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Biomedical subjects

A Alper

Publications and source records attributed to A Alper.

At least 19 recordsLinked to original sources
PubMed1998

Prescription drug use and self-prescription among resident physicians.

CONTEXT: Self-prescription is common among practicing physicians, but little is known about the practice among resident physicians. OBJECTIVE: To determine prescription drug use and self-prescription among US resident physicians. DESIGN AND SETTING: Anonymous mail survey of all resident physicians in 4 US categorical internal medicine training programs in February 1997. MAIN OUTCOME MEASURES: Self-reported use of health care services and prescription medications and how they were obtained. RESULTS: A total of 316 (83%) of 381 residents responded; 244 residents (78%) reported using at least 1 prescription medicine and 162 residents (52%) reported self-prescribing medications. Twenty-five percent of all medications and 42% of self-prescribed medications were obtained from a sample cabinet; 7% of all medications and 11% of self-prescribed medications were obtained directly from a pharmaceutical company representative. CONCLUSIONS: Self-prescription is common among resident physicians. Although self-prescription is difficult to evaluate, the source of these medications and the lack of oversight of medication use raise questions about the practice.

Drug Prescriptions↗
PubMed1996

Endoscopic sphincterotomy in the treatment of postoperative biliary fistulas of hepatic hydatid disease.

BACKGROUND: Ten patients with postoperative external biliary fistula treated by endoscopic sphincterotomy are reported. METHODS: Nine of these patients were operated for hepatic hydatid disease and one for a liver abscess. Mean daily output of bile through the fistulae which were present for 5-39 days was approximately 500 cc. RESULTS: Treatment was successful in nine patients with closure of the fistulae in 2-15 days (mean, 7 days). No response was obtained in one patient who was reoperated, and an intrahepatic biliary duct was found to be completely eroded by the cyst wall. CONCLUSIONS: Endoscopic sphincterotomy should be the first-line treatment for postoperative external biliary fistulae related to hepatic hydatid disease.

Adult↗
PubMed1996

Liver hamartoma in an adult: report of a rare case.

Liver hamartoma is a rare type of benign tumor which usually occurs in the first few years of life. Although it is the second most common benign tumor in childhood, only about 100 cases have been reported in the English literature. Thus, it is extremely rare to encounter liver hamartoma in adults. This report details the clinical presentation and surgical management of a 24-year-old woman with a rapidly growing liver hamartoma. A right hepatic lobectomy was successfully performed and the patient was discharged in good health on the 10th postoperative day.

Adult↗
PubMed1996

Laparoscopic treatment of hepatic hydatid disease.

Surgery is still the main modality in the treatment of hepatic hydatid disease. Laparoscopic methods, with their low morbidity, have gained prominence in many fields and, in some cases, have nearly replaced open surgery. In this report, a laparoscopic method for the treatment of hepatic hydatid disease is described and the results in the first six cases are presented. The method involves the use of an aspirator-grinder apparatus designed specifically for laparoscopic surgery. The postoperative courses of the patients were very comfortable and no complication related to the laparoscopic technique occurred. The method achieves evacuation of all viable cyst contents with the patient benefits of laparoscopic surgery. The apparatus practically eliminates the risk of spillage. The postoperative parameters and the early follow-up results (21-27 months) are very encouraging.

Adolescent↗
PubMed1993

[Are devascularization-transsection operations in treatment of bleeding esophageal varices still indicated?].

Sugiura procedure and its modifications were performed in 43 patients who were not suitable for shunt surgery. Four types of devascularisation-transection procedures on the technical basis of Sugiura operation were carried out. Thirteen patients died in the early postoperative period. Highest mortality was recorded in the standard Sugiura procedure (4/8 or 50%) and the lowest in modified Sugiura III (1/7 or 14%) which is the simplest form of all. Mortality in the early postoperative period was higher in emergency procedures. No variceal hemorrhage and hepatic encephalopathy were recorded in the early postoperative period. Based on our experience in relatively limited number of cases, the Sugiura operation and its modifications are not advantageous in emergency conditions and patients with poor liver function. However, these procedures can be performed in Child A-B cases. Limiting the extent of the operation by modifications affects the outcome positively.

Adult↗
PubMed1992

Purely cystic hydatid disease of the liver: treatment with percutaneous aspiration and injection of hypertonic saline.

