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Biomedical subjects

J Bendahan

Publications and source records attributed to J Bendahan.

15 recordsLinked to original sources
PubMed2000

Video-assisted transthoracic sympathectomy in the treatment of primary hyperhidrosis: friend or foe?

The authors hypothesize that palmar hyperhidrosis is a systemic manifestation of abnormal sudomotor function; consequently, thoracoscopic sympathectomy to alleviate symptoms in the hands may result in heat dissipation because sweating is transferred to other sites. To investigate this phenomenon and to determine whether it adversely affects patient satisfaction, a standard questionnaire was administered to 626 patients who underwent sympathectomy at a university-associated public hospital between 1991 and 1998; only patients treated at least 6 months before questionnaire distribution were included in the study. Replies were received from 336 (53.7%) individuals. The surveyed patients underwent bilateral T2, T3 (palmar sweating), or T3, T4 (axillary sweating) sympathectomy by a standard video-assisted transthoracic technique. Main outcome measures included the incidence of dry hands, compensatory sweating, chest pain, upper-limb muscle weakness, shortness of breath, and gustatory phenomena; in addition, patient perception of the success of the surgical procedure was assessed. After sympathectomy, 97.3% (P < 0.0001) and 29.2% (P < 0.001) of patients reported significant improvement in palmar hyperhidrosis and axillary sweating, respectively. Postsurgery, severe compensatory sweating was experienced in 90% of patients (P < 0.0001). The sites of compensatory sweating were the back (75%), abdomen (51%), feet (23%), groin and thigh (13%), chest (13%), and axillae (8%). Transient whole-body sweating for no apparent reason was experienced in 30% of patients. Thirty-seven patients (11%) regretted having undergone the surgical procedure. In contrast, 25% and 64% of patients were either satisfied or very satisfied with the outcome of the procedure. From the survey results, the authors conclude that palmar hyperhidrosis is a systemic manifestation of abnormal sudomotor function and that thoracic sympathectomy may alleviate symptoms in a large proportion of patients. However, for some individuals, compensatory sweating may prove to be an equally troublesome handicap. Because the occurrence of severe compensatory sweating is unpredictable, a reversible sympathectomy may be desirable.

Adolescent↗
PubMed1998

Congenital deficiency of the tibia: a report on 22 cases.

Congenital deficiency of the tibia (tibial hemimelia, aplasia, or dysplasia) is very rare, with an incidence of approximately 1 per 1 million live births. The disorder usually is accompanied by other congenital anomalies on the same limb or other parts of the body. A report is made of 22 limbs observed in 18 patients from 1970 to 1987 at San Juan de Dios Hospital in Caracas, Venezuela, with more than a 5-year follow-up. The report includes 11 girls and 7 boys, with observations of 11 left and 11 right tibiae. Familial antecedents were present in four patients: brother and sister and two brothers. According to the classification by Jones, Barnes, and Lloyd-Roberts, there were nine cases of type Ia, four of type Ib, three of type II, two of type III, and four of type IV. The foot of the affected limb was normal in only 12 cases. Treatment, always surgical, consisted of T/K amputation in 10 cases of types Ia and Ib, fibula pro tibia and B/K amputation in 1 case of type II, Syme amputations in 2 cases of type III, and astragalectomy and closure of diastasis in 4 cases of type IV deformity. Patients in five cases refused treatment. The sooner the amputation is performed, the easier and faster the rehabilitation and adaptation to the prosthesis. An early amputation is accepted by the child as a "congenital amputation."

Abnormalities, Multiple↗
PubMed1995

Abdominal compartment syndrome.

Abdominal compartment syndrome is still a controversial entity. We report on a patient who developed the classical hemodynamic, respiratory, and renal changes of abdominal compartment syndrome after surgical intervention for blunt abdominal trauma. A decompressive laparotomy improved the situation dramatically.

Abdominal Injuries↗
PubMed1995

Outpatient surgical treatment of anal fissure.

