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Biomedical subjects

E Hanna

Publications and source records attributed to E Hanna.

52 records · Page 3Linked to original sources
PubMed1994

Prevention and Treatment of Hypertension Study (PATHS). Rationale and design.

Alcohol consumption has been recognized as an important correlate of blood pressure in many epidemiologic studies, but few interventional studies have been conducted to examine the effect of a reduction in alcohol intake on blood pressure. Because these studies have usually included few subjects and been of short duration, the National Heart, Lung, and Blood Institute (NHLBI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the Veterans Affairs (VA) Cooperative Studies Program have initiated a randomized, controlled, multicenter trial to determine whether blood pressure and left ventricular mass are lowered over 6 months of alcohol moderation in non-dependent moderate to heavy drinkers (three or more drinks per day average but not alcohol dependent) with above-average normal (80 to 89 mm Hg) and mildly hypertensive (90 to 99 mm Hg) levels of diastolic blood pressure, and whether a reduction in alcohol intake can be maintained for 2 years. Eligible veterans are randomized to either an alcohol reduction intervention or a control observation group at seven clinical sites. The projected sample size is 580 participants. Alcohol intake is assessed by self-report using a retrospective diary (Chronological Drinking Record) and by various biochemical markers, including apolipoproteins, HDL cholesterol (and subfractions), and carbohydrate deficient transferrin, analyzed at a central laboratory. The alcohol intervention technique is a cognitive-behavioral program, the intensive phase of which consists of six counseling sessions over 3 months. Echocardiograms are obtained at baseline and 6 months after randomization. This trial has important implications for both the prevention and treatment of hypertension.

Adult↗
PubMed1993

Competency assessment of primary care physicians as part of a peer review program.

OBJECTIVE: To design and test a program that assesses clinical competence as a second stage in a peer review process and to determine the program's reliability. DESIGN AND SETTING: A three-cohort study of Ontario primary care physicians. PARTICIPANTS: Reference physicians (n = 26) randomly drawn from the Hamilton, Ontario, area; volunteer, self-referred physicians (n = 20); and physicians referred by the licensing body (n = 37) as a result of a disciplinary hearing or peer review. MAIN OUTCOME MEASURES: Standardized patients, structured oral examinations, chart-stimulated recall, objective structured clinical examination, and multiple-choice examination. RESULTS: Test reliability was high, ranging from 0.73 to 0.91, and all tests discriminated among subgroups. Demographic variables relating to the final category were age, Canadian or foreign graduates, and whether or not participants were certified in family medicine. CONCLUSIONS: The study demonstrated the feasibility, reliability, and validity of a multicomponent examination in the peer review process.

Adult↗
PubMed1993

Sex discrimination: how do we tell the difference between male and female faces?

People are remarkably accurate (approaching ceiling) at deciding whether faces are male or female, even when cues from hair style, makeup, and facial hair are minimised. Experiments designed to explore the perceptual basis of our ability to categorise the sex of faces are reported. Subjects were considerably less accurate when asked to judge the sex of three-dimensional (3-D) representations of faces obtained by laser-scanning, compared with a condition where photographs were taken with hair concealed and eyes closed. This suggests that cues from features such as eyebrows, and skin texture, play an important role in decision-making. Performance with the laser-scanned heads remained quite high with 3/4-view faces, where the 3-D shape of the face should be easiest to see, suggesting that the 3-D structure of the face is a further source of information contributing to the classification of its sex. Performance at judging the sex from photographs (with hair concealed) was disrupted if the photographs were inverted, which implies that the superficial cues contributing to the decision are not processed in a purely 'local' way. Performance was also disrupted if the faces were shown in photographic negatives, which is consistent with the use of 3-D information, since negation probably operates by disrupting the computation of shape from shading. In 3-D, the 'average' male face differs from the 'average' female face by having a more protuberant nose/brow and more prominent chin/jaw. The effects of manipulating the shapes of the noses and chins of the laser-scanned heads were assessed and significant effects of such manipulations on the apparent masculinity or femininity of the heads were revealed. It appears that our ability to make this most basic of facial categorisations may be multiply determined by a combination of 2-D, 3-D, and textural cues and their interrelationships.

