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Biomedical subjects

M Libeskind

Publications and source records attributed to M Libeskind.

At least 19 recordsLinked to original sources

Comparison of two sucralfate dosages presented in tablet form in duodenal ulcer healing.

Two hundred twenty-two patients with endoscopically proven duodenal ulcers participated in a controlled trial to assess and compare the effects of two dosage regimens of sucralfate tablets on ulcer healing, i.e., 1 g four times daily (group A, n = 131) and 2 g twice daily (group B, n = 128). Healing was defined as complete re-epithelialization. Clinical and endoscopic assessments were performed after four weeks (Day 28) and, if complete healing was not achieved, after four more weeks (Day 56). After four weeks, in group A (n = 114: eight patients were lost and nine were withdrawn), the ulcers had healed in 90 patients (79 percent), and in group B (n = 108: six patients were lost and 14 were withdrawn), the ulcers had healed in 80 patients (74 percent). The cumulative healing rates after eight weeks were 94 percent in group A and 95 percent in group B. No serious adverse effect was observed in either group. These results suggest that sucralfate tablets in a dosage of 2 g twice daily are as effective as 1 g four times daily in the treatment of acute duodenal ulcers and could lead to better patient compliance.

Adult↗

[Maintenance therapy of ulcer disease. Comparative multicenter study of sucralfate, cimetidine and a placebo].

Relapse rates were studied in one hundred patients in a multicentric, randomized trial during and after maintenance therapy comparing sucralfate, cimetidine and placebo. These patients were previously treated by cimetidine for peptic ulcer and were considered cured after endoscopic examination. Outpatients were randomly assigned to a 6 month maintenance treatment with either cimetidine (600 mg daily), sucralfate (300 mg daily) or a placebo. All patients underwent endoscopic evaluation after 3 and 6 months of therapy. A clinical évaluation was performed 6 months after all treatment had ceased. Clinical and endoscopic results proved the significant superiority of both sucralfate and cimetidine over the placebo. Remission rates with sucralfate were respectively 80,4 p. 100 after 6 months and 68,5 p. 100 after 12 months. These results were slightly superior to those observed with cimetidine (69,3 p. 100 and 61,3 p. 100). However, this difference is not statistically significant. Results for the placebo group were 47,9 p. 100 and 37,7 p. 100. Sucralfate is an effective medication in preventing the recurrence of peptic ulcer. Its pharmacological action, its few side effects and its effectiveness seem to make this medication very interesting in treating the ulcerous disease.

Aluminum↗

[Apparently primary malignant lymphoma of the rectum. Presentation of a case].

With reference to a case of apparently primary lymphoma of the rectum, the authors emphasize the difficulty of diagnosis, which requires deep biopsies, and of categorizing clinical cases in view of the constantly modified classifications. Treatment modalities, whose choice is dependent upon the disease itself and the general state of health of the individual patient, are summarized.

Aged↗

[Syndrome of inappropriate antidiuretic hormone secretion. A report of two cases with hyponatremia and hypouricemia].

Two cases of Schwartz-Bartter syndrome are reported. Both were due to malignant anaplasic tumours of the APUD type with multiple abnormal endocrine secretion, and both were accompanied with hypouricaemia of uncertain significance. The authors believe that the association of hypernatraemia with hypouricaemia should alert clinicians to the possibility of a syndrome of inappropriate antidiuretic hormone secretion (SIADH) of malignant origin.

Apudoma↗

Chronic non-specific ulcerative duodenojejunoileitis: report of four cases.

Four patients with chronic non-specific ulcerative duodenojejunoileitis (CNSUDJI) are reported. The clinical picture included abdominal pain, fever, and a malabsorption syndrome. Main rediological findings were diffuse narrowing of the jejunal loops with total effacement of the mucosal folds. Multiple peroral biopsies of the small intestine showed various degrees of mucosal abnormalities from total villous atrophy to normal villi, but ulcerations were diagnosed only by operative full thickness biopsies or resection of the small bowel. The ulcerative process was associated with well-documented coeliac disease in two patients: in one of them it occurred as a fatal complication involving also the colon, three years after the start of a gluten free diet, while the disease was in full clinical and histological remission. In the other case, coeliac disease was revealed by obstructive symptoms due to stenosing ulcerations; five months after surgical resection of the stenosis, institution of a gluten free diet induced a dramatic improvement. In the two other patients ulcerations were not associated with coeliac disease: one of them had a patchy villous atrophy and resisted a gluten free diet and total parenteral nutrition; she was improved by and dependent upon steroids but finally died. The last patient had normal villous height; ulcerations were located exclusively along the mesenteric border of the small bowel; he had a low-grade protracted evolution resisting any form of therapy and developed a peripheral neuropathy of unknown aetiology. On the basis of our cases and of a review of the literature the discussion focuses on the difficulty in diagnosing CNSUDJI, its relationship with coeliac disease, and its management and prognosis.

Adult↗

[Gastrointestinal haemorrhage in the cirrhotic. The value of injectable posterior pituitary extract (author's transl)].

The authors report the experience which the have acquired since 1970 in the use of posterior pituitary extract as part of the treatment of gastrointestinal bleeding in cirrhotics. 100 cases have been collected, in 73 patients. These may be divided into two groups: one of 32 patients, who did not receive posterior pituitary extract, with 31 deaths, and one of 41 patients who did receive the extract, with 6 deaths. These figures should be viewed in parallel with the results obtained by other techniques, and it would seem that comparison with other statistics is feasible. In addition, emphasis must be placed upon the simplicity of the administration and surveillance of treatment. Attention is also drawn to the absence of any inherent complication associated with the use of the drug, despite the administration, in certain cases, of high doses.

Gastrointestinal Hemorrhage↗

[Non-surgical treatment of hemorrhoids].

The treatment of hemorrhoids includes a vast array of medical and instrumental means. If there is no true medical treatment, there are numerous products in order to act on the symptoms or one of the factors of the hemorrhoidal complex. Thus, phlebotonics, local topical agents, anti-infectious and anti-inflammatory agents, myorelaxants, transit regulators. Instrumental means are essentially represented by sclerosing injections, infra-red photocoagulation, cryotherapy, and mainly elastic rubber bands. All these treatments, some of which were offered as a substitute to surgery, often give interesting results, but are not devoid of danger. The attitude of the medico-surgical proctologist is then to find a happy medium between a procedure which is insufficient and one which may become unnecessarily aggressive.

Cryosurgery↗