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Biomedical subjects

J S Barkin

Publications and source records attributed to J S Barkin.

At least 163 records · Page 9Linked to original sources
PubMed1976

Intractable peptic ulcer disease.

The intractable ulcer is usually complicated because of posterior penetration, obstruction, or postbulbar or channel location; or it is an atypical ulcer such as those occurring with the ZE syndrome, hyperparathyroidism, and the milk-alkali syndrome. The management of intractability depends upon finding the cause and initiating the appropriate therapy. Many abdominal diseases may masquerade as intractable ulcers, so every patient must be evaluated thoroughly to prove that his ulcer is indeed intracetable.

Aspirin↗
PubMed1975

A hypothetical case of gastrointestinal bleeding: incorporating a management self-test.

In this case study of upper gastrointestinal bleeding, a problem-solving question-and-answer format is used and is accompained by referenced discussion. The clinical area covered is one in which endoscopic and angiographic tools are available for diagnosis and tamponading devices and angiographic perfusion techniques exist for mangement. Of course, many varibles affect diagnostic and therapeutic decisions, but logic often dictates directions in management. The availability of skilled endoscopists and angiographers is an important factor in the optimal management of the patient with upper gastrointestinal bleeding in whom the source of bleeding is unknown.

Angiography↗
PubMedDate not supplied

Endoscopic retrograde cholangiopancreatography in pancreatic trauma.

The sensitivity and specificity of ERCP for the diagnosis of suspected pancreatic ductal rupture was prospectively studied. Fourteen consecutive patients who were referred for abdominal pain and hyperamylasemia subsequent to abdominal trauma underwent ERCP, the majority within 24 hours of admission. Twelve of these also underwent abdominal CT, and 7 had peritoneal lavage. Four patients were found to have ductal rupture at ERCP. This was confirmed at laparotomy. Three additional patients who underwent laparotomy were found not to have a ductal rupture, although one had a pancreatic capsular laceration. The remaining 7 had clinical resolution. ERCP was 100% sensitive and specific in the diagnosis of pancreatic ductal rupture, whereas no combination of serum amylase, CT scan, and peritoneal lavage was equally effective.

Adult↗
PubMedDate not supplied

Oxygen desaturation and changes in breathing pattern in patients undergoing colonoscopy and gastroscopy.

The respiratory effect of diagnostic colonoscopy and upper endoscopy were studied in 32 elderly patients. Twenty-two underwent colonoscopy and 10 upper endoscopy. In the group undergoing upper endoscopy, 4 of 10 patients experienced a decrease in oxygen desaturation greater than or equal to 4% during the medication period; an additional 2 patients desaturated during the procedure. In the group undergoing colonoscopy, 12 of 22 patients experienced oxygen desaturation during the medication period; 3 other patients desaturated during the procedure. Mean SaO2 for each group was lowest (p less than 0.05) during the medication period. Central apneas occurred in 13 of the patients undergoing colonoscopy during the medication period; however, only 8 of these patients with apneas experienced desaturation greater than or equal to 4% and the periods of desaturation did not correlate with the periods of apneas. Oxygen desaturation greater than or equal to 4% occurs frequently during both upper endoscopy and colonoscopy in this elderly population. This is related to the effects of sedation; the procedure itself worsened the desaturation in only 16% of the patients. Furthermore, the desaturation did not correlate with changes in the breathing patterns of the patients. Low-flow oxygen and/or close monitoring of patients during and subsequent to administration of medication is advised.

Aged↗
PubMedDate not supplied

Forceful balloon dilation: an outpatient procedure for achalasia.

The initial treatment of choice in patients with achalasia is balloon dilation. Heretofore, this procedure was performed on an in-hospital basis resulting in high patient cost. This study evaluated the safety and efficacy of pneumatic dilation as an outpatient procedure. Sixty-one procedures were performed on 50 patients at two centers. An overall treatment success rate of 95% (47 of 50 patients) was achieved. Two patients had elective surgical treatment and a third underwent surgery for perforation secondary to dilation. A total of three patients complained of post-procedure chest pain within 4 hours and were hospitalized. Two had perforations; one required surgical repair. The third patient had resolution of symptoms. We conclude that performing balloon dilation as an outpatient procedure is safe, efficacious, and cost effective.

Adolescent↗