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Biomedical subjects

S Eldar

Publications and source records attributed to S Eldar.

At least 73 records · Page 4Linked to original sources
PubMed1986

Postoperative acute cholecystitis complicating unrelated operations.

The entity of postoperative acute cholecystitis has striking features that demand special attention. The process may follow intra- and extra-abdominal procedures, and the diagnosis may be especially difficult after recent abdominal operations. The course of the disease is frequently obscure and fulminant, progressing rapidly to gangrene and perforation of the gallbladder, with a high mortality rate. Six such patients, aged 69 to 83 years, were managed in our department, with one death. The cause of this complication is probably multifactorial and includes: stasis of bile of high viscosity induced by dehydration, hypovolemia, fever, and shock; obstruction at the sphincter of Oddi following starvation, anesthesia, narcotics or other possible factors such as pigment load following blood transfusion; and impaired circulation to the gallbladder secondary to sympathetic stimulation or blood-borne toxic factors induced by septicemia. The key to successful treatment is awareness, early diagnosis, intensive preoperative treatment with fluids and antibiotics, and percutaneous drainage or immediate cholecystectomy.

Acute Disease↗
PubMed1985

The delivery of nutritional support. A potpourri of new devices and methods.

With continued interest and increasing awareness of nutritional support to patients, both hospitalized and at home, many new developments in the field of devices and methods of delivering nutritional support have occurred. The indications, methods of use, and the associated complications related to feeding via nasogastric tube, tube esophagostomy, gastrostomy, and jejunostomy in the light of new devices and methods are outlined. The authors' experience shows that postoperative enteral feeding is a reliable and efficient method of providing supportive nutrition, provided the appropriate patients are selected. Home enteral nutritional support via gastrostomy allows stable cancer patients to maintain their nutritional status and enjoy life independent of the hospital setting for an extended period of time. When feeding via the gastrointestinal tract is neither feasible nor desirable, for both short-term and long-term nutritional support, access to the central venous system becomes necessary because peripheral vein feeding has limited cost-effectiveness. Delivery of nutrients into the superior vena cava by long antecubital catheters has been advocated, and the use of Hickman/Broviac catheters, instead of conventional subclavian catheters, is becoming an increasingly common practice. Experience with the use of arteriovenous fistulae and the Infuse-A-Port (Infusaid Corp.) are reviewed; the method used for declotting infected and thrombosed catheters is outlined. Current trends in the use of three-liter bags containing a fat emulsion with glucose and amino acids are mentioned.

Arm↗
PubMed1985

Elective mutism--an atypical antecedent of schizophrenia.

Elective mutism (EM) is a rare psychiatric condition of childhood involving refusal to speak in social situations. We herewith describe such a case which developed into a full-blown schizophrenic illness. This may be the first detailed report of such an outcome in the literature.

Adolescent↗
PubMed1985

Extended resections for carcinoma of the colon and rectum.

Eighty-four of 1,081 patients with carcinoma of the colon and rectum operated upon at our institution between 1951 and 1980 had extended resections involving adjacent organs. The types of presenting symptoms or the duration had no affect on the survival time of these patients. Survival time was most significantly correlated with pathologic penetration and Dukes' stage. The operative mortality was 5.9 per cent with a complication rate of 28.5 per cent. The nature of the individual organs involved did not affect the survival time. Patients with carcinoma of the colon and rectum extending to adjacent organs can undergo resection with a five year survival rate comparable with all patients with surgically treated carcinoma of the colon and rectum.

Abdominal Neoplasms↗
PubMed1984

Cancer of the breast after prophylactic subcutaneous mastectomy.

We have reported a case of carcinoma of the breast in a patient that occurred after bilateral prophylactic subcutaneous mastectomy. We recommend that the patient and physician be aware of the limitations of prophylactic mastectomy in terms of cancer prevention and that patients who undergo prophylactic mastectomy continue to be carefully followed.

Adenocarcinoma↗
PubMed1984

Postoperative acute cholecystitis complicating urologic operations.