Percutaneous aspiration of purely cystic liver lesions was performed in 15 patients aged 11-56 years. After aspiration under guidance with computed tomography (CT) in 12 patients, a membrane that is diagnostic for hydatid disease was visible in the lumen of the cyst on CT scans. Hypertonic saline was injected in the cystic cavities of these patients as a scolecidal agent. No major complications occurred during or after the procedures. In the follow-up period of 6-16 months, control CT and ultrasound scans revealed a progressive decrease in the size of the lesions and no evidence of peritoneal seeding. It is concluded that percutaneous aspiration and hypertonic saline injection for purely cystic hydatid disease of the liver seem to be an effective form of treatment and may eventually prove to be an alternative to surgical intervention.

Adolescent↗
PubMed1992

Primary solitary tuberculosis of the liver.

Primary solitary tuberculous involvement of the liver is a rare condition. We present the case of a patient who was operated on with a preoperative diagnosis of hepatocellular carcinoma. Liver resection was performed and antituberculous therapy was started. It is difficult to make the correct diagnosis preoperatively except when a successful needle biopsy can be performed. Despite the rarity of the condition primary solitary tuberculosis should be considered among the space occupying lesions of the liver.

Adult↗
PubMed1991

Villous tumors of the duodenum.

Two patients with villous adenomas in the duodenum are described. These lesions have a predilection for the ampullary region, and tend to present with obstructive jaundice, especially if malignancy is present. The first patient, with a villous adenoma located at the ampulla of Vater, presented with jaundice and underwent pancreaticoduodenectomy at a second operation because of a high rate of false-negative biopsies. The second patient was admitted with partial mechanical obstruction symptoms and was treated by partial duodenectomy and antrectomy for a supraampullary villous adenoma, including in situ carcinoma.

Adenocarcinoma↗
PubMed1990

Hydatid cysts of liver and portal hypertension.

Two cases of portal hypertension due to hydatid cysts of the liver are reported. In one of the patients, symptoms were secondary to obstruction of inferior vena cava and hepatic outflow tract. The other patient was operated on with a diagnosis of extrahepatic presinusoidal portal hypertension caused by extrinsic compression of the liver by an hydatid cyst. Although hydatidosis is a benign disease, it can produce serious complications as in these reported cases. Therefore hydatidosis should be remembered amongst the causes of portal hypertension in countries where the disease is endemic.

Budd-Chiari Syndrome↗
PubMed1989

Introflexion as a method of surgical treatment for hydatid disease.

For the management of the residual cavity after removal of a hydatid cyst, several surgical methods have been suggested. To prevent the undesirable results of the previously suggested techniques, we have been using a new method called introflexion. This simple, safe and effective method has been described and discussed herein.

Echinococcosis, Hepatic↗
PubMed1988

Treatment of liver hemangiomas by enucleation.

Nine patients with hemangiomas of the liver were treated by enucleation between 1976 and 1985 at the Surgical Department of Istanbul (Turkey) Medical School. The tumors were removed by dissecting the plane between the capsule of the hemangioma and normal liver tissue. The diameters of the tumors ranged from 8 to 23 cm. There was no mortality and no massive bleeding. It is suggested that hemangiomas can be removed by an enucleation technique with low mortality and morbidity, rather than by liver resection.

Adult↗
PubMed1987

Choledochoduodenostomy for intrabiliary rupture of hydatid cysts of liver.

Frank intrabiliary rupture is an important complication of liver hydatid cysts and its incidence is between 5 and 25 per cent. The main principles of management are the surgical treatment of the cyst with removal of all cystic elements and drainage of the biliary tree. Accurate pre- and intra-operative diagnosis and permanent drainage of the biliary tree by a wide choledochoduodenostomy are important to reduce morbidity and mortality. In this report 28 cases of frank intrabiliary rupture of hydatid cysts treated by choledochoduodenostomy are presented.

Adult↗
PubMed1984

[Splenorrhaphy].

In 59 splenic injuries, with 2 of them being caused by penetrating abdominal trauma, and 57 caused by blunt abdominal trauma the feasibility of splenorrhaphy instead of splenectomy was evaluated. In 22 cases out of a total of 59 splenic tissue preventing intervention like splenorrhaphy and partial splenectomy could be practiced.

Adolescent↗