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Biomedical subjects

S Neimark

Publications and source records attributed to S Neimark.

7 recordsLinked to original sources
PubMed1985

Obstructive jaundice. Diagnostic and therapeutic considerations.

The diagnostic approach to obstructive jaundice must be individualized on the basis of the sensitivity and specificity of the various procedures available. No single diagnostic approach is optimal in all patients. The physician must be guided by knowledge of the yield, complications, and cost of the tests available. In addition, interventional endoscopic and radiologic techniques add a new therapeutic dimension to the standard surgical approach.

Cholangiography↗
PubMed1985

Effect of antibiotic prophylaxis in percutaneous endoscopic gastrostomy.

Thirty-three patients completed a prospective double-blind, randomized study to compare the effect of antibiotic prophylaxis or placebo on percutaneous endoscopic gastrostomy-associated wound infections. We define wound infection and arrive at an incidence of 29.4% in patients receiving Cefoxitin antibiotic prophylaxis and 31.2% in patients receiving placebo. Based on these results, we do not recommend antibiotic prophylaxis for percutaneous endoscopic gastrostomy tube placement.

Anti-Bacterial Agents↗
PubMed1982

Carcinoma of gastric remnant after surgery for benign peptic ulcer.

Twenty-two years after surgery for recurrent bleeding duodenal ulcer, a 63-year-old man was found to have an unresectable tumor just proximal to the gastrojejunal anastomosis. The incidence of carcinoma in the gastric remnant in patients who have had such surgery is significantly higher than in the general population. The mean time between surgery and diagnosis of carcinoma is 22 years. In patients who have undergone surgery for benign ulcer disease, new or altered symptoms appearing ten or more years after gastric surgery call for a high level of suspicion combined with in-depth investigation. Prompt, accurate diagnosis may result in improved survival.

Gastrectomy↗
PubMedDate not supplied

Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver.

A 40-yr-old man presented with encephalopathy and was found to have hepatocellular carcinoma without cirrhosis. A large vascular hepatic mass was defined by CT scan and angiography; laparoscopy with biopsy confirmed the absence of chronic liver disease. A definitive tissue diagnosis of hepatocellular carcinoma was made at laparotomy; the tumor was unresectable. Peripheral arterial and selective portal and hepatic venous ammonia levels were high, and this finding suggested that the encephalopathy was nitrogenous and hepatic in origin. The proposed mechanisms of the encephalopathy are generation of ammonia from tumor breakdown and portosystemic shunting, a result of partial tumor occlusion of the hepatic veins. An unusually high urinary excretion of orotic acid was found similar to that seen in hereditary orotic aciduria.

Adult↗