Wrongful life - its problems are not just semantic: a reply to Furrow.
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Biomedical subjects
Publications and source records attributed to S Taub.
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The evaluation and management of esophageal strictures ordinarily involves the three procedures of endoscopy, biopsy, and dilation at different times. The safety of performing these procedures in a single sitting was evaluated. The study included 48 patients (ages 44-85) with radiographically confirmed esophageal strictures located in the upper third (3/48), middle third (18/48), and lower third (27/48) of the esophagus. The strictures were determined to be due to peptic esophagitis of varying severity (28/48) or carcinoma (20/48). Dilation immediately followed endoscopy and biopsy with an average of three mercury-weighted dilators passed at this sitting. The size and type of dilators were determined clinically by the endoscopic estimation of esophageal lumen diameter. Anesthesia included topical Cetacaine and intravenous diazepam (5-15 mg.). All patients experienced symptomatic improvement immediately following the procedures. No complications were encountered. These data indicate that endoscopy, biopsy and dilation of esophageal strictures may safely be performed in a single sitting. Other advantages may include shortened hospital stay, earlier diagnosis and relief of symptoms and increased cost effectiveness.
An air bypass voice prosthesis and the refinement of a surgical technique has been developed. It involves a one-stage, low retrograde cervical esophagostomy that is functionally and cosmetically feasible since it permits hidden use of the device and eliminates fistula tract stenosis; and the problem of aspiration is eliminated. Most importantly, it provides a natural speech mechanism without any training period. Patients can regain immediate speech following installation of a voice prosthesis with a minimum of maintenance required. Ultimately, they have demonstrated greater self-reliance and developed a high degree of self-esteem which has enabled them to resume a normal way of life.
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An air bypass voice prosthesis and the refinement of a surgical technique has been developed. It involves a one-stage, low retrograde cervical esophagostomy that is functionally and cosmetically feasible since it permits hidden use of the device, while eliminating fistula tract stenosis and aspiration. Most importantly, it provides a natural speech mechanism without any training period. Patients can regain immediate speech following installation of a voice prosthesis with a minimum of maintenance required. Ultimately, they have demonstrated greater self-reliance and developed a high degree of self-esteem which has enabled them to resume a normal way of life.
This review briefly outlines the gastrointestinal manifestations of diabetes mellitus. Usually, gastrointestinal abnormalities are asymptomatic. Severe gastrointestinal dysfunction may be quite debilitating, however. Gastrointestinal symptoms that are a consequence of diabetes may be confused with other primary gastrointestinal disorders. We attempt to provide a clinical approach to differentiating the basis of symptoms and outline the therapeutic plan that we generally employ. Much additional research is necessary to clarify our understanding of the pathophysiology of the gastrointestinal complications of diabetes and to develop improved therapeutic strategies.
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