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Biomedical subjects

A Hussein

Publications and source records attributed to A Hussein.

At least 73 records · Page 4Linked to original sources
PubMed1994

The use of intensive clinic support to permit outpatient autologous bone marrow transplantation for breast cancer.

Recent studies have explored feasibility and cost considerations of administering high-dose chemotherapy with hematopoietic support in the outpatient setting. Between October 1991 and April 1993, we studied 110 women with primary metastatic breast cancer undergoing high-dose chemotherapy with hematopoietic support. Ninety-two patients were managed in an outpatient clinic after high-dose chemotherapy and autologous bone marrow transplantation and peripheral blood progenitor cells. The remaining 18 patients received the same high-dose treatment and hematopoietic support in the hospital and were discharged to a nearby hotel each night; these patients were the pilot group for this effort and also served as a control group. High-dose chemotherapy consisted of cyclophosphamide/cisplatin/carmustine. Chemotherapy was well tolerated, allowing 95% of 65 eligible patients enrolled since November 1992 to be discharged soon after chemotherapy for outpatient posttransplant support. Approximately 70% of these patients required either no hospital readmission or brief readmissions of 1 to 4 days. Median days of hospitalization required for historical groups of patients receiving high-dose chemotherapy plus bone marrow support as inpatient therapy, high-dose chemotherapy with colony-stimulating factor-primed peripheral blood progenitor cells and autologous bone marrow transplantation as inpatient therapy in a traditional transplant model, and outpatient management of autologous bone marrow transplantation patients were 37, 24.5, and 7 days, respectively, despite the same high-dose chemotherapy. Charges related to the transplant procedure were reduced by 50% over the last 2 to 5 years using the outpatient management approach. This procedure may be applicable to patients with other forms of cancer receiving intensive chemotherapeutic regimens. The use of outpatient management in a transplant setting is highly cost effective.

Adult↗
PubMed1994

Prevention of hemorrhagic cystitis after high-dose alkylating agent chemotherapy and autologous bone marrow support.

High-dose cyclophosphamide (CY) is associated with a high risk of hemorrhagic cystitis. The reported frequency ranges from 6.5 to 52% despite the use of hydration protocols. The current study reports a hyperhydration and continuous bladder irrigation protocol which resulted in a very low incidence of microscopic hematuria and no reported cases of visible hematuria. Patients received baseline fluids at 200 ml/m2/h during chemotherapy. Additional fluid boluses were given if urine output fell below 200 ml/h. Bladder irrigation was performed at a rate of 1 l/h during and for 24 h after high-dose CY. Three hundred three evaluable patients with solid tumors received high-dose chemotherapy with CY at a dose of 5625 mg/m2 over 3 days. Patients also received cisplatin 165 mg/m2 and carmustine 600 mg/m2. Some patients received thiotepa 300-750 mg/m2 instead of carmustine. The overall incidence of microscopic hematuria (> 15 RBCs per high power field) was 19%, with only 11% of patients experiencing more than 50 RBCs per high power field. No patient developed visible hematuria or symptomatic hematuria requiring intervention. These results using aggressive hyperhydration and high volumes of continuous bladder irrigation are among the best reported following high-dose CY chemotherapy.

Bone Marrow Transplantation↗
PubMed1993

Traumatic pseudoaneurysm of left internal mammary artery graft.

Traumatic pseudoaneurysm of the left internal mammary artery was recognized as a possible causal factor in the early recurrence of angina in a 51-year-old man. This patient underwent reoperation for revascularization with the left internal mammary artery graft in situ.

Angina Pectoris↗
PubMed1993

Role of cytokines in autologous bone marrow transplantation.

High-dose chemotherapy with autologous bone marrow support has been increasingly used in the treatment of malignant disease. The use of hematopoietic colony-stimulating factors (CSF), particularly when coupled with the use of CSF-primed peripheral blood progenitor cells, has enabled a substantial reduction in the duration of severe leukopenia and in the morbidity associated with bone marrow transplantation. Furthermore, their use has reduced resource utilization and hospital charges and has also permitted the performance of autologous bone marrow transplantation support largely on an outpatient basis.

Ambulatory Surgical Procedures↗
PubMed1990

[Effects of ipratropium bromide and salbutamol on isolated lung hyperinflation in symptom-free intervals in asthmatic children].

To evaluate the effects of salbutamol and ipratropium bromide on the isolated hyperinflation, without central airways obstruction, during asymptomatic periods in asthmatic children, 31 children, out of ca. 500, were selected for a double-blind therapy trial, according to the following criteria: Thoracic gas volume greater than 140% predicted (mean +/- 1SD: 162 +/- 16%) and/or trapped-gas greater than 15% (21 +/- 5%); airways resistance less than 140% (105 +/- 25%) and forced expiratory volume in one second greater than 75% (91 +/- 11%). On 4 consecutive mornings spirometry, bodyplethesmography and measurement of functional residual capacity by helium-dilution were performed before and 20' after inhalation of 2 ml of each of 4 solutions respectively. The children received the solution which produced the largest fall of thoracic gas volume and/or trapped-gas, 4 times/day for 4-5 weeks: 1. five children received saline; 2. 13 salbutamol, 2.5 mg; 3. 6 ipratropium, 0.250 mg; 4. 7 both drugs. Clinical aspects and lung function differed not significantly between the 4 groups. Lung function values showed no correlations with duration, clinical severity and typ of asthma. At the beginning and after 4-5 weeks of treatment lung function improved significantly in the groups 2-4, compared with pretreatment values. At study end, the improvements of thoracic gas volume, trapped-gas and airways resistance differed significantly between the groups, salbutamol + ipratropium produced altogether the best effect. With time, the effect of salbutamol + ipratropium on thoracic gas volume and trapped-gas increased and that of salbutamol on airways resistance and forced expiratory volume in one second decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

