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Biomedical subjects

F J Tedesco

Publications and source records attributed to F J Tedesco.

At least 19 recordsLinked to original sources
PubMed1991

Management considerations for an HIV positive dental student.

Health care workers who are HIV positive or who have AIDS are faced with unique and perplexing problems. Likewise dental students who are HIV positive present a special circumstance that demands review of ethical, legal, managerial, and medical considerations. The purpose of this paper is to describe the management considerations at the Medical College of Georgia following a recent report of an HIV positive dental student. The administration assembled a diverse team of experts for advice in the situation. This group assumed that the circumstance was a potential crisis with possible serious long-term implications. Therefore detailed planning, appropriate announcements, and careful management have been the administration's principle goal for several weeks. The key management strategies and actions are described from the time of notification of the student's HIV antibody test results through the initial testing of the patient population subgroup.

AIDS Serodiagnosis↗
PubMed1988

Differentiating Crohn's colitis from ulcerative colitis. A rundown of likenesses and dissimilarities.

Crohn's colitis and ulcerative colitis are two distinct clinical entities with differing clinical, pathologic, endoscopic, and radiographic findings. Because of distinct differences in their response to surgical and, in some instances, medical management, clinical separation of these two unique disease states is important. Although at times diagnostic confusion may persist, thorough clinical evaluation, including the judicious use of mucosal biopsy, yields the correct diagnosis in the majority of patients.

Colitis, Ulcerative↗
PubMed1987

Endoscopic sphincterotomy for suspected dysfunction of the sphincter of Oddi.

Fifty-one patients who underwent endoscopic sphincterotomy for suspected dysfunction of the sphincter of Oddi were evaluated retrospectively. The procedure resulted in complete abolition of pain allowing discontinuation of analgesics in 31 of the 46 patients available for follow-up. Patients with a dilated bile duct and delayed drainage of contrast material as demonstrated at endoscopic retrograde cholangiopancreatography (ERCP) had a more favorable response to sphincterotomy than those with normal ductal findings (p = 0.01). There was a higher complication rate in those without ductal dilation and delayed drainage compared to those with these ERCP abnormalities (p = 0.03). Sphincter of Oddi manometry was obtained in 29 patients prior to sphincterotomy; 24 were available for follow-up. A favorable outcome for sphincterotomy did not correlate with manometric assessment, particularly in patients with an abnormal ductal system.

Adult↗
PubMed1987

Complications of endoscopic injection sclerotherapy: a review.

As endoscopic injection sclerotherapy becomes more widely applied to the treatment of bleeding esophageal varices, an increasing number of complications are being reported. Dysphagia, chest pain, and fever are usually transient and incosequential but may herald more serious life-threatening sequelae. Mortality commonly results from the major complications of recurrent bleeding, perforation, sepsis, and respiratory disorders. We carried out a review of sclerotherapy complications to understand their basis and to determine what measures can be taken to prevent or manage them.

Deglutition Disorders↗
PubMed1986

Yersinia colitis masquerading as pseudomembranous colitis.

We describe a 15-month-old male who presented with fever and diarrhea 24 hr after receiving antibiotics for otitis media. A flexible sigmoidoscopy was initially interpreted endoscopically as antibiotic-associated pseudomembranous colitis, and the patient was treated with vancomycin. The diagnosis of antibiotic-associated colitis was excluded in our patient by the negative stool examination for Clostridium difficile toxin, the failure to obtain supportive features on rectal biopsy, and the failure to demonstrate sigmoidoscopic improvement with vancomycin therapy. Thirteen days later, Y. enterocolitica was cultured from the initial stool specimens. In this case, the raised central whitish area on an erythematous base was misinterpreted as pseudomembranous colitis.

Colitis↗
PubMed1986

Hydropneumothorax following peritoneoscopy.

Peritoneoscopy is recognized as a safe and effective procedure, even though numerous complications have been reported. We have seen a patient in whom left hydropneumothorax developed after laparoscopy, a complication not previously reported.

Adult↗
PubMed1986

Colitis after Hibiclens enema.

