Search PubMed⌕ Search

Biomedical subjects

Y Kluger

Publications and source records attributed to Y Kluger.

At least 127 records · Page 7Linked to original sources
PubMed1993

Hypoxemia after blunt chest injury: right-to-left intracardiac shunt managed non-operatively.

A case of patent foramen ovale with right-to-left intracardiac shunt after blunt chest injury is presented. The association of pulmonary contusion, pulmonary hypertension, and patent foramen ovale in a previously healthy subject is discussed. In such a case reduction of the afterload on the right ventricle is the suggested modality of treatment for hypoxemia due to the right-to-left shunt.

Adult↗
PubMed1993

Biliary and colonic cutaneous fistula successfully treated by endoscopic insertion of biliary stents.

We report a case in which a large, postoperative cutaneous biliary and a colonic fistula were successfully treated by means of endoscopic insertion of two endoprostheses into the common bile duct. Twenty-four hours after the procedure, bile flow through the leak ceased completely while the colonic fistula closed in 6 days. Six months after the treatment, when a new endoscopic cholangiography showed no evidence of leak or stricture, the stents were removed. For the treatment of postoperative biliary leaks, insertion of endoprostheses is a good and safe alternative to surgery.

Adult↗
PubMed1993

Acute obstructive uropathy secondary to pelvic hematoma compressing the bladder: report of two cases.

Two patients with traumatic retroperitoneal hematomas causing obstructive uropathy required surgical evacuation of the hematoma to relieve the obstruction. Fast recovery of renal function and an instant increase in urine output resulted. The obstruction to the urine outflow by the retroperitoneal hematoma caused near total collapse of the bladder in these patients, which was corrected by angiographic embolization and surgical removal of the hematoma.

Acute Disease↗
PubMed1993

Subtotal colectomy with primary ileocolonic anastomosis for obstructing carcinoma of the left colon: valid option for elderly high risk patients.

During a period of 4 years, 20 patients with obstructing carcinoma of the left colon were treated by subtotal colectomy with primary ileocolonic anastomosis. Thirteen patients (65%) were 65 years of age or older. All patients presented to the emergency room with large bowel obstruction. Twelve patients (age > 65) suffered other systemic diseases (chronic obstructive pulmonary disease, ischemic heart disease, morbid obesity), placing them in a high risk category. The mortality rate was 5% (1/20), 7.6% if only high risk patients are considered. The one-stage procedure in the treatment of obstructing carcinoma of the left colon offers the patient a number of advantages over stage intervention elimination of colostomy, namely removal of occult lesions in the resected colon, shorter hospitalization and low morbidity and mortality. We found this procedure to be a valid option also in the elderly (> 65) high risk patient. Metastatic disease in our view is not a contraindication, since the elimination of colostomy will improve the quality of life of these patients.

Adult↗
PubMed1991

A novel approach to military combat trauma education.

A heterogeneous group of 77 physicians on compulsory or reserve military service were exposed to a 5-day course in trauma management, specifically designed for military medical personnel. Cognitive knowledge of trauma care delivery of the medical officers was assessed by means of multiple-choice written tests, which were held before and upon completion of the course. The significantly improved (p less than 0.0001) scores of the post-course test demonstrate the value of a condensed trauma educational program. Analysis of the background variants (i.e., medical education, military, and residency training, and time since graduation) revealed that the relatively short but intensive course sufficed to surmount the difficulties inherent in instructing a student body composed of individuals with dissimilar professional experience. We advocate the institution of a compact course in trauma treatment, with the specific aim of enhancing the medical officer's knowledge in this critical field of medical care.

Analysis of Variance↗
PubMed1990

The danger of high compliance balloons for esophageal dilatation in achalasia.

High compliance balloons, commonly used for pneumatic dilatation of achalasia patients, theoretically subject the widened esophageal wall, proximal to the narrow zone, to increased pressure, and subsequently to a higher risk of perforation. The new type of inelastic cylindrically shaped balloons, such as the Gruntzig-type and Rigiflex Achalasia Dilator, seems to be safer, since it increases esophageal wall tension in the stenotic zone only. The purpose of this study was to present a pathophysiological consideration of this assumption, together with two cases which support it.

Adult↗
PubMed1990

[Late pneumothorax: a complication of subclavian vein catheterization].

Subclavian vein catheterization is safe as long as proper indications and contraindications are observed. In the hands of highly qualified personnel, subclavian vein catheterization has a minimum rate of complications. Pneumothorax is by far the most common complication of the procedure. We describe a 64-year-old man who developed pneumothorax late after left subclavian vein catheterization.

Catheterization, Central Venous↗
PubMed1990

Treatment of fistulas of the biliary tract by endoscopic insertion of endoprostheses.

Five patients with fistulas of the biliary tract are reported; three had fistulas caused by operative injury and two, by accidental blunt abdominal trauma. All patients were treated successfully by endoscopic transpapillary insertion of biliary endoprostheses. The endoprostheses were removed after four to 17 weeks in all patients, and no evidence of biliary leakage was revealed by repeat cholangiograms and other clinical follow-up study. This effective, simple and safe method allows the fistula to heal and is a good alternative to surgical treatment.

Adolescent↗
PubMed1990

Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem.

From our experience with chronic schizophrenic patients treated for acute intra-abdominal surgical disease, we present seven examples of this unique clinical condition. In all seven cases the decision to operate was preceded by considerable delay, owing to misleading medical history, patient behavior, and the lack of definitive signs of peritonitis. The intra-operative findings were unexpected, and in all cases the disease had reached an advanced stage. As chronic schizophrenic patients have a distorted perception of pain and seldom demonstrate a clinical picture commensurate with the disease, we advocate that a higher index of suspicion be assigned to these patients than to the average acutely ill patient.

Abdomen, Acute↗
PubMed1989

[Papillary cystic neoplasm of the pancreas].

Papillary cystic neoplasm of the pancreas, usually found in the tail, is a relatively benign tumor that occurs predominantly in young women. We report a 17-year-old girl admitted for investigation of an abdominal mass found on routine examination. At operation a 12 cm solid mass was found originating from the tail of the pancreas. Distal pancreatectomy was performed and histopathological examination revealed a solid papillary cystic tumor.

Adolescent↗