Adolescent↗
PubMed1993

Laser welding of fascial grafts and its potential application in tympanoplasty: an animal model.

This study evaluates the welding effect of argon laser on fascial grafts and its potential application in tympanoplasty. An animal model was designed so that surgically induced perforations of the lumbar fascia of the animals were grafted in an underlay fashion. Each graft was "spot welded" around the circumference of the perforation using a hand-held argon laser. Various lasing parameters were used on different grafts. Control perforations were grafted but not welded. A total of 96 perforations was studied. Weld sites were evaluated both histologically and by tensile strength measurement at the end of surgery, and at 7, 14, and 21 days postoperatively. Comparison with controls showed a higher tensile strength for welded grafts, which was most significant in the early postoperative period (p < 0.001). Histologically, it seems that the basic mechanism of fascial welding involves liquification and denaturation of extravasated proteins at the weld sites. Correlation between the extent of thermal damage on the tissues and the various lasing parameters is described. Based on the well-documented safety of argon laser in otologic surgery, and the successful welding of fascial grafts in this study, argon laser may prove beneficial in welding temporalis fascia grafts in tympanoplasty.

Animals↗
PubMed1992

Dying to be equal: women, alcohol, and cardiovascular disease.

This data note explores the relationship of gender, alcohol consumption and premature death from cardiovascular disease (MCVD). Data on the 8164 deaths attributed to MCVD from the National Mortality Followback Study (NMFS) were analyzed controlling for gender and consumption. Women who are heavy drinkers die young at a rate equal to that of men who drink heavily. In light of this, we recommend that future research and preventive efforts in this area include females as subjects and alcohol as a major risk factor.

Adult↗
PubMed1986

T cell lines mediating experimental autoimmune uveoretinitis (EAU) in the rat.

Long-term S-antigen (S-Ag)-specific T lymphocyte lines were derived from the lymph nodes of immunized Lewis rats that had been pretreated with low-dose cyclophosphamide. The protocol consisted of functional selection by alternating cycles of stimulation with S-Ag presented on syngeneic accessory cells and proliferation in IL 2-containing spleen-conditioned medium, coupled with early phenotypic selection for cells bearing the helper/inducer membrane marker (W3/25), by panning on antibody-coated plastic dishes. This protocol consistently resulted in the rapid generation of in vivo functional cell lines capable of mediating experimental autoimmune uveoretinitis (EAU) when transferred into naive rats at 5 to 10 X 10(6) cells/rat systemically or 1 to 2 X 10(6) cells/rat intravitreally. The disease appeared within 6 to 8 days, usually with minimal anterior chamber involvement, and was often unilateral. Pathologic changes resembled those seen in EAU induced by active immunization. The disease could be transferred without concomitant formation of serum antibodies. The uveitogenic line cells were negative for Ia antigen and positive for the W3/25 membrane marker, which appeared to be stable in long-term culture. They proliferated vigorously in vitro and produced IL 2 in response to S-Ag or Con A, but not to unrelated antigens. The establishment of uveitogenic T helper lymphocyte lines will permit the analysis of the cellular mechanisms involved in EAU in a more defined system than has been available.

Animals↗
PubMedDate not supplied

Squamous cell carcinoma in a thyroglossal duct cyst (TGDC): clinical presentation, diagnosis, and management.

Squamous cell carcinoma arising in a TGDC is a rare event, and a high index of suspicion is therefore needed for reaching a correct preoperative diagnosis to plan adequate therapy. The work-up should include fine needle aspiration cytology and high-resolution CT scan. The recommended therapy is adequate wide resection with frozen section control of the surgical margins. For localized lesions within the TGDC (diagnosed as an incidental histological finding), the Sistrunk operation is adequate. If, however, the tumor invades surrounding structures, wider resections (which may include strap muscles, thyroid, larynx, or base of tongue) are recommended. Neck dissection is reserved for cases with nodal metastasis. There is no role for prophylactic neck dissections except perhaps for the paratracheal nodes. Postoperative radiation therapy is recommended for larger lesions, positive surgical margins, or extensive nodal disease. Strict follow-up is recommended for prolonged periods of time, because local recurrences are common and could occur many years after the initial treatment.