Two cases are described of acute gangrenous cholecystitis following urologic operations. The subject is reviewed. The predominance of urologic procedures as the preceding factor for this postoperative complication is pointed out. The possible causes, the presenting features, the diagnosis, management, and serious prognosis are discussed. Awareness of the condition, early diagnosis, and operation are recommended. Its importance to the urologist is stressed.

Acute Disease↗
PubMed1983

Hydromediastinum and hydrothorax in the neonate with central vein catheterization.

A near fatal complication of central venous catheterization in a newborn infant is reported. Five days after insertion, the catheter tip eroded through the wall of the vein, causing hydromediastinum and hydrothorax with acute circulatory and respiratory distress. The diagnosis was confirmed by noting that the tip of the catheter had become curved downwards, by aspirating slightly bloodstained fluid from the pleural space and by injecting radio-opaque dye through the catheter. Recovery followed removal of the catheter, intercostal drainage, intubation and positive pressure respiration. The erosion of the vein may have been brought about by the location of the catheter tip at the junction of the left subclavian and innominate veins--a less than optimal position. The factors causing this complication are discussed. Recommendations are made about the type of catheter, its appropriate placement and maintenance. The diagnosis and management are surveyed.

Catheterization↗
PubMed1982

Splenectomy for the treatment of hairy-cell leukemia.

In conclusion, patients with hairy-cell leukemia may need no therapy for prolonged periods. If they are symptomatic from hypersplenism, they may be expected to benefit from splenectomy. Some patients will have a relapse after splenectomy. At this time, there is no method to predict which patients will have a long term benefit from splenectomy, and we believe that operation should not be recommended as the primary therapy for hairy-cell leukemia.

Adult↗
PubMed1981

Spontaneous rupture of an abdominal aortic aneurysm into the inferior vena cava.

A 70-yr-old man developed acute localized and generalized symptoms and signs associated with a large aneurysm of the abdominal aorta. During an emergency operation, it was found that the aneurysm had ruptured into the inferior vena cava (IVC). The fistula was closed and the aneurysm replaced by a bifurcated synthetic graft. Important factors in the operative management were: clamping of the aorta above and the common iliac arteries below the aneurysm; opening of the aneurysm through a vertical incision; control of back bleeding through the fistula by external pressure on the IVC; closure of the fistula by a continuous braided dacron suture incorporating the walls of the aneurysm and the IVC; and replacement of the aneurysm by a bifurcated synthetic graft without excision of the aneurysm.

Aged↗
PubMedDate not supplied

Correlates of violence risk in hospitalized adolescents.

Forty adolescent inpatients with histories of frequent interpersonal violent behavior were compared with 36 hospitalized adolescents without histories of overt violence using self-report questionnaires that measured violence risk, depression, impulsivity, and suicide risk. The two groups did not differ in terms of their demographic characteristics, but the violent patients had a higher prevalence of substance abuse and borderline personality disorder diagnoses. Violent adolescents were more impulsive and at higher suicide risk than nonviolent adolescents. In addition, violent adolescents had more positive histories of suicide attempts and had significantly higher family histories of attempted and completed suicide. In the total sample of adolescents, violence risk was significantly correlated with impulsivity and suicide risk, but not with depression.

Adolescent↗
PubMedDate not supplied

Thyroid function in attention deficit and hyperactivity disorder.

In view of the recent conflicting findings regarding the causative role of thyroid abnormalities in attention deficit hyperactivity disorder (ADHD), we performed a replication study to clarify the issue and establish clinical guidelines. Thyroid tests were performed in 43 ADHD children and 28 age- and gender-matched controls. Sixteen ADHD children showed total triiodothyronine (TT3) levels which were slightly above the upper limit of normal, but no significant difference in TT3 values was noted between the ADHD and the control groups. Moreover, none of the ADHD subjects had abnormal levels of total thyroxine, free thyroxine, thyroid stimulating hormone or total triiodothyronine reuptake. The present study supplies additional evidence for the lack of an association between thyroid function and ADHD, and counters the suggestion that thyroid function be routinely screened for in ADHD children.