OBJECTIVES: To review our experience of treating anal fissures by lateral subcutaneous anal sphincterotomy in the outpatient clinic. DESIGN: Retrospective study. SETTING: University hospital, Israel. SUBJECTS: 108 of 112 Consecutive patients with anal fissures. INTERVENTIONS: All patients had failed to respond to a two week course of conservative treatment. They all underwent lateral subcutaneous anal sphincterotomy under local anaesthesia in either the outpatient clinic or the day-case operating theatre. MAIN OUTCOME MEASURES: Early and late morbidity, patient satisfaction, admission to hospital, and recurrence. RESULTS: 108 of the 112 were followed up for a mean of 20 months (range 2-56). 100 (93%) reported that the late results were good to excellent. Four patients bled immediately after the operation and required admission to hospital and four developed abscesses of which only one responded to conservative treatment; 14 patients complained of initial mild incontinence but in most this resolved over time; 92 patients (85%) had no complaints at late follow up, and only 3 reported either no improvement or recurrence; 10 reported slight soiling, and only one patient remained incontinent. CONCLUSION: Sphincterotomy is the operation of choice for patients with anal fissures that have not responded to conservative treatment, particularly as it can be done effectively and safely in the outpatient clinic under local anesthesia.

Abscess↗
PubMed1994

The effect of administration of FK506 on delayed regeneration in flushed partially hepatectomized livers.

It has been shown previously that liver regeneration after partial hepatectomy in rats is delayed if the liver is subjected to either concurrent ischaemia, flushing with cold solution, or grafting. We have shown recently that treatment with CsA preoperatively overcomes the suppressive effect of flushing and returns the regenerative response to a normal time scale. The present study was designed to investigate whether administration of FK506 would also return the observed delayed regenerative response to normal. Long-Evans rats weighing 250-350 g were subjected to standard 68% partial hepatectomy. Group 1 had no further treatment; in group 2, the liver remnant was flushed with 10 ml cold (4 degrees C) Ringers lactate solution, and in group 3, FK506 (1 mg/kg/day) was administered by intramuscular injection for 3 days before the partial hepatectomy and flushing as in group 2; a final dose was given after completion of the procedures. Animals were killed in sets of 6 per group at 4, 24, 48, 72, and 96 hr after surgery and blood samples were taken for measurement of plasma aspartate amino-transferase. Liver biopsies were analyzed for measurement of thymidine kinase and ornithine decarboxylase activity and for counting of mitotic figures. While the highest recorded thymidine kinase activity occurred in group 1 at 24 hr, this was delayed to 48 hr in both group 2 and 3 and counts remained high up to 96 hr in group 3. Mitotic indices were only significantly elevated (compared with group 1 at 96 hr), while ornithine decarboxylase activity did not correlate with these changes being significantly lower than in groups 2 and 3 at 4 hr and in group 3 also at 24 hr. Plasma aspartate aminotransferase was also significantly higher in group 3. It is concluded that the administration of FK506 preoperatively to rats subjected to partial hepatectomy and flushing did not restore the delayed regenerative response to normal but enhanced the response (as measured by thymidine kinase but not by mitotic indices) which commenced at 48 hr and was still present at 96 hr.

Animals↗
PubMed1994

Endoscopic transthoracic sympathectomy in the treatment of primary hyperhidrosis. A review of 290 sympathectomies.

OBJECTIVES: To describe the surgical technique of endoscopic transthoracic sympathectomy for the treatment of palmar hyperhidrosis and to identify associated complications. DESIGN: Prospective clinical study. SETTING: University referral center. PATIENTS: A consecutive series of 150 patients with primary palmar hyperhidrosis. INTERVENTION: The surgical procedure is performed under general anesthesia. A trocar and endoscope are inserted into the chest cavity. The sympathetic chain and the second, third, and fourth ganglia are then identified, cauterized, and cut. After reinflation of the lung, the procedure is repeated on the other side. RESULTS: Two hundred ninety sympathectomies were performed with a 98% success rate. Complications of the procedure included pneumothorax in seven patients (2.4%), hemothorax in three (1.0%), and temporary Horner's syndrome in two (0.7%). Severe postoperative pain during the first 2 to 4 hours required treatment. Of 60 patients who were followed up for 12 months, 50% developed compensatory sweating and 8.3% developed rebound sweating. Hyperhidrosis recurred in three patients. CONCLUSION: Endoscopic transthoracic sympathectomy is an effective form of treatment for palmar primary hyperhidrosis, is associated with a low morbidity, and can be performed as an ambulatory procedure.

