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Biomedical subjects

J Haddad

Publications and source records attributed to J Haddad.

At least 127 records · Page 7Linked to original sources
PubMed1986

[Education development in health. Perspectives for the year 2000].

There are three aspects to the development of education in the health field: revision of the role of personnel, improvement of training schemes, and more efficient use of personnel. Since the setting of the goal of Health for All by the Year 2000, the world economic crisis has emerged as a new factor of analysis that opens up fresh prospects and points to alternative measures for the development of education in the health field. These prospects are the formulation of manpower planning and health personnel research policies; continuing education, which implies a redefinition of the role of teaching and service staffs; the integration of teaching and service; a search for an education methodology that encourages in-service learning; the monitoring and follow-up of the education process, and specific research on the relationship between manpower training and the labor market.

Developing Countries↗
PubMed1985

Mineral homeostasis in very premature infants: serial evaluation of serum 25-hydroxyvitamin D, serum minerals, and bone mineralization.

This study was designed to evaluate the role of vitamin D sufficiency, as reflected in serum 25-hydroxyvitamin D (25-OHD) concentrations, on serum minerals and bone mineralization in very premature infants. Seventy-two infants (mean +/- SD gestation 30.1 +/- 2.5 weeks, mean +/- SD birth weight 1178 +/- 278 gm) were observed serially for the first 3 months of life. Mean serum calcium and phosphorus values, but not magnesium, remained low prior to 12 weeks. The percentage of infants with moderate to severe hypomineralization was 75% at 3 weeks, 55% at 6 weeks, 54% at 9 weeks, and 15% at twelve weeks. Low serum calcium and phosphorus values, high alkaline phosphatase activity, and moderate-severe hypomineralization were more frequent in infants weighing less than 1000 gm and in those with lower mineral intake. With a 400 IU vitamin D supplement, 45% of infants could maintain an initially normal serum 25-OHD concentration or increase low concentrations, whereas 55% had falling or persistently low (less than or equal to 15 ng/ml) 25-OHD concentrations. Birth weight and mineral intakes were comparable in these two groups, yet the group with the lower serum 25-OHD concentration had lower serum calcium and higher alkaline phosphatase values, and a higher percentage of moderate to severe hypomineralization. Regardless of birth weight, mineral intake, or 25-OHD concentration, increases in serum calcium and phosphorus values and in mineralization were seen at postconception term (12 weeks in most infants, nine weeks in those weighing 1250 to 1600 gm). At 12 weeks of age, but not before, serum 25-OHD concentration was directly correlated with serum calcium (r = 0.47, P less than 0.01) and serum phosphorus (r = 0.47, P less than 0.01) and inversely correlated with alkaline phosphatase values (r = -0.71, P less than 0.01). Mineral availability and 25-OHD sufficiency both appear to be important and to act synergistically, with neither totally compensating for the other.

Alkaline Phosphatase↗
PubMed1985

Absorption, dosage, and effect on mineral homeostasis of 25-hydroxycholecalciferol in premature infants: comparison with 400 and 800 IU vitamin D2 supplementation.