DNA flow cytometry on breast carcinomas: comparison of a detergent and an enzyme-detergent preparation method.

In this study we have compared two different preparation methods for DNA flow cytometry on breast cancer. Tumour cell suspensions from 49 breast cancers were analysed on a Facscan flow cytometer. In seven of 49 cases, additional aneuploid peaks were found after enzyme/detergent treatment (E/D), not seen after the detergent (D) preparation. S-Phase fractions were significantly higher after D than after E/D preparation (mean values, 15 and 8%, respectively), although the correlation was high between the two methods. S-Phase fraction estimated after background correction diminished the differences between the two methods (mean values, 8 and 6%). Furthermore, the fraction of G2/M cells were generally greater with the D method. These differences can be explained by increased number of cell doublets and nuclear fragments after D compared to E/D preparation. This clearly shows that the preparation method influences the result of DNA flow cytometry on human breast cancers.

Breast Neoplasms↗
PubMed1990

[Short-term chemotherapy of tuberculosis in children].

The effectiveness of short-term drug treatment of tuberculosis is based on the use of INH, RMP and PZA (with or without SM or EMB), that have a pronounced bactericidal and sterilizing effect in all tissues and on all populations of mycobacteria which, depending upon the oxygen content and acidity of their surroundings, multiply at different rates. Treatment regimens over 6 or 9 months have proved effective in numerous studies involving 1500 children with pulmonary or extra-pulmonary tuberculosis. The recommended treatment of choice comprises a 6-month regimen with INH, RMP and PZA, with or without EMB or SM, the drugs being administered daily for two months, followed by INH and RMP applied daily, or 2 to 3 times a week for 4 months. If resistance to INH and/or SM is suspected, initially four suitable drugs are required, and are effective. Nine months of treatment with INH and RMP (with PZA and/or EMB if resistance is suspected) administered daily for two months and followed by INH and RMP applied daily or 2 to 3 times a week, is also both effective and safe. Overall side effects were observed in fewer than two per cent of the cases, and were severe in fewer than one per cent. Recurrences occurred in fewer than one per cent of the cases. Complementary measures such as bronchological treatment in the case of bronchial invasion of lymph nodes, and surgical measures in tuberculosis of the bone, joints, body cavities, etc., are of decisive importance for the success of therapy.

Antitubercular Agents↗
PubMed1989

Atypical spondyloarthritis in children: proposed diagnostic criteria.

Clinical and laboratory findings in 26 children with atypical spondyloarthritis were compared with those of 76 children with juvenile rheumatoid arthritis. The sensitivity, specificity, predictive value, and efficiency for diagnosis were calculated. The following findings (major criteria) were much more common in atypical spondyloarthritis than in juvenile rheumatoid arthritis: (1) spondyloarthritis within the family; (2) enthesopathy; (3) arthritis of digital joints; (4) sacro-iliitis; (5) presence of HLA-B27; (6) frequent recurrence of arthritis and arthralgia. Six additional findings (minor criteria) were significantly more common in atypical spondyloarthritis (SA): (1) disease onset after the age of 10 years; (2) male sex; (3) involvement of the lower extremities; (4) acute iridocyclitis or conjunctivitis; (5) arthritis of the hip joints; (6) manifestation following a history of enteritis. In the presence of 4 major criteria or 3 major and 3 minor criteria, the diagnosis of an atypical SA was established with a sensitivity of 84.6%, a specificity of 100%, and an efficiency of 96.1%.

Adolescent↗
PubMed1988

Attenuation of endotoxin-induced cytotoxicity and prostacyclin production in cultured bovine pulmonary artery endothelial cells by phosphodiesterase inhibition.

