Biomedical subjects
R Vasudeva
Publications and source records attributed to R Vasudeva.
Gastroesophageal physiology after stapled gastroesophagostomy in dogs.
A stapled vertical gastroesophagostomy (VGE) has been proposed for benign esophageal stricture. The VGE involves performing an anastomosis using a linear cutting stapler inserted via a gastrotomy (one limb in the esophagus, the other in the proximal fundus). In phase I of the study, a 50-mm VGE was performed in 13 dogs; 7 received an additional fundoplication. Endoscopy with pinch biopsies, esophageal manometry, and 4-hour ambulatory pH recordings were performed in each dog prior to and 1 month after VGE. The only difference between groups postoperatively was a higher lower esophageal sphincter pressure in the group with the added fundoplication. The incidence of histologic esophagitis was low in both groups. In phase II of the study, a VGE was performed in six dogs using a 75-mm linear cutting stapler, accompanied by fundoplication in each dog. These dogs were then followed for 6 months to more completely assess the long-term risk of developing reflux esophagitis. At necropsy, no gross or histologic evidence of esophagitis was found. The performance of a VGE through the lower esophageal sphincter in normal dogs does not result in significant reflux esophagitis. VGE may be an alternative to resection for esophageal stricture.
Is continuous, esophageal pH monitoring reliable in a community practice setting?
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A prospective, multi-center clinical trial of the Taylor intragastric balloon for the treatment of morbid obesity.
This report describes the result of a prospective, multicenter clinical trial of the Taylor intragastric balloon for the treatment of morbid obesity. Sixty patients, who had failed sustained weight loss on prior dietary restriction and behavior modification programs, were enrolled in four clinical centers. The Taylor intragastric balloon, a 550-ml, pear-shaped, liquid-filled, silicone device, was inserted in all patients for a period of 16 wk, and patients were maintained on a dietary restriction and behavior modification program. During the study period, patients experienced a 11.6% decrease in mean weight and an 11.4% decrease in body mass index. Seven balloons deflated spontaneously. Examination of these balloons revealed a manufacturing defect that was subsequently corrected. No further deflations occurred. Effects of the balloons on gastric mucosa were minimal with no gastric erosions or ulcerations noted.
Taylor intragastric balloon.
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Observations on the management of alcohol withdrawal syndrome.
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Intragastric devices for weight loss: fact or fancy?
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Isoniazid-related hepatitis.
Conclusive evidence of isoniazid (INH)-related hepatotoxicity ranging from asymptomatic elevation of liver enzymes to fulminant hepatic failure resulting in liver transplantation and/or death has been firmly established. Anticipation of the widespread usage of INH in the prevention and treatment of tuberculosis is expected due to the recent increasing incidence of tuberculosis. The aim of this article is to review the current concepts of pathogenesis, histopathology, risk factors and clinical features of INH-related hepatitis, emphasizing the need for vigilance.