Because the efficiency of vitamin D absorption or hepatic uptake and 25-hydroxylation appears decreased in very premature infants, the routine use of 25-hydroxycholecalciferol (25-OHD3) supplementation has been suggested. Absorption studies of a 3 micrograms/kg orally administered dose of 25-OHD3 showed peak serum 25-hydroxyvitamin D2 and -vitamin D3 (25-OHD) concentrations at 4 to 8 hours similar in timing but of lesser magnitude to those seen in adults. Administration of 1 microgram/kg birth weight/day of 25-OHD3 corrected moderately low, but not very low serum (25-OHD) concentrations, and 2 micrograms/kg BW/day resulted in rapid and sustained increase in serum 25-OHD. Administration of 800 IU ergocalciferol (D2) also produced significantly higher serum 25-OHD concentrations than those in infants given 400 IU vitamin D2, but increases in serum 25-OHD were more gradual than in infants given 25-OHD3. In treatment trials with infants weighing less than 1500 gm, those given 800 IU D2, compared with those given 400 IU D2, had higher serum calcium concentrations and less frequent moderate or severe hypomineralization. Infants given 2 micrograms/kg BW 25-OHD3 had a significant increase in serum phosphorus values, but a decrease in serum calcium and magnesium concentrations, and parathyroid hormone also was suppressed to low normal values. The frequency of moderate to severe hypomineralization remained the same as in infants given 400 IU D2. In a subgroup of infants, serum 1,25-dihydroxyvitamin D was elevated over adult values, both in infants given 25-OHD3 (68.5 +/- 8.4 pg/ml) and in infants given vitamin D2 (60 +/- 6.7 pg/ml). Serum vitamin D concentrations were undetectable in four of six infants receiving 25-OHD3, but were elevated (5 to 31 ng/ml) in four infants receiving vitamin D2. Although 800 to 1000 IU D2 can be recommended as routine vitamin D supplementation in very premature infants fed standard formula, the use of 25-OHD3 requires further study.

Absorption↗
PubMed1984

[Politics of human health resources: a proposal for their formation].

This article is an account of almost two years of experience in manpower policy. The authors worked together in the Central American area, one in an international cooperation agency and the other as a local official who also worked at the international level. The circumstances that have generated interest in work of this kind are examined, considerations are advanced on the framing of a definition of "policy" in relation to this particular problem, and a policy structure is proposed on the basis of elements grouped as homogeneously as possible. On the basis of the experience of three countries, the elements are determined that can be involved in the process of working out a manpower policy. A detailed description is then given of the model generated in the Community Health Training Program for Central America and Panama (PASCCAP) for the formulation and promulgation of a policy, and of the first results obtained in the Central American Area.

Central America↗
PubMed1983

[Training of personnel for the goal of health for all in the year 2000 and primary care strategy: a methodologic proposal].

As a result of health-related resolutions at world and regional level, the training of personnel to implement health activities has become a major factor in meeting the commitments assumed by the countries. The authors describe an alternative training methodology, beginning with an analysis of the problems to be addressed and setting forth some fundamental factors and basic premises to be considered as a prior step in the planning and execution of training activities. The need to fit the training to the particular functions and characteristics of the various staff levels is stressed, with special emphasis on the desirability of building the training around actual jobs and adapting it to the specific nature and characteristics of service in the national context of each country. It is important that this training be perceived as a continuous, ongoing process. With this in view, the authors suggest a number of ways of furthering the training of adults involved in the process, using these approaches as alternatives to the traditional modes, which are based on courses and seminars with a predetermined duration and accordingly create the impression that the education ends when the required number of hours and activities in the course have been completed. The ideas and opinions expressed in this article are validated at the end by a preliminary report on an experiment begun by the Community Health Training Program of Central America and Panama (PASCCAP), a joint activity of the Ministries of Health of the six area countries, that serves as a training facility of the Pan American Health Organization. Subsequent phases of the process will be the subject of later reports.

Curriculum↗
PubMed1982

Extraction of vitamin D metabolites by bones of normal adult dogs.

