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Biomedical subjects

A Neeman

Publications and source records attributed to A Neeman.

At least 19 recordsLinked to original sources
PubMed1998

Comparison of two bowel preparations for colonoscopy: sodium picosulphate with magnesium citrate versus sulphate-free polyethylene glycol lavage solution.

OBJECTIVES: Adequate preparation of the bowel is essential for accurate colonoscopic examination. We compared colonic preparation with sodium picosulphate plus magnesium citrate (SPS-Mg) with sulphate-free polyethylene glycol electrolyte lavage (PEG-EL) solution before colonoscopy, for quality of bowel cleansing, patient discomfort, and side effects. METHODS: Sixty-eight consecutive patients were randomly assigned to receive either 3 sachets of SPS-Mg (16.5 g each) (n = 39) or 3 L of PEG-EL (n = 29) on the day before colonoscopy. Shortly before the procedure each patient was interviewed to determine the degree of discomfort (1 = none or mild, 2 = moderate, 3 = severe) and side effects. The quality of bowel cleansing was graded by a gastroenterologist who was unaware of the method of preparation (from 1 = poor to 4 = excellent). RESULTS: Of the 29 PEG-EL patients, four (14%) did not complete the preparation because of side effects. The degree of discomfort was significantly greater with PEG-EL (mean score, 2.3 +/- 0.7) than with SPS-Mg (mean score, 1.4 +/- 0.5; p < 0.01). Nausea and vomiting were significantly more common in the PEG-EL group (38% vs 13%; p < 0.05). Using intention-to-treat analysis, bowel cleansing proved to be significantly better with SPS-Mg than with PEG-EL (mean score +/- SD, 3.05 +/- 0.9 and 2.57 +/- 1.0, respectively; p = 0.036). CONCLUSIONS: Colonic preparation with SPS-Mg is better tolerated, associated with significantly fewer side effects, and results in higher quality bowel cleansing than preparation with PEG-EL.

Adult↗
PubMed1996

Helicobacter pylori infection and blood groups.

OBJECTIVES: Bacterial attachment is a prerequisite for colonization of the gastric epithelial surface. Recently, it was demonstrated that the receptor for Helicobacter pylori is the blood group antigen Lewis b, which is exposed only in blood group O. We prospectively examined the prevalence of blood groups in H. pylori-positive and -negative patients. To avoid a genetic bias, we compared blood group prevalence of our patients with the general population of Israel. METHODS: In the 187 consecutive patients we studied, in addition to regular upper endoscopy, H. pylori status and blood group. Exposure to H. pylori was diagnosed when the results of two or more of three methods were found to be positive. RESULTS: Exposure was found in 123 patients and 64 negative. The groups were similar in average age and origin, and no significant difference was demonstrated for blood group. Blood group distribution between any given origin was not significantly different in our patients and in a sample of 182,701 blood donors. CONCLUSIONS: Positivity for H. pylori was not associated with blood group O. Our observation does not support the conclusion that the receptor for H. pylori in the gastric mucosa is the blood group antigen Lewis b.

Adolescent↗
PubMed1994

Selection of patients for treatment of duodenal ulcer infected with Helicobacter pylori.

Ninety patients with endoscopically proven duodenal ulcer were followed for 1 year. All patients were initially treated with an H2-receptor antagonist. Those with more than two relapses within 1 year received triple therapy consisting of colloidal bismuth subcitrate, amoxicillin, and metronidazole. Results showed that 27 patients were symptom-free after one full course of H2 antagonist, 47 had one or two clinical recurrences, and 16 patients had more than two recurrences. Twelve of the latter group were Helicobacter pylori positive and were treated with triple therapy. We conclude that only a minority of duodenal ulcer patients needs to be treated with triple therapy; most of them can be treated with antisecretory agents.

Adult↗
PubMed1993

Kaposi's sarcoma with visceral involvement after intraarticular and epidural injections of corticosteroids.

