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Biomedical subjects

I Segal

Publications and source records attributed to I Segal.

At least 91 records · Page 5Linked to original sources
PubMed1989

The distributional pattern of diverticular disease.

In Western communities diverticular disease occurs mainly in the sigmoid colon. This contrasts with Oriental populations, in which diverticula occur mainly in the right colon. Diverticular disease has recently emerged in black South Africans. This study shows that diverticula in this population occurs predominantly in the descending colon. The variable anatomic distribution of diverticula in different ethnic groups implies that fiber deficiency is not the only factor responsible for this condition. It is suggested that diverticular disease may comprise several entities with different causes.

Adult↗
PubMed1989

The prolonged course of gastrointestinal tuberculosis.

Review of biopsy specimens showed that a patient incorrectly diagnosed 7 years ago as having Crohn's disease actually had histologically proven gastrointestinal tuberculosis of 7 years' duration. It is significant that gastrointestinal tuberculosis and Crohn's disease can mimic each other not only in their clinical, radiologic, and histologic manifestations but also temporally. We discuss the interrelationship between AIDS, tuberculosis, and inflammatory bowel disease.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Appendicitis in Soweto, South Africa: traditional healers and hospitalization.

Appendicitis is near absent in rural blacks in Africa, and even in urban areas it remains very uncommon. Since the disease is new, and, moreover, potentially dangerous, a study was made of the antecedent history of 97 patients with proven appendicitis. Information was acquired concerning visits, and treatments and history, of (1) 34 patients who went first to traditional healers, and (2) 63 patients who sought orthodox medical attention. Of healers' treatments, none was beneficial; patients were ultimately directed, or decided to go to the hospital. Throughout Africa, traditional healers are held in high esteem and very extensively patronized. Accordingly, in both rural and in urban areas, concerted endeavours must be made by health authorities to promote recognition by healers of those diseases, acute or malignant, for which patients should be told to seek immediate medical attention.

Adolescent↗
PubMed1989

Prevalence of gallstones in elderly black women in Soweto, Johannesburg, as assessed by ultrasound.

In Western populations, about a third of elderly women have gallstones, as assessed from ultrasonography. In South Africa, cholelithiasis is reported to be increasing in urban blacks. Their recent dietary changes include a rise in fat and a fall in dietary fiber intake. To assess the current situation, we have carried out ultrasonography studies on 100 urban black women, 55-85 yr old, with no clinical evidence of gastrointestinal disease, especially with reference to the biliary system. Ten patients (10%) were positive. There was no association with parity. Their body mass index (27.8 +/- 6.9) was significantly higher (P less than 0.05) than those who were negative (25.7 +/- 6.1). From dietary intake assessments, there were no significant differences between those positive and negative with respect to mean intakes of energy, protein, fat, carbohydrate, dietary fiber or sugar (p greater than 0.05). Continuing exposure to a western lifestyle would be expected to increase prevalences of gallstones.

Black or African American↗
PubMed1988

The genesis of chronic pancreatitis in the South African black population.

Pancreatitis was previously an unknown disease among black South Africans but has recently emerged as a common clinical problem. This has taken place pari passu with a change in the pattern of alcoholic consumption--Western-type spirits in addition to home-brews. Seventy patients with chronic alcoholic pancreatitis manifesting as clinically acute pancreatitis, and 90 patients with chronic calcific pancreatitis were studied. A high alcohol intake was associated with the pancreatitis in all cases. The prognosis in clinically acute pancreatitis was good, whereas chronic calcific pancreatitis has a high morbidity and mortality rate.

Acute Disease↗
PubMed1988

The geography of chronic digestive disease in southern Africa.

Lifestyle and dietary patterns are in the process of rapid transformation in Soweto. Comparisons with whites indicate differences in bowel behaviour, lactase deficiency and breath methanes. The association between smoking pipe tobacco and cancer of the oesophagus is confirmed, but home-brew consumption has been found to be the major risk factor in this cancer. A recent swing to Western-type alcohol has led to the emergence of alcohol-induced pancreatitis in blacks. Urbanisation and westernisation have also affected the influence of the traditional healer and the incidence of duodenal ulcer disease. The fundamental environmental influence which determines non-infective large-bowel disease is diet. A dietary survey of Sowetans indicates that their present diet is low in fat and fibre. Despite the latter, appendicitis is still relatively uncommon. Other significant differences are observed in colorectal cancer and diverticular disease.

Black or African American↗
PubMed1988

Colorectal cancer. Some aspects of epidemiology, risk factors, treatment, screening and survival.

In developed populations colorectal cancer, which after lung cancer is the commonest of cancers, accounts for up to 6% of all deaths. It occurs most frequently in populations in prosperous industrialised countries, save Japan, and is rare in Third-World populations pursuing a traditional lifestyle. Peak occurrence is in the 7th decade. Colon cancer affects the sexes equally, but males are much more prone to rectal cancer. The precise causation is uncertain. Risk factors include genetic or familial predisposition, inflammatory bowel disease, diet (especially high fat and low dietary fibre intakes), and possibly alcohol intake. Surgery remains the treatment of choice. Stage is by far the most important factor influencing prognosis. Major refinements in both surgical and therapeutic measures have had disappointingly little effect on survival time. Overall median mortality occurs in 1-1 1/2 years; only one-third to one-half of patients survive for 5 years. While effective screening for very early detection could increase survival time, this will result only from further education. Since little avoiding action is practicable, the outlook for patients will remain daunting until help is sought far earlier.

Adult↗
PubMed1988

Ulcerative colitis in a developing country of Africa: the Baragwanath experience of the first 46 patients.

