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Biomedical subjects

M Schein

Publications and source records attributed to M Schein.

At least 127 records · Page 7Linked to original sources
PubMed1993

[Subtotal cholecystectomy: an emergency procedure for the difficult gallbladder and high-risk patient].

Emergency cholecystectomy in high-risk patients is still associated with significant morbidity and mortality. Occasionally technical difficulties and bleeding diathesis are complicating factors. Our prospective experience with subtotal cholecystectomy in 23 consecutive patients is presented. All presented as increased surgical risks (APACHE II above 10) and suffered from acute cholecystitis with empyema or perforation. 1 patient died (4.4%), but overall, surgical complications were minimal. We conclude that subtotal cholecystectomy combines the advantages of cholecystectomy and cholecystostomy. We believe that this short, simple and safe procedure is a logical choice for emergency situations in critically ill patients.

Adult↗
PubMed1993

Contemporary management of the appendiceal mass.

An appendiceal mass is the end result of a walled-off appendiceal perforation and represents a pathological spectrum ranging from phlegmon to abscess. Over the past decade, improved imaging and interventional radiological techniques have allowed a more accurate definition of pathology and thus a more specific and less invasive management than was previously possible. A management policy should be possible that allows over 80 per cent of patients presenting with an appendiceal mass to be safely spared an open operation.

Appendectomy↗
PubMed1993

Management of the leaking rectal stump after Hartmann's procedure.

Hartmann's procedure is often selected in situations in which the construction of a colorectal anastomosis is considered unsafe. Paradoxically, the creation of the rectal stump involves placement of an intestinal suture line that is prone to leakage. We report our experience with 11 patients with a clinically significant leakage from the rectal stump after Hartmann's procedure, which was manifested as persistent postoperative intra-abdominal infection. A method for the treatment and prevention of this potentially lethal complication is presented.

Adult↗
PubMed1993

Infected peri-pancreatic necrosis causing gallbladder necrosis by direct extension.

Acute acalculous cholecystitis may develop in patients suffering from necrotizing pancreatitis. Conversely, acute pancreatitis may complicate acute gallbladder disease. We present a case that lends support to the existence of another possibility: gallbladder necrosis caused by direct extension of the necrotizing pancreatitic process.

Alcoholism↗
PubMed1993

Limited contribution of emphysema in advanced chronic obstructive pulmonary disease.

Previous studies on autopsy specimens or surgically resected lobes or lungs have reached varying conclusions regarding the importance of small airways disease and emphysema in causing fixed expiratory airflow limitation in patients with chronic obstructive pulmonary disease (COPD). We obtained high resolution CT scans of the lung and lung function in 56 consecutive patients with fixed expiratory airflow limitation. There was poor correlation between CT emphysema score and either FEV1/FVC% (r = -0.36) or FEV1 % predicted (r = -0.20). In only 10 of the 35 patients with FEV1 < 50% predicted, the CT emphysema score was > 40, indicating significant emphysema. A strong negative correlation between diffusing capacity % predicted and diffusing capacity per alveolar volume and CT emphysema score was found only in patients with FEV1 > or = 1 L (r = -0.75, p < 0.0001). Thus, emphysema does not appear to be primarily responsible for expiratory airflow limitation in COPD. A low diffusing capacity may be spuriously misleading in patients with FEV1 < 1 L and no or trivial emphysema.

Aged↗
PubMed1993

[Conservative surgery in penetrating renal injuries].

In 11 of 21 patients with penetrating renal injury operated on during a year, salvage of the involved kidney or part of it was successful. We conclude that accurate diagnosis and staging of penetrating renal trauma, when combined with a conservative surgical approach, allows salvage of functional renal parenchyma in a large proportion of cases.

Humans↗