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Biomedical subjects

M Schiff

Publications and source records attributed to M Schiff.

At least 91 records · Page 5Linked to original sources
PubMed1978

Treatment of end-stage renal failure in a defined geographic area.

The treatment of end-stage renal failure was studied in southern Connecticut from 1967 to 1975 by (1) calculating survival rates for center and home dialysis patients and cadaver and living related donor transplant recipients and (2) assessing the quality of life with structured interviews and psychological tests. While the survival rate for our home dialysis and transplant recipients were similar to previously reported data, mortality for our center dialysis patients was slightly higher than previously reported. Quality-of-life testing, disclosed that dialysis patients had a substantial impairment in all parameters. Transplant recipients achieved a better degree of rehabilitation. Physicians and patients should be aware of the problems that they are likely to face; otherwise, expectations and goals may be raised to unreachable and ultimately frustrating levels.

Adult↗
PubMed1977

Myxoid neurofibroma of the testis.

A case of an intratesticular myxoid neurofibroma is reported. These tumors, which arise from perineural and Schwann cells, commonly occur throughout the body but have not been reported previously to originate within the testis. The mucoid material within the tumor is translucent, which may confuse the diagnosis with that of a hydrocele.

Adult↗
PubMed1977

Nephrectomy: indications and complications in 347 patients.

The indications, complications and mortality rate in a recent 12-year experience with 347 nephrectomies were reviewed. Renal tumor is the most frequent condition requiring nephrectomy, probably because of the improved, non-ablative methods to treat inflammatory, obstructive, calculous and hypertensive renal disease. The over-all mortality rate was 1.4 per cent but was almost nil in the absence of malignancy.

Adolescent↗
PubMed1977

Antibiotic treatment of renal carbuncle.

Renal carbuncles in seven young males were successfully treated with long-term administration of penicillinase-resistant antibiotics. Selective renal arteriography provided an accurate means of diagnosis and permitted a trial of medical therapy. All patients experienced a prompt and sustained clincial remission; surigical exploration was thus obviated in all but one instance, in which post-treatment radiographic changes persisted.

Adolescent↗
PubMed1976

The multiproblem family presents in a children's outpatient psychiatric clinic.

This study focuses on children from multiproblem families when they appear at an outpatient psychiatric clinic for children. The sample consisted of the first 50 children and their families referred to a large children's outpatient psychiatric facility early in 1974. A multiproblem family was defined in terms of the number of helping agencies and/or professionals contacted by family members within the 3-year period prior to the current psychiatric evaluation and by the number of households in which the designated child patient had lived. Eighteen percent of the 50 cases met the criteria established for a multiproblem family. These indicators successfully differentiated multiproblem from nonmultiproblem families along a number of socioeconomic, demographic, family health, and family stability dimensions. Special difficulties encountered in psychiatrically evaluating children of such multiproblem families are presented, and ways of dealing with them are discussed.

Child↗
PubMed1976

Seven-year survival of child with rhabdomyosarcoma of prostate.

A case is reported of a twenty-two-month-old child who has survived for seven years without recurrence after multimodal therapy of a rhabdomyosarcoma of the prostate. The patient was treated with preoperative irradiation, radical surgery, and intraoperative and postoperative actinomycin D.

Child, Preschool↗
PubMed1976

Influence of rejection on graft survival after renal transplantation.

The clinical course was reviewed of 102 renal allograft recipients between December 1967 and December 1973. Only 4 of 21 patients (19 per cent) who had 2 or more episodes of rejection during the first 2 months had a functioning graft at the end of 1 year, compared to 24 of 30 patients (83 per cent) who had no rejection episodes. A similar trend was seen 2 to 6 months after transplantation. During the first 2 years vigorous immunosuppressive therapy for rejection in the first few months resulted in 12 deaths (44 per cent) of 27 patients. Subsequent to this immunosuppressive therapy was modified and grafts were removed if there was not a prompt recovery of function after treatment, which resulted in a significant decrease in mortality rate to 16 per cent. There also was improvement in the over-all survival of patients with functioning grafts from 37 to 56 per cent. Serious complications and mortality could be related to high dosage of steroids and severe leukopenia. A white blood count of less than 1,000 mm.3 on 3 successive days was associated with a mortality rate of 52 per cent, compared to 15 per cent in those without leukopenia. Serious consideration should be given to early graft removal in patients who have 2 or more episodes of rejection in the first few months after transplantation, particularly when there is not a prompt improvement in renal function after immunosuppressive therapy. High doses of steroids (greater than 1 mg. per kg. for more than 26 days during the first 60 days) should be avoided to decrease morbidity and mortality rates from serious infections. The results of histocompatibility (HL-A) matching in 72 donor-recipient pairs indicated an improved graft survival when there was a match of 2 or more antigens, which is supported by the results recently reported by the Transplant Registry. The results of mixed lymphocyte reactions in 20 live donor-recipient pairs showed a marked improvement in graft survival when there was less than 20 per cent stimulation and it appeared that this reaction was of more important prognostic significance than the results of histocompatibility (HL-A) matching in these patients.

