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Biomedical subjects

R Udassin

Publications and source records attributed to R Udassin.

At least 55 records · Page 3Linked to original sources
PubMed1989

Peritonitis and empyema following the use of dextran in tubal operations.

Two patients developed severe bacterial sepsis with peritonitis and pleural empyema following tubal surgery. Intraperitoneal low-molecular dextran was used in both patients and hydrocortisone was administered perioperatively. The use of dextran in tubal surgery probably increases the risk of severe postoperative infection and should be avoided in susceptible patients. Prophylactic antibiotics may be indicated when dextran is administered.

Adult↗
PubMed1989

Gallbladder distention in premature neonates receiving parenteral nutrition.

Contraction of the gallbladder is mediated through the release of cholecystokinin from duodenal cells secondary to enteral feedings. Premature infants are often nourished by parenteral hyperalimentation leading to prolonged inactivation of the gallbladder. Such inactivation probably accounts for the increased incidence of gallbladder distention observed in premature neonates. Two cases of premature infants are described in whom distention of the gallbladder occurred during parenteral hyperalimentation. The distention resolved spontaneously secondary to the introduction of enteral feedings. A trial period of oral or tube feeding is recommended in such cases prior to any attempt to release the distention by a surgical intervention.

Gallbladder↗
PubMed1988

Idiopathic gastrointestinal perforation in the neonate.

Spontaneous localized perforation of the gastrointestinal tract, unrelated to mechanical intestinal obstruction and with no evidence of necrotizing entrocolitis (NEC), occurred in 20 neonates. Three perforations were located in the stomach, 11 in the small intestine, and six in the colon. Maternal obstetric complications as well as prematurity and postnatal distress were common in these patients. The overall survival rate was 80%. There was no late gastrointestinal symptoms in the survivors. Whether idiopathic perforation of the gastrointestinal tract results from a localized form of NEC or from a distinct lesion of unknown etiology has not yet been ascertained. Some ideas concerning the etiology of this entity, as well as some diagnostic aspects are discussed.

Colon↗
PubMed1988

Gastrointestinal perforations in the neonatal period.

Forty-eight neonates were treated for gastrointestinal perforation during a 9-year period. In 30, perforation occurred within the first week of life. Thirty-six were preterm infants and many had a history of obstetric and postnatal complications. Perforation resulted from necrotizing enterocolitis in 26 patients, whereas in 14 neonates spontaneous perforation occurred in an apparently normal bowel, with no evident cause (idiopathic perforation). In 6 patients perforation was associated with meconium ileus. Primary closure was carried out for perforations of the duodenum and stomach. Intestinal perforations were usually treated by resection and enterostomies. The overall mortality rate in this series was 46%. The highest mortality rate was associated with necrotizing enterocolitis (62%). The mortality rate was only 14% in patients with idiopathic perforation. Despite improvement in the prognosis of neonatal gastrointestinal perforations in recent years, it is still discouraging, reflecting the difficulty in preventing and treating necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1987

Serum copper level in gynecologic malignancies.

Serum copper level was determined before operation in 179 patients with various histologically proved gynecologic tumors: malignant, benign, or metastases to the ovary. Serum copper level was significantly higher (p less than 0.01) in all groups of patients with cancer and in the benign group when compared with control subjects. Serum copper level correlated well with stage of cancer disease (r = 0.70 to 0.79) except for ovarian carcinoma, in which serum copper level was already significantly elevated in Stages I and II. The sensitivity of serum copper level greater than 150 micrograms/dl in detecting malignancy was 87% to 100% in late cancer stages in all malignancies. Our data imply that the addition of serum copper level determination to other screening tests could increase their sensitivity.

Copper↗
PubMed1987

Localized pseudomembranous colitis simulating carcinoma of the cecum.

