Search PubMed⌕ Search

Biomedical subjects

Z Kaplan

Publications and source records attributed to Z Kaplan.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Compression anastomosis in acute resection of the colon].

The authors draw attention to the possible use of a biofragmentable anastomotic ring (BAR) for anastomosis of the gut, used by the authors for construction of an anastomosis after acute resection of the colon under particularly risky conditions with infection and advanced deterioration of the intestinal wall. In both instances when this alternative method was used the postoperative course was uneventful and the patients were discharged without complications into domiciliary treatment.

Adult↗
PubMed2000

Normalization of heart rate variability in post-traumatic stress disorder patients following fluoxetine treatment: preliminary results.

BACKGROUND: Spectral analysis of heart rate variability has been shown to be a reliable non-invasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a window reflecting the interaction of sympathetic and parasympathetic tone. Alterations in autonomic function are associated with a variety of physiologic and pathophysiologic processes and may contribute substantially to morbidity and mortality. Our previous study shows that patients with post-traumatic stress disorder have significantly lower HRV compared to controls, reflecting a basal autonomic state characterized by increased sympathetic and decreased parasympathetic tone. OBJECTIVES: To apply this tool to PTSD patients treated with selective serotonin re-uptake inhibitors in order to assess the impact of such treatment on the autonomic dysregulation characterizing these patients. METHODS: Standardized heart rate analysis was carried out in nine PTSD patients treated with SSRI agents and compared to that in a matched control group of nine healthy volunteers and in nine untreated PTSD patients, based on a 15 minute resting electrocardiogram. RESULTS: Our preliminary results show that the HRV parameters indicating autonomic dysregulation, which characterize PTSD patients at rest, are normalized in responding patients by use of SSRIs. Neither the clinical implications of these findings nor their physiological mechanisms are clear at present, although we presume that they reflect a central effect, since the peripheral autonomic effects of SSRIs are relatively negligible.

Adult↗
PubMed2000

[Late postoperative colonic stenosis caused by the biofragmentable anastomosis ring (BAR)].

The authors focused their attention on the prevalence of late postoperative stenoses of anastomoses following resection of the colon. In 42 patients the anastomosis was implemented by means of a Valtrac ring--i.e. by compressive biofragmentable seamless technique. Within an interval of 6 months after surgery the majority of these patients were subjected to colonoscopic examination with direct visualization of the intestinal anastomosis. The authors did not record any late postoperative stenoses of the BAR anastomosis of the colon. Moreover on colonoscopic examination in the majority of patients the original intestinal anastomosis was only difficult to detect.

Adult↗
PubMed2000

[Adenocarcinoma of the appendix--case report].

The authors describe a case with a rare diagnosis of adenocarcinoma of the appendix in an adult female patient. The patient was indicated for surgical revision on account of acute appendicitis with a peroperative finding suspect of malignity of the vermiform appendix. A radical resection of the ileocoecal area was performed along with part of the ascendant colon and appropriate mesocolon as a primary operation. According to the postoperative histological evaluation of the resected portion the diagnosis of adenocarcinoma of the appendix was confirmed.

Adenocarcinoma↗
PubMed1999

Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents.

OBJECTIVE: Subtle behavioral and intellectual abnormalities are often present in apparently healthy adolescents who later develop schizophrenia. The authors investigated whether these abnormalities can predict vulnerability for schizophrenia before the first psychotic manifestation. METHOD: The study consisted of linking the Israeli Draft Board Registry with the National Psychiatric Hospitalization Case Registry. The draft board tests measure intelligence, social functioning, organizational ability, interest in physical activity, and individual autonomy. Patients (N = 509) were compared to nonpatients, i.e., adolescents not appearing in the National Psychiatric Registry (N = 9,215), matched to patients by age, gender, and school attended at time of testing. RESULTS: Healthy male adolescents who were later hospitalized for schizophrenia had significantly lower test scores on all measures than adolescents not reported to the National Psychiatric Registry. The strongest predictors for schizophrenia were deficits in social functioning, organizational ability, and intellectual functioning. When patients were compared to matched nonpatients, the prediction model had a 75% sensitivity, a 100% specificity, a positive predictive value of 72%, and an overall rate of correct classification of 87.5%. Applied to the Israeli Draft Board Registry, the model yielded a sensitivity of 74.7%, a validated specificity of 99.7%, and a positive predictive value of 42.7%. CONCLUSIONS: This study demonstrated that simple assessment tools can predict predisposition to schizophrenia in healthy male adolescents. The model's predictive ability does not change as a function of the time elapsed between testing and first hospitalization. This suggests that the model identifies apparently healthy individuals who will manifest the disease later who are not prodromal to psychosis. Easily applied tools allowing early identification of schizophrenia or vulnerability to it may enable early intervention.

