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Biomedical subjects

J Adelson

Publications and source records attributed to J Adelson.

10 recordsLinked to original sources
PubMed1989

Pediatric liver transplantation: the Montreal experience.

The introduction of cyclosporine A in 1980 greatly improved the survival of children with end-stage liver disease undergoing orthotopic liver transplantation. The average 1-year survival rate following hepatic transplantation increased from 30% in 1963 to 70% in 1980. This report summarizes the initial experience of two pediatric hospitals in Montreal--Hôpital Ste-Justine and Montreal Children's Hospital. Since December 1985, 13 orthotopic liver transplantations have been performed in 11 patients: six females and five males. The median age was 18 months (range, 13 months to 17 years) and the median weight was 10 kg (range, 8.5 to 38 kg). The indications for transplantation were biliary atresia (5 patients), tyrosinemia (2 patients), biliary hypoplasia (1 patient), Amerindian cirrhosis (1 patient), Crigler-Najjar syndrome, type I (1 patient), and fulminant non-A, non-B hepatitis with grade IV encephalopathy (1 patient). Immunosuppression was ensured by cyclosporine A, azathioprine, and steroids. The function of 11 grafts was immediate following revascularization of the grafts. One graft had delayed function due to preservation injury, and one had primary nonfunction. Surgical complications included bile peritonitis (1), ruptured aneurysm of an aortic conduit (1), and thrombosis of the hepatic artery necessitating retransplantation (2). Three of our patients died, one from postoperative cerebral edema, one of primary nonfunction of the graft, and one of ruptured aneurysm of an aortic conduit. Our overall survival rate was 72% with a follow-up of 3 to 32 months. Pediatric liver transplantation can now provide successful treatment and cure of liver diseases considered, until recently, dismal and hopeless.

Adolescent↗
PubMed1986

Behavior abnormalities and poor school performance due to oral theophylline use.

Studies evaluating adverse effects of oral theophylline on learning and behavior have been performed on children with asthma receiving long-term theophylline therapy. To further differentiate the effects of asthma itself from the drugs used, we evaluated 20 asthmatic children (6 to 12 years of age) who had not received oral bronchodilators for at least 6 months. A double blind, placebo-controlled, parallel format was used with a 4-week theophylline or placebo period preceded by a 2-week baseline. Theophylline serum levels were maintained between 10 to 20 micrograms/mL. During baseline and treatment periods, the child's home and school behavior/performance were monitored independently by their parents and teachers using standardized report forms. A battery of psychologic tests was administered at the end of baseline and treatment periods. Seven children receiving theophylline were noted to have a change in school behavior and/or performance during their 4 weeks on drug compared to baseline, whereas none of the children receiving placebo were noted to be different (P = .004). Thus, the short-term administration of theophylline to asymptomatic asthmatic children not receiving oral bronchodilators can adversely affect school performance and behavior. Because this population represents the majority of asthmatic children, one needs to use theophylline cautiously in this age group, monitor school performance closely, or seek other treatment modalities.

Achievement↗
PubMed1980

Thromboembolism after insertion of the Mobin-Uddin caval filter.

The occurrence, in one patient, of a life-threatening pulmonary embolus 3 days following insertion of a Mobin-Uddin umbrella filter promoted a review of our experience with this device. Over the past 5 years, 41 patients had umbrella filters inserted at the Beth Israel Hospital. Five patients (12%) had proven or probable pulmonary embolization following filer placement. In four of the seven autopsied patients, thrombus was found on the cardiac side of the umbrella, and in one of these patients a fresh embolus was also found in the pulmonary artery. We conclude that the standard (nonheparin-impregnated) Mobin-Uddin umbrella device offers incomplete protection against pumonary embolization in patients who cannot concurrently receive anticoagulant drugs.

Adult↗
PubMed1980

Edema of the papilla of Vater simulating retained common duct stone.

A prominent or edematous papilla of Vater may prodce a rounded filling defect in the duodenum. During T tube or operative cholangiography, this may simulate a calculus impacted in the distal or intramural portion of the common bile duct. This communication reports such an occurrence. Recognition of this potential cause for a false positive cholangiogram should prevent some instances of unnecessary instrumentation of the common bile duct.

Aged↗
PubMed1969

Personality.

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Achievement↗