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Biomedical subjects

J S Barkin

Publications and source records attributed to J S Barkin.

At least 127 records · Page 7Linked to original sources
PubMed1986

Acute pancreatitis and its complications. Diagnostic and therapeutic strategies.

The most common causes of acute pancreatitis are biliary tract disease and alcoholism, but other causes account for about 10% of cases. Acute pancreatitis can be divided clinically into mild and severe (necrotic) disease. Risk of complications and death varies with the etiology, severity, and number of episodes and is highest in severe cases and biliary tract-related disease. Amylase determination is the best diagnostic serum screening test. Ultrasonography, computed tomography, and endoscopic retrograde pancreatography are also extremely useful in diagnosis. Treatment of acute pancreatitis usually consists of supportive measures; the roles of peritoneal lavage and surgery remain controversial. Pseudocysts occur in about 25% of patients but can be treated successfully with appropriate therapy.

Acute Disease↗
PubMed1986

Hypercalcemia: a risk factor to patients undergoing gastrointestinal endoscopy.

Hypercalcemia may be associated with neoplastic disease, either as an epiphenomenon resulting from tumor-produced humoral substances or as a direct consequence of bone involvement. Endoscopic procedures are occasionally performed in this group of patients for both diagnostic and therapeutic purposes. This report reviews the interaction of hypercalcemia and sedative hypnotic drugs and suggests that hypercalcemia might be a risk factor for those patients undergoing endoscopy.

Aged↗
PubMed1984

Enteric coccidiosis among patients with the acquired immunodeficiency syndrome.

Ten patients were identified at Jackson Memorial hospital/University of Miami Hospitals and Clinics with enteric coccidial infection due to Cryptosporidium spp. or Isospora belli. All had the acquired immunodeficiency syndrome as manifested by Kaposi's sarcoma or multiple opportunistic infections, or both. They presented with profuse diarrhea associated with weakness, anorexia, and weight loss. Routine examinations of stools for eggs and parasites as performed by the hospital laboratory were negative in all patients. Sugar flotation and modified acid fast techniques were used in the Tropical Disease Laboratory to identify oocysts of Cryptosporidium spp. in stools of seven patients. Malabsorption, characterized by a low 5-hour D-xylose and positive fecal fat, was observed in 6/6 of these patients. In three other patients Isospora belli oocysts were identified in stool specimens or via a duodenal string test. Spiramycin was the only drug found to be effective in treating patients with cryptosporidiosis. Patients with Isospora belli responded to a prolonged course of trimethoprim-sulfamethoxazole.

Acquired Immunodeficiency Syndrome↗
PubMed1983

A sign of symptomatic chronic cholecystitis on biliary scintigraphy.

Five hundred patients with acute right-upper-quadrant pain underwent biliary scintigraphy with 99mTc paraisopropyliminodiacetic acid. One hundred and thirty-four studies were reported normal (both gallbladder and activity in bowel are noted in 1 hr). Of the 134 studies reported as normal, 32 showed intestinal activity before gallbladder visualization during the first hour of the study. Sonography and/or oral cholecystography revealed that 24 patients had gallstones, and eight patients had no demonstrable pathology in the biliary system. Of the 134 studies, 102 showed visualization of the gallbladder before intestinal activity during the first hour of the study. Sonography and/or oral cholecystography showed that 73 patients had normal biliary system. The remaining 29 patients had gallstones. The overall sensitivity of this finding is 45%, the specificity is 90%, and the accuracy is 73%. In this group of symptomatic patients, the appearance of intestinal activity before gallbladder activity on biliary scintigraphy warrants further evaluation of these patients by sonography and/or oral cholecystography.

Cholecystitis↗
PubMed1983

Intestinal myiasis.

With international travel increasing to more rural areas, physicians must be aware of the accidental ingestion of fly ova from contaminated food, which results in the fecal passage of these nondigestible eggs. The purpose of this report is to review this entity.

Adult↗
PubMed1982

Defect in assimilation following combined radiation and chemotherapy in patients with locally unresectable pancreatic carcinoma.

The relative contributions of high-dose irradiation and/or chemotherapy to the nutritional problems of patients with inoperable pancreatic carcinoma were evaluated by study of pancreatic exocrine function and jejunal function and morphologic findings in ten patients before and after treatment. Nutrient assimilation studies included determination of serum carotene levels, D-xylose absorption and fat absorption. Crosby capsule biopsy specimen of jejunal mucosa were evaluated with light microscopy. Fat assimilation was the only parameter of nutritional function to significantly worsen after therapy. Low serum carotene levels present in the patients before therapy remained low but did not significantly change after treatment. D-xylose absorption and the morphologic structure of the jejunal mucosa were normal before and after treatment. These findings support the previous observations that the nutritional problems of the patient with inoperable pancreatic carcinoma are due to pancreatic insufficiency and that high dose irradiation and chemotherapy can exacerbate the pancreatic insufficiency but do not produce jejunal dysfunction. Therefore, it is suggested that pancreatic exocrine replacement therapy may improve the nutritional status of these patients.

Aged↗
PubMed1982

Diagnosis of pancreatic abscess via percutaneous aspiration.

UNLABELLED: The pre-operative diagnosis of a pancreatic abscess was not considered in a comprehensive review in 1972. However, advances in technology (Ultrasound--US, Computed Tomography--CT) has allowed guided percutaneous needle aspiration (PNA) of suspected pancreatic lesions. The purpose of this study was to evaluate the safety and diagnostic ability of PNA to differentiate acute pancreatic inflammatory masses from pancreatic abscess (PA). Thirteen patients underwent PNA after US or CT revealed an acute pancreatic inflammatory mass (12/13 cystic). One patient underwent a second aspiration. Clinical features T degrees--101.3 degrees F mean (13/13), leukocytosis 14,400 cu/mm (11/13). Aspirated material was gram-stained and examined for bacteria and leukocytes and cultured. RESULTS: PNA was accomplished successfully in all patients. Aspirate revealed bacteria in nine and pancreatic abscess was confirmed at surgery (8) or post-mortem exam (1). Four of five patients in whom no bacteria were visualized had medical resolution, the fifth had continued T degree and underwent a second aspiration which diagnosed a PA. PA contained moderate to large number of PML via aspiration. CONCLUSIONS: PNA provides a potentially important and safe diagnosis adjunct to earlier accurate differential diagnosis of pancreatic inflammatory masses from pancreatic abscess.

Abscess↗
PubMed1982

Chylous ascites.

Explore the source record for details and available documents.

Adenocarcinoma↗
PubMed1982

Biliary scintigraphy in acute pancreatitis.

A prospective study was carried out in 60 patients to determine the efficacy of 99mTc-PIPIDA scintigraphy in differentiating biliary pancreatitis from nonbiliary pancreatitis. Forty patients were classified as having biliary pancreatitis and 20 patients as having the nonbiliary type. Scintigraphic scans were divided into five main types according to the time to visualization of the gallbladder and the time to excretion of 99mTc-PIPIDA into the intestinal tract. Normal scans were obtained on 95% of patients (19/20) with nonbiliary pancreatitis; 22.5% of patients (9/40) with biliary pancreatitis had normal scans. It is concluded that elevated amylase levels together with an abnormal biliary scan, as defined by the criteria presented here, indicate biliary pancreatitis, while a normal scan largely excludes such diagnosis.

Acute Disease↗