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Biomedical subjects

H Herbsman

Publications and source records attributed to H Herbsman.

At least 19 recordsLinked to original sources
PubMed1988

A review of percutaneous drainage in splenic abscess.

The availability of ultrasonography and computerized tomography has significantly improved diagnostic capability in the evaluation of splenic abscess. In addition, recent evidence has shown that percutaneous drainage of splenic abscess is a safe and efficacious approach to therapy and is indicated especially when patients are seriously ill, postoperative or when the risks of general anesthesia, surgical drainage or splenectomy are substantial. Adequacy of response to percutaneous drainage correlates positively with the presence of unilocular collections that have a discrete wall without internal septations. In contrast, multiloculated or complex pyogenic splenic abscesses should usually be treated using operative intervention. Discussion of important features of this illness, as well as a comprehensive review of reported instances and guidelines related to percutaneous drainage of splenic abscess, are presented herein. A team approach, which uses the experience of imaging and surgical personnel, is invaluable in therapy when a splenic abscess is encountered.

Abscess↗
PubMed1981

Survival following breast cancer surgery in the elderly.

A retrospective analysis was performed on a series of 780 patients with breast cancer who underwent surgery, with emphasis on survival in the 138 patients over 70 years of age (elderly group). Absolute survival rates were determined using life table methods. Relative survival figures were derived from absolute figures by adjusting for expected longevity in each group. Patients over 70 years of age had overall 5 and 10 year absolute survival rates of 54% and 41%, respectively, which did not differ significantly from survival rates of younger patients. Relative five-year survival rates for the elderly were actually higher than those of younger patients, being 90% for those with local disease and 65% for those with regional disease. Survival in the elderly was comparable to that of younger patients, irrespective of race, type of surgery, histology or tumor size. These findings support the conclusion that there is little justification for avoiding conventional operative treatment in elderly patients with breast cancer solely on the basis of advanced age.

Age Factors↗
PubMed1981

Tracheal or esophageal compression due to benign thyroid disease.

Tracheal or esophageal compression was present in 91 (33 percent) of 273 consecutive patients with benign goiter during a 7 year experience. The underlying disease was nodular colloid goiter in 66 percent, adenoma in 21 percent, thyroiditis in 9 percent and Graves' disease in 4 percent. The incidence of tracheoesophageal compression was higher in patients with thyroiditis (67 percent) than in those with colloid goiter (46 percent). Thirty of 91 patients were completely asymptomatic but had marked tracheal deviation on roentgenography. Two thirds presented with significant dyspnea, or dysphagia or both. A long history of goiter preceding the onset of symptoms and progressive worsening of compression symptoms after its onset were common in the latter group. Previous radiographs demonstrating significant tracheal deviation during a previous presymptomatic period were available in 11 of 36 dyspneic patients. Sudden tracheal occlusion developed in 3 percent and required emergency treatment. Tracheal compression occurred more often and when present was a more ominous symptom. Compression manifestations were more frequent in patients with multinodular goiter, were more likely to appear when the underlying disorder was thyroiditis affected the tracheal more often than the esophagus and were generally gradually progressive with time. A clinical spectrum ranging from a presymptomatic tracheal compression stage to one wherein progressive worsening of symptoms occurs is suggested. After symptoms of tracheal compression become clinically manifest, the occurrence of complete airway occlusion may be sudden and unpredictable. Early operation whenever roentgenographic evidence of tracheal deviation becomes manifest is recommended.

Adolescent↗
PubMed1981

The influence of age upon the survival of adult patients with carcinoma of the colon.

Five hundred adult patients with carcinoma of colon were studied to determine the relationship between age and prognosis. Regardless of the stage of disease or curative or palliative operation, younger patients had a better prognosis. Deaths after three years postresection were usually due to associated disease, which probably accounts for the poorer prognosis in the older patient. The poor prognosis frequently reported in young patients with carcinoma of the colon usually applies to those less than 25 years of age who may have a different form of the disease.

Adult↗
PubMed1978

Treatment of hepatic metastases with a combination of hepatic artery infusion chemotherapy and external radiotherapy.

Systemic chemotherapy has given good results when compared with that of patients who received no chemotherapy. When resection was performed, the results are slightly better. The group of patients who underwent combined therapy, using infusion chemotherapy, radiation and systemic chemotherapy, had the best results. It appears that infusion chemotherapy and radiotherapy can improve the palliation available for patients with metastases in the liver from carcinoma of the colon and rectum and warrants further investigation.

Adult↗
PubMed1977

The value of laparoscopy in general surgery.

Fifty-six general surgical patients were evaluated by laparoscopy, primarily for diagnostic problems, ascites or liver assessment for potential metastatic disease. There was minimal morbidity and no mortality from the procedure. Overall laparoscopic accuracy was 87%. In properly selected cases, laparoscopy can often resolve a diagnostic problem, determine the extent of disease and permit initiation of appropriate therapy.

Adenocarcinoma↗