Search PubMed⌕ Search

Biomedical subjects

T H Baron

Publications and source records attributed to T H Baron.

79 records · Page 5Linked to original sources
PubMed1993

Low-dose oral methotrexate in refractory inflammatory bowel disease.

The purpose of this study was to evaluate the efficacy and safety of low-dose weekly, oral methotrexate in patients with steroid-dependent or steroid-refractory inflammatory bowel disease (IBD). Oral methotrexate was given weekly at 15 mg/week. The primary criterion of response was based on steroid withdrawal. Of the 10 patients with Crohn's disease, daily prednisone dosage dropped from a mean of 37 +/- 9.6 mg to 8.3 +/- 2.1 mg/day (P < 0.02); two had a complete withdrawal and four a partial response (< 7.5 mg/day). In the eight patients with ulcerative colitis, daily prednisone dose dropped from a mean of 26.3 +/- 3.2 mg/day to 12.7 +/- 2.0 mg/day (P < 0.001); three had a partial response. Adverse effects due to methotrexate were mild in both groups. We conclude that oral methotrexate may be useful and reasonably safe as a steroid-sparing agent in patients with refractory IBD.

Administration, Oral↗
PubMed1993

Unusual presentation of mucosal hypersensitivity secondary to gastroesophageal reflux disease.

We report an unusual presentation of gastroesophageal reflux disease in a 14-yr-old boy with cervical dysphagia and vomiting immediately after swallowing. Reflux disease was diagnosed by the combination of eosinophils on esophageal biopsies and abnormal 24-h pH results. The cervical site of dysphagia demonstrated acid-induced hypersensitivity to esophageal distension with water or air. The patient's symptoms resolved with marked acid suppression, which was made difficult because intact capsules of omeprazole initially could not be ingested.

Adolescent↗
PubMed1993

The use of esophageal function tests.

The esophagus is subject to a variety of disorders that can be mechanical or functional in origin. In addition, GERD is quite common and can present with atypical manifestations. Mirroring these disorders, the esophageal function tests can likewise be broken down into anatomic and functional studies. The barium esophagogram, when properly performed, is probably the single most important test because it evaluates both oropharyngeal and esophageal anatomy and motility as well as the presence or absence of GERD. Endoscopy allows direct inspection and sampling of the esophagus. Esophageal scintigraphy and manometry play less important but well defined roles. Finally, the advent of prolonged ambulatory esophageal pH monitoring has advanced our knowledge about GERD and has particularly helped in the diagnosis of patients with atypical reflux presentations such as chest pain and pulmonary or otolaryngologic symptoms.

Esophageal Diseases↗
PubMed1992

Gastroesophageal reflux disease in pregnancy.

Heartburn during pregnancy occurs in approximately two thirds of all pregnancies. The origin is multifactorial, but the predominant factor is a decrease in LES pressure resulting from female sex hormones, especially progesterone. Mechanical factors play a small role. Serious reflux complications during pregnancy are rare outside the obstetric setting. Therapy involves lifestyle modifications and nonsystemic medications as the initial choices. H2 blockers are probably safe in severe and refractory cases.

Anesthesia, Obstetrical↗
PubMedDate not supplied

An in vitro, randomized, prospective study to maximize cellular yield during bile duct brush cytology.

Endoscopic retrograde brush cytology is useful for the evaluation of biliary strictures. Access across a stricture can be maintained by removing the cytology brush while leaving the sheath in the bile duct. We examined the potential for loss of diagnostic cellular material in this setting using the canine biliary system. Twenty consecutive samples were randomly collected by (1) pushing the brush from the end of the sheath or (2) pulling the brush through the length of the sheath. Slides prepared from cell suspensions were scored by a cytopathologist blinded to the collection method. Pulling the brush resulted in a significant loss of cellular material (p < 0.001). In a second phase, 23 consecutive samples were randomly obtained in the same fashion. Combining salvage cytology of material from the sheath with cytology of the pulled-brush specimens produced cellular yields similar to those of specimens obtained by pushing the brush from the sheath. If the brush is pulled from the sheath during bile duct brush cytology, we suggest that salvage cytology be performed in order to maximize the diagnostic sensitivity.

Algorithms↗
PubMedDate not supplied

Suction sclerotherapy for the treatment of esophageal varices: a report of a preliminary feasibility study.

We report a new treatment modality for esophageal varices, suction sclerotherapy, which was designed to lift away mucosa and submucosa during treatment to prevent deep injection and resultant esophageal ulcerations. In order to compare the posttreatment complications of suction sclerotherapy against freehand sclerotherapy, we randomized 4 mongrel dogs to receive ten injections of 0.5-ml aliquots of absolute alcohol into the esophagus by either the suction or freehand sclerotherapy technique. The animals were humanely sacrificed after 48 h and examined. A total of five large, deep, confluent ulcers, free perforation, and lung abscess were seen in the animals randomized to freehand sclerotherapy. In contrast, a total of 14 shallow, discrete, erythematous lesions were found in the suction sclerotherapy group; none of these lesions extended deeper than the submucosa. We conclude that suction sclerotherapy produced local complications limited to the submucosa which were less severe as compared with freehand sclerotherapy.

Animals↗