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Biomedical subjects

J Haddad

Publications and source records attributed to J Haddad.

At least 55 records · Page 3Linked to original sources
PubMed1997

Hydrogen peroxide in acute otitis media in guinea pigs.

Evidence has emerged that oxygen free radicals contribute to middle-ear mucosa damage in acute otitis media (AOM). Streptococcus pneumoniae is the most common pathogen in AOM and produces hydrogen peroxide, a free radical intermediate, as it grows. To better characterize the mechanism of free radical damage in AOM, an experiment was conducted to examine the production of hydrogen peroxide. Thirty-two guinea pigs were injected transtympanically with bacteria in the left (infected) middle ear and sterile saline into the right (control) middle ear. Middle-ear fluid was removed and analyzed for quantity of hydrogen peroxide. Results indicated significantly greater hydrogen peroxide levels in infected versus control middle-ear fluid at 6, 12, and 24 h. Likely sources of hydrogen peroxide include both the neutrophil response to infection and pneumococcal growth and death.

Animals↗
PubMed1997

Eosinophilic granuloma of the clivus: case report, follow-up of two previously reported cases, and review of the literature on cranial base eosinophilic granuloma.

OBJECTIVE AND IMPORTANCE: To our knowledge, this is the first reported case of the use of stereotactic radiotherapy for an eosinophilic granuloma (EG) of the clivus. We report follow-up information on two previously reported cases and suggest a management plan for this rare lesion. CLINICAL PRESENTATION: We report the case of a 4.5-year-old boy who presented with a complete abducens palsy on the right with an associated head turn. A computed tomographic scan of his head revealed a lytic lesion on that side, and magnetic resonance imaging showed the mass to be of low intensity on T1-weighted images and of high intensity on T2-weighted images with heterogeneous enhancement. INTERVENTION: A transnasal stereotactic biopsy was performed, revealing an EG. The patient was treated with stereotactic radiotherapy, and he became symptom-free with radiographic resolution of his lesion. Reviewing the literature, we found 13 series with 87 cases of EG in the petrous portion of the temporal bone. EG in the cranial base occurring outside of the temporal bone or in the temporal bone and extending intracranially is, however, quite rare, with only nine other cases reported, two of them clival. CONCLUSION: These findings suggest a classification schema in which cranial base EG lesions be grouped with either the more common extracranial petrous temporal bone lesions or the very rare intracranial lesions. Although there are few cases in the literature, treatment results indicate that clival EG, and perhaps all intracranial cranial base EGs, be treated by a biopsy alone, followed by surgery or stereotactic radiotherapy if there is an incomplete resolution of the symptoms or if there is a recurrence.

Child, Preschool↗
PubMed1996

Health status response of rheumatoid arthritis to treatment with DAB486IL-2.

OBJECTIVE: To examine and compare health status and disease activity changes in patients with rheumatoid arthritis (RA) in a clinical trial of the biologic agent DAB486IL-2. METHODS: Data on 45 patients with RA who were enrolled in a multicourse, double-blind trial, consisting of a first, placebo-controlled, course followed by open-label treatment with the active agent to a total of 3 active courses, were examined for evidence of improvement in health status (measured using the 5 components of the Arthritis Impact Measurement Scales 2 [AIMS2]) and disease activity (measured using standard clinical measures and erythrocyte sedimentation rate). RESULTS: Over a single course of treatment, DAB486IL-2-treated patients showed significant improvement relative to placebo-treated patients on the symptom and social components of AIMS2 and in patient's assessment of disease activity. With subsequent open-label courses of treatment with DAB486IL-2, all 5 AIMS2 health status components and the disease activity measures of tender and swollen joint counts, grip strength, and the observer and patient assessments showed steady and generally parallel improvement. CONCLUSION: Short-term health status effects of this biologic agent were detected using the AIMS2.

Activities of Daily Living↗
PubMed1996

Middle ear catalase distribution in an animal model of otitis media.

