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        תוצאת חיפוש

        מאי 1997
        ד' אסטליין וי' וולוך

        Gastric Duplication Cyst in an Adult

         

        D. Estlein, Y. Wolloch

         

        Dept. of Surgery B, Rabin Medical Center (Golda Campus), Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University

         

        Gastric duplication cysts are rare in adults and usually asymptomatic. In most cases they are discovered incidentally by abdominal ultrasound, CT, or upper gastrointestinal x-rays. Most of the duplications (82%) are cystic and do not communicate with the stomach. Approximately half of the cases are associated with other congenital anomalies. We report a 59-year-old woman operated on for a pancreatic mass that proved to be a gastric duplication cyst. The cyst was resected and the postoperative course was uneventful.

        מאת א' עסליה, ד' קופלמן, ה' בחוס, י' קליין ומ' חשמונאי

        Gastrografin for Mechanical Partial, Small Bowel Obstruction due to Adhesions

         

        A. Assalia, D. Kopelman, H. Bahous, Y. Klein, M. Hashmonai

         

        Dept. of Surgery B, Rambam Medical Center and Technion-Israel Institute of Technology, Faculty of Medicine, Haifa

         

        The therapeutic effect of astrografin is occasionally mentioned in the literature. However, this effect has not been objectively evaluated. We studied prospectively the effect of Gastrografin in cases of adhesive, simple, partial, small bowel obstruction (SBO) compared to conventional management. During 3 years, a total of 137 episodes of simple, partial SBO in 127 patients (10 recurrent episodes) were treated. The episodes were randomized into a control group(80 episodes) treated conventionally, and a trial group (77 episodes), which received in addition 100 ml of Gastrografin administered through the nasogastric tube. The two groups were well-matched with regard to age, gender, weight, medical and surgical background and duration of complaints before admission. Time to first stool and resolution of obstruction, complications, need for surgery, and hospital stay were noted. Mean time to first stool was significantly shorter in the trial group: 6.2±3.9 hours vs 23.5±12.7 (p<.0001). Mean hospital stay for unoperated patients was also shorter in the trial group: 2.7±2 days vs 5.5±2 days, (p<.0001). In addition, significantly fewer episodes in the trial group required operation, 10.4 vs 26.7% (p<0.013). 1 patient in each group died following operation. There were no Gastrografin-related complications and it was effective and safe for adhesive, partial, simple SBO. It significantly speeds resolution of obstruction, reduces the need for operation, and shortens convalescence.

        א' שחר, ר' שרון, מ' לורבר וש' פולק

        Angioedema Caused by Splenectomy with Malignant Lymphoma Foll-Owed by Multiple Myeloma 7 Years Later

         

        A. Shahar, R. Sharon, M. Lorber, S. Pollack

         

        Institute of Allergy, Clinical Immunology and AIDS and Institute of Hematology, Rambam Medical Center and B. Rappaport Technion- Faculty of Medicine, Haifa

         

        Acquired C1-inhibitor (C1-INH) deficiency has been reported in patients with immunoglobulin abnormalities and lymphoproliferative disorders, and angioedema has appeared simultaneously with the lymphoproliferative disease. We present a 50-year-old woman with acquired C1-INH deficiency and angioedema which preceded by 7 years the diagnosis of malignant mantle cell lymphoma. During the interval she was treated with Danazole and there were no attacks of angioedema. When routine follow-up bone marrow aspiration revealed infiltration of nonspecified lymphoma cells, exploratory laparotomy and splenectomy were performed. A month later Danazol was stopped, C1-INH levels returned to normal and there were no attacks of angioedema. Mantle cell lymphoma consisting of lymphocytes with cytoplasmic IgM-lambda was diagnosed in the excised spleen but chemotherapy was not initiated. 6 months later, a second lymphoproliferative disorder, multiple myeloma IgA kappa, was diagnosed.

