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D Pantanowitz

Publications and source records attributed to D Pantanowitz.

At least 19 recordsLinked to original sources
PubMed1992

Role of prophylactic antibiotics in open and basilar fractures of the skull: a randomized study.

The aim of this study was to investigate the controversial issue of the use of prophylactic antibiotics in open and basilar fractures of the skull. A series of 157 patients were randomized to receive no antibiotics (group A = 46 patients) or ceftriaxone for 3 days (group B = 50 patients), or the combination ampicillin/sulphadiazine for 3 days (group C = 61 patients). The incidence of meningitis was similar in both the antibiotic and non-antibiotic groups. However, the overall incidence of infectious complications in the non-antibiotic group was significantly higher than in the antibiotic group (8.7 per cent vs 0.9 per cent, P < 0.05). There was no significant difference between the ceftriaxone group and the ampicillin/sulphadiazine group. The results of the study suggest that antibiotic prophylaxis has a role in the management of open and basilar fractures.

Adult↗
PubMed1992

Gunshot wounds of the colon: role of primary repair.

This is a prospective study of 100 patients with bullet injuries of the colon. Primary repair was performed except in cases of severe colonic damage requiring colectomy or in the presence of disseminated gross peritoneal contamination. Primary repair was performed in 76% with an incidence of abdominal sepsis of 11.8%. The remaining 24% of the patients had a colostomy and the incidence of abdominal sepsis was 29.2% (P < 0.05). Left-sided colonic injuries, multiple colonic perforations, shock on admission, delay > 6 h, more than two associated intra-abdominal injuries, high Injury Severity Score (ISS), and high Penetrating Abdominal Trauma Index (PATI), are not in themselves contraindications for primary repair.

Adult↗
PubMed1991

Innovative medicine?

Explore the source record for details and available documents.

Black or African American↗
PubMed1991

The significance of the carotid bifurcation angle in carotid body tumours.

This is a retrospective report on 22 patients with carotid body tumours (intercarotid paragangliomas or carotid chemodectomas) treated by excision using either the dissection technique or en bloc resection. The type of operation to be carried out can be predicted pre-operatively by measuring the carotid bifurcation angle or degree of splaying of the carotid arteries. An angle of less than 90 degrees implies that the tumour can be dissected off the internal carotid artery. An angle of more than 90 degrees implies that it will probably require en bloc resection, including the carotid bifurcation, followed by carotid reconstruction.

Adolescent↗
PubMed1991

Gunshot wound of the abdomen: role of selective conservative management.

This prospective study includes 146 patients with gunshot wounds of the abdomen. One hundred and five patients (72 per cent) had an acute abdomen on admission and were operated on immediately. The remaining 41 patients (28 per cent) had minimal or equivocal abdominal signs and were observed with serial clinical examinations. Seven of the observed patients needed subsequent laparotomy, but there was no mortality or serious morbidity. Had a policy of mandatory exploration for abdominal gunshot wound been applied the incidence of unnecessary or negative laparotomies would have been 27 per cent. By using a policy of selective conservatism this figure was only 5 per cent. We suggest that abdominal gunshot wounds should be assessed and managed exactly like knife wounds. Physical examination is reliable in detecting significant intra-abdominal injuries. Many carefully selected patients with abdominal gunshot wounds can safely be managed non-operatively.

Abdominal Injuries↗
PubMed1991

Short-course antibiotic prophylaxis in penetrating abdominal injuries: ceftriaxone versus cefoxitin.

This was a prospective, randomized study of 123 patients with penetrating abdominal injuries. The patients received ceftriaxone or cefoxitin for 24 h (in the presence of colonic injury, 48 h). The overall incidence of abdominal sepsis was 7.3 per cent (ceftriaxone 5 per cent, cefoxitin 9.5 per cent, P greater than 0.05). Colonic injury was the most important risk factor for the development of septic complications. Other factors, such as the weapon used, a prehospital time longer than 4 h, shock on admission, multiple organ injuries, and small bowel perforation, did not influence the incidence of sepsis.

