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Biomedical subjects

A Reuben

Publications and source records attributed to A Reuben.

7 recordsLinked to original sources
PubMed1979

Endoscopic retrograde cholangiopancreatography in carcinoma of the pancreas.

The value of gastroduodenal endoscopy and retrograde cholangiopancreatography has been assessed in 55 patients subsequently confirmed to have pancreatic carcinoma. The technique provided a precise and accurate diagnosis in 45 patients. In nine of these patients, the diagnosis was obtained by duodenoscopy and biopsy alone. Cannulation of the duct was attempted in 47 of the 55 patients; roentgenograms of the pancreatic or biliary tree, or both, were obtained in 40 studies, 36 of which were diagnostic. Tumors were most common in the head of the pancreas, and virtually all roentgenograms showed duct obstruction or a major stricture with upstream dilatation. One pancreatogram of poor quality was reported as normal. Endoscopic cholangiograms were often diagnostic when pancreatography failed in patients with tumors of the head of the pancreas. Endoscopic retrograde cholangiopancreatography is a precise technique for the diagnosis of patients with tumors of the papilla of Vater which may present relatively early and prove resectable. Patients with tumors of the pancreas itself usually present with advanced disease, and in this series, endoscopic retrograde cholangiopancreatography provided no clear benefit in terms of operability or patient survival. However, the efficient documentation of inoperable tumors is important, and endoscopic retrograde cholangiopancreatography sets a standard against which other techniques can be evaluated.

Adult↗
PubMed1978

Is pancreatogram interpretation reliable?--a study of observer variation and error.

Observer variation in the interpretation of endoscopic pancreatograms has been examined by asking four experienced observers to assess 40 sets of well-documented radiographs (from 20 patients with cancer and 20 with pancreatitis), both without ("blind") and with clinical details, each on three occasions. Individual consistency for "blind" diagnoses ranged from 61% to 78%, increasing significantly with clinical information. Overall diagnostic accuracy with clinical information varied from 52% to 83% for cancer, and from 87% to 95% for pancreatitis. However, unanimous and correct opinions were given by the four observers for only 53% of all cases, even when clinical details were provided. Clinical information changed the radiographic diagnosis in 43% of assessments, 83% of these changes leading to improved accuracy. ERCP gives direct information about the major pancreatic and biliary duct systems and often provides an accurate diagnosis. Caution must be exercised in relying upon radiological appearances alone.

Diagnosis, Differential↗
PubMed1978

Operative pancreatic biopsy: a survey of current practice.

The attitudes of surgeons working in Great Britain and Ireland towards pancreatic biopsy and the use of other preoperative investigations in cases of pancreatic disease are examined on the basis of replies to a postal questionnaire. The value, accuracy, and complications of pancreatic biopsy are discussed with reference to the surgical literature.

Attitude of Health Personnel↗
PubMed1977

Plasma calcitonin in chronic renal failure: relation to other factors of importance in bivalent ion metabolism.

1. Plasma concentrations of human calcitonin were measured in groups of patients with chronic renal failure, treated either conservatively or by haemodialysis, and compared with a normal group of persons. 2. Plasma calcitonin was statistically significantly elevated in both groups with renal failure. 3. When the data from the three groups were pooled, plasma calcitonin was found to be inversely correlated with total calcium and directly correlated with plasma creatinine.

Calcitonin↗
PubMed1977

Renal vein thrombosis as the major cause of renal failure in familial Mediterranean fever.

Eighteen out of 57 patients (31-6 per cent) suffering from Familial Mediterranean Fever (FMF) were found to have the nephrotic syndrome, histologically proven amyloidosis and progressive renal failure. In 14 cases renal function deteriorated rapidly after the first appearance of significant proteinuria, and 12 cases (66-7 per cent) required regular haemodialysis. Seven of these patients, seen in the early stages of renal impairment, were subsequently diagnosed clinically as probably having developed renal vein thrombosis. There was radiological proof of intrarenal or major renal vein occlusion in five which in one patient progressed to inferior vena cave obstruction. Treatment with heparin, plasminogen activators and fibrinogenolytic agents was disappointing although renal function has stabilized in one patient on long term oral anticoagulant therapy. It is suggested that renal vein thrombosis is common in FMF with renal amyloidosis and usually causes rapid deterioration of function and irreversible renal failure requiring dialysis. Renal phlebography may delineate clot in the main renal veins or indicate areas of reduced blood flow due to thromboses in intrarenal venules. Treatment is only partially satisfactory but there is some evidence to suggest that renal phlebography should be undertaken promptly when renal function begins to fall followed by anticoagulant therapy to prevent further thromboembolic complications.

Acute Kidney Injury↗