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R Rozin

Publications and source records attributed to R Rozin.

At least 19 recordsLinked to original sources
PubMed1993

Determinants of wound infection in gastrointestinal operations: the Israeli study of surgical infections.

Risk factors for wound infection in operations involving the opening of the gastrointestinal (GI) tract, were explored in a prospective study. There were 813 consecutive operations performed during a period of 9-14 months in 11 Israeli hospitals. The total crude infection rate was 21.6%, and the respective rates for operations on the stomach, small bowel and colon were 14.8, 21.4 and 25.4%. Of 17 putative risk factors, the strongest predictor was the performance of 2 or more operations during the same admission. Other significant risk factors were: a diagnosis of intestinal obstruction or perforation, introduction of an open drain, emergency admission, age over 40, hospital stay prior to surgery 7 or more days, urinary catheter and infection on admission. Adjustment for these factors in a logistic regression model reduced the effect of the anatomical site of the operation (i.e. large bowel vs stomach) to a non-significant level.

Adult↗
PubMed1990

Surgical palliation combined with synchronous therapy in pancreatic carcinoma.

Palliative surgery has a role in nonresectable pancreatic carcinoma. We attempted to evaluate the efficacy of palliative surgery followed by synchronous therapy in such cases. A group of 92 patients was studied. Sixty-six patients (Group 1) with biliary obstruction underwent surgical biliary bypass. Twenty-six patients (Group 2) underwent explorative laparotomy only. Thirty patients (45.5%) in Group 1 and 10 patients (38.5%) in Group 2 received synchronous therapy consisting of 10 intravenous administrations of 5-fluorouracil (750 mg/m2) over 8 h, followed 8 h later by radiation with 400 rads repeated every 4 days. The mean survival for the entire group was 8.9 months. Those in Group 1 who received synchronous therapy had a mean survival of 13.5 months; those who did not 8.9 months (P less than 0.01). Patients in Group 2 who received synchronous therapy survived with a mean of 5.4 months, those who did not 2.7 months (P less than 0.01). Toxicity due to synchronous therapy was minimal. Of the 40 patients receiving synchronous therapy, 37 suffered from abdominal pains prior to initiation of therapy, 29 of which (78.4%) were free of pain upon completion of therapy. In nonresectable carcinoma of the pancreas, surgical palliation provides an acceptable survival. When combined with synchronous therapy, it results in prolonged survival and an ameliorated quality of life.

Adult↗
PubMed1990

The Israeli Study of Surgical Infection of drains and the risk of wound infection in operations for hernia.

In a prospective follow-up study of 5,571 general surgical patients at 11 hospitals (23 departments) in Israel, 1,487 patients underwent operations for hernia (all types) and were screened daily for the development of postsurgical wound infection. Infection developed in 68 (4.6 per cent) at the site of the incision. Fourteen factors were analyzed for the presumed effect on the risk of infection; only four were significant in a multivariate model. Of these factors (old age, incarcerated or recurrent hernia, coexistent infection and drains), the introduction of drains had the strongest effect (relative risk equaled 4.1; p less than 0.001). Drains increased the risk in all the participating hospitals and in any category of patient. They prolonged the period a wound was susceptible to bacterial infection from nine to 16 days. The risk increased linearly with the duration of the drainage. The over-all proportion of patients who had a drain inserted was 19 per cent, with hospitals varying from 9 to 40 per cent of patients operated upon (p less than 0.001). Our findings suggest that the risk of an infection associated with drains may outweight their worth. Furthermore, there is no concensus among surgeons on the need for drains. Some surgeons use drains indiscriminately and others, rarely.

Aged↗
PubMed1989

Amplification of c-myc and c-erbB-2 proto-oncogenes in human solid tumors: frequency and clinical significance.

Molecular probes for cellular proto-oncogenes have recently been extensively used in order to search for functional and structural alterations in tumor tissues. Variable, and sometimes contradictory, results have been obtained regarding the frequency and clinical significance of amplification of the c-myc and c-erbB-2 proto-oncogenes in different series of human solid tumors. We addressed this question by performing Southern blotting analysis on 131 primary adult solid tumors of various tissues and 5 metastases of unknown origin, using molecular probes for both genes. Amplification of c-myc was found in 5 of the primary tumors, and amplification of c-erbB-2 in 5 others. In 2 tumors of the latter group, the c-erbB-2 gene was also rearranged. The distribution of these 10 tumors with regard to clinical stage and course of the disease did not point to an association between the amplification events and specific stage or prognosis. We concluded that, in this series, the amplification of both proto-oncogenes was occasional and was not a prognostic marker.

Breast Neoplasms↗
PubMed1989

[Retroperitoneal ganglioneuroma].

Ganglioneuroma is an infrequent tumor composed of sympathetic ganglion cells and sheathed neurites. It arises mainly from the large sympathetic chains, most frequently in the posterior mediastinum and retroperitoneum, but rarely may develop from the peripheral sympathetic chains. It is usually benign, and may grow asymptomatically to relatively large size. However, it can cause symptoms due to local expansion and pressure on adjacent structures. It does not seem to have hormonal activity. Some ganglioneuromas contain immature cells or elements of neuroblastoma or pheochromacytoma and can metastasize. The preoperative diagnosis of retroperitoneal tumors has now become more frequent due to the extensive use of imaging modalities, mainly computed axial tomography. Whenever the imaging correlates with the clinical presentation, or there is a reasonable suspicion of a malignancy, operation is indicated. Many retroperitoneal space-occupying lesions are found in asymptomatic patients during attempts to diagnose other diseases. In these cases opinions differ as to therapeutic approach. Many adrenal tumors may be benign adenomas, and several therapeutic protocols have been proposed. The clinician can decide on the basis of clinical presentation and radiographic features whether a conservative approach rather than operation is indicated. Since the majority of retroperitoneal tumors are malignant, histologic diagnosis is essential and in such cases surgical intervention is warranted. A young patient with a retroperitoneal ganglioneuroma is presented.

