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Biomedical subjects

I Segal

Publications and source records attributed to I Segal.

At least 109 records · Page 6Linked to original sources
PubMed1986

Rectal manifestations of pellagra.

Twenty (44%) of 45 patients with cutaneous pellagra had diarrhoea. Inflammation was seen on sigmoidoscopy in 42 and was severe in 5 (11%), moderate in 4 (9%) and mild in 33 (73%). Six patients (13%) had perianal excoriation. Rectal biopsies taken in all cases showed extensive ulceration in 1 case, moderate to severe inflammation in 16 (36%) and mild inflammation in 18 (40%). Minimal oedema of the lamina propria was seen in 11 (24%) patients. At 5 to 7 days after starting vitamin treatment in nine cases histological changes had returned to normal in 4, improved in 3 and had not changed in 2. Diarrhoea stopped within a week in all cases.

Adult↗
PubMed1986

Further observations on social factors associated with duodenal ulcer in Soweto.

It has been postulated that urbanisation is an important factor in the genesis of duodenal ulcer. This study of 100 duodenal ulcer patients, and 100 hospital controls, matched according to sex, age, education and occupation, and an additional 50 unmatched endoscopically negative controls, confirmed that duodenal ulcer patients were mainly young men who were more likely to have been born in an urban area than the controls. Furthermore, a significant number of duodenal ulcer patients were born and reared in the smaller towns of South Africa and then moved to Soweto. It is suggested that frustrated aspirations in these towns might even be greater than in Soweto. In the context of the Soweto population where occupational and educational status is generally low, duodenal ulcer patients were of a higher educational and occupational category than Sowetans and unselected controls. Thus factors associated with urbanisation such as education and occupation and the pattern of urbanisation play key roles in duodenal ulcer. Investigation into particular aspects of the work situation such as the degree of autonomy exercised at work, authority over others and attitudes to supervision yielded no significant results.

Adult↗
PubMed1986

Survival of black men with prostatic cancer in Soweto, Johannesburg, South Africa.

While prostatic cancer has a low frequency in rural African black men living traditionally, the disease occurs more often and is increasing in black men in the cities. Between 1982 and 1984, 101 patients with prostatic cancer were detected in Soweto, Johannesburg. Of these patients 90 had clinical stage D disease and metastasis was common. The 50 per cent mortality period of 1.6 years, while similar to that reported in some series of white patients, is considerably shorter than that noted in several others series.

Adult↗
PubMed1986

Characteristics and occurrence of appendicitis in the black population in Johannesburg, South Africa.

In black patients seen at Baragwanath Hospital, Johannesburg, appendicitis occurs most frequently in the 10-19-year-old age group. There is a pronounced male bias. Parasitic ova in the appendix are very seldom observed (3.6%). Fecaliths, present in 20% of diseased appendices, are noted far less frequently than are reported for white patients (50%-75%). There are about two cases of appendicitis per 1,000 admissions of adults annually, a low frequency consistent with the tenfold differential of appendectomies reported to prevail in urban black and white adolescents. The progressively changing diet of urban blacks, currently low in fat and in dietary fiber, has not yet become associated with a marked increase in the occurrence of the disease (nor of most other noninfective bowel diseases).

Adolescent↗
PubMed1986

Obstructive jaundice in the South African black population.

We report the causes of obstructive jaundice in 56 black South African patients. Chronic pancreatitis and malignant biliary obstruction occurred with equal frequency. These two conditions may be difficult to differentiate clinically and radiologically, and only operative pancreatic biopsy may be diagnostic. Choledocholithiasis caused jaundice in only 7.1% of the patients, reflecting the relatively low prevalence of gallstones in this population.

Adult↗
PubMed1986

Low-fat intake with falling fiber intake commensurate with rarity of noninfective bowel diseases in blacks in Soweto, Johannesburg, South Africa.

Among urban blacks in Johannesburg, South Africa, a measure of westernization of diet has occurred. Yet, the frequencies of most noninfective bowel diseases not only are low but also appear to have scarcely increased. To assess more adequately the current dietary pattern, a survey was undertaken. Results indicated a habitually low-fat intake, which supplied a mean of 24% of energy but also greatly decreased fiber intake (now about 14 g daily). Possibly, a meaningful rise in the incidence of bowel diseases requires, among other things, simultaneous rise in fat intake; alternatively, there are factors yet unknown in the dietary context of urban blacks (perhaps operating in their bowels) that are inhibiting rises in the diseases mentioned.

Adult↗
PubMed1985

Benign extrinsic oesophageal dysphagia. Case reports.

Six patients with benign extrinsic oesophageal dysphagia are presented, 4 with dysphagia aortica and 1 each with dysphagia due to cervical osteophytes and traction diverticulum. The radiological features of these cases are discussed. It is emphasized that such cases form a small but significant entity.

Adult↗
PubMed1985

Bowel function in an urban black African population.

Despite a low daily dietary fiber intake, an urbanized black African population in southern Africa has a low incidence of those diseases associated with fiber deficiency. Stool weights, defecation frequencies, and transit times in this group are much closer to those of westernized whites than to rural blacks.

Adult↗
PubMed1985

The prevalence of appendiceal fecaliths in patients with and without appendicitis. A comparative study from Canada and South Africa.