Adult↗
PubMedDate not supplied

Acute intravaginal misoprostol toxicity with fetal demise.

We report a case of an overdose with fetal demise from the intravaginal administration of misoprostol. A 25-yr-old gravid female self-administered 6000 micrograms misoprostol intravaginally and 600 micrograms orally. She rapidly developed shaking chills, abdominal and extremity cramping, emesis, and confusion. Hyperthermia and hypotension developed within 3.5 h after drug administration, with a temperature of 41.4 degrees C (106 degrees F). Ultrasound at 3.5 h after drug administration showed no fetal movement or heart motion. A nonviable fetus was delivered by emergent cesarean section. Treatment of the mother was supportive and included intravaginal decontamination and endotracheal intubation with neuroparalytic therapy to control agitation and hyperthermia. Recovery was complete within 15 h of drug administration.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

Genetic deletions of glutathione-S-transferase as a risk factor in squamous cell carcinoma of the larynx: a preliminary report.

PURPOSE: To test whether genetic deletions of glutathione-S-transferase (GST) are associated with squamous cell carcinoma (SCC) of the larynx. GST are a group of detoxifying enzymes that may help reduce the risk of developing cancer in response to environmental carcinogens. Polycyclic aromatic hydrocarbons, found in high concentration in cigarette smoke, are known carcinogens especially for SCC of the larynx. Individuals with absolute or relative deficiency of the GST enzyme system may therefore be at a higher risk of developing laryngeal carcinoma. MATERIALS AND METHODS: Genotyping for GST-M1 and GST-T1 was performed using polymerase chain reaction (PCR) assay on fresh frozen tissue specimens of 20 patients with SCC of the larynx and on 20 control subjects with a similar smoking history. Because this assay results in the absence of a PCR product in individuals expressing the GST-M1/GST-T1 null genotype, oligonucleotide primers that amplify a portion of the albumin gene were included in a multiplex PCR as a positive control for DNA quality and PCR conditions. The chi-square test was used for statistical analysis. RESULTS: GST-M1 gene was deleted in 80% of patients with laryngeal SCC and in 50% of control subjects (P <.05). No statistically significant difference was observed in the incidence of GST-T1 gene deletion in patients with SCC of the larynx and control subjects. CONCLUSION: GST-M1 gene deletion was significantly associated with SCC of the larynx and may produce a risk for this particular disease.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Is glutathione-S-transferase-pi expression a reliable predictor of chemoradiation response in cancer of the head and neck?

PURPOSE: Concurrent radiation and chemotherapy is being evaluated as an alternative treatment to surgery for patients with advanced squamous cell carcinoma of the head and neck, because organ preservation maybe possible without compromising survival. However, the response to concurrent chemoradiation treatment varies from patient to patient, and there is currently no available molecular predictor of response for this particular treatment modality. There is some evidence to indicate that glutathione S-transferase-pi (GST-pi), which is one of the drug detoxifying enzymes, may decrease the effectiveness of platinum-based chemotherapy in the treatment of a variety of tumor types. This study was performed to investigate whether GST-pi expression was correlated with response to concurrent chemotherapy and radiotherapy in patients with advanced squamous cell carcinoma of the head and neck. MATERIALS AND METHODS: Diagnostic biopsy specimens of 36 patients who underwent concurrent chemoradiotherapy for the treatment of advanced squamous cell carcinoma of the head and neck were examined for GST-pi expression by using immunohistochemistry with polyclonal antihuman GST-pi antibodies. GST-pi expression scores were compared among responders and nonresponders. RESULTS: Although the staining rate with antiGST-pi was slightly lower in the responder group in comparison with the nonresponders (82% vs 100%), the difference was not statistically significant. CONCLUSION: GST-pi expression is unlikely to be a valuable predictor of response to concurrent chemotherapy and radiation treatment in patients with advanced squamous cell carcinoma of the head and neck.

Adult↗