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Biomedical subjects

R A Abdu

Publications and source records attributed to R A Abdu.

13 recordsLinked to original sources
PubMed1997

Accuracy and efficacy of nuclear scintigraphy for the detection of gastrointestinal bleeding.

OBJECTIVES: To determine the accuracy and cost-effectiveness of nuclear scintigraphy for the diagnosis and localization of gastrointestinal (GI) bleeding and to determine whether nuclear scintigraphy accurately predicts the results of angiography. DESIGN: Retrospective chart review. The following data were obtained from the medical records: age; diagnosis before scintigraphy; duration of bleeding; hemoglobin and hematocrit values; number and duration of blood transfusions; results of angiography and GI endoscopy; location of bleeding as determined by angiography, endoscopy, and nuclear scintigraphy; treatment received by patients; actual site of bleeding as documented in the medical record; and outcome of treatment. SETTING: Community hospital in a city with a population of approximately 100,000 and a catchment area of approximately 500,000. PATIENTS: One hundred fifty-five patients undergoing 161 nuclear scintigraphic examinations because of GI bleeding between January 1, 1989, and December 31, 1992. MAIN OUTCOME MEASURES: Diagnosis and location of GI bleeding as determined by nuclear scintigraphy and angiography and actual site of GI bleeding as confirmed by operative intervention or endoscopy. RESULTS: Of 114 scintigraphic examinations for which the diagnosis and localization of GI bleeding were definite, results were positive in 56 (49.1%); of these 56, a definite location of the bleeding was shown in 51 cases (91.1%), and the bleeding was localized to its exact site in 22 cases (19.3%). Of the scintigraphic examinations for which results were positive, results of angiograms were positive in 7 cases, which gives nuclear scintigraphy a 39% positive predictive value for angiography. CONCLUSION: The routine use of nuclear scintigraphy is neither accurate nor cost-effective for determining the site of GI bleeding in the community hospital.

Adult↗
PubMed1996

Survey analysis of the American Board of Surgery In-Training Examination.

OBJECTIVE: To determine how other program directors use the American Board of Surgery In-Training Examination (ABSITE) scores in the resident evaluation process. DESIGN: A cover letter and a printed one-page survey of eight questions about individual residency programs, the use of ABSITE scores in the evaluation process, minimum score for advancement, and actions taken, if any, for failure to meet required scores; space was provided for comments. SETTING: Two hundred seventy directors of surgical residency programs. PARTICIPANTS: Two hundred thirty-one (86%) directors of general surgery residency programs. MAIN OUTCOME MEASURES: The responses received in this questionnaire were similar to those received in the 1983 survey given by the American Board of Surgery. RESULTS: The majority of directors require their residents to take the ABSITE, but they differ greatly in their methods to retain or dismiss a resident, to evaluate the program and the cognitive knowledge of the residents, and to measure resident performance. CONCLUSIONS: The actions taken by program directors in their use of ABSITE scores vary widely, with a noticeable difference found when comparing the methods between the university and community hospital directors. Our survey findings show that there is still no uniform standard or agreement as to how the scores should be used, even though the ABSITE has been in existence for 20 years.

Educational Measurement↗
PubMed1993

Gastric syphilis mimicking linitis plastica.

The decreased incidence of gastric syphilis has made its clinical presentation less widely appreciated. A 61-year-old man suffering from epigastric pain, nausea, and vomiting had an initial diagnosis of gastric carcinoma; the pathologic diagnosis was equivocal. Eventually, gastric syphilis was diagnosed. In the context of the case described below, positive serologic findings in a relatively young adult should raise the suspicion of gastric syphilis. Carcinoma must be ruled out, lest the patient lose valuable time while being treated for syphilis.

Biopsy↗
PubMed1992

Initial experience with laparoscopic surgery: establishing a new surgical procedure.

Laparoscopic surgery impacted the surgical world in the United States in 1990. This report reviews the initial experience of 34 surgeons in 8 teaching hospitals of the Northeastern Ohio Universities College of Medicine. There were 538 cases reported from May 1, 1990 to January 31, 1991. There was no mortality and the morbidity rate was 4.8%, including three bile duct injuries. The conversion rate to an open procedure was 6.1%. The criteria for credentialing, training, and resident and faculty education are included. The data reported by the Surgery Department of Northeastern Ohio Universities College of Medicine are very similar to reported series from the current literature.

Adult↗
PubMed1992

Delayed splenic rupture: real or imaginary?

Although splenic injury is the most frequent abdominal injury resulting from blunt trauma, delayed splenic rupture is a rare event. From 1981 to 1990, 75 patients treated at St. Elizabeth Hospital Medical Center (Youngstown, OH) had blunt splenic injury. Splenic rupture was delayed in six of these patients (8%). More severe trauma, such as occurs with motor vehicle accidents, is more likely to lead to immediate rupture. Lesser trauma resulting from minor falls or fights is more likely to lead to delayed rupture. Subcapsular hematoma is the most common etiology for delayed splenic rupture. Although there is no reliable symptom or sign during the latent period, abdominal pain occurs almost uniformly and Kehr's sign is quite common. Peritoneal lavage and abdominal computerized axial tomography scan are accurate in diagnosing splenic rupture. Unfortunately, they are not always reliable in predicting delayed rupture.

