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Biomedical subjects

J M Levey

Publications and source records attributed to J M Levey.

14 recordsLinked to original sources
PubMed2002

Intestinal perforation in a parastomal hernia by a migrated plastic biliary stent.

Organ perforation is a well-described complication of plastic biliary stent placement [1, 2, 3, 4, 5, 6, 7, 8, 9, 10][1-10]. Most commonly, a stent will cause duodenal perforation while still in the area of the biliary system. This often occurs in the setting of a periampullary diverticulum. Less frequently, a perforation occurs as a result of stent migration into the distal lumenal gastrointestinal tract. These cases have involved a migrated stent impacting at the level of the ileum or a sigmoid colon diverticulum. A plastic biliary stent causing perforation inside an incarcerated small bowel hernia sac has been reported [10]. We describe the first reported case of a plastic biliary stent causing perforation inside a parastomal hernia.

Aged↗
PubMed2001

Extrahepatic manifestations of infection with hepatitis C virus.

Chronic hepatitis C is associated with, and may trigger or exacerbate, an extraordinary variety of extrahepatic manifestations. Most of these manifestations affect the skin, the most frequent and important of which are the leukocytoclastic vasculitis of MC type II and PCT. The former is an example of an autoimmune disorder triggered by HCV infection, whereas PCT is a skin disease caused by hepatic overproduction of uro- and 7-carboxyl porphyrins caused by increased oxidative stress in hepatocytes. Currently available effective therapies of CHC (IFN, ribavirin) may also trigger or exacerbate extrahepatic manifestations, especially including autoimmune thyroiditis, skin rashes, and hemolytic anemia.

Arthralgia↗
PubMed1998

Diffuse pancreatic fibrosis: an uncommon feature of multifocal idiopathic fibrosclerosis.

Multifocal idiopathic fibrosclerosis (MIF) is a rare syndrome characterized by exuberant fibrosis involving diverse organ systems. MIF is manifest by varying combinations of the following conditions: mediastinal fibrosis, retroperitoneal fibrosis, orbital pseudotumor, Riedel's thyroiditis, and sclerosing cholangitis. Less common features of MIF include Dupuytren's contractures, lymphoid hyperplasia, Peyronie's disease, vasculitis, testicular fibrosis, and pachymeningitis. Fibrosis arising from the pancreas has been previously described in two patients with MIF. We report a 58-yr-old white man with MIF manifest as orbital pseudotumor, sclerosing cholangitis, lymph node hyperplasia, and diffuse pancreatic fibrosis.

Cholangitis, Sclerosing↗
PubMed1996

Adult pancreatoblastoma: a case report and review of the literature.

Pancreatoblastoma is an uncommon pediatric neoplasm with distinct acinar and squamoid cell differentiation. This tumor often contains neuroendocrine and/or mesenchymal components. Pancreatoblastoma is exceedingly rare in adults, with only eight cases described (Table 1). We report a 68-yr-old white female with adult pancreatoblastoma, the oldest patient, to date, diagnosed with this unusual malignancy.

Aged↗
PubMed1994

Mixed cryoglobulinemia in chronic hepatitis C infection. A clinicopathologic analysis of 10 cases and review of recent literature.

We present 10 cases of mixed cryoglobulinemia in patients infected with hepatitis C, including pertinent clinical, serologic, and pathological data. The findings attributable to MC appear to be similar in patients who are HCV-infected as in those with unknown HCV status. The prevalence of MC in HCV-infected patients appears to be lower in our region (13%) than in southern Europe (50-90%) although some of this difference is due to our requirement that patients included in our study have a cryocrit of at least 5%. In our patients, cryoglobulins were shown to be deposited in skin and kidney, but not in liver. The mechanisms by which HCV and MC are related remain uncertain. Although we and others have evidence for enrichment of HCV RNA in the cryoprecipitates of some patients, this was not always the case, and it is not yet clear that this finding is of fundamental pathogenic importance. Finally, it appears that some patients with HCV and MC may have a beneficial clinical response of vasculitic symptoms to therapy with alpha-interferon, as well as to glucocorticoids or other immunosuppressants. In our group, no predictors were apparent to distinguish responders from nonresponders before treatment. Similarly, the duration of response remains to be determined.

Adult↗
PubMed1981

Hospital microbial environment: need for continual surveillance.

In an epidemic of nosocomial infection, Pseudomonas cepacia emerged as a significant pathogen capable of causing severe infection. The epidemic was controlled by tracing and controlling the source of the infection, which proved to be "sterile" water and "in-use" dilution antiseptic. Problems of sterile water were controlled by regular maintenance of equipment and surveillance. Antiseptic problems were overcome by changing the type of antiseptic, and paying attention to correct concentration of "in-use" dilution. A four-year follow-up of the water supply shows no further problems. Further infectious episodes caused by P. cepacia have not been encountered.

Anti-Bacterial Agents↗
PubMed1981

Treatment of granulating wounds with silastic foam dressings.

We have examined the usefulness of a Silastic foam dressing in the management of open granulating wounds in 55 outpatients. It is an acceptable and comfortable dressing, which allows earlier discharge from hospital. The method of making the dressing, and the daily care of the wound are described. Improved wound care is achieved by providing two dressings, so that when one is in place the other is being thoroughly cleaned. This technique has been shown to reduce bacterial contamination of the wounds and to improve wound healing (p less than 0.02).

Abdomen↗