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Biomedical subjects

A B van As

Publications and source records attributed to A B van As.

9 recordsLinked to original sources
PubMed2003

The effects of war on children in Africa.

There is no doubt that the effects of war extend to the most vulnerable members of society, including children. Although armed conflicts occur throughout the world, the African continent seems to be a particular background for civil and international wars. The aim of this study was to identify causes of conflict in Africa and to evaluate the effect of war on children and their health in order to make practical recommendations to health care workers dealing with children in the setting of war. All articles written in the past 5 years concerning "war" and "children" were identified by means of a literature search and internet review. Contrary to common belief, the causes of conflict are complicated and multi-factorial. The effects of war on childhood are disastrous and include severe negative effects on general paediatric health status. Short-term recommendations for health care workers working with children in war include supply of emergency medical infrastructures, basic health care, rehabilitation and education. Long-term recommendations include orchestrating the relief and support efforts from both national governments and international non-profit organisations and speeding up of economic recovery. The causes of conflict in Africa are complex and unlikely to be resolved soon. The effects of war on children are horrendous in many ways, but can be limited by providing timely and appropriate health care.

Africa↗
PubMed2003

Child rape.

Explore the source record for details and available documents.

Child↗
PubMed2002

Gunshots to the neck: selective angiography as part of conservative management.

Trauma units all over the world are faced with an ever-increasing number of gunshot injuries. While the traditional view is that exploration is mandatory for all gunshot wounds to the neck, this issue is now often debated amongst trauma surgeons. The aim of this particular study was to assess the outcome of gunshot wounds to the neck using a selective conservative approach. Haemodynamically stable patients were investigated with angiography. Only when this proved to be positive, the patient was surgically explored. The records of 116 patients presenting with a gunshot to the neck to our trauma unit over a 3-year-period were reviewed. We studied demographics, bullet track, clinical findings, diagnostic investigations, methods of treatment, time in hospital and outcome. Seventy of the 116 patients sustained a direct hit to the neck, in 46 patients the bullet traversed the face or chest first. Eighty-five patients presented with vascular injury, 61 with an injury to the airway, 32 with an injury to the pharynx or oesophagus, and 12 with sustained neurological damage. Angiography was performed in 89 patients and was positive in 12 patients. Lesions occurred in the common carotid artery (seven), the internal carotid artery (three), the external carotid artery (three), the vertebral artery (two) and the subclavian artery (one). Five patients had more than one lesion. In total 18 patients were treated operatively by performing a neck exploration. Four patients had emergency surgery for exsanguinating bleed. Fourteen had surgery after a positive diagnostic study; 12 after angiography, 2 after another positive investigation. Ten (8.6%) patients died; three during resuscitation, three during emergency exploration, two due to respiratory failure, one postoperative and one from the adult respiratory distress syndrome (ARDS). Our results suggest that selective conservative management is a good treatment for gunshot wounds of the neck. In our experience angiography plays a key role in the detection of a major vascular injury requiring surgical exploration. Careful clinical assessment enhanced with the appropriate investigations is the cornerstone for deciding to explore a gunshot wound to the neck.

Adolescent↗
PubMed2001

Impact of Celsior solution on hepatocellular, reperfusion and endothelial cell injury after liver transplantation.

BACKGROUND: Initially, preservation solutions were developed to maintain cell function of the transplanted organs. However, recently developed preservation solutions also contain a variety of substances to reduce the reperfusion injury. AIM: To study the effect of three different preservation solutions on the liver cell injury, endothelial cell function and reperfusion injury after liver transplantation. MATERIAL AND METHODS: Large White X Landrace pigs of either sex were subjected to orthotopic liver transplantation. Donor livers were flushed and stored in University of Wisconsin Solution, Eurocollins Solution or Celsior Solution for 3 hours. Blood samples were taken at various times post transplantation for assessment of aspartate aminotransferase, hyaluronic acid, malondialdehyde and Vitamin A levels. RESULTS: Serum aspartate aminotransferase levels were lower in the livers preserved in the Wisconsin solution. Plasma malondialdehyde levels were lower and serum Vitamin A levels were higher in the livers preserved in Celsior solution. Serum hyaluronic acid levels increased after liver transplantation but were similar with all three solutions. CONCLUSIONS: There was less hepato-cellular injury in the livers preserved in Wisconsin solution and less reperfusion injury with the Celsior solution. The endothelial cell injury was similar with all three solutions.