Increasing evidence implicates free radicals in the pathogenesis of inflammatory disease, including otitis media. The anti-oxidant enzymes catalase, glutathione peroxidase and superoxide dismutase protect tissues from the destructive effects of free radicals. Our previous work has shown depressed levels of superoxide dismutase in the infected middle ears of a guinea pig model of otitis media in comparison with normal control ears. We studied the distribution and relative abundance of catalase in the middle ear of this animal model in an effort to elucidate the role free radicals play in the pathogenesis of otitis media. Catalase distribution was mapped immunohistochemically in the middle ears of guinea pigs with induced streptococcus otitis media, and compared with normal control ears. In the control ears, catalase was localized to the epithelium of the middle ear mucosa, with scant distribution in the submucosa. The infected ears demonstrated inflammatory cell invasion with hyperemia and submucosal edema. Catalase was localized to the epithelium and had scant distribution in the submucosa. This distribution was similar to that found previously with superoxide dismutase. Enzyme-linked immunosorbent assay of catalase demonstrated a mean value of 1.00 +/- 0.06 microgram/mg protein in the control ears, and 1.06 +/- 0.12 microgram/mg in the infected ears, but these two values were not statistically different.

Acute Disease↗
PubMed1996

[Complete heart block after percutaneous mitral valvotomy with Inoue balloon].

We report a permanent complete heart block, in a 27 year-old female patient, developed during mitral percutaneous valvotomy using a single inflation of the Inoue balloon catheter. After one month, even using corticoids, a Mobitz II second-degree atrioventricular block persisted, the patient became symptomatic to moderate efforts and a cardiac pacemaker was implanted.

Adult↗
PubMed1996

[Atrial septal defect percutaneous transvenous occlusion with the buttoned device].

PURPOSE: To analyse the experience with the use of Sideris' device for percutaneous transvenous occlusion of atrial septal defect (ASD). METHODS: Thirty six procedures of ASD occlusion were performed in 32 patients; 27 (84.4%) female and five (15.6%) male, mean age of 16 years (4-61). All patients had secundum atrial septal defects with clinical and hemodynamic compromise. The ASD diameter measured < 31 mm and occupied less than 50% of the septal length in all cases. The basic device was used in 28 (87.5%) patients and the self centered model in four (12.5%). The direct implant technique was employed in 15 (41.7%) procedures while in the other 21 (58.3%) an over a wire technique was used. The size of the device was selected according with the Sideris' normogram. RESULTS: Occlusion of the defect was achieved in 29 patients (90.63%). In two (6.25%) the position of the device was not adequate and in one (3.12%) the device embolized to the pulmonary artery. In these three cases the device was removed surgically during the defect closure. There was neither morbidity nor mortality in this series. Trivial or small residual shunt was detected with color flow mapping in three (9.4%) patients immediately after the procedure. In 22 patients with 12 months follow-up, trivial residual shunt was present in only one (4.5%). Structural modification of the device was detected in one patient, however with complete ASD occlusion and neither clinical nor hemodynamic disturbance. CONCLUSION: The Sideris' device is safe and efficient for ASD occlusion in selected patients. Although there is a relatively high incidence of residual shunt immediately after the procedure, the shunt itself tends to become smaller or disappear during the follow-up and it does not preclude clinical and hemodynamic improvement.

Adolescent↗
PubMed1995

Superoxide dismutase in an animal model of otitis media.

Cu, Zn superoxide dismutase (SOD) is a metalloprotein that catalyzes the dismutation of the superoxide anion into O2- and H2O2, and therefore functions to maintain a low intracellular concentration of an otherwise toxic metabolite of oxygen. SOD protects living tissue from the destructive effects of free radicals. Increasing evidence implicates free radicals, including the superoxide radical (O2-), in the pathogenesis of disease, including otitis media. In an effort to elucidate the role free radicals play in the pathogenesis of otitis media, SOD was localized immunocytochemically to determine its cellular distribution in specimens of guinea pig middle ear. In normal ears, SOD was found concentrated in the epithelium of the middle ear mucosa. Low quantities were characteristic of connective tissue, bone, and cartilage. In streptococcus-infected ears, SOD localized similarly, concentrating in the epithelium. The infected ears had extensive submucosal edema which stained poorly and appeared to have less SOD than did normal ears. This was confirmed by an assay using laser densitometry of Western blots to quantify the amount of SOD in the mucosa of normal versus infected middle ears. This demonstrated a value of SOD in normal mucosa of 1.77 +/- 0.48 micrograms/mg of protein compared with 1.02 +/- 0.28 micrograms/mg in the infected mucosa. The two groups were significantly different at P < 0.05. These findings are discussed, and suggestions for future experimentation addressed.

