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Biomedical subjects

E Scapa

Publications and source records attributed to E Scapa.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Groove pancreatitis and adenocarcinoma of the pancreatic head].

A mass within the head of the pancreas causing obstructive jaundice is frequently adenocarcinoma, or infrequently focal pancreatitis. Groove pancreatitis is an inflammation of the head of the pancreas which fills the anatomic space between the head of the pancreas on 1 side and the second part of the duodenum on the other. Obstruction from either cause may cause vomiting, abdominal pain, and loss of weight. It is sometimes impossible to differentiate between the 2 conditions clinically. We present 2 women, aged 41 and 42 years, respectively, with recent onset of diabetes mellitus, obstructive jaundice, abdominal pain and severe loss of weight in whom diagnosis was difficult. In 1 repeated fine needle biopsy directly from the mass did not show adenocarcinoma, but she died of the disease a few months later. The other, in whom malignancy was also suspected, recovered from what was retrospectively diagnosed as groove pancreatitis.

Adenocarcinoma↗
PubMed1993

[Endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy].

In 11 of 82 patients undergoing laparoscopic cholecystectomy, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed. Indications were biliary pancreatitis in 5 and suspected common bile duct (CBD) stones in the other 6 (based on US or liver function tests, or both). The biliary tree was normal in 9 and laparoscopic cholecystectomy was performed. In 8 there was uneventful recovery but in the ninth open surgery was required when the attempted cholecystectomy resulted in uncontrolled cystic artery bleeding. Of the remaining 3 patients, 1 underwent sphincterotomy via ERCP and 3 weeks later, laparoscopic cholecystectomy. In the others, we intended to explore the CBD by laparoscopy, but had to resort to open cholecystectomy due to technical difficulties resulting from unsuspected acute cholecystitis. Based on our short experience, ERCP combined with laparoscopic cholecystectomy seems to be both safe and effective.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

Vaccination against hepatitis B in a general hospital in Israel: antibody level before vaccination and immunogenicity of vaccine.

We offered hepatitis B vaccine (Heptavax B) to 809 of the health care personnel of a 650-bed regional hospital; 290 accepted the offer. Anti-HBs measurement was done by enzyme immunoassay (AUSAB EIA, Abbott, UK) and expressed in mIU/ml. Seroconversion was determined at a level of 2.1 mIU/ml. Of 290 employees 58 (20%) were found positive for hepatitis B antibodies before vaccination. Of the laboratory technicians, 40.9% were found positive for antibodies before vaccination, as were 26.5% of nurses and 10.9% of physicians. Among vaccine recipients 35.8% responded after the first dose, 86.6% after the second and 92.7% after the third. Seventeen workers (7.3%) were nonresponders, of whom 14 received the whole vaccine series. There was no difference in immune responses to the vaccine between men and women. The present study confirms the relatively high prevalence of HBV infection in health care workers. Furthermore, vaccination of employees has been highly effective and well tolerated. The present data, therefore, support the introduction of active vaccination against HBV in health care workers in Israel.

Adult↗
PubMed1993

Miliary Crohn's disease: early or different?

We describe what we take to be the eighth case of miliary Crohn's disease since 1967 with a view to the possibility that miliary Crohn's disease is a disease different from Crohn's disease, and not just an early stage. Miliary Crohn's disease might be a different disease because (a) miliary tubercles are seen so rarely on the serosal surface of the bowel, (b) the 100% chance of finding crowded, typical granulomas in the bowel wall, and (c) the anatomic distribution of the lesion.

Adolescent↗
PubMed1992

[Percutaneous endoscopic gastrostomy].

Although percutaneous endoscopic gastrostomy (PEG) for feeding purposes has been in use for the past 10-12 years, many practitioners are unaware of this option. We describe 10 patients who underwent PEG with only 1 major, but nonfatal, complication. We stress that PEG is indicated for those who cannot swallow, and is safe, easy to perform, and a relatively cheap procedure. It is therefore a useful substitute for surgical gastrostomy.