Adolescent↗
PubMedDate not supplied

The prevalence of mitral valve prolapse in children with anxiety disorders.

Studies in adults have suggested a comorbidity of mitral valve prolapse and anxiety disorders, especially panic disorder. The nature of the association between these disorders is yet unclear. In the last years, case studies have appeared, reporting on the comorbidity of anxiety disorders and mitral valve prolapse in children. The present study evaluated the prevalence of mitral valve prolapse in children with anxiety disorders as compared to normal controls. The study group consisted of 52 children, 6-18 years old, with a diagnosis of panic disorder (9.6%), separation anxiety disorder (65.4%) and/or overanxious disorder (61.5%). Fifty-one normal age- and gender-matched healthy children served as controls. All participants were evaluated for the presence of mitral valve prolapse by cardiac auscultation and echocardiography. None of the 52 children with anxiety disorder and one of the 51 control children (1.96%) had mitral valve prolapse. There appears to be no association between childhood anxiety disorders and mitral valve prolapse. Whether children with panic disorder proper show a greater prevalence of mitral valve prolapse remains an open question. Implications to the association of mitral valve prolapse and panic disorder are discussed.

Adolescent↗
PubMedDate not supplied

Neurocognitive correlates of anxiety disorders in children: a preliminary report.

Children with anxiety disorders have been suggested to possess a specific cognitive scheme that underscores negative information and leads to the formation of a negative view of themselves and of the world. The aim of the present study was to assess the neuropsychological processes of children and adolescents with anxiety disorders, as compared to healthy matched controls. Nineteen children (6-18 years) with anxiety disorders and 14 age-matched healthy controls participated in the study. Both groups scored within normal range on the Wechsler Intelligence Scale for Children-Revised (WISC-R). All children underwent neuropsychological assessment with the California Verbal Learning Test (CVLT) (Verbal Processing), the Rey-Osterrieth Complex Figure test (ROCF) (Nonverbal Processing), and the Wisconsin Card Sorting Test (WCST) (Executive Functions). The anxiety group scored lower than the control group on all measures of the CVLT and had a significantly greater number of errors, perseverative responses, and incorrect answers after negative feedback on the WCST. No differences were detected for the ROCF. We conclude that in children and adolescents, anxiety disorders may be associated with lowered linguistic abilities and cognitive flexibility, as measured by neuropsychological paradigms. Anxiety does not appear to be associated with nonverbal processes.

Adolescent↗
PubMedDate not supplied

Computer-assisted image analysis of small cell lymphoma of the thyroid gland. Comparison of nuclear parameters of small lymphocytes in lymphomas and Hashimoto's thyroiditis.

The nuclear parameters of the small lymphocytes in nine cases of small cell lymphomas of the thyroid gland and 17 cases of Hashimoto's thyroiditis were assessed by computer-assisted image analysis. The nuclear area, maximal, minimal and averaged Ferret diameters, perimeter, regularity factor and elongation factor were gauged. Statistically, the nuclear area was ascertained to be the optimum descriptor discriminating between small neoplastic and reactive lymphocytes. Application of a novel variable, combining a nuclear area cut-off value of 14 microm2 with a nuclear averaged Ferret diameter cut-off value of 4.5 micron, allows for the distinction - with a high degree of sensitivity and specificity - between small neoplastic lymphocytes in thyroidal lymphomas and the reactive lymphocytes in Hashimoto's thyroiditis.

Adult↗
PubMedDate not supplied

Pneumothorax following attempted nasogastric intubation for nutritional support.

Nasogastric intubation is a routine procedure, performed daily by both medical and nursing staff. It is a simple procedure, but not without complications which can be life threatening. We present an unusual, life threatening complication which occurred when nasogastric intubation using a no. 8 polyurethane tube with its metal stilet resulted in a pneumothorax after intubation of the endotracheal tree in the presence of a cuffed endotracheal tube. We emphasize that the presence of a cuffed endotracheal tube should not be considered a safeguard against pulmonary intubation during nasogastric placement of a feeding catheter.

Aged↗