Acute Disease↗
PubMed1995

Heat shock proteins in acute otitis media.

Heat shock proteins (hsps) are essential for the survival of cells under an environmental insult. To elucidate the relationship between these intracellular proteins and acute otitis media (AOM), the authors studied hsp production in guinea pigs with AOM induced by inoculation of Streptococcus pneumoniae into the middle ear. Animals were sacrificed 1, 3, or 5 days after inoculation. Immunocytochemical study showed localization of hsp70 within the epithelium of infected ears, while the normal control epithelium showed very light staining. Western blot tests of the mucosal extraction confirmed the presence of hsp70 in otitis media. Enzyme-linked immunosorbent assay (ELISA) showed that hsp levels were higher in the infected mucosa than in the normal control mucosa. In contrast, hsp60 was not stimulated in infected ears. This study showed that hsp70, and not hsp60, was produced in the AOM model.

Acute Disease↗
PubMed1995

Head and neck infections in pediatric cardiac transplant patients.

A retrospective chart review was undertaken at Columbia Presbyterian Medical Center to assess the incidence, etiology and management of head and neck infections in pediatric cardiac transplant patients on immunosuppression. From June 1984 to February 1992, 59 cardiac transplants were performed on 57 pediatric patients. Standard immunosuppressive therapy was used. Thirteen of these patients died within three months of transplant and were not included. Of the 44 patient charts reviewed, 82 head and neck infections were documented in 27 patients (61%). There were 26 episodes of sinusitis, 27 episodes of otitis media and 20 episodes of tonsillitis/pharyngitis. Unusual middle-ear pathogens seen included Morganella morgagni and Pseudomonas aeruginosa. These preliminary data suggest that children on immunosuppression for cardiac transplant may be at risk for head and neck infections from unusual or unsuspected organisms, and tympanocentesis plays an important role in diagnosis and treatment. A prospective study is planned to gain further data.

Adolescent↗
PubMed1994

Fetal arachnoid cyst: report of two cases.

Two new cases of antenatal diagnosis of arachnoid cyst are described. Diagnosis was made at 2.5 and 32 weeks' gestational age. In the first case, a slight increase in the diameter of the anechoic mass was observed in the second trimester. In the second case, ventricular dilatation was present prenatally. Appropriate surgical therapy was initiated at 2 months in the first case and at 8 days in the second and the neurological development of the two children is considered as normal at 18 months of age. Major features of in utero diagnosis, treatment and follow-up are discussed.

Journal Article↗
PubMed1994

Ear disease in children with cystic fibrosis.

OBJECTIVE: To assess otitis media in children with cystic fibrosis. DESIGN: Prospective prevalence survey. SETTING: Otolaryngology and cystic fibrosis/pulmonology outpatient clinics, Children's Hospital of Pittsburgh (Pa), a regional referral center. PATIENTS: Seventy patients, aged 4 months to 17 years, with documented cystic fibrosis who presented to the cystic fibrosis/pulmonary clinic with scheduled appointments were asked to volunteer for the study. The 70 patients recruited represent approximately one fourth of the children younger than 17 years with cystic fibrosis who were followed up by the cystic fibrosis/pulmonary clinic. INTERVENTION: Ear, nose, and throat examination including pneumatic otoscopy, with tympanometry when indicated; relevant history taking. MAIN OUTCOME MEASURE: Presence or absence of otitis media. RESULTS: Seven (10%) of the 70 patients had unilateral or bilateral otitis media. CONCLUSIONS: Children with cystic fibrosis have a low prevalence of otitis media compared with normal children.

Acute Disease↗
PubMed1994

Progressive sensorineural hearing loss (SNHL) and peripheral neuropathy: a case report.

Sensorineural hearing loss (SNHL) is infrequently associated with peripheral neuropathy. When co-existent with peripheral neuropathy, it tends to present in the early adult years, is slowly progressive and is accompanied by optic atrophy or bowel abnormalities. The following case presents an unusual patient with severe and rapidly progressive SNHL and peripheral neuropathy.

Audiometry↗