Adolescent↗
PubMed1993

Congenital absence of the radius.

Between 1971 and 1987, we treated 26 patients with congenital absence of the radius which had produced a club hand; 37 hands were affected. Treatment before the age of 8 months was by gentle manipulation and serial plasters. If a functional position was not obtained, and in patients over 8 months, surgical reduction was carried out. A modified Riordan procedure was used until 1983, and thereafter a double Z-plasty. The best results were achieved in patients under 4 years of age.

Child, Preschool↗
PubMed1992

The possible role of Chlamydia trachomatis in perineal suppurative hidradenitis.

OBJECTIVE: To find out if there is an association between perineal suppurative hidradenitis and Chlamydia trachomatis infection. DESIGN: Open study. SUBJECTS: Seven consecutive patients treated for perineal suppurative hidradenitis during the past three years, and 10 control subjects who were being treated for acute cryptogenic perianal abscesses. MAIN OUTCOME MEASURE: Presence of C. trachomatis detected by direct immunofluorescent staining. RESULTS: All but one patient had serological evidence of C. trachomatis infection. All 10 control subjects failed to react to IgA antibodies to C. trachomatis, and two reacted to IgG antibodies. CONCLUSION: There may be a link between C. trachomatis infection and suppurative hidradenitis, but it is uncertain whether it is a direct cause or a predisposing factor.

Abscess↗
PubMed1992

Seasonal pattern in the incidence of bleeding caused by peptic ulcer in Israel.

We have reviewed all endoscopies performed in our hospital between 1977 and 1986. During that period, 1337 endoscopies were performed to identify bleeding from peptic ulcers. Excluded were cases in which a predisposing factor was found, such as the use of ulcerogenic drugs. Also excluded were chronic or critically ill patients. The remaining 540 cases were reviewed. In 447 of those cases, the bleeding lesion was a duodenal ulcer, whereas, in 93 cases, a gastric ulcer was found (a ratio of 5:1). The seasonal variation in the incidence of bleeding from peptic ulcers was evaluated. We found a significant difference in bleeding in the cold and hot seasons, the incidence being significantly greater during the cold season (November until February). A similar pattern was found for bleeding from both duodenal and gastric ulcers.

Duodenal Ulcer↗
PubMed1991

[Use of somatostatin analogue for intestinal and pancreatic fistulas].

The hormone somatostatin, a tetra-deca-peptide, was discovered in 1972. It inhibits the central nervous system and the endocrine and exocrine secretions of the gastrointestinal tract. The first clinical use of the hormone was to inhibit hormone-secreting tumors of the CNS. It has also been used to treat hormone-secreting tumors of the pancreas and GI tract. Treatment of small bowel and pancreatic fistulas has also been attempted. A new synthetic analogue of the hormone, SMS 210-995, (Sandostatin) has a long half-life and is highly effective after subcutaneous injection. It was used in the treatment of 3 patients with fistulas of the small bowel and pancreas. In all impressive reduction of fistula secretion was achieved within 24 hours. In 2 there was complete, spontaneous closure of the fistula: in 1 after 10 days and in the other after 15 days of treatment. In the 3rd, there was significant reduction of fistula output. There were no side-effects except for mild pain at the injection site in 1 patient. Previous reports and our own results indicate that this somatostatin analogue may be very useful in the nonsurgical treatment of GI tract fistulas.

Aged↗
PubMed1987

Posterior duodenal ulcer: acute free perforation into the lesser sac.

Perforation of a peptic ulcer located on the posterior wall of the duodenum is very rare. We present here three cases with acute and free perforation of a posterior duodenal ulcer with a fatal outcome. To the best of our knowledge such an acute free perforation has not been previously published.

Acute Disease↗
PubMedDate not supplied

Sarcoidosis masquerading as a parathyroid adenoma.

Two patients presented with a presumptive diagnosis of hyperparathyroidism. Surgically excised "parathyroid glands" were found to be, in fact, large lymph nodes with sarcoid granulomata. In one patient, the preoperative localization of the "parathyroid adenoma" was based on scintigraphy (thallium-technetium subtraction imaging) and sonography procedures. The differential diagnosis of hypercalcemia, and positive scintigraphy-sonography studies, must include sarcoidosis in an isolated cervical lymph nodes.

Adenoma↗