Abdominal Injuries↗
PubMed1990

Pneumopericardium following penetrating chest injuries.

The presence of pneumopericardium following penetrating injuries of the chest is highly suggestive of a cardiac injury. For this reason, it is generally considered that its presence should be an indication for surgery. In the present study 20 patients with pneumopericardium were selected for conservative treatment. All patients were closely observed by means of clinical examination, serial chest roentgenography, electrocardiography, and Doppler echocardiography. In five patients the electrocardiogram showed pericarditis, and in three patients the echocardiogram demonstrated small pericardial effusions. One patient developed tension pneumopericardium 36 hours after admission and required surgical intervention. The remaining 19 patients had an uneventful recovery. We suggest that the presence of a pneumopericardium following penetrating chest trauma is not an absolute indication for surgery. Electrocardiographic and echographic studies may help in the selection of patients for conservative treatment; but the final decision should be made on the basis of clinical signs and symptoms.

Adolescent↗
PubMed1990

Late sequelae of penetrating cardiac injuries.

Fifty-four patients who survived a penetrating cardiac injury were assessed for late cardiac complications. The mean follow-up after injury was 23 months. Clinical history and physical examination suggested cardiac complications in nine patients (17 per cent). Electrocardiogram was abnormal, but usually not diagnostic, in 17 (31 per cent). Routine two dimensional Doppler echocardiography revealed abnormalities in 17 (31 per cent). Ten patients (19 per cent) had valvular or septal defects. Other abnormalities included pericardial effusion, ventricular and septal dysfunction, and ventricular dilatation. Although it is impossible to determine how many of these abnormalities were post-traumatic, it seems that the incidence of late sequelae of cardiac injuries is high, and it is recommended that routine late follow-up of these patients should be done. Assessment should include routine echocardiograms.

Adolescent↗
PubMed1990

Are carotid body tumours malignant?

Carotid body tumours (CBTs) are slow-growing, malignant neoplasms by virtue of their local spread by continuity and contiguity and metastatic spread by lymph and blood. This article reports the findings of a pathological study of the growth characteristics of CBTs.

Carotid Body Tumor↗
PubMed1990

Giant lateral neck swellings.

Four patients with extremely large lateral neck swellings are described. In the discussion the controversy about using radiotherapy: (i) to make an 'inoperable tumour operable', and (ii) to 'sterilise the operative field' is considered. It is concluded that modern radiotherapeutic techniques probably satisfy these requirements.

Adolescent↗
PubMed1989

Multiple malignant paragangliomas. A case report.

The extra-adrenal paraganglia may be divided into branchiomeric (parasympathetic) and paraxial or para-aortic (sympathetic) networks. A patient is described with two synchronous branchiomeric paragangliomas--a carotid body tumour (glossopharyngeal) and a cardiac chemodectoma (vagus). Both tumours were locally invasive and therefore, by definition, malignant.

Carotid Body Tumor↗
PubMed1987

Carotid body tumours. A review of 52 cases.

During a 22-year period (1962-1984) 52 carotid body tumours were encountered in 50 patients. In addition, 2 of the patients had tumours of the glomus intravagale. One patient had a recurrent tumour, the first one having been removed 23 years previously. The ages ranged from 23 to 80 years, the female/male ratio was 2:1, and the right side was affected twice as often as the left. Four patients were treated non-surgically; 3 were too elderly and frail to undergo the operation and in the 4th case the tumour was considered inoperable. In 2 cases excision was attempted but abandoned for technical reasons. In the remaining 44 patients 46 tumours were excised, with grafting of the internal carotid artery in 6 cases. There were 2 deaths (4.5%), 1 after hemiplegia and 1 a pulmonary embolus. Eight patients were left with cranial nerve palsy, which had been present preoperatively in 5 cases. Of the tumours 7 (13.5%) were found to be malignant. The results of endocrine studies when undertaken were normal. Although ultrasonography and computed tomography were used in some cases, arteriography was the definitive mode of investigation.

Adult↗