The unsupported arm: a cause of falsely raised blood pressure readings.
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Biomedical subjects
Publications and source records attributed to E Shemesh.
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The efficiency and safety of the 2 most commonly used endoscopic dilators, Savary-Gilliard and pressure balloons, were compared in 2 groups, each including 30 patients, with benign esophageal strictures. Four additional patients with tight and tortuous cervical esophageal strictures were initially managed by balloon dilatation followed by Savary-Gilliard dilatation. These patients could not be dilated by each of the methods alone. Sixty patients [35 males and 25 females with a mean age of 52 years (range, 4-91)] underwent 165 esophageal dilatations. The etiologies of strictures included reflux esophagitis (65%), caustic damage (18.3%), and postoperative (anastomotic, or post-Nissen operation) in 16.7%. Dysphagia improved in all patients; however, 2 patients (1 from each group) with hard postoperative anastomotic stricture eventually underwent surgical resection of stricture. There were no major complications or mortality related to the dilatations. Both methods were highly effective and well tolerated, yet Savary-Gilliard dilators were slightly more effective and simpler to use than balloons. Nevertheless, tortuous cervical strictures and multiple closely-placed strictures were more effectively managed by initial use of balloon followed by Savary dilators.
We present the computed tomographic (CT) findings in two cases of small bowel diverticulitis, one affecting the jejunum and the other a Meckel's diverticulum. The main CT finding was that of a mass with an air-fluid collection in contiguity with small bowel loops.
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We examined a novel hypothesis that links symptoms of MI-related posttraumatic stress disorder (PTSD) to nonadherence. According to this hypothesis, patients who are traumatized by their medical illness do not take their medications as prescribed. As a part of the avoidance dimension of PTSD, patients who are traumatized may avoid being reminded of the MI by not taking the medication. MI survivors were prospectively followed for 6 months to 1 year. Adherence was assessed by pill count of Captopril. Demographic variables, medical risk factors, PTSD, and other psychiatric symptom dimensions were evaluated during follow-up. One hundred two of 140 recruited patients completed follow-up. Nonadherence to Captopril was associated with poor medical outcome (r=.93, P=.006). Above-Threshold PTSD symptoms were associated with nonadherence to medications (P=.05). No other psychiatric symptom dimensions were independently associated with nonadherence. Nonadherence to medications predicts adverse outcome during the first year after an acute MI. Nonadherence is associated with PTSD symptoms, which may either be a marker for or a cause of nonadherence. Treatment of PTSD may prove to be a useful approach for improving adherence.