The Positive and Negative Syndrome Scale (PANSS): A Three-Factor Model of Psychopathology in Marginally Housed Persons with Substance Dependence and Psychiatric Illness.

Rates of psychopathology are elevated in marginalized and unstably housed persons, underscoring the need for applicable clinical measures for these populations. The Positive and Negative Syndrome Scale (PANSS) is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms. The current study investigates whether a reliable and valid PANSS factor structure emerges in a marginally housed, heterogeneous sample recruited from the Downtown Eastside of Vancouver where substance use disorders and psychiatric illness are pervasive.

Neurocognitive profiles of marginally housed persons with comorbid substance dependence, viral infection, and psychiatric illness.

Introduction: Individuals living in single-room occupancy (SRO) hotels constitute a socially marginalized group with exposure to multiple factors with adverse effects on neurocognition, including substance use, viral infection, psychiatric illness, and brain injury. Consequently, marked heterogeneity in neurocognitive functioning is observed. This study aimed to identify and describe distinct neurocognitive profiles within a marginally housed sample.

The pylorus: take it or leave it? Systematic review and meta-analysis of pylorus-preserving versus standard whipple pancreaticoduodenectomy for pancreatic or periampullary cancer.

Background: Our objective was to determine the relative effects of pylorus-preserving pancreaticoduodenectomy (PPPD) and standard Whipple pancreaticoduodenectomy (SWPD) in patients with pancreatic or periampullary cancer.

Methods: We searched seven bibliographic databases, conference proceedings, and reference lists of articles and textbooks, and we contacted experts in the field of hepatobiliary surgery. We included published and unpublished randomized controlled trials.

Prospective study comparing human albumin vs. reinfusion of ultrafiltrate-ascitic fluid after total paracentesis in cirrhotic patients with tense ascites.

Although, total paracentesis associated with human albumin substitution has shown to be a rapid, effective and safe treatment of diuretic refractory ascites in advanced liver cirrhosis, it implies high costs and has a limited availability. Therefore an alternative procedure the reinfusion of concentrated ascites has gained popularity in recent years (Smart et al. 1990; Grazioto et al.

Causes and pathomechanisms of oesophageal varices development.

Portal hypertension is a common clinical syndrome with chronic liver diseases and is characterised by a pathological increase in portal pressure. Moreover, portal hypertension is associated with increased portal blood flow. Increased vascular resistance in portal hypertension is because of an increase in both intrahepatic and portosystemic collateral resistance.

[Small unilocular hepatocellular carcinoma (0 < 5 cm) in patients with liver cirrhosis. Early diagnosis, surgical indications, resection and prognosis].

In 151 (17.5%) of 861 patients with liver cirrhosis regularly screened by sonography and determination of alpha-fetoprotein a hepatocellular carcinoma (HCC) was detected. Diagnosis was verified by sonographically guided fine needle puncture and exceptionally by laparoscopy and direct puncture.

Appraisal of surgical resection of gallbladder carcinoma with special reference to hepatic resection.

Carcinoma of the gallbladder a gastrointestinal malignancy with an extraordinarily poor prognosis. However, aggressive surgery, with special reference to hepatic resection, may improve survival. To prove this, we performed a retrospective analysis over an 18-year period to investigate the experience of a center that began employing liver resection in patients with gallbladder cancer in 1978.

Analysis of factors affecting outcome after hepatectomy of patients with liver cirrhosis and small hepatocellular carcinoma.

Objective: To review our policy of screening patients at risk of developing hepatocellular carcinoma (HCC), and to present 10 years' experience of hepatic resection for small HCC (< 5 cm).

Design: Retrospective study.

Setting: Teaching hospital, Germany.

Prophylactic endoscopic sclerotherapy in patients with liver cirrhosis, portal hypertension, and esophageal varices.

A major cause of death among patients with cirrhosis and portal hypertension is bleeding from esophago varices. The reasons for variceal haemorrhage and which varices have a high risk of bleeding are discussed. In addition, the question as to whether prophylactic endoscopic sclerotherapy is a viable solution to prevent variceal haemorrhage.

Prediction of the first variceal haemorrhage.