Abdominal Injuries↗
PubMed1991

Osteosarcoma of the spermatic cord.

Malignant tumors of the spermatic cord are rare but the vast majority of these tumors are sarcomas. We report on a patient with osteosarcoma arising in the spermatic cord. Left radical orchiectomy with high dissection of the spermatic cord was performed, and the patient remains free of recurrence 2 years postoperatively. We could find no previous discussion or report of this tumor.

Genital Neoplasms, Male↗
PubMed1990

Urgent management of a giant scrotal hernia.

An unusual case of giant scrotal hernia is presented. Hernias of this magnitude are extremely rare, even in underdeveloped countries, and their repair is challenging to the surgeon and stressful to the patient. Only a few case reports on the use of pneumoperitoneum prior to herniorrhaphy have been published; however, our patient's accompanying complications of diabetes mellitus and gastrointestinal symptoms precluded the use of pneumoperitoneum. The emergency management, including the expansion of the abdominal cavity with prosthesis, the ensuing postoperative complications, and the patient outcome, are discussed.

Abscess↗
PubMed1987

Acute gastric necrosis in anorexia nervosa and bulimia. Two case reports.

In recent years we have treated two patients with gastric infarction as a complication of anorexia nervosa and bulimia. We found only three other cases reported in the literature. Surgical intervention was delayed in all five patients either because the diagnosis was missed by the physician or because the patient failed to seek medical attention. Physicians should be alerted to the possibility of acute gastric dilatation if a young woman, who may be undernourished and anorexic, complains of abdominal pain after ingestion of a large meal. Often this condition can be treated conservatively before irreversible damage to the gastric wall has taken place. If the gastric dilatation progresses, the stomach loses its contractility, resulting in venous occlusion, infarction, and gastric perforation. An extensive operation is required, and the patient undergoes an often complicated and prolonged hospital course.

Adolescent↗
PubMed1987

Mesenteric venous thrombosis--1911 to 1984.

The objective of this study was to identify those patients in whom mesenteric venous thrombosis (MVT) is likely to develop and to review the pathophysiology, clinical presentation, diagnostic modalities, and patient outcome. We present a review of the literature from 1911 to 1984 with respect to 372 patients with MVT, including five of our own patients. Data on 99 of these patients were obtained from autopsy reports and were not included in the study. This disease is common in the sixth and seventh decades of life, with 81% of these older patients having associated illnesses. MVT involves segments of the small bowel, but rarely of the colon, with hemorrhagic infarcts rather than gangrene. This disease does not conform to a pattern, although a prodromal period of days or weeks of abdominal pain (which is usually out of proportion to physical findings), marked leukocytosis, and dehydration are all highly suggestive of MVT. Serosanguineous fluid obtained by means of peritoneal tap is a useful diagnostic tool. A high index of suspicion, early diagnosis, and prompt surgical intervention with the addition of anticoagulants seems to improve survival and reduce recurrence.

Age Factors↗
PubMed1986

Comparison of right colon, left colon, and rectal carcinoma.

Three hundred fifteen cases of adenocarcinoma were analyzed for differences between lesions in the right colon, left colon, and rectum for the period 1978 to 1983. The right colon cancers accounted for 1/3 of the cases and were associated with a higher incidence of anemia. The incidence of obstruction was the same between the right and left colon but lower for the rectal lesions. Left colon and rectal cancers had a higher incidence of gross bleeding than right colon cancers, but all had a high rate of occult blood in the stool. The Duke stage of the lesions, which was similar throughout the colon and rectum, is a reliable prognostic indicator.

Adult↗
PubMed1983

Ambulatory herniorrhaphy under local anesthesia in a community hospital.

Four hundred groin hernias were repaired under local anesthesia over a 5 1/2 year period. Eighty-two percent of the patients were discharged on the same day of operation and 12 percent within 24 hours. In 60 percent of these patients, knitted polypropylene mesh (Marlex) was used to reinforce the inguinal floor. There were two infections in this series and other postoperative complications were minimal. Most of the patients returned to their full-time occupations in 4 to 6 weeks. The saving in hospital beds and cost was profound. The follow-up results, although not 100 percent complete, are very encouraging and suggest that this method can be appropriately and safely used by surgeons working in community hospitals.

Adolescent↗
PubMed1982

Repair of paracolostomy hernias with Marlex mesh.

The author's limited experience with the use of Marlex mesh to repair large paracolostomy hernias on five patients supports the experiences of others who have used this method of repair. The use of synthetic material in the repair of these often troublesome hernias is by no means conclusive since it was used only in a small number of patients. However, it is encouraging enough to warrant further use.

Adult↗