Kaposi's sarcoma has been reported in patients receiving immunosuppressive therapy, most of whom are organ transplant recipients. The development of Kaposi's sarcoma after treatment with corticosteroids has been reported in only 38 patients who have not had acquired immunodeficiency syndrome or undergone organ transplantation. Cutaneous Kaposi's sarcoma developed 2 months after intraarticular steroid injections in a man with ulnar nerve entrapment. The lesions regressed spontaneously after 3 months but reappeared with visceral involvement 18 months later, shortly after initiation of a course of epidural steroid injections for treatment of low back pain. The cutaneous lesions and some visceral lesions rapidly regressed after cessation of treatment.

Administration, Topical↗
PubMed1991

Treatment of esophageal varices: low versus high dose of 5% ethanolamine oleate.

Twenty-four patients, undergoing sclerotherapy for esophageal varices, were injected with 10-20 ml of ethanolamine oleate 5% in the first treatment session (group A). Fourteen patients were injected with 40 ml of the same sclerosant in the first session (group B). Retrospective analysis was carried out to evaluate the efficacy and safety of the two doses. Variceal eradication was achieved in group B in significantly fewer sclerotherapy sessions. Rebleeding occurred in 16% of patients in group A, compared with no rebleeding in group B. There was no significant difference in the incidence of various complications. We conclude that the use of 40 ml of 5% ethanolamine oleate in the first session is more effective and as safe as the use of 20 ml of the same sclerosant.

Adolescent↗
PubMed1987

Does duodenal ulcer lead to an early diagnosis of gastric cancer?

In four of five patients with gastric cancer who also had a chronic duodenal ulcer, the histologic type was "early gastric cancer," which offers a better prognosis than the more common type. Patients with duodenal ulcer who develop gastric cancer may have a better prognosis than patients with gastric cancer without duodenal ulcer because their duodenal ulcer places them under more frequent surveillance, including clinical and endoscopic follow-up.

Aged↗
PubMed1984

Are acid secretory tests of diagnostic value in patients with benign-looking gastric ulcers?

In 41 patients in whom endoscopy showed benign gastric ulcer, gastric secretory function was assessed before and after stimulation with pentagastrin (6 micrograms/kg); they were then followed up for a period of 2-4 years. Of these 41 patients, 37 had benign and the remaining 4 malignant ulcers. Of the 37 patients with benign gastric ulcers, 11 had basal achlorhydria but all secreted acid after pentagastrin stimulation. Seven of these 37 patients (19%) secreted less than 5 mmol/h in response to stimulation with pentagastrin. Of the 4 patients with malignant gastric ulcer, 3 had basal achlorhydria. After pentagastrin stimulation 3 of these patients (75%) secreted up to 5 mmol/h and 1 patient secreted 17 mmol/h. Biopsy evidence of malignancy was only obtained after repeat endoscopy and biopsy in 2 of these 4 patients. The present study confirms that a malignant ulcer may simulate a benign ulcer on endoscopy, and shows that the finding of hypochlorhydria in such patients warrants a cautious approach with repeat endoscopy and biopsy to exclude a malignant lesion.

Adult↗
PubMed1984

New therapeutic approach in postoperative phytobezoars.

Postoperative phytobezoars (duration from 2 months to 46 years) after surgery for duodenal ulcer disappeared in seven patients, by both x-ray and gastroscopy, on conservative approach aimed at the major role of delayed gastric emptying in phytobezoar formation. During a 3-day period, metoclopramide was given by drip infusion, 40 mg/24 hours, and the patient received only a copious clear diet, with no solid food. In one patient, two courses of treatment were necessary for complete elimination of the phytobezoar. None of the patients had any underlying disease. All but one had good dentition. "Disruption" of the bezoars allowed the discovery upon endoscopy of unusual etiological features such as carcinoma of the stoma and stomal polypoid hypertrophic gastritis (so-called gastritis cystica polyposa ) in one patient, and a retained suture narrowing the stoma in another.

Aged↗
PubMed1981

Candidal infection of benign gastric ulcers in aged patients.

In seven elderly patients with benign gastric ulcer, numerous spores and mycelia of Candida were found in the inflammatory exudate and in the base of the ulcer. All patients were treated with cimetidine and antacids. In five patients the ulcer failed to heal. Cimetidine was replaced with mycostatin and after four weeks of treatment, the ulcers healed completely in four patients. It is assumed that in the elderly, due to the weakening of the host defense mechanisms, Candida may invade the base of the ulcer and disturb the normal process of healing.

Aged↗