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Biomedical subjects

J F Fitzgerald

Publications and source records attributed to J F Fitzgerald.

At least 109 records · Page 6Linked to original sources
PubMed1981

Prognostic determinants after hepatoportoenterostomy for biliary atresia.

Hepatic secretory functions were measured postoperatively in 17 infants undergoing hepatoportoenterostomy for biliary atresia. These studies were compared in surviving and nonsurviving infants to attempt early identification of infants who might require reoperation. Statistically significant differences between surviving and nonsurviving infants were found in alkaline phosphatase clearances at 1, 4, 12 and 24 weeks postoperatively. In addition, bilirubin clearance and secreted 24 hour bilirubin measurements were significantly increased in survivors 12 and 24 weeks postoperatively. Iodine-131 rose bengal excretion, measured 6 months postoperatively, was likewise significantly increased in survivors. Six of the 10 surviving infants required reoperation when their secretory functions deteriorated; all improved postoperatively. None of the seven nonsurviving infants underwent reoperation. Biliary secretory functions have early prognostic significance and apparently can predict which infants require reoperation. Reexploration and higher transection of atretic ducts may improve survival.

Alkaline Phosphatase↗
PubMed1980

Transabdominal esophagomyotomy for achalasia in children.

Achalasia is an uncommon esophageal problem in children. Nine cases accumulated over 7 yr at one institution are reviewed. Infants present with failure to thrive and may be misdiagnosed as suffering from chalasia. older children demonstrate dysphagia, nocturnal regurgitation, and failure to thrive. Contrast studies and esophageal manometry are diagnostic of the disease. Transabdominal esophagomyotomy is advocated, especially if Nissen fundoplication is also felt to be indicated to prevent reflux. All nine patients were treated successfully with this variation of the operation.

Abdomen↗
PubMed1980

Gastroesophageal reflux in infants and children comparative accuracy of diagnostic methods.

To assess the diagnostic accuracy of methods employed for detection of gastroesophageal reflux, 30 infants and children with symptoms of GER were evaluated by upper gastrointestinal series, gastroesophageal scintiscan, measurement of mean resting lower esophageal sphincter pressure, esophageal intraluminal PH measurement (acid reflux test), and endoscopy. Fifteen control patients were also evaluated by the above studies. GER was demonstrated by UGI in 15 and by GE scintiscan in 17 study patients. LESP less than 15 mm Hg was noted in 12 and a positive acid reflux test was obtained in 29 study patients. Esophagitis was detected in two (of 30) study patients radiographically and in 15 (of 21) study patients by upper gastrointestinal endoscopy. Pulmonary aspiration of gastric contents was not detected by the radionuclide method. None of the 15 control patients had GER demonstrated with any of the above methods. These studies indicate that (1) the acid reflux test correlates most closely with symptoms of GER; (2) THE GE scintiscan is complementary to the UGI in the diagnosis of GER, i.e., the combination increases sensitivity; (3) normal LESP does not necessarily exclude GER; and (4) endoscopy is superior to the UGI in detecting the presence of esophagitis.

Adolescent↗
PubMed1979

Gastroesophageal reflux in infants and children. Diagnosis and management.

Eighty-three infants and children underwent surgical correction of gastroesophageal reflux (GER) from 1973 to 1978. Fifty-four patients had coexistent brain damage (most commonly due to cerebral palsy), eight were previously treated for esophageal atresia, and four had gastroschisis or omphalocele repair. Clinical presentation included failure to thrive in 64 patients, vomiting in 59, and recurrent bouts of aspiration pneumonitis in 43. Barium roentgenography showed GER in 61 patients, whereas additional tests (particularly pH monitoring) were required for detection of GER in 22 patients. After failure of medical management, transabdominal Nissen fundoplication was performed in 80 cases and a Hill repair in three cases. The surgical mortality was zero, but there were five late deaths. Results were considered excellent in 54 patients, good in 22 patients, and poor in seven. Ten of 12 patients with preoperative stricture responded to dilation after fundoplication. Nissen fundoplication was a safe and effective antireflux procedure in 76 of the 83 cases.

Adolescent↗
PubMed1979

Chronic diarrhea in infants and children.

A useful clinical classification of chronic diarrhea is based on the character of the stool--watery, fatty or bloody. Pathophysiologic mechanisms include osmotic and secretory diarrheas, bacterial overgrowth leading to excess colonic bile acids and fatty acids, defective anion exchange systems, mucosal damage and abnormal motility and transit. Evaluation may require hospitalization. Antidiarrheal agents are not used. Antibiotics are generally not indicated. Parenteral hydration and feedings of special formulas are carefully monitored.

Bile Acids and Salts↗
PubMed1978

Determination of disaccharides in feces by permethylation and gas chromatography: rapid screening for carbohydrate intolerance in children.

Disaccharides can be identified and determined quantitatively in fecal specimens by permethylation of the components in crude supernatants followed by isothermal gas chromatographic separation on OV-17 columns. The method provides a rapid screening procedure for detecting patients suspected of having a carbohydrate intolerance secondary to intestinal disaccharidase deficiency.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1978

Disseminated varicella complicating ulcerative colitis.

Disseminated varicella is an uncommon complication of ulcerative colitis, despite the frequent use of steroid therapy in this disorder. Fatal varicella infection occurred in a patient with ulcerative colitis who was receiving steroid therapy. This observation suggests that zoster-immunoglobulin should be administered to patients exposed to varicella with ulcerative colitis who are receiving steroid therapy.

Adolescent↗
PubMed1978

Competency evaluations in Connecticut.

New procedures for conducting competency evaluations were adopted in Connecticut in 1975 as a result of a change in the state law. The accused person is now evaluated in the setting in which he finds himself by virtue of his conflict with the criminal justice system, rather than automatically being remanded to the state hospital for evaluation. The criteria used are legal rather than medical-psychiatric, and the evaluations are conducted by a mental health team consisting of a psychiatric social worker, a psychiatrist, and a psychologist. The authors describe the procedures and discuss the benefits deriving from them, as well as some of the real and potential problems.

Adult↗
PubMed1978

Percutaneous cholangiography in infants.

Percutaneous transhepatic cholangiography was attempted in eight infants with normal-size bile ducts and was successful in four. The technique described is feasible in the infant age group, and is useful in the infant with obstructive jaundice.

Child, Preschool↗