Using the isolated perfused canine tibia we examined the extraction of [(3)H]25(OH)D(3), [(3)H]1,25(OH)(2)D(3) and [(3)H]24,25(OH)(2)D(3) by bone of normal adult dogs. The studies were performed with and without vitamin D binding protein (DBP) in the perfusate to examine the effect of protein binding on the extraction of the vitamin D metabolites. An average of 48+/-2% of [(3)H]25(OH)D(3) was extracted by bone, when no DBP was present. However, addition of only a small amount of DBP ( approximately 720 ng/ml of perfusate) nearly completely abolished the extraction of [(3)H]25(OH)D(3) by bone. No degradation and/or transformation of the labeled 25(OH)D(3) could be demonstrated during passage through the isolated perfused bone. The extraction of [(3)H]24,25(OH)(2)D(3) in a DBP-free medium averaged 33+/-5%. Addition of 720 ng of DBP/ml of perfusate completely inhibited the extraction of this metabolite. The extraction of [(3)H]1,25(OH)(2)D(3) averaged 30+/-3% in a DBP free medium and no inhibition of the extraction was demonstrated after addition of DBP (720 ng/ml of perfusate). However, addition of DBP in a concentration of 14.4 mug/ml of perfusate reduced the extraction of 1,25(OH)(2)D(3) to 8+/-2%, a value still significantly higher than that seen after addition of 20 times less DBP to perfusions with 25(OH)D(3) and 24,25(OH)(2)D(3). It is concluded that the isolated perfused bone of normal dogs can extract significant amounts of 25(OH)D(3), 1,25(OH)(2)D(3), and 24,25(OH)(2)D(3). Small concentrations of DBP (720 ng/ml) in the perfusate significantly inhibited the extraction of 25(OH)D(3) and 24,25(OH)(2)D(3). A carrier role for DBP is suggested and it is proposed that the levels of free vitamin D are important for extraction of the metabolites by bone. Therefore, due to the different affinities of DBP for the various metabolites of vitamin D, only 1,25(OH)(2)D(3) is extracted in vitro in significant amounts by bone of normal adult dogs, in the presence of DBP.

Animals↗
PubMed1982

[Current status of public health education in Central America and Panama].

The document relates the efforts made in the Central American countries over the last two decades to develop public health education programs in light of the demands of the Governments' health programs, including the proposal to set up a subregional public health school in one of these countries. They indicate the various activities carried out in this field, including the public health course given each year in CAP, with emphasis on nutrition and maternal and child care; the health administration course recently begun in Nicaragua to train hospital management teams, and the public health course for doctors in social service planned in 1981 by the Ministry of Health of Costa Rica and the support of the Community Health Training Program of Central America and Panama (PASCCAP). A description is given of the course model prepared by PASCCAP to train personnel for primary health care in light of the strategies adopted by the countries to achieve the goal of health for all by the year 2000. Two courses have already been given using the model, and two more will be offered in 1982.

Central America↗
PubMed1981

Control of mineral homeostasis during lactation: interrelationships of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, parathyroid hormone, calcitonin, prolactin, and estradiol.

To further define control of mineral homeostasis during lactation, 28 lactating (L) and 20 nonlactating (NL) women were studied at 6 weeks post partum. Serum and urine calcium, magnesium, and phosphorus were normal and the same in both groups. 25-Hydroxyvitamin D (25-OHD) was the same (L, 18.6 +/- 4.8; NL, 17.0 +/- 5 ng/ml) in spite of a twofold higher intake of vitamin D in the lactating group. The serum fractions containing 24,25-dihydroxyvitamin D (24,25(OH)2D) were lower than in nonpregnant adults in both groups but significantly lower (P less than 0.05) in lactating than in nonlactating women (L, 1.67 +/- 1.7; NL, 2.46 +/- 1.3 ng/ml). 1,25-Hydroxyvitamin D (1,25-(OH)2D) was normal in both groups (L, 25.8 +/- 8.6, NL, 31.8 +/- 8.1 pg/ml). Parathyroid hormone (PTH) was normal in both groups (L, 5.6 +/- 2.0; NL, 7.2 +/- 1.9 microliters Eq/ml), and calcitonin (HCT) was equally detectable. As expected, prolactin was higher in the lactating group (L, 46 +/- 36; NL, 14.3 +/- 14.9 ng/ml). Serum prolactin levels had no correlation with serum 1,25(OH)2D. Estradiol was significantly (P less than 0.02) lower in lactating women (L, 78 +/- 23; NL, 105 +/- 28 pg/ml). One could speculate that the lower levels of estradiol in the presence of low 24,25(OH)2D and normal HCT allow bone resorption to occur at a rate adequate to supply the mineral needs of lactation without elevations of either PTH or 1,25(OH)2D.