We followed 87 cirrhotic patients with esophageal varices and without previous hemorrhage for a mean period of 24 mo to prospectively evaluate the occurance of variceal bleeding within (early) or after (late) 6 mo from entry and the contribution of portal Doppler ultrasound parameters to the prediction of early and late hemorrhage. Clinical, biochemical, endoscopic and portal Doppler ultrasound parameters were recorded at entry. Variceal bleeding occurred in 22 patients (25.

[Ruptured pseudoaneurysm of the splenic artery. A complication of chronic pancreatitis].

History And Findings: A pale looking 33-year-old man with a history of perforated gastric ulcer and pancreatitis with surgically drained pseudocyst was admitted because of painless anal bleeding. Heart rate was 100/min, blood pressure 90/60 mm Hg.

Investigations: Haemoglobin concentration (6.

[The value collateralization and venous obstruction operations in acute bleeding esophageal varices in patients with cirrhosis of the liver].

Despite the development of new techniques and the great successes in recent years in Japan, the value of surgical venous obstruction in the treatment of oesophageal and gastric variceal bleeding remains controversial. For this reason we chose to evaluate our own results over a period of 10 years. Splenectomy is the only curative operation that eliminates the local portal hypertension in peripheral thrombosis of the splenic vein.

[Narrow-lumen mesocaval interposition shunt in liver cirrhosis and recurrent esophageal varices hemorrhage. Standard surgery of the future in failure of sclerotherapy?].

In a prospective study, conducted between 1.1.1987 and 31.

Mesocaval interposition shunt with small-diameter polytetrafluoroethylene grafts in sclerotherapy failure.

Fifty-seven patients with failed sclerotherapy received a mesocaval interposition shunt with an externally supported, ringed polytetrafluoroethylene prosthesis of either 10 or 12 mm diameter. Thirty-one patients had Child-Pugh grade A disease and 26 grade B; all had a liver volume of 1000-2500 ml. Follow-up ranged from 16 months to 6 years 3 months.

Prophylactic sclerotherapy for esophageal varices in high-risk cirrhotic patients selected by endoscopic and hemodynamic criteria: a randomized, single-center controlled trial.

Controlled trials of sclerotherapy for the prevention of the first variceal hemorrhage in cirrhotics have given conflicting results, in spite of an initial positive controlled trial. We designed therefore a new study in which only 89 of 396 investigated patients were randomized to sclerotherapy (44 patients) or a control group (45 patients). The admission criteria were: no history of variceal bleeding, the presence of high risk varies, i.

Current therapeutic strategy in bleeding esophageal varices in babies and children and long-term results of endoscopic paravariceal sclerotherapy over twenty years.

71 consecutive babies and children with bleeding esophageal varices managed primarily by emergency or elective paravariceal endoscopic sclerotherapy (PES) have been reviewed and followed up for twenty years. In 36 of them 53 different operations to prevent further variceal hemorrhage had been performed without permanent success. In 50 children (70 per cent--Group Ia), portal vein obstruction, in 2 (3 per cent--Group Ib), congenital hepatic fibrosis and in 19 (27 per cent--Group II) babies and children different types of cirrhoses were the cause of portal hypertension.

Massive and recurrent gastrointestinal hemorrhage due to jejunal varices in an afferent loop--diagnosis and management.

Bleeding from "ectopic" varices outside the gastroesophageal region is an uncommon complication of portal hypertension. Although the high mortality rate of bleeding duodenal varices has been emphasized (1-4), an awareness of the condition and its characteristic presentation may enable diagnostic and therapeutic procedures to be performed rapidly with an increased likelihood of a successful outcome. This report describes a patient with recurrent, frequent and massive hemorrhage from jejunal varices in the afferent loop after a Billroth II resection, chronic pancreatitis and portal hypertension; the diagnosis and management of this unusual case of recurrent gastrointestinal bleeding are discussed.

[Correlation between pulmonary hypertension and portal hypertension--2 case reports of different forms of pre-sinusoidal portal hypertension].

Since its first description in 1951 by Mantz and Craig pulmonary hypertension in combination with portal hypertension has been observed more and more frequently. In a recent prospective study Hadengue et al. reported an incidence of 2%.