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Biomedical subjects

D Jarjoura

Publications and source records attributed to D Jarjoura.

26 records · Page 2Linked to original sources
PubMed1989

Weight gain in supervised and take-home feeding programmes in Chad.

The rehabilitative effects of a supplementary feeding programme for Chadian children are reported. Both feeding centre-based and take-home premix strategies for the delivery of an 821 kcal/day porridge supplement were employed. A total of 641 malnourished children no more than 80 per cent median reference weight for height from two nomad reinstallation camps were enrolled in a supervised feeding programme. In a third camp, 133 children were enrolled in a take-home feeding programme. The mean length-of-stay in the programmes was 59 days. A regression model was developed to permit analysis of anthropometric data obtained from follow-up measures varying in number and distribution across time. The model estimates indicate that the supervised group had an average weight gain 60 days after enrollment of 1013 g, while the take-home group had an average 60-day gain of 951 g. The 62 g difference in the two strategies is not significantly greater than zero (P = 0.56).

Chad↗
PubMed1988

Breast cancer screening in a private women's clinic.

A review of 6109 mammograms representing 4332 patients seen over 4 years is presented. The American Cancer Society guidelines for mammography screening were followed. Forty-five percent of all tumors were nonpalpable; in 12% of these the lymph nodes were positive for cancer. In the group with palpable breast cancers, 62% had positive lymph nodes. Screening mammography results in an increased number of localization biopsies. Biopsy rates were compared with several series. Costs for mammography screening programs were reviewed and related to the cost of each breast cancer detected. In our series the cost per cancer detected was $13,000. This study provides evidence to justify the American Cancer Society guidelines.

Adult↗
PubMedDate not supplied

Mortality from early neonatal group B streptococcal sepsis: influence of obstetric factors.

Our objective was to determine if the neonatal mortality from early group B streptococcal (GBS) septicemia was associated with obstetric factors other than birthweight. Medical records from our institution for all neonates with positive blood cultures for GBS in the first 7 days of life between January 1981 and December 1992 were reviewed (n = 61). All the neonates had received broad-spectrum intravenous antibiotics within 3 h of birth, and all had cerebrospinal fluid (CSF) cultures obtained. In a multivariate model we found a significant association between neonatal mortality and birthweight (P = .01). The other significant associations were with positive CSF cultures (P = .01) and intrapartum invasive fetal scalp electrode monitoring (P = .03). After controlling for these and other variables in the model, the odds of death for the infants with scalp electrode monitoring was 8 times greater (95% CI = 1.1,56), compared to those who had the GBS septicemia but no intrapartum fetal scalp electrode monitoring. In conclusion, the association we found between neonatal fatality from early GBS septicemia and invasive fetal scalp electrode monitoring is plausible and needs further study.

Analysis of Variance↗
PubMedDate not supplied

Autoschizis of human ovarian carcinoma cells: scanning electron and light microscopy of a new cell death induced by sodium ascorbate: menadione treatment.

Human ovarian carcinoma (MDAH 2774) cells were treated with sodium ascorbate (VC), menadione (VK3), or a combination of both in a ratio 100:1 for 1h and then examined with scanning electron microscopy (SEM) and light microscopy (LM). Light microscopy data corroborated SEM observations, which demonstrated that death of VC+VK3-treated tumor cells occurred primarily by autoschizis. This type of cell death is characterized by a decrease in cell size, cytoplasmic self-excisions, and nuclear and nucleolar morphologic degradations without the formation of apoptotic bodies. Ultimately, cell death results from karyorrhexis and karyolysis. This study illustrates that plasma membrane damage (branching filopodia, blisters, blebs) results from VC treatment; cytoskeletal damage and self-morsellation are caused by VC, VK3 and VC+VK, treatments. The VC treatment results in a 23% decrease in cell diameter while VK3-treated cells decrease cell diameter by 66%. After 1h of VC+VK3 treatment, a heterogenous cell population is found. This population can be resolved into one population whose diameters are 23% smaller than those of sham-treated cells, and a second population whose diameters are approximately twice those of sham-treated cells. This second population is indicative of doublet formation in which the cells appear to be dividing (an early stage of autoschizic cell death). One half of the doublet contains the cell nucleus while the other half consists of cytoplasm and membrane only. The enucleate portion of this doublet will then be excised. When the types of cell death are enumerated following VC+VK3 treatment, 43% of the cells die by autoschizis, 3% by apoptosis, and 1.9% by oncosis. These results confirm that autoschizis is the principal form of cell death that results from the in vitro treatment of human ovarian carcinoma cells with the vitamin combination.