Appendicitis is more common in developed than in developing societies and appendiceal fecaliths are thought to have an etiologic role in the disease. The geographic distribution of appendiceal fecaliths was investigated by systematic, intraoperative palpation of the appendix in patients in Toronto, Canada and Johannesburg, South Africa. The incidences of fecaliths found on pathologic sectioning of the appendix in appendicitis patients in both societies were compared. In the Canadian population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was 32% versus 52% for those with appendicitis (p less than 0.01). In the African population, the prevalence of fecaliths in patients whose appendices were palpated incidentally was four per cent versus 23% for those with appendicitis (p = 0.04). The difference in prevalence of incidental appendiceal fecaliths in the two populations was statistically significant (p less than 0.005). The prevalence of fecaliths is higher in developed countries, such as Canada, than in developing countries, such as Africa, and is also higher in patients with than in those without appendicitis. These data support the theory that the low-fiber diets consumed in developed countries lead to fecalith formation, which then predisposes to appendicitis.

Adolescent↗
PubMed1985

Low survival of South African urban black women with cervical cancer.

In Soweto, Johannesburg, the incidence of cervical cancer, the most common cancer in black women, is higher than in most white populations but lower than in many other populations. In a series of 210 patients who were diagnosed in 1981 and 1982, 50% had died within 1.6 years of diagnosis, a third of the reported survival time in white patients. The pattern of stage at presentation was similar to, although sometimes later than, those reported for various white communities. Data on patients' age at birth of first child, parity, smoking practice, and socioeconomic status, differed little from those in a control group. Neither these factors, nor availability of medical services, could be correlated with the distressingly short period of survival, which also occurs among urban black patients with breast and oesophageal cancers. Presumably, unidentified factors linked with low socioeconomic status affect survival time.

Adult↗
PubMed1985

The liver in biliary obstruction due to chronic pancreatitis.

Biliary obstruction is an important complication of chronic calcifying pancreatitis. In this study, liver biopsies were examined to determine the nature and severity of hepatic complications in 23 such cases. The most striking changes were portal tract expansion due to oedema and fibrosis, with proliferation of bile ducts. Although common, these changes were not severe, and no patient had developed secondary biliary cirrhosis. Other features of note were intrahepatic cholestasis, iron overload (56.5%), copper-associated protein stained with the orcein technique (34.7%) and mild fatty change or perivenular sclerosis in 13%. It is concluded that no serious, irreversible pathological changes occurred in the liver despite clinically marked biliary obstruction.

Adult↗
PubMed1984

Short duration of survival among South African blacks with oesophageal cancer.

South African urban Blacks are very prone to oesophageal cancer, and mean age at diagnosis is almost a decade lower than that of White patients (male preponderance is equally marked in both ethnic groups). In recent years the socio-economic position of urban Blacks has improved greatly, with considerable strides being made in literacy and awareness of hospital services. This socio-economic improvement could conceivably improve the extremely short durations of survival among oesophageal cancer patients noted in earlier studies; this, however, has not occurred. Of a series comprising 146 male and 37 female patients, 50% had died after 3,6 and 4,2 months respectively. The corresponding periods noted for White patients are about twice as long.

Adult↗
PubMed1984

Intramural pseudodiverticulosis of the oesophagus. A case report.

A patient with oesophageal intramural pseudodiverticulosis (believed to be the first case reported in the southern African literature) is described and the literature is reviewed. Although the pathogenesis of the condition remains uncertain, reflux oesophagitis, increased intra-oesophageal pressure and chronic monilial oesophagitis may be important antecedents. The characteristic histopathological findings include dilatation of the excretory ducts of the submucosal oesophageal mucous glands with periductal inflammation. The appearance of multiple flask-shaped outpouchings on barium studies is diagnostic. More recently, computed tomography has been shown to be useful in confirming the diagnosis.

Adult↗
PubMed1984

Pyoderma gangrenosum and ulcerative colitis in black South Africans. Case reports.

Two patients with pyoderma gangrenosum and ulcerative colitis are described. To our knowledge this is the first report of such an association in Blacks. The unusual vesicopustular form of pyoderma gangrenosum was well demonstrated by one patient who also responded remarkably to clofazimine. The associations, pathological findings and therapy are briefly reviewed. Colectomy may ameliorate the skin lesions when conventional therapy is unsuccessful.

Adolescent↗
PubMed1984

Intestinal tuberculosis, Crohn's disease and ulcerative colitis in an urban black population.

The clinical, epidemiological and pathological manifestations of intestinal tuberculosis, Crohn's disease and ulcerative colitis in the Johannesburg Black population are reviewed. Crohn's disease and particularly ulcerative colitis have emerged as definite disease entities in urban Blacks. There is an evident similarity between the clinical manifestations of intestinal tuberculosis and of Crohn's disease, and also between those of Crohn's disease and ulcerative colitis. Furthermore the data suggest that genetic and environmental factors play a vital role in susceptibility to these diseases. The similarity between the clinicopathological manifestations of intestinal tuberculosis and those of Crohn's disease lends support to the view that microbial, viral or cellular toxic agents are involved in the aetiology of Crohn's disease. Moreover, the clinical and epidemiological features of ulcerative colitis support the concept that environmental factors present in an urbanized milieu are important in its aetiology.

Adult↗
PubMed1984

The syndromes of pancreatic pseudocysts and fluid collections.

The clinical and radiologic spectrum of pseudocysts associated with alcohol-induced pancreatitis is wide and variable. Several illustrative cases which delineate the diversity of syndromes that occur with pseudocysts are presented. A classification is proposed to facilitate a more coherent approach to the concept of pseudocysts and is based on the clinical presentation. Thus, in acute pancreatitis duct disruption and enzyme activation may result in intrapancreatic or extrapancreatic fluid collections. In calcifying chronic pancreatitis duct obstruction may result in pseudocysts of the head, body, or tail of the pancreas, which can enlarge and penetrate into extrapancreatic sites. This subdivision will assist in elucidating the natural history of pseudocysts and pancreatic fluid collections. Furthermore, it may establish new guidelines for diagnosis and therapy.

Adult↗