Adult↗
PubMed1992

Serum B-N-acetyl hexosaminidase levels in rats with experimental acute pancreatitis, small-bowel ischemia, and small-bowel obstruction.

B-N-acetyl hexosaminidase (B-NAH), a lysosomal hydrolase, was measured in the blood of rats with induced acute pancreatitis, massive small-bowel ischemia, and small-bowel closed-loop obstruction. B-NAH was not significantly elevated within 24 h after induction of the above conditions. This suggests that B-NAH is not an acute phase reactant in a severe acute abdominal catastrophe, such as those mentioned above. Some rats showed an extremely high level of B-NAH, and this may imply a fatal prognosis in such animals.

Acute Disease↗
PubMed1992

Colonoscopy in patients aged 80 years or older and its contribution to the evaluation of rectal bleeding.

Colonoscopies performed in patients aged 80 years or older at the Sheba Medical Center were analysed according to the primary indication for the procedure: 101 colonoscopies were performed because of rectal bleeding of at least 2 months duration, and 335 for all other indications. Carcinoma of the large bowel was found in 29 (28.7%) bleeders, with the rectum being the most frequently involved site (12 patients). Among the non-bleeders, the prevalence of cancer was significantly lower (33 cases, 9.8%; P less than 0.001), and rectal carcinoma was less common (five patients, P = 0.04), but proximal tumours were more frequent. Of patients with cancer who had operations, the majority (72%) had a tumour confined to the bowel wall (Dukes A or B). The rate of adenomas was similar for both groups (34% vs 29%). The non-bleeders complained more frequently of abdominal pain or a change in bowel habits as compared to the bleeders, but both groups had similar rates for anaemia and weight loss. In all, 47% of these octogenarians with cancer, and 26% with adenomas were referred for colonoscopy because of rectal bleeding. This procedure was found to be safe in old age, as we recorded only four (0.9%) non-fatal complications among our series, a similar figure to the overall incidence of complications at our Institute. In conclusion, our data indicate that rectal bleeding in octogenarians warrants a complete colonic investigation, preferably by total colonoscopy.

Aged↗
PubMed1992

Helicobacter pylori Before and After Gastric Reduction for Morbid Obesity.

Nine patients with morbid obesity were evaluated for the presence of Helicobacter pylon (Hp) before gastric reduction, and all were negative. Fifteen patients, Including those nine, were evaluated for the presence of Hp in antral and 'channel' region biopsies by culture and urease test after gastric reduction. Hp-negative patients totaled 73.3% by both tests, although chronic superficial gastritis type 'B' was found In eight out of 13 (61.5%), and six out of seven (85.7%) gastritis patients were positive for Holicobacter-like organisms in the hematoxylin- and eosin-stained biopsies. Our data suggest that in stomachs of morbid obesity patients before as well as after gastric reduction procedures, the incidence of Hp is very low, and the reasons for this observation are yet unknown.

Journal Article↗
PubMed1992

Appreciation of pain in the elderly.

Pain was evaluated in 333 duodenal ulcer patients, and 86 myocardial infarction patients by the verbal rating scale method. We compared older patients (greater than 65 years of age) to younger controls and found a highly significant association between old age with mild pain and young age with moderate or severe pain in both diseases. We investigated two totally different diseases and got similar results. Thus, it could be concluded that age itself might be the underlying reason for the association with pain severity and not the character or origin of the pain.

Adult↗
PubMed1991

B-N-acetyl hexosaminidase (B-NAH) serum levels after endotoxin administration into the portal vein in the rat.

Endotoxin was injected directly into the portal vein in rats with and without common bile duct (CBD) ligation. B-N-acetyl hexosaminidase (B-NAH) activity levels in the serum were found to be significantly elevated 24 h later in both groups. Serum bile acid levels were found to be significantly higher in the endotoxin-injected groups of rats compared to controls. Thus, endotoxin, as well as bile acids, may cause damage to Kupffer cell membranes, resulting in accumulation of B-NAH in rat serum.

Animals↗