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Biomedical subjects

M Carmon

Publications and source records attributed to M Carmon.

14 recordsLinked to original sources

Anger and blood pressure readings in children.

This study investigated the relationship of state and trait anger measured by the Jacob's Pediatric Anger Scale, patterns of anger expression measured by Jacob's Pediatric Anger Expression Scale, and blood pressure readings (BPR) in 230 third-grade children. Analysis of data revealed significant inverse relationships between anger suppression and diastolic BPR and anger reflection and control and both diastolic and systolic BPR. As anger suppression increased, diastolic BPR decreased. As anger reflection and control increased, both systolic and diastolic BPR decreased. When gender was considered, the relationship between anger reflection and control and systolic BPR was apparent only for girls, whereas the relationship between anger reflection and control and diastolic BPR was apparent only for boys. When correlations were computed based on gender and race, a significant inverse relationship between anger reflection and control and systolic BPR in Black girls was found. The results suggest that the influence of race and gender on the relationships between anger expression and systolic and diastolic BPR, which has been documented in adults, may be present in childhood.

Analysis of Variance

Water-soluble contrast material has no therapeutic effect on postoperative small-bowel obstruction: results of a prospective, randomized clinical trial.

BACKGROUND: Hyperosmotic water-soluble contrast materials have been fo und to be helpful diagnostic tools in postoperative small-bowel obstruction (POSBO); however, their therapeutic value remains controversial. PATIENTS AND METHODS: A prospective, randomized clinical study was conducted to examine the use of meglumine ioxitalamate as a supplement to the standard conservative treatment of POSBO. Patients with POSBO (n = 50) suitable for a conservative approach were randomized to receive standard conservative treatment with (n = 25) or without (n = 25) the addition of 100 mL of meglumine ioxitalamate via the nasogastric tube (patients with diffuse carcinomatosis and early POSBO were excluded). Both groups were compared for resolution of obstruction, need for surgical relief of obstruction, and complications. RESULTS: Seven (14%) patients required surgery: 3 in the contrast material group and 4 in the control group (P = not significant [NA]. Resolution of symptoms was achieved in nonsurgical patients within an average of 25.7 hours in the contrast material group and 28.7 hours in the control group (P = NS). There was no mortality in this study. In 2 (4%) patients (1 in each group), strangulated bowel was found during surgery, but only the 1 (2%) patient in the contrast material group required bowel resection. No difference was found in the length of hospital stay or rate of complications. There were no complications that could be attributed to the use of the contrast material itself. CONCLUSIONS: Although water-soluble contrast material is a safe and useful diagnostic tool, it offers no advantage as a supplement to the usual conservative treatment of POSBO.

Adolescent

A pitfall in the technique of jejunal tube insertion, resulting in jejunal perforation.

Enteral feeding by a jejunostomy tube is a reliable and cost-effective method for both long- and short-term nutritional support in selected patients, although a high complication rate has been reported in some series. The authors report on jejunal perforation in an infant, caused by a kinked jejunostomy tube, and emphasize this possible pitfall as a warning to others.

Enteral Nutrition

Jejunal obstruction as a late result of neonatal jejunal atresia.

The authors report on two adults who had jejunal dilatation after having had resection for jejunal atresia in the neonatal period. Both patients presented 20 years after the initial procedure, with severe iron deficiency anemia, marked jejunal dilatation proximal to the old anastomotic site (which was not narrowed), and a bezoar within the dilated segment. Upper gastrointestinal series were used to evaluate both patients before surgical resection of the enlarged intestine, with subsequent correction of the anemia.

Adult

Conservative treatment of a traumatic subdural hematoma of the posterior fossa in a child: case report.

Traumatic posterior fossa hematomas are uncommon. Subdural hematomas in this location are probably the rarest. The natural history in acute cases is one of rapid deterioration and death from brain-stem compression. Rapid surgical intervention is indicated in acute cases. We report a case of a traumatic posterior fossa subdural hematoma in a 3-year-old child treated conservatively with a good outcome.

Child, Preschool

Spontaneous rupture of the urinary bladder complicated by extensive fascitis: the importance of a high index of suspicion.

Spontaneous rupture of the urinary bladder is a rare entity. This is, in part, the cause for the low rate of correct preoperative diagnosis, the high rate of delayed diagnosis, morbidity and mortality. We report a case of spontaneous rupture of the urinary bladder in an adult patient, complicated by extensive fascitis of the abdominal wall. The stormy course and long hospitalization in the case described are characteristic of patients with spontaneous bladder rupture and warrant a high index of suspicion in order to achieve an early diagnosis.

Abdominal Muscles

How conservatively can postoperative small bowel obstruction be treated?

Although postoperative adhesion ileus is the most common cause of small bowel obstruction in adults, its management remains controversial. We retrospectively studied 297 admissions of 227 patients over a period of 14 years to evaluate our conservative approach in managing adhesion ileus. We found that nonoperative therapy of up to 5 days' duration can be used safely for the majority of patients who present with postoperative intestinal obstruction, including those with complete obstruction. In those patients, who responded to conservative treatment, the obstruction resolved within a mean of 22 hours and a maximum of 5 days. A trial of more than 5 days' duration proved ineffective. The conservative approach resulted in a 73% resolution of obstruction with no significant increase in mortality or in the rate of strangulated bowel.

Humans

Septicemia in the elderly: incidence, etiology and prognostic factors.

A study on septicemia in the elderly (mean age 80.3 +/- 9.1 years) was carried out during 1982-85. A total of 184 episodes of bacteremia occurred in 175 patients (incidence rate 7.2%); 61% were attributed to community-acquired sepsis. Gram-negative microorganisms accounted for 64% of all episodes and gram-positive for 30%. The overall mortality was 18.3%. Using univariate analysis, significant factors associated with a high mortality were: hospital-acquired sepsis, respiratory infections as source of the sepsis, severe underlying disease, Klebsiella and Proteus as pathogens, comatose state, hypothermia, thrombocytopenia, and serum sodium abnormalities. Using logistic regression analysis the odds ratio for hospital-acquired septicemia and hypothermia were positive and statistically significant, whereas soft tissue and urinary tract infections as sources were negative and significant. The relative low mortality in our study confirms that age alone is not necessarily a poor prognostic indicator of septicemia in the elderly.

Aged