Lege Artis Medicinae

[The role of non-operative treatment in esophageal performations]

ALTORJAN Áron1, KISS János1, VÖRÖS Atilla1, BOHÁK Ágnes1

FEBRUARY 24, 1993

Lege Artis Medicinae - 1993;3(02)

[The authors give an account of their experience with the non-operative management of the esophageal perforations. Non-operative therapy implies that the patient receives nothing by mouth for a minimum period of 7 days – and that broadspectral antimicrobial therapy and intravenous hyperalimentation are prescribed. No direct attempt is made to close the esophageal injury. The authors have established criteria for the non-operative management of esophageal perforations. They warn that failure to show signs of improvement within 24 hours of non-operative therapy should prompt a consideration for operative intervention. ]

AFFILIATIONS

  1. Orvostovábbképző Egyetem Sebészeti Klinika Budapest

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Antiphospholipid syndrome]

GERGELY Péter

[Antiphospholipid syndrome is a recently recognized clinical entity characterized by the presence of deep vein and cerebral thrombosis, thrombocytopenia and recurrent fetal loss. The syndrome is caused by autoantibodies directed against phospholipid antigens. The clinical syndrome is most frequently associated with systemic lupus erythematosus.]

Lege Artis Medicinae

[Intraoperative ultrasonography during laparoscopic cholecystectiomia ]

ANTAL András, SCHMIDT Pál, TAKÁCS Judit, HADIJEV Janaki

[Our preliminary experience with intraoperative ultrasonography during laparoscopic cholecystectomy is presented. The importance of intraoperative diagnostic procedures in biliary surgery such as cholangiography and operativ ultrasonography are discussed.]

Lege Artis Medicinae

[Xamoterol in severe heart failure]

MATOS Lajos

[The two groups did not differ from each other in terms of improvement in clinical symptoms. Using a visual analogue scale and the Likart questionnaire, breathlessness appeared to be relieved with the active agent, but the duration of exertion or exercise capacity was found to be the same. Exercise-induced tachycardia and blood pressure elevation were attenuated with xamoterol (p < 0.01). The drug showed no arrhythmogenic effect. At 100 days after randomisation, 32 patients in the xamoterol group (9.1%) had died, compared with 6 (3.7%; p=0.02) of those treated with placebo.]

Lege Artis Medicinae

[Alcohol induced organ and tissue injury]

BÉLY Miklós

[The patho-histological characteristics of alcohol induced acute and chronic organ and tissue injuries were reviewed. Neuropathy and brain lesions, gastrointestinal tract in alcoholism, alcoholic liver disease, pancreatitis, cardiomyopathy, aseptic bone necrosis, rhabdomyolysis were discussed based on the literature. ]

Lege Artis Medicinae

[Oral precancerous lesions and conditions]

DOMBI Csaba, CZEGLÉDY Ágota, BÁNÓCZY Jolán

[Each year tumours, including oral cancers, result in more and more deaths in Hungary. The oral cavity has a special position, because the precancerous lesions and conditions which occur in it can be detected by simple procedures. The authors use the latest definitions and disease classifications approved by WHO, to systematize the essential knowledge for the early diagnosis of the most frequent precance roses in Hungary, taking into consideration aspects of clinical morphology, epidemiology, localizational frequency, the risk/level of the tumour and the main principles of treatment. In addition to a detailed description of leukoplakia, erythroplakia, smoker's palate, actinic cheilitis, lichen and sideropenic anaemia, cheilitis glandularis, cornu cutaneum, naevus pigmentosus, discoid lupus erythematosus, submucosus fibrosis, xeroderma pigmentosum and tertiery syphilis are also mentioned. The purpose of the review is to call attention to the fact, that, due to the significant increase in mortality caused by oral tumours, the early diagnostic activity of dentists should be supported by the awareness of general practitioners and a national stomatooncological screening network should be established. ]

All articles in the issue

Related contents

Lege Artis Medicinae

[The role of esophagectomy in the management of esophageal perforations]

ALTORJAY Áron, KISS János, VÖRÖS Attila, SZIRÁNYI Endre, VIMLÁTI László

[The authors give an account of their experiences with esophagectomy and immediate reconstruction in the management of the esophageal perforations. Twenty-two adults with intrathoracic esophageal perforations underwent esophagectomy. There was only one hospital death (4.5%). It has been found that the more major initial operation is more reliable and therefore safer therapy in the long run. It eliminates the source of the intrathoracic sepsis as well as the diseased esophagus. The authors hold a high opinion of restoration alimentary continuity in a single stage. They suggest that esophagectomy is one of the best opportunities in the management of delayed spontaneous esophageal perforation as well.]

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.