Adenocarcinoma↗
PubMedDate not supplied

Obesity management in primary care: assessment of readiness to change among 284 family practice patients.

BACKGROUND: Most adults in primary care are overweight or obese; two thirds of patients with weight problems have other obesity-related conditions. The study objective was to explore the feasibility of a primary care obesity intervention based on the transtheoretical model (TM) of behavior change and principles of chronic disease (CD) care. METHODS: A prospective study of the initial version of the TM-CD intervention with obese family practice patients (n = 284) yielded cross-sectional data on baseline stage of change for six target behaviors: dietary fat, portion control, vegetable intake, fruit intake, usual physical activity, and planned exercise. The sample consisted of obese patients scheduled for an office visit during times when recruitment and informed consent did not conflict with acute care. RESULTS: Obese patients volunteering for a TM-CD program are in different stages of change for six target behaviors. Preparation was the most frequently reported stage for increased exercise (49%) or activity (34%), decreased dietary fat consumption (44%), and increased portion control (51%). Patients in a particular stage for one behavior were distributed across all five stages for another behavior. Stage of change for five target behaviors was associated with body mass index or waist girth (P < .05) in a manner consistent with stage-of-change theory. CONCLUSIONS: Using the transtheoretical model of behavior change will allow physicians to recognize when obese patients are receptive to specific behavioral interventions.

Adult↗
PubMedDate not supplied

Dialysis leg cramps. Efficacy of quinine versus vitamin E.

A controlled randomized double-blind study was done to determine the frequency and severity of leg cramps in 40 patients on dialysis with a history of leg cramps. All patients entered a 2 month placebo washout and were randomized into a 2 month double-dummy phase of quinine 325 mg at bedtime versus vitamin E 400 IU at bedtime. Of the 29 patients completing the study, 16 received quinine and 13 vitamin E. During placebo washout, the vitamin E group had a mean of 10.4 leg cramps per month, and the quinine group had a mean of 10.9. The vitamin E and quinine groups had a 1 month reduction in leg cramps to 3.3 and 3.6, respectively (p < 0.0005 for both groups combined); this was sustained at 2 months. A severity of pain index showed a statistically significant decrease for both groups. The 95% confidence interval for the difference between the number of leg cramps after vitamin E versus quinine treatment (95% confidence interval, -3.8, +3.2) suggests similar efficacy. Quinine and vitamin E were effective treatments for leg cramps in these patients. Considering the potential toxicity of quinine, vitamin E is recommended as the initial treatment of choice for patients on dialysis with leg cramps.

Adult↗
PubMedDate not supplied

End of life issues in ESRD. A study of three decision variables that affect patient attitudes.

The substantial end-stage renal disease (ESRD) mortality rate reflects an older population, worsening comorbidity, and increased cardiovascular disease. Advance directives in ESRD may simplify issues such as cardiopulmonary resuscitation (CPR) and dialysis discontinuation. However, ESRD patients with advance directives may change their mind or allow surrogate leeway for override of end-of-life decisions. Three decision variables (requesting CPR, discontinuation of dialysis with depression, or discontinuation with dementia) were studied in 141 ESRD patients through a 47 item questionnaire. Duration of dialysis (> or = 4 years) (P = 0.002) and prior CPR experience (P = 0.02) increased the probability of refusing CPR by 12 times. The use of surrogates and substituted judgement for dialysis discontinuation with depression was more likely in women (P = 0.0006) and in patients with higher levels of education (P = 0.003). The odds of deciding to discontinue given dementia were three times greater for hemodialysis than peritoneal dialysis patients (P = 0.03). Eighty-three percent of the patients requested that physicians periodically check with them to determine if their advance directives had changed. The authors conclude that advance directives may assist ESRD patients, families, and staff with end-of-life decisions. Three end-of-life decision variables are significantly affected by duration and type of dialysis, previous CPR, gender, and level of education.

Adult↗