        ר' דורסט ופ' רבאודנגו-רושקה

        Attention Deficit Hyperactivity Disorder, Facilitating Alcohol and Drug Abuse in an Adult

         

        R. Durst, P. Rebaudengo-Rosca

         

        Talbieh Mental Health Center, Jerusalem (Affiliated with the Hebrew University-Hadassah Medical School)

         

        Attention-deficit hyperactivity disorder (ADHD) has been considered a mental and behavioral disorder of childhood and adolescence. It is being increasingly recognized in adults, who may have psychiatric co-morbidity with secondary depression, or a tendency to drug and alcohol abuse. We describe a 32-year-old woman known for years as suffering from borderline personality disorder and drug dependence (including hasshish, marijuana, LSD and "exstasy'") and alcohol abuse that did not respond to treatment. Only when correctly diagnosed as ADHD and appropriately treated with the psychotropic stimulant, methylphenidate (Ritalin), was there significant improvement. She succeeded academically, which had not been possible previously, the craving for drugs diminished and a drug-free state was reached. Although administration of psychostimulants to drug abusers is controversial, as they are addictive, in cases of ADHD they have promoted drug abstinence.

        אפריל 1997
        סרג'יו מרצ'בסקי ושושנה וייס

        Characteristics of Hospitalized Alcoholics

         

        Sergio Marchevsky, Shoshana Weiss

         

        Residential Center for Alcoholics and Israel Society for the Prevention of Alcoholism, Ramat Gan

         

        The background characteristics of 1,173 alcoholics hospitalized for 3 months in this center during December 1982 to December 1994 were reviewed. Socio-demographic variables and termination-of-treatment data, are described. The profile of the typical hospitalized alcoholic was that of a Jewish, urban, married, unemployed man, born in Asia-Africa (or in Israel) who had been living for many years in Israel and had many children and a low educational level. They usually start drinking in adolescence and come to the center after more than 15 years of drinking, mainly at home and alone, and also have family relatives who drink. Implications of the data for treatment and for family physicians are presented.

        שושנה וייס

        Knowledge of Adolescents about the Fetal Alcohol Syndrome

         

        Shoshana Weiss

         

        Prevention Department, Israel Society for the Prevention of Alcoholism, Ramat Gan

         

        The level of knowledge of the risks of drinking during pregnancy in 175, 17-18 year olds from kibbutzim in the eastern Upper Galilee was studied in January 1996. This population had the highest rate of involvement with alcohol in Israel and had been involved in alcohol education activities in previous years. About 53.71% of the sample believed that heavy drinking increases the risk of birth defects, but only 20.57% could correctly describe the fetal alcohol syndrome.

        מרץ 1997
        ד' סופר, י' גלילי, נ' נסראללה, ד' אלג'ם, א' אבלאי וי' קוגלר

        Patterns of Injuries and Preventive Measures for Motorcycle Accidents

         

        D. Soffer, Y. Galili, N. Nasralla, D. Aladgem, O. Ablai, Y. Kluger

         

        Depts. of Surgery B and C, Trauma Services, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        Retrospective analysis of a series of 32 motorcyclists admitted after road accidents was performed. 62% were injured on scooters with 50 cc engine capacity and most of the combined injuries occurred in this group. Most crashes occurred at road junctions.Riders of scooters with larger engine capacities tended to wear protective garments as opposed to riders with smaller engines. There was no correlation between engine capacity and severity of injury. We conclude that motorcyclists should receive special education, especially as to behavior on entering road junctions. We recommend that taxes on protective garments should be lowered in order to encourage motorcyclists to use them.

