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J E Losanoff

Publications and source records attributed to J E Losanoff.

At least 19 recordsLinked to original sources
PubMed2001

Multiple factor scoring system for risk assessment of acute pancreatitis.

BACKGROUND: The initial prognostic classification of a pathologic event has important implications for management, outcome, and resource utilization. A variety of prognostic classification methods have been developed, but none has thus far shown consistent predictive accuracy in individual patients. In an attempt to overcome some of the limitations encountered by earlier workers, we have developed a simplified system for evaluation and prognosis of acute pancreatitis. MATERIALS AND METHODS: We studied retrospectively 306 patients with acute pancreatitis. Nonstandard statistical calculations were used to create risk indices for pancreatitis severity for all 13 variables which were included in a standard chart. RESULTS: The risk assessment rule's correct prediction is 81.32% (sensitivity) and 93.95% (specificity) for severe and mild pancreatitis, respectively. The total accuracy is 90.20%. CONCLUSION: The results of this nonstandard small retrospective study seem promising. It should remain experimental until larger prospective studies confirm the usefulness of the method.

Acute Disease↗
PubMed2001

Recurrent Spigelian hernia: a rare cause of colonic obstruction.

Spigelian hernia is considered a surgical rarity. Recent articles describe only six recurrent hernias and a scant number of patients with colonic obstruction resulting from incarceration. A patient with intestinal obstruction resulting from recurrent Spigelian hernia with strangulated colon is described. The patient underwent tension-free repair using a prosthetic mesh. Recent literature suggests that the deficiency of connective tissue in patients with hernias justifies the widespread use of permanent mesh for tissue reinforcement and avoidance of recurrences. The rare case presented should be regarded as an illustrative example for application of the tension-free repair principle in the definitive management of recurrent Spigelian hernia.

Aged↗
PubMed2001

Gastrointestinal "crosses": an indication for surgery.

BACKGROUND: We present our experience with a unique type of foreign body that was specifically designed to arrest in its passage and cause perforation of the gastrointestinal tract. STUDY: Between 1994 and 1999, nine male prisoners from the same jail presented after ingestion of "crosses." A cross is constructed from the two halves of a standard paperclip that are tied together with a rubber band. The resulting construction is elastic: the two branches can be pulled to lie parallel, but they assume their original position once released. The cross is wrapped into paper with its branches parallel and ingested. After release from the wrapper, it "opens" and causes bowel perforations. RESULTS: All patients underwent emergency surgery for foreign body removal and treatment of peritonitis. A total of 19 crosses were removed from the patients. Six (32%) were found in the stomach; five, in the duodenum (28%); three, in the jejunum and ileum (16%); and one, in the pylorus and colon. There was no morbidity or mortality. CONCLUSIONS: Foreign bodies of this type never pass distally. The ultimate key to success in the management of patients who have ingested crosses is emergency surgical intervention.

Adolescent↗