Adolescent↗
PubMed1999

The goals and limitations of Israel's psychiatric case register.

The Israeli Ministry of Health maintains a psychiatric case register that includes basic demographic and clinical information for all psychiatric hospital admissions since 1950. Currently, the case register includes information about some 130,000 people who have been hospitalized. The case register is an important tool in many aspects of mental health care planning, such as delineating problem populations, developing interventions, assessing the ramifications of policies, enacting programs for quality control, and conducting research. In certain situations stipulated by law, some information in the case register is shared with other authorities. Although the full potential of the psychiatric case register has not been exploited so far, creation of additional linkages with other databases and increased application of case register data in field studies could enhance its usefulness.

Databases as Topic↗
PubMed1999

Stress and intervention strategies in mental health professionals.

There is growing evidence to show that mental health professionals by the nature of their work are particularly vulnerable to stress with all its detrimental effects on service delivery and quality of care. This comes at a time when mental health services in many countries are under considerable strain. The present paper examines the multifaceted stressors encountered by the mental health team and recommends possible ways of reducing burnout through innovative intervention strategies. The detection of emotional distress and psychological dysfunctioning in mental health providers is outlined and their management carefully considered.

Burnout, Professional↗
PubMed1999

[Continuous loop stitch in single-layer laparotomy suturing].

The authors evaluate their favourable experience with the use of a new absorbable loop suture for one-layer closure laparotomy. The percentage of dehiscences of surgical wounds was lower in the group of patients where Safil Loop suture was used than in the control group. The speed of completing the suture was also greater and the safety of closure of laparotomy was more favourable.

Absorption↗
PubMed1998

Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder.

BACKGROUND: Spectral analysis of heart rate variability has recently been shown to be a reliable noninvasive test for quantitative assessment of cardiovascular autonomic regulatory responses, providing a dynamic map of sympathetic and parasympathetic interaction. In a prior study exploring the state of hyperarousal characterizing the posttraumatic stress disorder (PTSD) syndrome, the authors described standardized heart rate analysis carried out in 9 PTSD patients at rest, which demonstrated clear-cut evidence of a baseline autonomic hyperarousal state. METHODS: To examine the dynamics of this hyperarousal state, standardized heart rate analysis was carried out in 9 PTSD patients compared to a matched control group of 9 healthy volunteers. Twenty-minute recordings of electrocardiogram in response to a trauma-related cue as opposed to a resting state were performed and analyzed. The PTSD patients were asked to recount the presumed triggering traumatic event, and the control subjects recounted a significant stressful negative life event. RESULTS: Our results show that, whereas the control subjects demonstrated significant autonomic responses to the stressogenic stimulus supplied by the recounting of a major stressful experience, the PTSD patients demonstrated almost no autonomic response to the recounting of the triggering stressful event. The PTSD patients demonstrated a degree of autonomic dysregulation at rest which was comparable to that seen in the control subjects' reaction to the stress model. CONCLUSIONS: The lack of response to the stress model applied in the study appears to imply that PTSD patients experience so great a degree of autonomic hyperactivation at rest, that they are unable to marshal a further stress response to the recounting of the triggering trauma, as compared to control subjects.

Adult↗
PubMed1998

Inhibition of anxiety in rats by antisense to cholecystokinin precursor protein.

BACKGROUND: Cholecystokinin (CCK) and its analogs generates anxiety in humans and measurable anxiety-like behaviors in rats. CCK receptor blockers have had mixed results as a treatment approach for anxiety disorders. Since CCK is a peptide, we explored another strategy to reduce CCK levels in brain by antisense oligodeoxynucleotide inhibition of DNA transcription or messenger RNA (mRNA) translation for CCK precursor protein. METHODS: Antisense oligodeoxynucleotide complementary to the start coding region of rat CCK-precursor was intracerebroventricularly (icv) infused into rats three times at 24-hour intervals. Control groups received infusions of either a scramble sequence oligodeoxynucleotide or vehicle. On the fourth day, rats were assessed in the elevated plus maze paradigm. RESULTS: Compared to vehicle and scramble sequence oligodeoxynucleotide control, icv CCK-antisense exogenous administration for 3 days significantly diminished anxiety behavior in rats. CONCLUSIONS: Antisense inhibition of CCK-mediated anxiety could have therapeutic potential in human anxiety disorders.

Animals↗
PubMed1998

Effect of transcranial magnetic stimulation in posttraumatic stress disorder: a preliminary study.