Acute colitis occurred after a Hibiclens cleanser enema. Endoscopic and histologic features were not helpful in distinguishing this colitis from an infectious or idiopathic colitis, and a careful history proved invaluable. We review the complications of using soapsuds and various chemical-containing enemas; these complications range from mild colitis to death. Because soap and other chemicals are damaging to colonic mucosa, these enemas should be included as a cause of acute colitis.

Biopsy↗
PubMed1985

Sucralfate therapy in patients with symptoms of alkaline reflux gastritis. A randomized, double-blind study.

The effects of sucralfate (6 g per day) and placebo on symptoms, endoscopic findings, and gastric mucosal histology were compared in 23 patients with symptoms of alkaline reflux gastritis who had undergone Billroth I, Billroth II, or vagotomy and pyloroplasty. Patients were randomly assigned to receive sucralfate (n = 11) or placebo (n = 12) for six weeks. Then all received six weeks of open sucralfate therapy before treatment codes were revealed. Twelve gastric biopsy specimens were obtained before patients began treatment and at six and 12 weeks. The two groups did not differ significantly with respect to symptom scores or endoscopic findings at baseline, after the double-blind phase, or after open sucralfate treatment. There were also no significant differences between the treatment groups with respect to epithelial cell scores and conventional gastritis scores. However, after the six-week, double-blind phase, the inflammatory cell score of the sucralfate-treated group was significantly lower (p less than 0.05) than that of the placebo-treated group (1.3 +/- 0.3 versus 1.9 +/- 0.4). After six weeks of open sucralfate treatment, patients who had initially received placebo had a significant reduction (1.4 +/- 0.3 versus 1.9 +/- 0.4) in their inflammatory cell score. Sucralfate lowered the inflammatory cell scores of patients with symptoms of alkaline reflux gastritis. This reduction, however, was not associated with an improvement in symptoms.

Aluminum↗
PubMed1985

Marked elevation of serum transaminase activity associated with extrahepatic biliary tract disease.

Nine patients with choledocholithiasis or cholelithiasis developed transient elevations of serum glutamic oxalacetic transaminase (SGOT) levels of greater than 600 units. Awareness of such transient biliary disease will prevent an unnecessary evaluation of a primary hepatocellular disorder. In our study, we concluded that 1) The SGOT level rose and fell rapidly within a 24- to 72-hour period. 2) Higher SGOT levels were seen in patients with choledocholithiasis in whom the gallbladder had been removed. 3) In patients with choledocholithiasis a fall in SGOT level did not necessarily mean the stone had passed.

Adult↗
PubMed1985

The histology of the stomach in symptomatic patients after gastric surgery: a model to assess selective patterns of gastric mucosal injury.

We assessed selective patterns of histological injury in the gastric mucosa of 25 patients (12 Billroth II, 8 Billroth I, 5 vagotomy and pyloroplasty) with symptoms of alkaline reflux gastritis. Each patient had 12 biopsies taken from standardised sites. Histology was scored separately for surface epithelial changes and for inflammatory cells. The traditional grading of gastritis was also done using the categories of superficial and atrophic gastritis. The main histological changes were epithelial, especially in the pits (foveolae) of Billroth II patients. Although mild to moderate atrophic gastritis was present, the inflammatory cell density was only mild. Differences between surgery types for any given histological parameter became apparent only upon the analysis of regional changes within the stomach. Conventional grading of gastritis is based mainly on degrees of gland loss and thus is mainly of value to study chronic changes. However, the type of histological evaluation used here, with standardised biopsy sites, and separate scoring of epithelial and inflammatory changes is potentially more suitable to study shorter term changes as might occur with cytoprotective or damaging agents.

Biopsy↗
PubMed1985

Asymptomatic choledochal cyst.

Choledochal cyst is a rare cystic malformation of the extrahepatic bile ducts. In all previous reports patients were investigated either for symptoms suggesting hepatobiliary disease or for laboratory data suggestive of biliary obstruction. We report a completely asymptomatic patient with normal hepatic function whose cyst was discovered serendipitously during sonogram to determine renal size.

Cholangiopancreatography, Endoscopic Retrograde↗