Adult↗
PubMed1989

[Dieulafoy's lesion].

Massive upper gastrointestinal tract bleeding from a ruptured abnormal gastric artery was reported by Gallard in 1884. The lesion is rare and its characteristics were only described 24 years later by the French surgeon Dieulafoy. It is characterized by an abnormal, tortuous, submucosal artery protruding from a small lesion in otherwise normal gastric mucosa, and is usually located in the posterior wall of the lesser curvature near the cardia. Preoperative diagnosis is very difficult and it is easily overlooked, even during operation. Hence, rebleeding and second laparatomy are common. Treatment is mainly surgical: by wedge resection or oversewing the lesion. A 30-year-old patient with this condition who was operated on for upper gastrointestinal bleeding is presented.

Adult↗
PubMed1988

New concepts of forward combat surgery.

A modular, mobile and versatile evacuation hospital evolved by the Israel Defence Forces (IDF) during the last 15 years serves as a sorting facility for the hospitals in its rear, in much the same manner as an emergency department functions within a hospital. It has extensive sorting and resuscitation capabilities, contrasting with a relatively small hospitalization potential. Surgery is performed only for resuscitation or for limb salvage. The evacuation hospital handled more than 4500 casualties during the 1973 and 1982 Arab-Israeli wars. Only 3 per cent of the wounded had to be operated on prior to further evacuation. Seventeen per cent were returned to the front lines after minor treatment and 80 per cent were sorted and stabilized and then evacuated further to rear hospitals. The eventual mortality for these 4500 casualties was 2.3 per cent.

Emergency Medical Services↗
PubMed1987

Rectoscopic decompression of acute recto-sigmoid obstruction.

Effective non-operative decompression of a low obstruction of the colon can sometimes be accomplished by inserting a tube into the rectum and threading the tip up to a point proximal to the obstruction (1). Failure of this non-surgical decompression would require emergency surgery--either a diverting colostomy or a two-stage resection. A new non-surgical treatment performed on a patient with an obstructive tumor of the recto-sigmoid is described. Decompression of the obstructed bowel was achieved with a rectal tube introduced over a flexible guide wire proximal to the obstruction with the aid of a rectoscope, following which a one-stage procedure--an anterior resection was performed in one patient, while the other was referred for oncological treatment.

Acute Disease↗
PubMed1986

The effects of perioperative fluorouracil administration on convalescence and wound healing.

Administration of chemotherapy is delayed by most clinicians until complete recovery from surgery because it is generally feared that cytotoxic drugs impair wound healing, reduce resistance against infection, and may hinder the recovery process. However, clinical experience is lacking. This clinical study examines the effect of perioperative administration of fluorouracil on the healing of wounds and intestinal anastomoses and the recovery process in general. Forty patients with advanced gastrointestinal tract cancers entered the study. Intravenous bolus administration of 0.5 g of fluorouracil was started during surgery. The patients underwent a variety of abdominal operations for palliation or cure. A total of 22 gastric and enteric anastomoses were performed. One half gram of fluorouracil diluted in 150 mL of 5% glucose solution was given intravenously over one hour daily for ten days postoperatively. The patients were carefully evaluated for any alteration in the postoperative recovery. Thirty-eight of the 40 patients received the full course of fluorouracil. Twenty-one patients had an uneventful postoperative course. Eighteen had mild to moderate respiratory and cardiovascular complications unrelated to fluorouracil administration. One patient died of pulmonary emboli 16 days after abdominoperineal resection. Surgical wounds healed without complications in 37 patients. One case of wound disruption occurred after sigmoidectomy. Two patients developed wound infections that healed secondarily. All 22 patients with anastomoses recovered without any evidence of leakage. Colostomies and gastrostomies functioned as anticipated. Side effects attributed to fluorouracil appeared in seven of the patients; in only two of the patients were complications life-threatening, involving bone marrow depression. All patients recovered after discontinuation of fluorouracil therapy and with supportive treatment. On the whole, the course of recovery of this group was no different than expected from patients with advanced malignant neoplasms who were undergoing extensive surgery. Based on this study, it seems that fluorouracil administration during and immediately after surgery has no deleterious effect on wound healing and recovery.

Abdominal Neoplasms↗
PubMed1984

Acute spinal cord injuries in the Lebanon War, 1982.

Our experience with 17 patients with spinal cord injuries (SCI) acquired in the Lebanon War, 1982, is described. The SCI were due to gunshot wounds in 12 patients and to other causes in 5. Two laparotomies and one thoracotomy were performed. Corticosteroids were not seen to influence recovery, nor was laminectomy, which was performed in three cases. Complications such as pressure sores, hydronephrosis, ileus and deep vein thrombosis were rare or did not occur. Three high quadriplegics died. Based on our experience, we recommend conservative treatment and rehabilitation in acute SCI.

Adolescent↗
PubMed1983

Are chronic spinal cord injured patients (SCIP) prone to premature aging?

Our hypothesis, based upon clinical observation and on the literature, is that chronic spinal cord injured patients are prone to premature aging. Physical and mental disabilities and prolonged immobilization change the entire homeostatic mechanisms into a new state. Thus, we feel that this lead to accelerated aging among these chronic handicapped persons.

Aging↗