PubMed Health⌕ Search

Biomedical subjects

J Peiser

Publications and source records attributed to J Peiser.

50 records · Page 3Linked to original sources
PubMed1985

Incidence, etiology, diagnosis and treatment of cardiac tamponade in the Negev.

The files of 20 patients who required surgical intervention for cardiac tamponade between May 1976 and June 1983 were reviewed. The most frequently implicated etiological factors were viral or idiopathic (8 of 20 cases). Clinical signs of major importance were: tachycardia, 19 of 20; dyspnea, 17 of 20; and venous engorgement, 17 of 20. Valuable bedside examinations were the pulsus paradoxus for the cardiac tamponade of nontraumatic etiology and the central venous pressure examination for traumatic cardiac tamponade. Echocardiography was the most reliable laboratory examination. All patients were treated surgically either through a left thoracotomy or by the subxiphoid approach. Although both methods were equally effective in controlling this life-threatening condition, the latter technique resulted in a lower rate of postoperative complications.

Adolescent↗
PubMed1984

Sleep apnea syndrome in the morbidly obese as an indication for weight reduction surgery.

Fifteen morbidly obese patients with Sleep Apnea Syndrome (SAS) were studied during nocturnal sleep before and between 2 to 4 months after a weight reduction surgery. Six patients were also recorded between 4 to 8 months after surgery. Postoperative recordings revealed a dramatic reduction in the sleep apnea index and an improvement in sleep motility and daytime vigilance levels. A further decrease in apneas and sleep motility was seen in the late post-treatment recording. These results indicate that weight reduction surgery is an effective definitive treatment for obesity associated SAS.

Adult↗
PubMed1984

Lipoma of the esophagus.

Lipomas of the esophagus are relatively rare, but are of clinical interest since they may produce significant clinical symptoms that must be differentiated from malignant conditions. A case of esophageal lipoma is reported. The pliable, pedunculated esophageal tumor, which changes shape radiologically and has minimal clinical symptomatology, are the hallmarks for a correct diagnosis.

Diagnosis, Differential↗
PubMed1984

Simultaneous replacement of a failed jejunoileal bypass with a gastric bypass.

This study was undertaken in order to evaluate the implications of substituting a failed jejunoileal bypass with a gastric bypass, another bariatric procedure. During the same operation, the jejunoileal bypass is taken down and a Roux-en-Y gastric bypass created. All 12 patients who underwent the procedure and who form the basis for this study survived. In comparison with patients who underwent gastric bypass alone during the same period, peri- and postoperative morbidity did not increase. Following this operation blood glucose levels and arterial blood pressure decreased as the patients with the failed jejunoileal bypass lost weight. Serum cholesterol and triglyceride levels, which are known to decrease significantly after jejunoileal bypass, slightly increased but always remained within normal range after substitution by the gastric bypass. All patients who underwent the combined operation showed a dramatic improvement in life quality. We conclude that the simultaneous performance of these two procedures is a preferable alternative to the take-down alone of the original unsuccessful procedure.

Adult↗
PubMed1984

Acute cholangitis caused by ruptured hydatid cyst.

In four patients, acute cholangitis was found to result from a ruptured hydatid cyst. In three patients, the diagnosis was established before operation by ultrasonography, and the fourth case was diagnosed during operation. Once the diagnosis of cholangitis is reached, our working policy includes administration of antibiotics and fluids, accelerated diagnostic workup, and operation as soon as possible. Our suggested operative procedure is cholecystectomy, choledochotomy, choledochoduodenostomy, and removal of the echinococcal cyst. In all four cases treated by us, there were no deaths, and only one patient who did not undergo removal of the echinococcal cyst at the initial operation needed a second operation 2 months later.

Acute Disease↗
PubMedDate not supplied

Computed tomography of elephantiasis neuromatosa.

A case of an unusually symmetric and grotesque elephantiasis neuromatosa of the trunk is presented. Computed tomography demonstrated the extent of the disease, which is essential if surgery is planned.

Back↗
PubMedDate not supplied

Avulsion fracture of the medial epicondyle caused by arm wrestling.

Fractures occurring in teenagers during arm wrestling usually involve the distal humerus and appear as a fracture of the medial epicondyle. We studied eight male patients, aged 13 to 15 years, with such fractures. All fractures involved the right hand and occurred while the patients were in the final stages of winning a match in a formal competition. Three fractures occurred during an official competition and the other five occurred during a match between friends. One patient suffered from ulnar nerve paresis that eventually recovered spontaneously. All of the patients were immobilized for 10 to 21 days, and progressed gradually to motion of the elbow. At 1-year followup, clinical and functional results were satisfying. Therefore, we recommend conservative management for fractures of the medial epicondyle sustained during arm wrestling.

Adolescent↗
PubMedDate not supplied

Early detection and treatment of a leaking gastrojejunostomy following gastric bypass.

A leaking anastomosis between the proximal stomach and the jejunum is a serious postoperative complication of the gastric bypass operation. Associated intra-abdominal sepsis carries a high mortality rate. Early diagnosis, particularly at the time of operation, and remedial treatment reduce mortality. We have devised a method for the detection of leaks, using nasogastric infusion of methylene blue with an i.p. sump suction catheter. In our initial group of 150 patients, where this method was not used, 5 patients had an anastomotic leak and 2 died of fulminant sepsis. The presence of a leak in these cases was diagnosed on clinical grounds and confirmed in all five by Gastrografin swallow between the 3rd and 5th postoperative day. In a later group of 250 patients, methylene blue was routinely used intra-operatively and twice daily thereafter to verify the integrity of the anastomosis. Of this group, seven patients developed leaks, five of which were diagnosed intra-operatively while the other two were diagnosed on the 1st postoperative day. There was no mortality in this group. The use of methylene blue provides early detection of a leaking anastomosis and thus may significantly reduce the morbidity and mortality of the gastric bypass operation.

Adolescent↗