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Biomedical subjects

A Mazor

Publications and source records attributed to A Mazor.

At least 19 recordsLinked to original sources
PubMed1998

The peripheral effect of fentanyl on postoperative pain.

UNLABELLED: The clinical value of the analgesic effect of opioids administered peripherally (except for intraarticular administration) has not been clearly demonstrated. The aim of this study was to test the hypothesis that fentanyl, added to a local anesthetic for wound infiltration, can enhance postoperative analgesia via a peripheral mechanism. Patients with inguinal herniorrhaphy performed under spinal anesthesia were randomly assigned to one of two groups (n = 10 each). At the end of surgery, the wound was infiltrated with 10 mL of lidocaine 0.5% and fentanyl 0.001% (10 microg) in one group; in the other group, the wound was infiltrated with 10 mL of lidocaine 0.5% alone (and fentanyl 10 microg IM contralaterally). The following variables were determined in a double-blind manner: the duration of anesthesia (response to a von Frey filament), the duration of analgesia (time to mild postoperative pain), postoperative meperidine consumption, intensity visual analog scale of spontaneous and movement-associated pain 24 h after surgery, and wound pain threshold 24 h after surgery (pressure algometry). The addition of fentanyl for wound infiltration enhanced the duration of anesthesia (130+/-37 vs 197+/-27 min; P < 0.001) and decreased the intensity of spontaneous (50+/-17 vs 19+/-18 mm; P < 0.002) and movement-associated (56+/-15 vs 26+/-21 mm; P < 0.002) pain 24 h postoperatively. Differences between groups for other variables were not statistically significant. Fentanyl added to a local anesthetic for wound infiltration after spinal anesthesia can enhance postoperative analgesia by a peripheral mechanism. IMPLICATIONS: Fentanyl can enhance analgesia by a peripheral mechanism. Added to a local anesthetic for wound infiltration, it may be of benefit for the relief of postoperative pain.

Adolescent↗
PubMed1993

Endorectal advancement flap repair of rectovaginal and other complicated anorectal fistulas.

BACKGROUND: Surgical correction of rectovaginal and complicated anal-perineal fistulas has been associated with high rates of complications and failure of repair. METHODS: This paper reports on 107 patients treated during the past 10 years by endorectal advancement flap repair. Ninety-two percent of the patients were women with mean age of 38 years (range, 20 to 71 years). Seventy-one had low rectovaginal, 28 had anterior anal-perineal, and 8 had posterior anal-perineal fistulas. The causes were obstetric injury, 48; cryptoglandular abscess-fistula, 31; Crohn's disease, 24; and trauma or after operation, 4. The technique completely preserves the sphincter muscle, covers the internal opening of the fistula tract with healthy rectal wall, and provides counter drainage to aid healing. RESULTS: No deaths occurred in the series. Persistent or recurrent fistula occurred in 17 patients (16%). Nine patients whose initial operation failed underwent a secondary successful operation. Continence status was unchanged in 80%, improved in 18%, and was unknown in two patients who still had intestinal flow diversion. Recurrence of the fistula did not result in destruction of the sphincter mechanism in those patients who underwent simultaneous reconstructive operation. CONCLUSIONS: The endorectal advancement flap repair successfully treated 93% of the complicated anorectal fistulas, avoiding fecal diversion and improving, not injuring, sphincter function.

Adult↗
PubMed1993

[Crohn's disease of small bowel manifested by obstructive carcinoma].

In ulcerative colitis the incidence of adenocarcinoma of the small bowel is higher than in the general population. More than 100 cases of carcinoma of the small bowel have been reported in patients with Crohn's disease of the same segment. However, obstructive carcinoma of the small bowel as the first manifestation of Crohn's disease has seldom been reported. We present such a case in which the first manifestation of otherwise silent Crohn's disease was intestinal obstruction by adenocarcinoma of the same segment.

Adenocarcinoma↗
PubMed1993

Laparoscopic anterior resection of the rectum using a triple stapled intracorporeal anastomosis in the pig.

