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Biomedical subjects

Y Niv

Publications and source records attributed to Y Niv.

At least 163 records · Page 9Linked to original sources

Colonoscopic findings in patients with hemorrhoids, rectal bleeding and normal rectoscopy.

Within a period of 18 months, 387 patients were referred to the Proctologic Service at the Chaim Sheba Medical Center because of recurrent rectal bleeding. Hemorrhoids were found in 194 of these patients and further investigation showed that 45 of the 194 patients (23.2%) had other coexisting colonic pathology (12 cancers, 28 polyps, 4 inflammatory bowel diseases and 1 angiodysplasia). Sixteen of 40 patients with diverticulosis and 13 of 30 patients with hemoglobin less than 11 g/dl had additional colonic pathology. Single-contrast barium enema, which was used in this survey for screening of the colon, proved to be inaccurate. In view of the issue of cost-effectiveness, this study suggests that patients with recurrent rectal bleeding and hemorrhoids (Grades II and III) who had normal rectoscopy should be further investigated by double-contrast barium enema if they are greater than 40 years of age. All patients with anemia, diverticulosis or abnormal findings in barium enema should undergo total colonoscopy.

Adult↗

Gastric polyps--a clinical study.

In 72 of 13,500 patients who underwent endoscopy of the upper digestive tract during an 8-year period, 99 gastric polyps were found. All the polyps were biopsied; 18 were also removed. Histological examination of the 99 polyps showed that 25 were inflammatory, 23 hyperplastic, 17 hyperplasiogenic, 10 adenomatous, 3 hamartomatous, 3 with intestinal metaplasia and 18 with normal mucosa. The histological diagnosis was changed following polypectomy in 50% of the polyps that had been removed. Dysplasia was discovered in two adenomatous polyps; no carcinoma was found. In two cases the polyps were syncronous to carcinoma; in two other cases, they were metachronous to carcinoma. Inflammatory polyps were found in association with inflammation of the upper gastrointestinal tract, such as duodenal and gastric ulcer, esophagitis, gastritis and duodenitis. No correlation was demonstrated between the symptoms and the type or location of the polyps. In 10 patients, who were under observation for an average duration of 3.5 years, 3 polyps disappeared, 1 was removed and 11 had not changed. We conclude that endoscopic polypectomy of gastric polyps may not always be indicated and should be reserved for polyps that were adenomatous, according to the biopsy, or that had grown and changed their shape in a follow-up endoscopy.

Adenocarcinoma↗

The development of negative skin tests in children treated with venom immunotherapy.

Twenty-eight of 62 children (45%) with a history of sting-induced anaphylaxis and initially positive skin tests to venom(s) developed negative venom skin tests to one or more of the venoms used in their treatment after 3 yr or more of immunotherapy. Children who developed negative venom skin tests were less sensitive prior to treatment, as judged by venom skin tests and venom-specific IgE antibody determinations, than children who maintained positive venom skin tests. Levels of venom-specific IgE antibodies declined with time in most children, but to lower levels in those with negative skin tests. Venom-specific IgG antibody levels were similar in both patients with negative skin tests and those with persistently positive skin tests. The development of negative skin tests may reflect a loss of allergic sensitivity, which is sufficient to allow the physician to consider the discontinuation of venom injections.

Adolescent↗

A prospective study of the natural history of large local reactions after Hymenoptera stings in children.

Large local reactions are a frequent occurrence after insect stings. We prospectively studied the demography, immunology, and significance of these reactions in the pediatric age group. Most children (83%) who have had large local reactions have positive skin test results to one or more venoms. Elevated amounts of venom-specific IgE antibody are usually present. Over 3 to 5 years, allergic sensitivity declines, as evidenced by less positive skin test results and lower levels of antivenom IgE antibodies. Most significantly, of 113 repeat stings, only 2% resulted in a systemic reaction.

Adolescent↗

Ketamine anesthesia for pediatric gastrointestinal procedures.

Ketamine HCl anesthesia was used for gastrointestinal therapeutic and diagnostic procedures in 26 children aged 3 mo to 16 yr. In addition, atropine was used for the gastroscopies and diazepam for the colonoscopies. Ketamine, 5 to 8 mg/kg body wt administered i.m., produced rapid anesthesia of short duration which allowed easy performance of the procedure. No serious side effects were noted, but care must be taken as ketamine is a general anesthetic with potential side effects during and after the period of anesthesia. This satisfactory initial experience should be confirmed by a controlled study of anesthetic agents for pediatric gastrointestinal procedures.

Adolescent↗

Imuran in the treatment of ulcerative colitis.

A retrospective study of 35 patients with ulcerative colitis is presented. The patients were treated with Imuran, alone or combined with corticosteroids, in single or repeated courses, over a period of 11 years. The usual indication for Imuran treatment was nonresponse to Azulfidine or corticosteroids. Criteria for response to treatment were: 1. decrease in stool frequency, 2. decrease in frequency and amount of rectal bleeding and 3. weight gain. Improvement was noted on the average two weeks after the start of Imuran therapy and 62% of the patients had complete remission afer 1.7 months. When patient-months of remission and activity were compared on different therapies. Imuran, both alone and combined with steroids, was clearly superior to nontreatment or steroid therapy. With the exception of two patients with fulminant disease, who developed fatal septicemia on Imuran therapy, there were no serious complications. Seven patients eventually underwent colectomy and one patient developed carcinoma of the colon. Our results indicate that there is a definite place for Imuran in the treatment of selected patients with ulcerative colitis.

Adolescent↗

The clinical course of subacute hepatic necrosis.

The clinical course is reported in 17 patients in whom the histological picture of subacute hepatic necrosis ("bridging hepatitis") was found on needle liver biopsy or at autopsy. The patients' ages ranged from 10-71 years, 12 patients being less than 40 years old. Ten patients were males. Jaundice lasted 2-4 months in nine cases and over six months in two, one of the latter having developed cirrhosis. In five patients a relapse of jaundice occurred within three months. Hepatitis B antigen was found in one of 13 patients tested. Two patients died in fulminant hepatic failure, one developed cirrhosis. These three patients and an additional two received prednisone therapy. Twelve of the remaining patients were followed for periods of 8-81 months; an additional two patients' follow-up was incomplete. None developed clinical evidence of chronic liver disease, and laboratory data at the last examination were normal except for slight elevation of alkaline phosphatase in six cases. Repeat biopsies showed persistent hepatitis in one case, slight portal fibrosis in one, cirrhosis in one and at autopsy in a patient who died of unrelated causes two years after hepatitis no evidence of chronic liver disease was found. This relatively good outome of subacute hepatic necrosis is probably due to the young average age of the patients, and the low incidence of B hepatitis in this series.

Adolescent↗