perforation, and were caused by both anaerobic and aerobic bacteria. The median duration of therapy was 6 days for each group. The clinical response rate for the 95 evaluable patients in the cefotetan group was 98%, and that for the 43 evaluable patients in the cefoxitin group was 95%. Bacteriologically, 97% of the 58 evaluable patients in the cefotetan group and 89% of the 27 evaluable patients in the cefoxitin group had a satisfactory or presumed satisfactory response; two patients in the cefotetan group and three in the cefoxitin group were considered bacteriologic failures. Cefotetan was as effective as cefoxitin in eradicating Bacteroides fragilis and other species of Bacteroides, Clostridium sp., and gram-negative bacilli. The incidence of treatment-related adverse reactions for cefotetan (27%) was not statistically different from that for cefoxitin (17%). No clinically significant differences were detected between the treatment groups in changes in the results of clinical laboratory tests performed before and after treatment; a decrease in hematocrit among the cefotetan group was statistically greater (p = 0.04) than that for the cefoxitin group, and a decrease in serum creatinine level for the cefoxitin group was greater than that for the cefotetan group (p = 0.02). Cefotetan may represent an effective, safe, and cost-saving alternative to cefoxitin for the prompt treatment of community-acquired intra-abdominal infections.

Abdomen↗
PubMed1986

Current attitudes in the management of obstructive biliary tract disease.

The current attitudes of surgeons towards the management of obstructive biliary tract disease were assessed by analyzing the responses of general surgeons to a 20-item questionnaire. The responses indicate that ultrasound is the most favored initial diagnostic test for suspected choledocolithiasis. Ninety-nine per cent of the respondents always or almost always insert a T-tube following exploration of the common bile duct for stones. For patients with stone impacted at the ampulla of Vater, sphincterotomy with or without sphincteroplasty is recommended by 86 per cent of surgeons. However, differences are noted in the approach to management of malignant lesions in the biliary tract. For carcinoma of the head of the pancreas, at laparotomy, if the lesion is resectable, 59 per cent of the surgeons will perform a Whipple procedure, nine per cent a total pancreatectomy, and 28 per cent recommend bypass only. For unresectable carcinoma of the head of the pancreas, 73 per cent perform cholecystojejunostomy, and 26 per cent prefer choledocojejunostomy. In addition to the biliary bypass, only 57 per cent perform a gastric bypass routinely. The favored treatment (62%) for unresectable common bile duct tumors is an internal bypass. However, following bypass, only 45 per cent recommend further treatment with radiation and/or chemotherapy. Therefore, it appears that there is agreement on the treatment of biliary obstruction due to stones. Differences are noted, however, in the approach to the management of malignant disease.

Attitude of Health Personnel↗
PubMed1978

Pyogenic liver abscess.

A review of 20 cases of pyogenic liver abscesses seen from 1971 through 1976 is presented. In this five-year interval, no amebic liver abscesses were found. The primary inflammatory processes were evenly divided among those patients with biliary, urinary, and intraperitoneal disease. Intensive antibiotic therapy was less efficient in sterilizing the abscess than the blood stream. The nebulous histories, clinical findings, and routine laboratory studies emphasize the difficulty in establishing an early diagnosis of liver abscess. Radioisotopic scanning of the liver proved to be the most reliable tool not only for the diagnosis but also for monitoring the postoperative course of the drained cavities. The overall mortality of pyogenic liver abscesses was 45% and the greatest mortality occurred in those patients over 40. Closed needle aspiration of pyogenic liver abscess in the elderly poor-risk patient in conjunction with the appropriate antibiotics may offer an acceptable alternative.

Adolescent↗
PubMed1977

Colon and rectal carcinoma: clinical experience.

A 10 year clinical review of 220 patients treated for colorectal carcinoma is reported. Weight loss, abdominal pain and rectal bleeding were the leading signs and symptoms, occurring in 48.6%, 45.5%, and 42.7%, respectively. Patients treated in this series had more advanced disease, with a resectability for cure of only 37.7%. However, the overall five-year survival of 29.3% compared favorably with several other institutional reports. Earlier diagnosis and prompt treatment remain the major factors influencing ultimate survival.

Adult↗