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Biomedical subjects

S Hishon

Publications and source records attributed to S Hishon.

14 recordsLinked to original sources
PubMed1993

Treatment of active Crohn's disease by exclusion diet: East Anglian multicentre controlled trial.

Elemental diet is as effective in producing remission of Crohn's disease (CD) as is corticosteroid treatment, but most patients relapse soon after resumption of a normal diet. We have investigated the efficacies of dietary modification and oral corticosteroids in maintaining remission achieved with elemental diet. In a multicentre trial, 136 patients with active CD were started on elemental diet and other treatment was withdrawn. 43 (31%) declined to continue elemental diet for 14 days, but 78 (84%) of the remaining 93 achieved remission and were randomly assigned corticosteroids (38) or diet (40). Corticosteroid treatment started at 40 mg prednisolone daily, which was tapered and stopped after 12 weeks; that group received dietary advice on healthy eating. The diet group received "tapered" placebo and were instructed to introduce one new food daily, excluding any that precipitated symptoms. Assessment of progress for up to 2 years was made by physicians unaware of group assignment. Intention-to-treat analysis showed median lengths of remission of 3.8 (interquartile range 5.0) months in the corticosteroid group and 7.5 (15.3) months on diet, and relapse rates at 2 years, adjusted for withdrawals, of 79% and 62%, respectively (p = 0.048). Clinical improvement in the diet group was associated with significant changes in plasma albumin and alpha 1-antichymotrypsin concentrations and erythrocyte sedimentation rate. Food intolerances discovered were predominantly to cereals, dairy products, and yeast. Diet provides a further therapeutic strategy in active Crohn's disease.

Adrenal Cortex Hormones↗
PubMed1990

ECG record during changes in oesophageal pH.

Seventeen patients with non-cardiac chest pain were investigated by simultaneous ambulatory 24 hour ECG and oesophageal pH monitoring. While 11 patients lowered their oesophageal pH below 4 for a significant percentage, (3.4%) of recorded time and experienced chest pain, no simultaneous ECG changes occurred. In 10 patients chest pain was reproduced by an oesophageal acid perfusion test (Bernstein test). No changes in ECG record during the test were shown. We conclude that although reflux oesophageal pain may be difficult to differentiate from cardiac pain, clinically oesophageal pH changes do not produce any ECG changes.

Adult↗
PubMed1982

A clinical trial of levamisole in primary biliary cirrhosis.

A small pilot study of levamisole in primary biliary cirrhosis failed to demonstrate any improvement in liver function and immunological abnormalities even in 'early' cases. This may be due to the fact that the defect in the immune system lies in its afferent arm. At present, levamisole, which is potentially toxic, cannot be recommended in conventional doses for the treatment of this disease.

Clinical Trials as Topic↗
PubMed1981

The management of colonoscopic and sigmoidoscopic perforation of the large bowel.

The treatment of 8 patients who sustained endoscopic perforation of the large bowel at this hospital in the past 5 years is described. Two had signs of general peritonitis and were operated on. One had a laparotomy under the same general anaesthetic as that during which perforation occurred. Of the remainder, 4 were treated conservatively, while no perforation was found at operation in the other case. All recovered. We conclude that when signs of general peritonism are absent and the patient's condition is good, expectant management with nasogastric suction, intravenous fluids and broad spectrum antibiotics should be adopted. Free gas on X-ray is not per se an indication for laparotomy. A defunctioning colostomy is often unnecessary in those patients treated operatively.

Adult↗
PubMed1980

Diagnosis of haemobilia by duodenoscopy.

A case of haemobilia due to liver abscess presenting as haematemesis and melaena is described. Duodenoscopy in the acute phase can distinguish haemobilia from other causes of upper gastrointestinal bleeding and is the first step towards accurate localization of the lesion by hepatic arteriography.

Duodenum↗
PubMed1976

Cytology in the diagnosis of oesophageal cancer.

The value of brush cytology under direct vision in the diagnosis of oesophageal cancer was evaluated and compared with other diagnostic procedures in a prospective study of 33 patients suspected of having an oesophageal lesion. Barium swallow correctly diagnosed cancer in 19 out of 20 patients, the remaining patient was diagnosed by both histology and cytology. In all, cytology was correct in 18 cases (90%), whereas histology confirmed the diagnosis in 10 (50%). In the 13 patients with benign lesions, barium swallow was correct in 12; cytology was benign in all 13; biopsy was only possible in 9, although the results of this procedure were always correct. Thus barium swallow is still the ideal screening procedure for patients with oesophageal symptoms, but per-endoscopic brush cytology seems to be the method of choice for confirmation of the diagnosis.

Barium Sulfate↗