        אלי עטר, אלכסנדר גרניאק, עיסאם ראבי, בנימינה מורג וזלמן רובינשטיין ז"ל

        Angioplasty and Stenting of the Carotid Artery

         

        Eli Atar, Alexander Garniek, Issam Rabi, Benymina Morag, Zallman Rubinstein

         

        Dept. of Diagnostic Imaging, Interventional Radiology Unit, and Dept. of Vascular Surgery; Chaim Sheba Medical Center, Tel Hashomer (Affiliated with the Sackler Faculty of Medicine, Tel Aviv University)

         

        Percutaneous endovascular techniques are well established procedures in the management of peripheral vascular disease and visceral arterial stenosis. They are now being adapted for use in the carotid artery as well. 8 patients with 9 extracranial carotid artery stenoses were successfully treated by percutaneous angioplasty, following which in 4 of them 5 stents were inserted. The stenotic lesions were situated in the proximal internal carotid artery and in its bifurcation and also in the common carotid artery. The indications for angioplasty in these patients were the same as for surgery. There were no major complications. 1 patient had transient hemiparesis lasting a few hours, and another had bradycardia following balloon dilatation in the region of the carotid body. Percutaneous endovascular treatment of carotid artery stenosis is becoming a safe, feasible alternative to surgery.

        פברואר 1997
        חוליו וינשטיין ומדינה ידווב

        Efficacy and Safety of Acarbose Treatment of Niddm

         

        Julio Wainstein, Medinah Jedwab

         

        Dept. of Medicine C and Diabetes Unit, Wolfson Medical Center, Holon

         

        An uncontrolled multicenter study of the efficacy and safety of treatment of diabetes with acarbose was conducted on 169 NIDDM patients in 12 medical centers in Israel. Acarbose was administered for 19 weeks, and the patients were followed for an additional 12 weeks. A substantial decrease in HbA1c levels from 8.5% to 7.5% (p<0.001) and in postprandial serum glucose levels from 283.6 mg/dl to 248.5 mg/dl (p<0.01) was seen during treatment. On follow-up, HbA1c levels increased by 0.45% and postprandial serum glucose rebounded from 256.4 mg/dl to 287.9 mg/dl. Acarbose was shown to be effective in treating NIDDM and to be safe and well-tolerated.

        אשר ברק, לידיה גביס, בנימין מוגילנר ושולמית גלמן-קוהן

        "Charge" Association

         

        Asher Barak, Lidia Gabis, Biniamin Mogilner, Shulamit Gelman-Kohan

         

        Pediatric and Neonatal Depts., and Clinical Genetic Unit, Kaplan Hospital, Rehovot

         

        CHARGE association represents a group of congenital anomalies with no clear etiology. The broad array of abnormalities, which involves several systems, has been the basis for the acronym CHARGE: coloboma, heart anomaly, choanal atresia, retarded growth and development, hypoplastic genitalia and ear malformation. We present 3 children with CHARGE association to illustrate the phenotypic variability and note the multidisciplinary treatment they received. It is recommended that this entity be approached in an interdisciplinary, integrated way to allow for faster diagnosis and better prognosis.

        י' שויד, א' אנגל ומ' הלברטל

        Effectiveness of Selective Hepatic Artery Embolization in a Child after Blunt Hepatic Trauma

         

        Y. Sweed, A. Engel, M. Halberthal

         

        Depts. of Pediatric Surgery and Radiology and Pediatric Intensive Care Unit, Rambam Medical Center, Bruce Rappaport Faculty of Medicine, The Technion, Haifa

         

        A 9-year-old boy was admitted after a bicycle fall. Abdominal CT-scan revealed severe liver injury (stage IV according to the liver injury scale of the American Association for Surgery Trauma), including ruptured intraparenchymal hematoma with active bleeding. The patient was hemodynamically stable and was treated conservatively for the first 2 days. On the 3rd day selective hepatic artery angiography was performed because of abdominal distension and the need for 7 pints of packed red blood cells. Active right hepatic artery bleeding was identified and treated successfully by embolization. We think that early angiography and selective embolization should always be considered for acute or continuous bleeding after liver injury.