Laparoscopic anterior resection of the rectum was performed in the porcine model. Colorectal anastomosis was accomplished with a closed triple staple technique using a circular stapler. The anvil and shaft were passed beyond the level of resection and retrieved through the proximal transverse linear cutter staple line. The stapler post was passed through the distal rectal staple line transanally. The resulting stapled anastomosis contained portions of three staple lines. There were no anastomotic leaks or strictures at one month follow-up autopsy. The triple-stapled anastomosis via a laparoscopic approach after an anterior resection of the rectum in a pig is a safe, reliable technique.

Anastomosis, Surgical↗
PubMed1992

[Incarcerated obturator hernia causing bowel obstruction].

Obturator hernia is rare and is usually discovered by chance at operation or autopsy. In certain cases obturator hernia may cause sliding and strangulation of abdominal viscera inside the hernial sac, presenting clinically as bowel obstruction. An 83-year-old woman with signs of bowel obstruction was operated after 48 hours of conservative treatment and a small bowel loop was found strangulated inside the sac of an obturator hernia.

Aged↗
PubMed1990

[Multiple enteral fistulas in peritoneal tuberculosis].

A 40-year-old Ethiopian man had abdominal pain for a year and a half, diarrhea and weight loss. Multiple enteral fistulas were diagnosed by X-ray and colonoscopy. During investigation, the differential diagnosis was between Crohn's disease, intestinal lymphoma and intestinal tuberculosis. Therapeutic trial with corticosteroids was unsuccessful. At operation peritoneal tuberculosis was diagnosed and several entero-enteric fistulas were found, but there were no other intestinal lesions nor other foci of tuberculosis. Intestinal fistulas complicating peritoneal tuberculosis are rare in comparison with enteral tuberculosis, lymphoma or Crohn's disease. After the fistulas were closed surgically and antitubercular treatment given, the patient recovered, returned to his normal weight, and had no complaints.

Adult↗
PubMed1988

Alpha-adrenergic blocker for posthernioplasty urinary retention. Prevention and treatment.

In a prospective, randomized study, 102 patients over the age of 60 years underwent inguinal hernioplasty. We compared a group of 58 patients who received phenoxybenzamine hydrochloride with a control group of 44 patients. The phenolsulfonphthalein test was performed in all patients. Twenty-six (25.5%) of the 102 patients developed acute urinary retention after the hernioplasty; all of them were in the control group. All of these 26 patients had pathological phenolsulfonphthalein test. In 21 of these 26 patients, urinary retention disappeared within 48 hours following phenoxybenzamine administration.

Aged↗
PubMed1988

The development of the individuation process from a social-cognitive perspective.

A sequence of four developmental levels for the individuation process, from a social-cognitive perspective, was proposed from late childhood to late adolescence. Individuation is defined as the separation of the self from family. The individuation interview, Selman's self-awareness measure and the Lunzer test were administered in 4th, 7th, 10th grades and a post-high school group (N = 78). Results confirmed age increases in individuation as follows: late childhood subjects consolidate on level I, exhibiting the dominance of parental view over individual perspectives; early adolescents on level 2, demonstrating an increased self-awareness and the beginning decline of parental view; mid-adolescents, on level 3, characterized by conflicts between the recognition of the autonomous self and the parental views; and late adolescents (young adults) on level 3 and level 4, showing the ability to integrate the parental view within the self-system without losing individuality. Further, construct validation confirmed the common as well as the discriminant qualities of the individuation sequence to self-awareness and Piagetian logical development. These results support the uniqueness of the individuation construct within the social-cognitive domain.

Adolescent↗
PubMed1985

Differentiation, individuation, and identity formation: the integration of family system and individual developmental perspectives.

This paper examines the constructs of individuation, differentiation, and identity formation from the individual development and family system theory perspectives. The goal of the paper is to achieve a more thorough understanding of the role of the individuation process in identity formation, and the role of the family system's level of differentiation as a mediator of both these processes. The basic assumption is that both the family system and individual developmental perspectives are interdependent in that the individuation and identity formation process encompass two frames of reference--the individual's efforts toward separation from the family of origin and the impact of these efforts on identity formation and the family system as the social framework within which, and in relation to which, the individuation occurs.

Adolescent↗