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Biomedical subjects

S Bank

Publications and source records attributed to S Bank.

At least 73 records · Page 4Linked to original sources
PubMed1988

Aortoesophageal fistula: early and late endoscopic features.

Endoscopic photographs were obtained in a patient with back pain and hematemesis. External compression of the mid-esophagus and small esophageal diverticula was noted, as well as a small erosion oozing bright red blood in otherwise normal mucosa. Angiography revealed an aneurysm of the thoracic aorta without leak. Surgical closure of the aneurysm was initially successful; however, the patient developed recurrent bleeding one month later. Repeat endoscopy revealed a recurrent fistula with an intramural mass in the mid-esophagus, oozing blood with adherent clot. These findings are the earliest endoscopic features of aortoesophageal fistula described, and this is the only case with subsequent reendoscopy, demonstrating previously reported findings in an advanced stage of fistula formation. Flexible endoscopy is a safe, valuable diagnostic study in suspected aortoesophageal fistula. The literature on endoscopy in aortoesophageal fistula is reviewed.

Aorta, Thoracic↗
PubMed1987

Repeat colonoscopy after endoscopic polypectomy.

The records of all patients undergoing endoscopic polypectomy between December 1979 and December 1982 were reviewed. One hundred seventy-two patients underwent colonoscopic polypectomy in the absence of carcinoma or inflammatory bowel disease. Of these, the polyp could not be retrieved in 4, and 19 were lost to follow-up. One hundred forty-nine patients underwent subsequent endoscopy from one to four years after the initial polypectomy. Seventy-five (50.3 percent) of the patients developed new polyps. Although 61 of the 75 patients with new polyps were identified in the first two years, new polyps were noted throughout all four years. The presence of multiple polyps on the initial examination was statistically significant in predicting new polyps. The age and sex of the patients, size of the polyps, and the presence of atypia did not identify patients at higher risk for new polyps. The data indicate that new polyps are more likely to develop in patients who had a previous polyp. It would appear that annual examinations should be performed until two successive examinations are negative. Following a second negative examination, reexamination at two- or three-year intervals, unless symptomatic, would appear to be adequate.

Adenoma↗
PubMed1987

Macroamylasaemia in association with the acquired immunodeficiency syndrome.

A patient with macroamylasaemia in association with the acquired immunodeficiency syndrome is described. Patients with the acquired immunodeficiency syndrome commonly have gastrointestinal symptoms that often prompt serum amylase determination. Macroamylasaemia has been found to occur in a variety of diseases including various autoimmune disorders. The marked immunological abnormalities and increased circulating immunoglobulins associated with the acquired immunodeficiency syndrome may have predisposed this patient to macroamylase formation. Macroamylasaemia is a benign condition that requires no treatment and must be excluded in the patient with unexplained hyperamylasaemia to avoid unnecessary diagnostic tests and treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The identifier concept: clinical parameters to stratify hospital costs within gastroenterology DRGs.

Prospective payment systems using the diagnostic related group (DRG) payment mechanism are changing the incentives offered to hospitals. We studied hospital costs of all gastroenterological (GI) patients (n = 2500) treated during a 2-yr period at our academic medical center. We showed that patients within GI DRGs could be grouped regarding hospital costs by four clinical variables: intensive care unit or emergency admission, and blood or plasma product consumption. Patients within each DRG with the variable usually had higher total hospital costs, a longer stay in the hospital, a greater number of diagnoses, more outliers, and a poorer outcome than patients without the variables. As the variables accumulated, these differences became more pronounced. This study demonstrated that hospital costs may be stratified within GI DRGs by clinical parameters that occur during the patient's hospital stay. These four variables could identify higher cost patients within a DRG; cost containment could then be directed at these patients with, hopefully, resultant savings.

Blood Transfusion↗
PubMed1987

Pneumatic dilatation in achalasia under endoscopic guidance: correlation pre- and postdilatation by radionuclide scintiscan.

Pneumatic dilation of the lower esophageal sphincter was accomplished by endoscopic visualization and positioning of a modified polyurethane dilator (90 F diameter) without fluoroscopy in 17 consecutive patients with advanced symptomatic achalasia. All patients were monitored for completeness of dilation by pre- and postdilation radionuclide scintiscan. Despite advanced megaesophagus, prior dilatations, or complicating disease, all patients showed prompt relief of symptoms.

Adult↗
PubMed1986

Multicenter pathological study of chronic pancreatitis. Morphological regional variations and differences between chronic calcifying pancreatitis and obstructive pancreatitis.

