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Biomedical subjects

R Balon

Publications and source records attributed to R Balon.

At least 19 recordsLinked to original sources
PubMed1998

[Gastrointestinal hemorrhage after operation for dissecting aneurysm of the thoracic aorta].

We present the case of a 45-year-old man who underwent surgical repair of a dissecting aneurysm of the descending thoracic aorta. 25 days postoperatively, the patient unexpectedly developed hematemesis and hypovolemic shock. Emergency gastroscopy was performed and a suspected aortoesophageal fistula was diagnosed. Unfortunately, the patient died prior to emergency surgery. Aneurysms of the aorta or of aortic grafts occasionally lead to the development of fistulae to the upper gastrointestinal tract. Once this rare, but life-threatening complication is suspected, endoscopy must be performed immediately. Emergency surgery is associated with a high risk, but represents the only possibly chance of survival for the patient.

Aortic Dissection↗
PubMed1998

[Resorbable interference screws. Histologic study 4.5 years postoperative].

The use of degradable implants in recent years has brought not only good results. Foreign body reactions to implantation of degradable polymers clearly curtailed the initial expectations. Bioabsorbable polymers have been used for sutures, vascular clips, and fixation implants for both intra-articular fractures and malleolar fractures. In the literature these implants are controversial. Potential benefits remain for the use of this material for interference screws if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal. In one patient, 4,5 years after to implantation of an degradable interference screw (Copolymer 85/15 D,L lactide glycolide; Biologically Quiet, Instrument Makar, Inc. Mount Hope, MI 48864, USA) we took an biopsy and made histological examinations. No foreign body reaction or inflammation signs could be detected.

Absorbable Implants↗
PubMed1998

Low cholesterol and violence.

OBJECTIVE: The association between violent behavior and low serum total cholesterol levels was examined in a psychiatric inpatient population with diverse diagnoses. METHODS: The study used a case-control design to compare the cholesterol levels of patients in a long-term psychiatric hospital who had a history of seclusion or restraints (N = 20) and those who did not (N = 20). A low cholesterol level was defined as less than 180 mg/dL. RESULTS: A strong association was found between low cholesterol levels and violent behavior (odds ratio = 15.49), an association that was not due to age, race, sex, or diagnosis. The finding was consistent whether mean levels or dichotomized levels of cholesterol were examined. Physical health, cholesterol-lowering medication, current alcohol use, or unusual diets could not explain the results. However, the raw frequency of episodes of seclusion or restraint as an indicator of the frequency of violent behavior was not associated with cholesterol level. Dichotomizing cholesterol levels at 180 mg/dL yielded high sensitivity (90 percent) for predicting violent behavior but at the cost of low specificity (65 percent). CONCLUSIONS: The results support the hypothesis that an association exists between low cholesterol and violent behavior among psychiatric patients but argue against using cholesterol level as a screening tool for predicting violent behavior.

Adult↗
PubMed1998

[Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia].

A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.

Adult↗
PubMed1997

Possible discrimination in recruitment of psychiatry residents?

OBJECTIVE: The authors sought to determine whether there is a selection bias against international medical graduate applicants for U.S. residency training positions in psychiatry. METHOD: Identical requests for a program application were sent by two resident applicants--one international medical graduate and one graduate of a U.S. medical school--to 193 residency training programs, and the rate and character of responses were compared. RESULTS: The response rate to requests for an application form was significantly higher for the U.S. medical school graduate (159 responses) than the international medical graduate (87 responses). The quality of responses was also different in some cases. CONCLUSIONS: Some residency programs in psychiatry are attempting to limit the influx of international medical graduate applicants at the very first level: the request for an application form. The reasons for this practice are not known, but discrimination could be a possible explanation.

Educational Measurement↗
PubMed1997

[Diagnostic angiography in life-threatening colonic hemorrhage in Crohn disease].

Life-threatening colonic hemorrhage is a very rare condition in Crohn's disease. Lower gastrointestinal hemorrhage in Crohn's disease occurs in 0.6-2.5% of cases. In a patient presenting with severe gastrointestinal bleeding after ileocolectomy, mesenteric angiography provided precise localisation of the bleeding site in the area of the splenic flexure.

Adolescent↗
PubMed1996

Effects of lactate on cross-spectral analysis of heart rate, blood pressure, and lung volume in normal volunteers.

Baroreceptor reflex sensitivity, coherence functions, and transfer functions between respiration and heart rate, and between respiration and blood pressure, were studied in nine normal volunteers before and after intravenous sodium lactate infusions. Cross-spectral analysis was used to examine heart rate, finger blood pressure, and respiration obtained with the subjects in a supine posture during spontaneous breathing. Sodium lactate produced a significant decrease of the modulus between respiration and heart rate (beats/min/l). There was no such change for the placebo infusions. The absence of a significant difference in the modulus between systolic blood pressure and heart rate for placebo or lactate indicated that there were no significant changes in the baroreceptor sensitivity index. These findings suggest that lactate infusions are associated with a decrease in cardiac vagal function.

Adult↗
PubMed1996

Intermittent amantadine for fluoxetine-induced anorgasmia.

Various drugs, including amantadine, have been reported in the successful treatment of antidepressant-induced sexual dysfunction. Only a regular daily dosing schedule of amantadine has been used for the treatment of sexual dysfunction so far. This case demonstrates that an intermittent dose of amantadine at 100 mg five to six hours prior to coitus could be useful in the treatment of fluoxetine-induced anorgasmia.

Adult↗
PubMed1996

Antidepressants in the treatment of premature ejaculation.

The SSRI antidepressants have emerged as effective new treatment for patients with premature ejaculation whether or not these patients suffer from depression. Clomipramine, fluoxetine, paroxetine, and sertraline seem to be a safe treatment option for patients with premature ejaculation, especially in cases of failed psychological treatment, in rejection of psychological treatment, and when partners are unwilling to cooperate in treatment. Further controlled and larger studies that focus on clinically relevant issues such as dose, length of treatment, maintenance of beneficial effects after treatment discontinuation, and the combination of pharmaco- and behavior therapy for premature ejaculation are warranted. Other medications, such as benzodiazepines, may be useful in some cases of premature ejaculation.

1-Naphthylamine↗