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Biomedical subjects

M Brotman

Publications and source records attributed to M Brotman.

13 recordsLinked to original sources

Percutaneous gastrostomy. A new simplified and cost-effective technique.

A refined endoscopically controlled percutaneous tube gastrostomy has been described in detail, and the experience gained in 28 patients has been reported herein. A majority of the patients had severe underlying neurologic disorders, malignancy of the oral pharynx or esophagus or chronic intestinal obstruction due to advanced malignancy. The three groups of patients were analyzed regarding mortality and morbidity. Three minor complications occurred in the entire group, and three in-hospital deaths occurred which were unrelated to the tube. In addition, four other patients died from their underlying disease several months after discharge from the hospital. Analysis of this technique has shown it to be safe, easy to perform, and acceptable to the patients and supporting personnel. A cost analysis showed significant savings when this technique was utilized instead of operative gastrostomy.

Aged

Cimetidine-induced hemolytic anemia: the fallacy of clinical associations.

Two patients developed hemolytic anemia while taking cimetidine. Neither patient was taking other drugs known to cause hemolytic anemia. In both, the hemolytic anemia resolved after the drug was stopped. In one patient, the direct antiglobulin (Coombs') test was strongly positive when the hemolytic anemia was recognized and became only weakly positive as the hemolysis subsided. However, serologic studies for antidrug antibodies yielded negative results in both patients; readministration of cimetidine for 55 days in patient 1 and for more than 24 months in patient 2 did not cause recurrence of hemolysis. We conclude that we cannot incriminate cimetidine as the cause of the hemolytic anemia in either of our patients. These findings emphasize that a temporal association of drug administration and hemolytic anemia is not proof of a cause-effect relationship and that reports of drug-related adverse hematologic effects must be interpreted with caution.

Adult

Hospital family planning: termination of pregnancy and contraceptive use.

A review of termination of pregnancy in a district hospital catchment area for 1970 to 1972 shows how a decrease in total numbers of terminations and repeat terminations may be effected by the use of intensive family planning. In 1972 over 80% had first trimester abortions, but most of the second trimester abortions came from the manual skilled, semi-skilled, and unskilled occupational groups. Over half those attending for termination had never used any method of contraception. Acceptance of family planning after termination was high but motivation poor, emphasizing the suitability of intrauterine devices inserted at the time of termination. The complication rate after termination was low.

Abortion, Legal