PubMed Health⌕ Search

Biomedical subjects

R Halpert

Publications and source records attributed to R Halpert.

6 recordsLinked to original sources
PubMed1989

Combined endoscopic and fluoroscopic balloon dilatation of a complex proximal jejunal stricture.

Dilatation of esophageal strictures has been practiced for many years. More recently, balloon dilatation, with endoscopic guidance, has been applied to the stomach and the colon. The small bowel has been less accessible to the endoscope, and, as far as we have been able to determine, balloon dilatation of jejunal strictures has not been reported. We present a patient who was referred to us after curative resection of two abdomino-pelvic malignancies, external beam irradiation to the abdomen and pelvis, and multiple later operations for bowel obstruction and dehiscence of intestinal anastomoses. The bowel obstruction and anastomotic dehiscence occurred during the present hospitalization and resulted finally in the development of a high-output proximal jejunal fistula. The area of stricture, as seen by means of barium contrast, had two separate components with an associated acute angulation. We report the combined use of endoscopic and fluoroscopic manipulation and balloon dilatation of this complex stricture.

Aged↗
PubMed1988

The application of uterine and umbilical artery velocimetry to the antenatal supervision of pregnancies complicated by maternal sickle hemoglobinopathies.

To assess the efficacy of Doppler flow velocimetry in predicting fetal compromise and neonatal outcome in pregnant women with sickle cell hemoglobinopathies, a prospective study was conducted of 96 patients, 48 with sickle cell hemoglobinopathy (8 with SS and 40 with AS hemoglobin) and 48 low-risk AA hemoglobin controls. All subjects were followed biweekly from the third trimester of pregnancy through delivery with uterine and umbilical artery velocimetry, nonstress, tests, and hematocrit and blood pressure measurements. An abnormal systolic/diastolic ratio was defined as a value greater than or equal to 3. The incidence of abnormal systolic/diastolic ratios for uterine or umbilical arteries was significantly higher in pregnant women with SS hemoglobin (88%) when compared with patients with AS (7%) and AA (4%) hemoglobin. In addition, the abnormal systolic/diastolic ratios for both umbilical and uterine arteries are correlated with abnormal nonstress test results. The nonstress test results became abnormal on average 3 weeks after the systolic/diastolic ratios did. The presence of abnormal systolic/diastolic ratios for umbilical and uterine arteries is predictive of fetal distress and infants small for gestational age. The high incidence of concordant uterine and umbilical artery abnormal systolic/diastolic ratios in pregnant women with SS hemoglobinopathy, which were identified earlier than were abnormal nonstress results, suggests an important parameter in the monitoring of these high-risk pregnancies.

Adult↗
PubMed1986

Human papillomavirus and lower genital neoplasia in renal transplant patients.

Lower genital cytopathology was evaluated in 105 immunosuppressed renal transplant recipients. Evidence of human papillomavirus infection was found in 17.5% and of lower genital neoplasia in 9.5%. The rate of the virus infection in the immunosuppressed was nine times greater than in a general population and 17 times greater than in a matched immunocompetent population. The rate of cervical neoplasia was 16 times greater than in a general population and nine times greater than in a matched immunocompetent population. In one-third of patients with human papillomavirus lesions and one-half of patients with neoplastic lesions, multiple lower genital sites were also involved. Of risk factors evaluated, only the number of sexual partners was associated with the development of human papillomavirus/lower genital neoplasia.

Adult↗
PubMed1983

Gastroduodenal response to low-dose glucagon.

A prospective, double-blind clinical study of the double-contrast upper gastrointestinal examination involving 240 patients was performed using glucagon in doses from 0.025 to 0.125 mg, in 0.025 mg increments. Although motility was diminished, neither gastric distension or coating was improved with the use of glucagon. However, duodenal distension and coating were markedly enhanced. The response of the pylorus was individualistic. The pylorus remained patent in most patients, and glucagon would not prevent barium spillage in the duodenum. However, in those patients with a "competent" pylorus, increasing glucagon doses produced a delay in gastric emptying. Several other variables, including weight, age, and gender, were studied and were not believed to be of clinical significance. Spontaneous gastroesophageal reflux was also increased with the use of glucagon. Glucagon mainly enhanced duodenal visualization but had no beneficial effect on the stomach or pylorus. Absolute dose is the most important factor, and all observable changes can be seen once a certain threshold dose (0.05 mg) is reached.

Digestive System↗