Exposure of cultured bovine pulmonary endothelial cells to endotoxin (lipopolysaccharide, LPS) causes cytotoxicity and increased prostacyclin production. Since cyclic nucleotides have been proposed as modulators of inflammation, we wondered whether they were involved in LPS-induced endothelial damage. Bovine pulmonary endothelial cells were exposed for 24 h to LPS and the effects of 1-methyl-3-isobutylxanthine (MIX), a phosphodiesterase inhibitor, dibutyryl cyclic AMP (db-cAMP), forskolin (an adenylate cyclase activator), and sodium nitroprusside (an agent known to stimulate intracellular cyclic GMP generation) on LPS-induced injury were determined. Injury was assessed by measurement of lactate dehydrogenase (LDH) (activity) and prostacyclin (6-keto-PGF1 alpha) in the bathing medium. Incubation with MIX attenuated LPS-induced endothelial cytotoxicity and prostacyclin production in a dose-dependent manner (ANOVA, p less than 0.001). Dibutyryl cyclic AMP also inhibited LPS-stimulated LDH release from the endothelial cells but did not suppress increased prostacyclin production. The combinations of MIX and dibutyryl cyclic AMP produced protection similar to that of MIX alone. Neither nitroprusside nor forskolin affected LPS-induced endothelial injury. Measurements of intracellular cyclic nucleotide concentrations showed that MIX caused marked increases in both cyclic AMP and cyclic GMP within 30 min of incubation, while forskolin and nitroprusside failed to cause such early elevations. Thus, phosphodiesterase inhibition protects endothelial cells from the effects of LPS. Increased intracellular concentrations of cyclic AMP also protect endothelial cells from LPS-induced cytotoxicity but do not alter the prostanoid response. We conclude that increased intracellular concentrations of cyclic AMP protect against LPS-induced endothelial cytotoxicity if present early in the exposure. We further conclude that LPS-mediated endothelial cytotoxicity can be separated from increased prostacyclin production.

1-Methyl-3-isobutylxanthine↗
PubMed1988

Odontoid process fracture osteosynthesis with a direct screw fixation technique in nine consecutive cases.

The authors present their experience with surgical treatment of odontoid process fractures using a direct screw fixation technique via an anterolateral retropharyngeal approach. Nine consecutive patients have been operated on with this technique. There were two deaths unrelated to the surgery, and anatomical union with conservation of the craniospinal hinge mobility was achieved in the remaining seven patients. The direct screw fixation technique appears feasible, efficient, and logical.

Adult↗
PubMed1988

[Analgesic intolerance in asthmatic children].

The different clinical presentations of analgesics-intolerance are presented in four asthmatic children. Analgesics-intolerance is rare in children and both sexes are equally affected. The affected children have either a severe mixed asthma and often a chronic sinusitis and nasal polyps, or a chronic urticaria. Often, the first manifestation occurs several years after onset of asthma and is triggered by respiratory infections. Ingestion of most analgesics may cause severe bronchial obstruction, urticaria, angioedema, collaps and rhinitis. The diagnosis can be established by an unequivocal history, or, in uncertain cases, by an inhalation challenge with lysin-acetylsalicylate. The best prophylaxis and therapy is to avoid all responsible drugs. The inhibitory effect of most analgesics on the cyclooxygenase initiates impairments in the metabolism of prostaglandins and leukotrienes, which are suspected to cause the bronchial obstruction in intolerant patients.

Adolescent↗
PubMed1988

[Comparison of sonographic and roentgenologic findings in the paranasal sinuses in children].

Sonography of maxillary sinuses was performed in 362 asymptomatic children with chronic airway diseases, using a 7.5 MHz sector scanner. Pathologic findings were detected in 78 (21.5%) children. Occipito-frontal radiographs of the sinuses were performed in 40 (11%) randomly chosen children and the findings were later compared with those of sonography. An overall agreement in terms of "normal-abnormal" findings was present in 94% of the 80 sinuses examined. In sinuses judged as "normal" or "abnormal" in either of the methods, findings were corresponding as "normal" in 40 of 45 (89%) and as "abnormal" in 35 of 40 (87%) sinuses. A differentiated assessment of pathologic findings showed an agreement in only 19 of 40 (48%) sinuses. Thus, an overall agreement of differentiated findings was present in 59 of 80 (74%) sinuses. Sonography was superior to radiography especially in differentiating the sinus content in secretion, swelling of the mucosa, polyps, cysts and air. In conclusion, sonography offers an accurate screening method for assessment of paranasal sinuses in children.

Adolescent↗
PubMed1988

[Effect of the diagnosis and prevention of exercise-induced bronchial obstruction on sports participation by asthmatic school children].

To assess the sport activities and the previous management of asthmatic children with an exercise-induced bronchial obstruction (EIB), we studied 124 children, aged 8-17 years, with a history of EIB, which was confirmed in a free-running exercise test. Participation in school sports was regular in 38% of the children, irregular in 45% and absent in 17%. Participation in sports outside the school was even lower: In 26% regularly, 18% irregularly and absent in 56%. 17% of all children were not active in any sport. EIB had previously been diagnosed in 38 (31%) children, and 20 (16%) of these had received an appropriate prophylactic medication. Children who received prophylaxis participated significantly more often in school sports (p less than 0.01) and in other sports (p less than 0.05), compared with those who had been diagnosed but had not received prophylaxis. After exercise, peak expiratory flow decreased by a mean of 41% of the preexercise values, but following a prophylactic administration of 0.2 mg Salbutamol-aerosol it decreased only by 2%. A complete protection of EIB was achieved in 94% of the children and the mean %-protection was 95%. The protective effect of 2 mg DNCG-aerosol in 21 children was significantly lower (53%, p less than 0.05) than that of salbutamol and a complete protection was achieved in only 71% (p less than 0.025) of the children.

Airway Resistance↗