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Biomedical subjects

P J Buchin

Publications and source records attributed to P J Buchin.

8 recordsLinked to original sources
PubMed1988

Swallowing disorders. Diagnosis and medical treatment.

In this article, the diagnosis and treatment of gastroesophageal reflux (GER), esophageal primary dysmotilities, and esophageal infections were reviewed. Important systemic diseases, including endocrine, neurologic, and collagen vascular types, that affect the esophagus were discussed. Finally, theoretical mechanisms of aspiration and possible reflex bronchoconstriction secondary to GER have been reviewed. What is needed are further controlled studies of medications to treat GER, achalasia, and diffuse esophageal spasm (DES) with side effects safe enough, and efficacy strong enough, to permit patient acceptance and FDA approval for esophageal purposes.

Deglutition Disorders↗
PubMed1986

Down's syndrome and the gastrointestinal tract.

Gastrointestinal (GI) abnormalities are frequent in patients with Down's syndrome. In a 12-year retrospective review, we identified 187 patients with Down's syndrome admitted to the Columbia-Presbyterian Medical Center. Twenty-seven had major GI disorders, the most common being duodenal stenosis (DS, nine), gastroesophageal reflux (GER, five), imperforate anus (five), and Hirschsprung's disease (four). The mortality for the whole group was 11% (20 patients). The mortality in the small group of patients with duodenal stenosis was particularly high (five out of nine, or 56%). Associated congenital heart disease, especially endocardial cushion defects, and the frequent occurrence of pneumonia contributed to this high mortality rate.

Adolescent↗
PubMed1984

Medical management of disorders of swallowing.

Disorders of swallowing in a given patient can result from abnormalities of dentition, the oral cavity (mouth and pharynx), the cricopharyngeal muscle, esophageal skeletal (proximal) or smooth (distal) muscle, the lower esophageal sphincter, and the stomach. Recent advances include refinements in esophageal manometric techniques with reclassification of motility disorders; newer drugs to treat gastroesophageal reflux; recognition of more frequent infections of the esophagus in immunosuppressed patients; and adaptation of the use of medications such as nitrates and calcium-channel blockers, which were previously primarily cardiotonic, for investigative treatment of esophageal motility abnormalities.

Combined Modality Therapy↗
PubMed1982

Esophageal dysfunction in Down's syndrome.

Abnormalities in esophageal function were identified in seven children with Down's syndrome. Three had recurrent episodes of pneumonia from gastroesophageal reflux; two of these and one other patient had esophageal strictures. Two patients with Down's syndrome revealed no evidence of gastroesophageal reflux but did show significant abnormalities in esophageal peristalsis. These data would suggest that ambulatory children with Down's syndrome may be at risk of developing serious sequellae of gastroesophageal reflux. The spectrum of data of these seven patients is discussed, and pertinent prior reports from the literature are reviewed.

Adolescent↗
PubMed1981

Therapy of esophageal stricture: a review of 84 patients.

The course of patients with stricture of the esophagus is variable. Operation is effective, but preoperative trials of dilatation are often inadequate. We reviewed the records of 84 patients with esophageal stricture of various causes of assess efficacy of operative and nonoperative management. Sixty-five percent of patients were successfully treated with serial bouginage alone and 35% required operation, with an overall mean follow-up of 59.6 months. Sixty-eight percent of 37 patients with reflux-induced stricture were successfully treated with bouginage, whereas 32% required operation. Eighty-five percent of patients with stricture from nasogastric tubes of esophageal surgery wre successfully treated with dilatation, but 67% of those with corrosive stricture needed operation. Although surgical therapy is effective and generally safe on the management of esophageal stricture, we estimate that two-thirds of patients with stricture can be treated satisfactorily with nonoperative dilatation. Bouginage should be tried as the initial therapy in patients with reflux-induced, postoperative, or tube-related stricture of the esophagus.

Adolescent↗
PubMed1981

Ultrasonographic scanning of the pancreas. Prospective study of clinical results.

The symptoms of pancreatic cancer are nonspecific and are common in the elderly, who are at risk for pancreatic cancer. Ultrasound is an economic means for screening such individuals. This report describes a prospective study of the efficacy of ultrasound in 83 patients with symptoms of pancreatic cancer. Scanning techniques, which resulted in visualization of the head, neck, and body of the pancreas in 90% of the patients scanned, are reviewed. A sensitivity of 94% and a specificity of 99% were achieved. Small defects in the parenchyma may be seen with ultrasound before there are any changes in the size or contour of the organ.

Adult↗