To examine previous work carried out at a single center, i.e., France, on the pathologic features of chronic pancreatitis and to examine geographic differences, 359 cases of chronic pancreatitis from five centers were studied pathologically and the results analyzed according to appropriate statistical methods. It was found that it was easy to separate chronic calcifying pancreatitis from obstructive pancreatitis occurring distal to obstruction to the pancreatic duct by pathological means. On the other hand, geographic differences between France, Italy, Brazil, and South Africa, although present, were not sufficient for identification of a specific profile for each of the countries studied, and it was found that the minor differences were probably dependent on environmental rather than racial factors.

Brazil↗
PubMed1986

The effect of verapamil on pancreatic exocrine secretion.

This study set out to examine the effects of a Ca++ channel blocker, verapamil, on pancreatic exocrine secretion because of the known relationship between amylase secretion and intracellular Ca++. Pancreatic secretion was stimulated in dogs by infusing secretin and cholecystokinin. Verapamil was found to inhibit the secretion of amylase but to have no effect on lipase, trypsin, or total protein. There was no effect on the secretion of water and bicarbonate. To determine the possible physiologic significance of these findings, the pancreas was stimulated by a meat meal, and verapamil was found to inhibit amylase secretion again and in addition to inhibit the secretion of water and bicarbonate. The results suggest that verapamil has an inhibitory effect on amylase secretion by blocking the influx of Ca++ into the acinar cell and has an indirect effect leading to inhibition of water and bicarbonate secretion from the duct cells.

Amylases↗
PubMed1986

Adenocarcinoma of the duodenum in a patient with nontropical sprue.

Celiac sprue is associated with an increased risk of malignant lymphoid tumors. A patient is presented with celiac disease and adenocarcinoma of the duodenum; this association suggests that a careful search for complicating malignant tumors be undertaken in those patients with sprue whose clinical course has changed or deteriorated.

Adenocarcinoma↗
PubMed1985

Comparison of antacid and sucralfate in the prevention of gastrointestinal bleeding in patients who are critically ill.

In a randomized open trial, a regimen consisting of sucralfate administered every six hours was shown to be as effective as a regimen consisting of an antacid given hourly in the prevention of upper gastrointestinal bleeding in 155 patients who were critically ill. Two of 75 (2.6 percent) patients receiving antacid and three of 80 patients (3.8 percent) receiving sucralfate showed evidence of bleeding. In no case was bleeding severe enough to necessitate blood transfusions or surgery. The cost-effectiveness, ease of administration, reduced nursing hours, greater compliance, and fewer side effects make sucralfate a useful substitute for antacid in preventing upper gastrointestinal bleeding in patients who are critically ill.

Aluminum↗
PubMed1985

Prevention of duodenal ulcers in the rat using a combination of ranitidine and sucralphate in subtherapeutic doses.

This study investigated whether ulcer prevention would be greater with the combined use of an acid-inhibiting agent, ranitidine, given together with a mucosal-protective agent, sucralphate. Duodenal ulcers were induced in rats with the secretagogues pentagastrin and bethanechol. Subtherapeutic doses of ranitidine (5 mg/kg/6 hours) and sucralphate (50 mg/6 hour) yielded an ulcer index of 4.0 and 4.1 respectively, not significantly different from the control (untreated) ulcer index of 4.3. Therapeutic doses of ranitidine (20 mg/kg) and sucralphate (200 mg/animal) gave an ulcer index of 0.4 and 0.5 respectively. Subtherapeutic doses of ranitidine and sucralphate given in combination yielded an ulcer index of 0.7. Thus, subtherapeutic doses of ranitidine and sucralphate given in combination had a synergistic effect equal to therapeutic doses of each of these drugs given alone. The therapeutic implications of combined acid inhibiting drugs with mucosal protective drugs is discussed.

Aluminum↗
PubMed1985

Amylase isoenzymes in the acute abdomen: an adjunct in those patients with elevated total amylase.

The role of routine isoamylase determinations in differentiating acute pancreatitis from other causes of an acute abdomen with hyperamylasemia and/or hyperamylasuria was evaluated. Values were analyzed from a control group of 21 patients with acute pancreatitis (group I) and from 100 consecutive patients diagnosed in our emergency department as having an acute abdomen (group II). In group I, 100% of patients had hyperamylasemia, hyperamylasuria, and a P isoamylase fraction greater than 0.75 of the total amylase value. In group II, 50% of patients had hyperamylasemia and/or hyperamylasuria. Of these patients, 44% had a P isoamylase fraction less than 0.75 of the total amylase value, a finding apparently incompatible with a diagnosis of acute pancreatitis as identified by our control group. We conclude that routine isoamylase determinations in patients with an acute abdomen and hyperamylasemia and/or hyperamylasuria allows the differentiation from acute pancreatitis in 44% of cases.

Abdomen, Acute↗