Animals↗
PubMed2001

Effect of early arterialization of the porcine liver allograft on reperfusion injury, hepatocellular injury, and endothelial cell dysfunction.

The conventional technique of liver transplantation involves the initial perfusion of the graft with portal blood. However, recent evidence suggests that initial arterialization of the graft may be better. The aim of this study is to evaluate the timing of arterialization on reperfusion injury, hepatocellular injury, and endothelial cell function after liver transplantation. Large white X Landrace pigs (n = 24) were subjected to orthotopic liver transplantation. The animals were randomly assigned to 4 groups, ranging from late arterialization (60 minutes after portal reperfusion) to early rearterialization (20 minutes before portal reperfusion). Aspartate aminotransferase levels continued to increase 4 hours posttransplantation in group 1 (late arterialization), but remained stable after 1 hour posttransplantation in group 4 (early rearterialization). Levels of malondialdehyde doubled in all groups after portal reperfusion with the exception of group 4, in which the liver received arterial blood before portal reperfusion. Vitamin A levels decreased in all groups after revascularization, but the decrease was more pronounced and prolonged in groups 1 and 2 (late arterialization) compared with groups 3 and 4 (early rearterialization). Hyaluronic acid levels continued to increase in all groups until 1 hour posttransplantation except in group 4, in which the level decreased from 20 minutes posttransplantation. Results of this study show that early rearterialization is associated with less hepatocellular damage, less reperfusion injury, and improved liver endothelial cell function. In conclusion, our results indicate that early rearterialization of the graft is beneficial to the transplanted liver.

Animals↗
PubMedDate not supplied

Do diets enriched with oil prevent multiple organ failure in mice?

OBJECTIVE: To examine the effects of various diets supplemented with fat in an experimental model of multiple organ failure in mice. DESIGN: Two randomised laboratory studies. SETTING: University hospital. MATERIAL: 177 female Swiss mice (weight 20-30 g). INTERVENTIONS: Experiment I: 59 mice; 20 received no dietary supplement, 20 received 15% palm oil, and 19 received 14% fish oil plus 1% corn oil, eight weeks before injection of 100 mg zymosan/100 g in 4 ml liquid paraffin; 5 mice in each group killed after 1.5 hours, and the rest on day 12. Experiment II: 118 mice; 29 received no dietary supplement, 30 received 15% palm oil, 30 1% corn oil, and 29 14% fish oil, 12 weeks before injection with zymosan. 20 mice in each group received streptomycin 5 g/l in drinking water starting five days before injection of zymosan and continued until the end of the experiment. All mice killed on day 12. MAIN OUTCOME MEASURES: Mortality, body and organ weights, and culture of peritoneal fluid. Detection of tumour necrosis factor-alpha (TNF-alpha) in plasma. RESULTS: Experiment I: only 5 control mice, 2 in the fish oil, and 7 in the palm oil, groups survived to day 12. Spleens in mice given fish oil were significantly heavier than those that had had palm oil (p = 0.03). Experiment II: 108/118 mice survived until day 12, and most had macroscopic signs of multiple organ failure. Liver weights in the fish oil group were lower than in the control (p = 0.04) and palm oil (p = 0.03) groups, and kidney weights higher than in the corn oil group (p = 0.007); there were no differences in the amounts of TNF-alpha detected in the blood. One culture in each experiment grew bacteria. CONCLUSION: Diets supplemented with fish oil did not prevent multiple organ failure or reduce plasma concentrations of TNF-alpha. Decontamination of the gut did not alter these results.

Animals↗