A 76-yr-old woman complained of right lower quadrant abdominal pain, nausea, and fever. There was no history of antibiotic therapy or preceding diarrhea. At laparotomy, a cecal lesion simulating a tumor was found with an otherwise normal colon. Right hemicolectomy was performed. Pathological examination showed pseudomembranous colitis confined to the cecum. It is suggested that pseudomembranous colitis unrelated to prior exposure to antimicrobial agents can occur without diarrhea, and may be a localized process mimicking colonic carcinoma.

Aged↗
PubMed1985

Serum copper level in ovarian carcinoma.

Serum copper levels (SCL) were determined before any diagnostic procedure was performed or treatment given in 40 women admitted for the investigation of a pelvic mass and, later, in those patients with ovarian carcinoma after chemotherapy and before a second-look operation was performed. Patients with ovarian carcinoma were found to have significantly higher SCL than patients with benign ovarian lesions. A SCL of 150 micrograms/dl clearly separated patients with a pelvic mass on the basis of ovarian carcinoma and those with benign noninflammatory pelvic lesions. The same SCL of 150 micrograms/dl separated patients with ovarian carcinoma that responded to chemotherapy and those with residual disease. It is suggested that SCL be included as a member of the screening panel of biologic tumor markers in general and in ovarian carcinoma in particular.

Adenocarcinoma↗
PubMed1985

The surgical management of children with familial dysautonomia.

Familial dysautonomia (FD) is a rare incurable genetic disorder with multisystem involvement. Most of its clinical manifestations are related to disorders of the autonomic nervous system. The disease is associated with specific disturbances of the upper gastrointestinal tract: pharyngoesophageal dyskinesia, gastroesophageal reflux, and prolonged gastric emptying. About 40% of the dysautonomic children manifest repeat vomiting crises. In view of the extensive gastrointestinal symptomatology, children with FD are prone to repeated aspiration pneumonia and chronic respiratory failure, while inadequate calory and fluid intake may lead to a chronic state of hypovolemia and severe failure to thrive. Control of vomiting, prevention of aspiration due to abnormal swallowing, and the assurance of adequate calory intake are three major objectives in the treatment of the dysautonomic child. Medical treatment of the gastrointestinal disorders using different drugs has had limited success. This study reviews the surgical experience in ten children with FD. The type of the procedure used was determined by the severity of the upper GI disturbances. Nine children underwent gastroesophageal Nissen fundoplication and gastrostomy. In seven of them, a pyloroplasty was added. Gastrostomy alone was done in one patient only. Postoperative complications included transient dysphagia in four patients, gastric dilatation in four patients, and dumping syndrome in one. There has been no incidence of immediate postoperative death. One child died 6 months after operation from severe and irreversible respiratory failure. Following operation, the patients still suffered from dysautonomic crises but these were not associated with vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Meconium plugs and intussusception in a premature infant.

Neonatal intussusception in premature infants is uncommon and may mimic other abdominal disorders. We present a case of intussusception in a very low birthweight neonate. Presenting signs initially suggested necrotizing enterocolitis and meconium disease, and the diagnosis was confirmed at laparotomy.

Humans↗
PubMed1985

Percutaneous subclavian venous catheters in premature infants weighing less than 1500 gm.

Thirty-two percutaneous subclavian venous catheters were inserted in critically ill, low birthweight (less than 1500 gm) neonates. No complication occurred secondary to insertion. The total number of catheter-patient days was 754 days, with the average duration of a single catheter being 23.5 days. The incidence of primary catheter-related clinical sepsis was 3.1%. The safety and bedside feasibility of the procedure, as well as long catheter duration make it the best option for long-term venous access in this unique group of patients.

Birth Weight↗
PubMed1984

Isolated emphysematous gastritis in an infant.

A case of isolated emphysematous gastritis in a full-term infant, which is the fifth so far in the medical literature, is described. Predisposing factors, mode of treatment, and sequelae differ from the rare adult form of this disease. Of special interest are malnutrition as a predisposing factor in the development of this disease in infants and the very important role of intravenous hyperalimentation in its successful treatment.

Anti-Bacterial Agents↗