BACKGROUND: Transcranial magnetic stimulation (TMS) has become, over the last few years, a promising avenue for new research in affective disorders. In this study we have evaluated the clinical effect of slow TMS on posttraumatic stress disorder (PTSD) symptoms. METHODS: Ten PTSD patients were given one session of slow TMS with 30 pulses of 1 m/sec each, 15 to each side of the motor cortex. RESULTS: Symptoms of PTSD were assessed by using three psychological assessment scales, at four different time points. In this first, pilot, open study, TMS was found to be effective in lowering the core symptoms of PTSD: avoidance (as measured by the Impact of Event Scale), anxiety, and somatization (as measured by the Symptom Check List-90). A general clinical improvement was found (as measured by the Clinical Global Impression scale); however, the effect was rather short and transient. CONCLUSIONS: The present study showed TMS to be a safe and tolerable intervention with possibly indications of therapeutic efficacy for PTSD patients.

Adult↗
PubMed1998

Disadvantages of local repair in acute type A aortic dissection.

BACKGROUND: In acute type A dissection of the aorta, local repair with glue-aortoplasty was compared with aortic replacement. METHODS: Between 1992 and 1996, 106 consecutive patients (mean age, 59 years; 84 men) were operated on average 14.5 hours after onset of dissection. A local repair (gelatin-resorcine-formaldehyde/glutaraldehyde glue, Trigon AG, Monchengladbach, Germany) without graft replacement was performed in 21 patients. Graft replacement and reinforcement of aortic stumps with gelatin-resorcine-formaldehyde/glutaraldehyde glue was performed in 85 patients (supracoronary graft, 68; aortic root replacement, 17). RESULTS: Survival was 79% after 30 days and 69% after 2 years. There was no difference in early mortality (p = 0.2240) and survival (p = 0.07649). Risk factors for early mortality were preoperative shock, neurologic disorder, duration of crossclamp, and extracorporeal circulation. The rate of reoperation on the proximal aorta was 31.6% (6 of 19) after local repair and 9% (6 of 64) after aortic replacement (p = 0.0157). Local repair was a significant predictor for reoperation (p = 0.0087), with decreased reoperation-free survival (p = 0.01164). In all reinterventions (four supracoronary grafts, including two valve replacements; two composite grafts; two arch replacements) breakdown of the aortoplasty was confirmed. CONCLUSION: Local repair has satisfactory early results but an increased incidence of reoperations due to a breakdown of the glue-aortoplasty. Indications for local repair should be restricted to high-risk patients requiring a minimal emergency surgical procedure.

Acute Disease↗
PubMed1998

Debriefing with brief group psychotherapy in a homogenous group of non-injured victims of a terrorist attack: a prospective study.

This study describes a follow-up of 15 non-injured women, all from the same socio-economic background, who were exposed to a terrorist attack in Israel. All of the women participated in group debriefing with brief group psychotherapy, involving six meetings during the first 2 months following the event. Two days after the attack, and 2 months and 6 months after the event, the women were administered a post-traumatic stress disorder (PTSD) diagnostic scale, the Impact of Event Scale (IES) and the SCL-90. At 6 months, four subjects (27%) were diagnosed with full PTSD. The IES showed significantly higher scores at the first measure than at the other two measures. Furthermore, the phobic anxiety subscale score immediately after the event was significantly associated with the General Severity Index of the SCL-90 and the severity of PTSD symptomatology at 6 months. The present paper discusses the effectiveness of psychological intervention following trauma, and raises questions concerning the need to invest public resources in this kind of intensive intervention. Suggestions are proposed regarding the desired emphasis of the psychological treatment in order to improve its benefits to victims.

Cost-Benefit Analysis↗
PubMed1998

[Laparoscopy in oncology patients].

In a group of 23 patients with suspected malignant disease in the abdominal cavity laparoscopy was indicated and 11 times positive findings were obtained--six time a primary tumourous process and five times secondaries. The authors demonstrate on case-histories the advantages of laparoscopy when other examination fail or give dubious results. In their group of patients it always helped to establish a definite diagnosis.

Abdominal Neoplasms↗
PubMed1998

Validity study of the EDI-2 in Israeli population.

This study was designed to validate the EDI-2 (1) in an Israeli population. The sample consisted of 29 anorectic patients and 18 recovering anorectics, recruited from six hospitals, and 67 female control subjects matched by age. Results of the validity study indicate that the translated EDI-2 was reliable and valid. Anorectic patients scored higher than the recovering anorectics on most scales. Recovering anorectics resembled the control subjects on most scales except Perfectionism.

Adolescent↗