Azathioprine↗
PubMed1976

Management of urinary fistulas after renal transplantation.

Urinary fistulas developed in 13 of 134 patients after renal transplantation. Bladder fistulas originating from the anterior suture line in 6 patients were satisfactorily managed by urethral or paravesical drainage. Fistulas arising from the donor ureter were best treated by surgical repair using the recipient's own ureter. Caliceal fistulas in 3 patients were successfully treated with nephrostomy drainage. A favorable outcome was achieved in 11 of the 13 patients, with closure of the fistula and preservation of renal function.

Female↗
PubMed1976

Urologic complications of inflammatory bowel disease.

Urologic complications occurred in 54 of 233 patients with inflammatory bowel disease followed during a 15-year period. Urinary calculi, enterovesical fistulas and ureteral obstruction were the most common problems. Urinary tract complications may arise many years after primary bowel disease has been diagnosed. Symptoms frequently may be absent or obscured by those of the gastrointestinal disorder. We recommend that urologic evaluation be included periodically in the long-term management of patients with inflammatory bowel disease.

Adult↗
PubMed1976

Reflux and trapping.

Although functional ureteral obstruction results in a decrease in the rate of antegrade urine flow, urine may still traverse the obstructed segment in a retrograde direction. Decreased musculature is found in the obstructing area. The combination of these processes results in reflux with trapping. This process has been demonstrated radiographically at both the ureterovesical and the ureteropelvic junctions.

Child, Preschool↗
PubMed1976

The antecubital fossa fistula.

We have reviewed our experience with 19 proximal forearm arteriovenous fistulas used in chronic hemodialysis. Thirteen functioned adequately, and of these 10 were complicated by dislodge needles during dialysis, arm edema or hematomas. Although 3 patients developed symptoms of arterial steal, none required ligation of the fistula. This experience suggests that antecubital fossa fistulas might best be used as a second line angioaccess when distal forearm fistulas have been unsuccessful or are impossible to contruct.

Adolescent↗
PubMed1975

Successful management of caliceal fistulas following renal transplantation.

Caliceal fistulas are unusual complications of renal transplantation. Segmental renal infarction and distal ureteral obstruction may be contributing factors in their formation. Two cases are reported, the first probably a result of segmental renal infarction from failure to recognize and anastomose an accessory renal artery, the second possibly related to blunt trauma to the area of the graft in an automobile accident and ureteral obstruction resulting from blood clots. Nephrostomy drainage through a healthy area of renal parenchyma was instrumental in the salvage of both kidneys.

Accidents, Traffic↗
PubMed1975

Hypertension and unilateral hydronephrosis.

Three patients with unilateral hydronephrosis, a normal contralateral kidney, and sustained hypertension were investigated by means of arteriography and differential renal vein renin determinations. The close correlation of the onset of hypertension to the obstructive uropathy, as well as the increased renin production from the affected side, were indicative of a causal relationship. Nephrectomy produced a prompt cure of hypertension in each instance.

Adolescent↗
PubMed1975

Palliative urinary diversion for pelvic malignancy.

Palliative urinary diversion was done in 47 cases for ureteral obstruction secondary to advanced pelvic malignancy. The average survival time was 5.3 months, with only 50 per cent of the patients alive at 3 months and only 22.7 per cent alive at 6 months. After the diversion 63.8 per cent of the survival time was spent in the hospital. Patients with carcinoma of the prostate fared better than those with other sites of tumor origin, which may reflect the natural history of this tumor.

Adult↗