        חן גרינברג, שמואל אביטל, חנוך קשתן ויהודה סקורניק

        Diverticular Disease of the Appendix

         

        R. Greenberg, Shmuel Avital, Hanoch Kashtan, Yehuda Skornik

         

        Dept. of Surgery A, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        The incidence of appendiceal diverticulosis in pathologic specimens is 0.004-2.1%. Diverticular disease of the appendix is classified as congenital (true) or acquired (false). The clinical presentation differs from that of acute appendicitis. The average age is older, the pain is often intermittent, and while localized in the right lower abdominal quadrant, is of longer duration. No further treatment besides appendectomy is needed. Since a high rate of perforations, peritonitis and lower gastrointestinal bleeding have been reported as complications, it is recommended that in those with an incidental finding of diverticula of the appendix during surgery, that appendectomy be performed. It is not recommended to perform prophylactic appendectomy when diverticula of the appendix are found on barium enema.

        ינואר 1997
        נגה רייכמן, נתן קאופמן ועדית פלטאו

        Acute Effusive Constrictive Pericarditis in Influenza A

         

        N. Reichman, N. Kaufman, E. Flatau

         

        Dept. of Medicine B, Central Emek Hospital, Afula and Technion Faculty of Medicine, Haifa

         

        Constrictive pericarditis may complicate the course of several viral infections, mainly Coxsackie virus group B, as well as in rheumatoid disease, radiation and neoplasm. Perimyocardial involvement during influenzal infections is usually mild and does not progress to constriction or tamponade. A single case of cardiac tamponade caused by influenza A was reported in 1986. We report a case of acute effusive-constrictive pericarditis due to influenza A infection. Corticosteroids resulted in some benefit, but did not relieve constriction, which required extensive pericardiectomy.

        רות שמרת, רויטל ברוכים, ירון גלנטי, ציונה סמואל, סיריל ליגום, מיכה רבאו ופאול רוזן

        Familial Adenomatous Polyposis: Establishing a Registry and Genetic and Molecular Analysis

         

        R. Shomrat, R. Bruchim, Y. Galanty, Z. Samuel, C. Legum, M. Rabau, P. Rozen

         

        Genetic Institute and Depts. of Gastroenterology and Surgery, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University

         

        Familial adenomatous polyposis (FAP), a dominantly inherited disease, is caused by a mutation in the adenomatous polyposis coli gene in chromosome 5q21. The gene has 15 exons, a physical length of 10 Kb and an open reading frame of 8.5 Kb. Exon 15 codes 66% of the mRNA and has a mutation cluster region which accounts for over 50% of mutations. The disease usually leads to the appearance of hundreds of adenomatous polyps in the transverse and descending colon between puberty and age 20 years and to colon cancer before the age of 40. Early detection is essential to prevent the development of metastasizing cancer. Since 1994 we have recruited 23 families for genetic counseling. DNA was obtained from 19 unrelated FAP patients and 219 high risk relatives in 19 unrelated families following confirmation of the diagnosis. In addition to linkage studies, direct mutational analysis was performed using the protein truncation test for most of exon 15 and single strand conformation polymorphism analysis for the other exons. These exons account for most of the mutations identified to date. Of 19 unrelated probands, 14 had detectable mutations. Exon 15 accounted for 6 families, exons 5, 7 and 14 for 1 each, exon 9 for 3, and exon 8 for 2. Combined mutational and linkage analysis identified 18 presymptomatic carriers who received genetic and clinical counseling. Our FAP patients did not differ significantly from those of larger studies in other countries with regard to the distribution of the mutations, gender and genotype-phenotype correlation, or ethnic distribution.

        א' ירצקי, י' פלדמן, פ' אלתרמן, ב' פינקלטוב

        Rheumatoid Arthritis in the Elderly

         

        A. Yaretzky, J. Feldman, P. Alterman, B. Finkeltov

         

        Dept. of Geriatric Medicine and Rheumatology Clinic, Meir Hospital, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University

         

        Opinions differ as to whether late onset rheumatoid arthritis (RA) represents a clinical subset and whether age at onset involves differences in therapy and prognosis. In this retrospective study we compared 23 patients with early onset RA (average onset 52.8 years; 91.3% of them women), with 36 with late onset (average onset 70.3 years; 67% of them women). No statistically significant differences were found as to demographic, clinical, laboratory or radiographic characteristics. 

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303