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Biomedical subjects

R R Rozin

Publications and source records attributed to R R Rozin.

At least 55 records · Page 3Linked to original sources
PubMed1986

The evacuation hospital in civilian disasters.

In a mass casualty situation the hospital nearest to the disaster scene is usually overwhelmed by the injured. We propose a solution whereby a civilian hospital in times of crisis can become an evacuation hospital (EH) to meet the immediate needs of the casualties. An EH is a hospital located as near as possible to the disaster area, whose function is to serve as a forward treating facility. All the wounded should be brought first to the EH, where they are sorted, resuscitated and stabilized for transportation, after which they are evacuated. Only the critically wounded undergo surgery at the EH; the lightly wounded remain in the EH, and all other wounded are distributed among the general hospitals for rapid definitive treatment. This principle was first applied in a civilian medical system. The Rokach (Hadassah) Hospital in Tel Aviv served as an EH in admitting 40 casualties following a nearby terrorist attack. Seventeen seriously and moderately wounded patients were resuscitated and evacuated to hospitals in the vicinity. All arrived in stable condition. Seventeen lightly wounded were detained in the EH and 4 underwent life-saving surgery there.

Disasters↗
PubMed1985

Acral (volar-subungual) melanoma.

Acral melanoma occurs in the volar surface of the hands, feet, fingers, toes and subungual sites. Recently it has been recognized as a distinct entity with characteristic clinical and pathological features. Of our 340 patients with malignant melanoma, 24 (7 per cent) had acral melanoma. Sixteen were in the plantar skin, two in the palms and six in the nailbed. The delay in diagnosis was 6 months to 5 years and most of the patients presented with large neglected tumours. Fourteen lesions had histological features consistent with acral lentiginous melanoma - a unique pattern to this area. Fourteen patients were in clinical stage I at diagnosis, seven in stage II and three had distant metastases (stage III). The treatment was mainly surgical. Palmar-plantar lesions were widely excised. One patient underwent below-knee amputation. Lesions of the digits were treated by amputation of the affected toe. Fourteen of the patients underwent either prophylactic or therapeutic lymph node dissection. In 9 of them, regional metastases were found. In patients with advanced disease chemotherapy was added. Three patients had isolated limb perfusion. Fourteen patients died of metastatic disease within 1-5 years. Four are alive but have metastatic spread. Six patients are disease-free, one to 4.5 years following diagnosis.

Adult↗
PubMed1985

A correlation between oestrogen receptors and tumour size in primary breast cancer.

Oestrogen receptor (OR) assay has an essential role in selecting therapy for breast cancer patients, OR status is probably also of prognostic value. The correlation between the size of the primary tumour and OR status was evaluated in 100 women with breast cancer. In 72 post-menopausal patients the OR average level was significantly higher in large primary tumours--T2, T3, when compared to OR levels of T1 tumours. In the 28 pre-menopausal women, this difference was not statistically significant. No correlation between OR level and stage of disease was found. Women presenting with large primary tumours do not necessarily have a poor prognosis.

Adult↗
PubMed1984

Contemporary options in the operative treatment of breast cancer.

The past decade has witnessed many changes in the basic concepts and understanding of breast cancer. The classic radical mastectomy, which prevailed for almost 100 years, has given way to a less aggressive surgical approach that aims to provide a better quality of life without compromising survival. Modified radical mastectomy, simple mastectomy, and breast-conserving local excision are discussed.

Adult↗
PubMed1983

Renal cell carcinoma presenting as acute pancreatitis and GI bleeding.

A 75-year-old woman was admitted for acute pancreatitis, jaundice, GI bleeding, and a tender mass in the right hypochondrium. Upper gastrointestinal series demonstrated a diverticulum-like structure on the lateral aspect of the second part of the duodenum. This structure was excised and turned out to be a renal cell carcinoma invading the duodenum by direct extension from the right kidney. Although renal cell carcinoma may present in numerous and often perplexing manifestations, this is a unique presentation.

Acute Disease↗
PubMed1983

Unknown primary melanoma.

Of 230 melanoma patients treated during the past 8 years, 12 (5.2%) were found to have unknown primary lesions. Nine of these "unknown primary melanoma' patients presented with metastases in regional lymph nodes, one inside the parotid gland, and two presented with disseminated melanoma and no detectable primary tumor. The patients with melanoma confined to a regional lymph node underwent block dissection followed by adjuvant chemotherapy and immunotherapy. Four patients with metastasis in only one lymph node are disease free 4-6 years after diagnosis. One patient with multiple metastases in the groin is alive 8 years after lymphadenectomy. The other five patients with metastases in multiple regional lymph node died 16 months to 3 years after surgery. Both patients with disseminated melanoma succumbed to their disease within a month of diagnosis. The prognosis of unknown primary melanoma seems to be no worse than the typical melanoma at the same stage. This justifies the aggressive surgical approach to this unusual entity of melanoma.

Adult↗
PubMed1983

Breast carcinoma originating in cystosarcoma phyllodes.

Only three cases of carcinoma infiltrating the stroma of cystosarcoma phyllodes have been reported. An additional case is presented. Unlike the treatment of cystosarcoma phyllodes which is limited to complete removal of the tumor, carcinosarcomas should be treated in the same manner as carcinoma by mastectomy and axillary dissection.

Adenocarcinoma↗
PubMed1983

Cholelithiasis in Dubin-Johnson syndrome.

Only one instance of Dubin-Johnson syndrome associated with cholelithiasis has been reported. We present one additional patient, a 30 year old man with Dubin-Johnson syndrome in whom pancreatitis and cholecystitis, secondary to cholesterol gallstones, developed. A possible cause for the lithogenicity of the bile in the Dubin-Johnson syndrome is considered.

Adult↗
PubMed1981

[Rectus sheath hematoma].

Rectus sheath hematoma is rarely diagnosed preoperatively. It can mimic acute intra-abdominal disease and other familiar disorders. It is more frequent during pregnancy and debilitating diseases. Blunt trauma to the abdomen, straining, coughing and anticoagulant therapy are also common contributing factors. The presenting symptom is onset of acute, localized, abdominal pain soon after the precipitating event. A tender abdominal mass is palpated in one of the rectus muscles. There are no specific diagnostic laboratory tests. Ultrasonography is the procedure of choice for correct diagnosis. Most of these patients can be successfully managed conservatively. During a period of two years, five cases were treated. Three of the patients suffered from acute cough associated with upper respiratory infections. Two had had multiple childbirths, one had had an abdominal operation and another had Cushing's disease and morbid obesity. Three were misdiagnosed and operated on. The hematoma was evacuated but the peritoneum was not opened. In two patients the correct diagnosis was made by ultrasonography and they were successfully treated conservatively.

Abdomen, Acute↗
PubMed1976

Modern war surgery: operations in an evacuation hospital during the October 1973 Arab-Israeli war.

A forward evacuation hospital functioned in the southern front in October 1973 Israeli-Arab War as an intermediate unit in the Israeli casualty management logistics. Casualties were characterized by frequent multiple-system injuries and variable combinations of penetrating wounds, blunt trauma, burns, and inhalation injury, with an increased incidence of associated blunt trauma. As the result of the systems organization, the EH was able to provide the wounded with early intensive and definitive resuscitation therapy which permitted further evacuation of the casualties to the central hospitals in a better state of physiological stability. In the most critically wounded when there was imminent threat to survival, operations were performed at the EH as an integral part of the resuscitation process. Performance of operations in a forward evacuation hospital did not increase the number or severity of postoperative complications. Morbidity and mortality were related to the nature and magnitude of injury.

Egypt↗