Ulcerative colitis is reported to be rare in black populations of sub-Saharan Africa. This series of the first 46 patients treated at Baragwanath Hospital, Soweto, indicates that most patients (72%) presented with severe symptoms and extensive colonic involvement. There is a paradox of severe extensive disease yet relative lack of complications requiring surgery. This is probably due to the modification of the natural history of the disease through medical treatment, particularly corticosteroid therapy. There is a long delay between onset of symptoms and diagnosis (3 years). Ulcerative colitis affects mainly women. The mean age of presentation is 36 years. Patients are urbanized and most belong to the upper educational group while a significant proportion are in the higher occupational categories. Follow-up is poor with only one third of patients regularly attending the out-patients department once the disease is controlled.

Adult↗
PubMed1988

Factors associated with oesophageal cancer in Soweto, South Africa.

Cancer of the oesophagus was a rare disease in the South African black population until the last few decades. Increases in incidence have occurred and at present it is the commonest cancer in black men in many parts of South Africa. A case-control study of 200 oesophageal cancer patients and 391 hospital controls has been carried out in order to determine the risk factors in the urban black population of Soweto. The results indicate that the cancer patients were long-term urban residents from a very low socio-economic group. The association between smoking pipe tobacco and oesophageal cancer previously noted in South Africa is confirmed. In addition, consumption of traditional beer was found to be a major risk factor.

Adult↗
PubMed1988

Quantitation of autoantibodies to cytokeratins in sera from patients with squamous cell carcinoma of the oesophagus.

Sera drawn from healthy individuals, patients with squamous cell carcinoma (SCC) of the oesophagus and patients with mild active oesophagitis were examined for autoantibodies to cytoskeletal proteins extracted from the normal oesophageal keratinocyte or from 2 carcinoma cell lines, each of the latter have a simple cytoskeleton. Using a radioimmunoassay with normal oesophageal cytokeratins as bound antigen, 86 normal, 76 SCC and 14 oesophagitis sera were compared. No significant difference in autoantibody titre was found. When the bound antigen was changed to one containing predominantly simple epithelial cytokeratins a significant increase (32% P less than 0.001) was noted in the SCC category only. Western blots using simple epithelial cell extracts as antigen revealed autoantibodies to cytokeratins 8, 18 and 19 as well as to one other unidentified protein in most SCC sera, and in some normal sera. Antibodies to cytokeratin 18 predominated. Normal and SCC sera were applied using indirect immunofluorescent techniques to normal oesophageal keratinocytes, SNO oesophageal SCC cells and HeLa cells grown in vitro. Autoantibodies to oesophageal cytokeratins were, with few exceptions, barely detectable. Strong reactions were noted against SNO and HeLa cytoskeletal components, but also against nuclear membrane and nucleolar determinants. These experiments suggest that raised levels of autoantibodies to certain cytoskeletal and nuclear determinants may be a feature of oesophageal cancer.

Adult↗
PubMed1988

Breath methane and large bowel cancer risk in contrasting African populations.

Breath methane has been measured in 1016 people from four populations resident in Southern Africa which experience widely different risks of bowel cancer and other colonic diseases. Highly significant differences in the proportion of subjects with detectable methane in breath were found; % producers--rural black 84, urban black 72, white 52, Indian 41 (chi 2 121 p less than 0.001 3 df). There was a slight preponderance of female producers over male (female producers 63%, males 57%) and an age trend with fewer producers in the older age groups in the urban blacks and Indians, these comparisons being significant when tested by stepwise logistic regression analysis. Bowel cancer risk, determined from a variety of sources, was lowest in rural blacks, greatest in whites, with intermediate rates for urban blacks and Indians. Methane production in the human colon shows significant interethnic differences but which bear no relation to bowel cancer risk in these populations.

Adolescent↗
PubMed1987

Salivary immunoglobulins in healthy white and black adults compared with oesophageal cancer patients.

Saliva is a readily accessible mucosal secretion and salivary antibodies reflect the repertoire of gut-associated antigens; it therefore appears to be ideal for the study of gastro-intestinal disease. A study of salivary immunoglobulins in healthy white and black adults and patients with oesophageal cancer showed that salivary immunoglobulin A levels were higher (but not significantly) in whites than blacks. The levels, however, were similar in healthy blacks and oesophageal cancer patients. There is a wide variation in normal levels of salivary immunoglobulins. Also, immunoglobulins are readily influenced by physiological factors and so at present are unreliable indices of gastro-intestinal disease.

Adult↗
PubMed1987

Primary lymphoma of the small bowel with obstructive jaundice and pancreatitis. A case report.

Primary lymphoma of the small bowel resulting in pancreatic duct or biliary obstruction is rare. Only 1 case of pancreatic obstruction causing pancreatitis has previously been reported. A patient with primary small-bowel lymphoma of the 'Western' variety is described. This was associated with extensive duodenal involvement and obstruction of the pancreatic and biliary system accompanied by obstructive jaundice and pancreatitis.

Cholestasis, Extrahepatic↗
PubMed1986

Chronic digestive disease in an urban black population.

There is a marked contrast in incidence of chronic digestive diseases between black populations of sub-Saharan Africa and Western populations. Environmental factors inherent in modern Western civilization have been incriminated as largely responsible for the differences observed. The significance of these factors in chronic digestive disease in Soweto is emphasized since they provide clues to aetiology. In this context research avenues with regard to specific diseases are suggested.

Black or African American↗
PubMed1986

Esophagitis in a population at risk for esophageal carcinoma.

A previously unreported high incidence of endoscopically identifiable, diffuse, largely nonulcerative esophagitis, is described in a selected population of Southern African blacks at risk of cancer of the esophagus. This is comparable with findings in similar groups in Iran and China. The incidence of dysplasia and "early" cancer is still undefined in South Africa.

Adolescent↗