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Biomedical subjects

R D Halpert

Publications and source records attributed to R D Halpert.

At least 19 recordsLinked to original sources
PubMed1999

Effect of uvulopalatopharyngoplasty and genial and hyoid advancement on swallowing in patients with obstructive sleep apnea syndrome.

OBJECTIVE: Uvulopalatopharyngoplasty (UPPP) and genial and hyoid advancement (GHA) are surgical techniques for the treatment of obstructive sleep apnea. These techniques enlarge the oropharyngeal and hypopharyngeal airway, reducing collapse at these levels. This study evaluated the effect of these procedures on swallowing. METHODS: Fifteen patients who had undergone UPPP and GHA were evaluated with a modified barium swallow to assess biomechanical changes in swallowing. Specifically, velopharyngeal insufficiency; changes in tongue-base movement, laryngeal elevation, and closure; epiglottic movement; and pharyngoesophageal opening were examined. A brief swallowing questionnaire was administered to assess for subjective changes in swallowing. RESULTS: Nine of 15 patients demonstrated abnormal objective swallow, of whom 5 reported normal subjective swallowing. Six of 15 demonstrated normal objective swallowing. Of these, 5 reported subjective change. CONCLUSION: UPPP with GHA may alter biomechanical events during deglutition. However, little correlation exists between subjective symptoms and objective findings. Further studies that include preoperative and postoperative modified barium swallows are needed to identify a cause-and-effect relationship.

Adult↗
PubMed1993

Preoperative evaluation of patients for liver resection. Appropriate CT imaging.

OBJECTIVE: The authors determined which combination of computed tomography scans is most helpful for preoperative assessment of patients with liver tumors. SUMMARY BACKGROUND DATA: Multi-institutional studies have shown that the most important prognostic factors for selection of patients with metastatic colorectal cancer considered for liver resection are: Dukes' stage of primary tumor, the number of hepatic metastases if greater than 3, the presence of extrahepatic cancer, and the ability to resect tumors with an adequate margin (> 1 cm.) Therefore the ability to predict the presence of extrahepatic disease and the number and location of hepatic tumors are important in these patients. METHODS: One hundred and nine consecutive patients with evidence of hepatic tumors were evaluated by computed tomography with arterial portography (CTAP) and abdominal computed tomography after a 4-hour delay (CT-D). Results of these studies and conventional computed tomography (CT-C) were compared with findings at operation. RESULTS: CTAP proved to be the most sensitive test for assessing distribution of intrahepatic disease. CT-D was no more sensitive than CT-C for the detection of hepatic or extrahepatic disease. CONCLUSIONS: CT-C in concert with CTAP provides the most reasonable CT evaluation of patients considered for operation for the treatment of hepatic tumors.

Humans↗
PubMed1993

Abdominal complications in organ transplant recipients.

A variety of intraabdominal complications are associated with organ transplantation. These include inflammatory changes involving the bowel, liver, and pancreas and range from technical complications associated with the surgery to organ rejection, opportunistic infections, and an increased risk of de novo malignancy in transplantation patients.

Bone Marrow Transplantation↗
PubMed1990

Adenocarcinoma of the appendiceal stump.

We have reported the case of a 58-year-old woman with nonspecific abdominal complaints in whom barium enema and subsequent colonoscopy showed a 3 cm lobulated adenocarcinoma within a villous adenoma arising from the appendiceal stump. Because such appendiceal malignancies have no specific clinical signs, symptoms, or radiologic features, preoperative diagnosis is extremely difficult, and colonoscopy may be required to clarify radiologically demonstrated irregularities.

Adenocarcinoma↗
PubMed1989

Rectal diverticulosis: a case report and review of the literature.

The occurrence of rectal diverticulosis is rare. We report the incidental finding of a large rectal diverticulum in a patient receiving an air-contrast barium enema. The presence of uncomplicated rectal diverticulosis is probably of little clinical significance. However, there can be associated complications such as inflammation and perforation, and potential confusion with rectal carcinoma.

Aged↗
PubMed1989

Patient "no-shows"--a costly problem.

The cost of patients' failure to keep scheduled appointments can be significant. This article examines two methods of reducing this problem and evaluates their effectiveness: the reminder phone call and computer-generated reminder letters. The varying success rates of these two methods are discussed as they relate to several areas of the Radiology Department at the University of Texas Medical Branch at Galveston, Texas.

Appointments and Schedules↗
PubMed1989

Patient "no-shows"--are we scheduling failure?

Radiology departments may inadvertently be contributing to their patient "no show" problems. This article continues the analysis of patients' failure to keep scheduled radiology appointments first described in "Patient 'No Shows'--A Costly Problem" (Radiology Management, 11:1) and illustrates "no-show" patterns in three examination groups in the Department of Radiology at the University of Texas Medical Branch, Galveston, Texas. The study shows a strong link between patients' failure to keep appointments and the length of time between scheduling and the performance of the examination.

Appointments and Schedules↗
PubMed1988

Digital radiography of the gastrointestinal tract.

The gastrointestinal tract lends itself quite well to digital imaging. Since fluoroscopy is already employed, the images can easily be obtained in digital format and several manufacturers have now developed systems for commercial use. Because of the type of pathology as well as the inherent subject contrast, it would appear the resolution requirements for digital imaging of the gastrointestinal tract are less than in other organ systems. The necessary resolution level is already technically available and feasible without significant cost. Digital imaging also holds promise of at least a modest reduction in radiation dose to the patient, as well as a reduction in costs, although these factors are operator dependent. However, digital imaging provides a latitude in performing the examination that is not available with screen-film systems. Finally, there is promise that by acquiring gastrointestinal images in digital format, manipulation of the images may help increase diagnostic accuracy by improving both technical and perceptive components of diagnosis. Not only will simple image manipulation be helpful but there is even potential for computer-assisted evaluation of gastrointestinal images.

Colitis, Ulcerative↗