24,25-Dihydroxyvitamin D 3↗
PubMed1979

Serum concentrations of 25-hydroxyvitamin D in rickets of extremely premature infants.

Nine premature infants developed radiographic and biochemical rickets at a mean +/- SD of 12.6 +/- 2.8 weeks of age. Serum 25-hydroxyvitamin D concentrations were all low, with a mean of less than 3.6 +/- 2.1 ng/ml. The mean average daily intake of vitamin D since birth had been 300 +/- 181 IU, and the mean average daily intake during the week of diagnosis was 587 +/- 313 IU. All of the infants were extremely premature (mean weight 948 +/- 153 gm, mean gestation 27.7 +/- 1.1 weeks), and were being fed either a low-calcium "human milk-like" formula or a soy formula. It is postulated that low-calcium intake may have increased 25-OHD utilization in the face of a decreased ability of the extremely premature infant to produce 25-OHD. Because of multiple factors leading to both decreased production and possible increased utilization of 25-OHD, such infants have an increased requirement for vitamin D to maintain normal serum 25-OHD concentrations, and daily intakes of at least 400 IU vitamin D orally must be assured. Serum 25-OHD measurements and radiographs may be important in following infants at risk.

Humans↗
PubMed1979

[An assessment of caustic oesophageal burns in the child (author's transl)].

68 patients who might have had a caustic oesophageal burn were observed in the E.N.T. department of Enfants Malades Hospital between 1973 and 1977. We describe the causes, the age, the character of the burns analysed after systematic oesophagoscopy, and treatment. The results are studied taking into account the depth of the burn, the nature of the toxic agent and the therapeutic possibilities.

Adolescent↗
PubMed1979

[Nursing in the National Health Plan of Honduras].

After summarizing the health situation in Honduras and describing the National Health Plan launched in 1973, the authors explain the changes that have come about in nursing, the difficulties that had to be surmounted to reach a new professional position, and the administrative decisions that had to be taken to devise a health policy. An account is given of the changes made in the training of nursing staff and in the functions that staff must perform in the planning, implementation, and evaluation of the coverage extensive program. The article high-lights the role of the Nursing Division in the Ministry of Public Health and Social Welfare and the levels of coordination established with the other technical divisions and institutions responsible for the health personnel training. In closing, the article points out that the nursing sector represents the keystone of the model for the delivery of services to attain the goal of health for all by the year 2000.

Education, Nursing↗
PubMed1977

Phosphate control and 25-hydroxycholecalciferol administration in preventing experimental renal osteodystrophy in the dog.

Previous studies from this laboratory demonstrated that secondary hyperparathyroidism in dogs with chronic renal disease may occur, at least in part, as a consequence of the need for progressive adaptation in renal phosphorus (P) excretion that occurs as glomerular filtration rate falls. However, the studies were of relatively short duration. Moreover, no information emerged regarding a potential role of calcium malabsorption in the pathogenesis of secondary hyperparathyroidism. The short duration of the protocol did not lend itself to the study of the effect of P control or the administration of vitamin D in the pathogenesis of renal osteodystrophy. In the present studies, 14 dogs with experimental chronic renal disease were studied serially for a period of 2 yr. Each animal was studied first with two normal kidneys on an intake of P of 1,200 mg/day. Then, renal insufficiency was produced by 5/6 nephrectomy. The dogs then were divided into three groups. In group I, 1,200 mg/day P intake was administered for the full 2 yr. In group II, P intake was reduced from the initial 1,200 mg/day, in proportion to the measured fall in glomerular filtration rate, in an effort to obviate the renal adaptation in P excretion. In group III, "proportional reduction" of P intake also was employed; but in addition, 20 mug of 25(OH)D(3) were administered orally three times a week. In group I, parathyroid hormone (PTH) levels rose throughout the 2-yr period reaching a final concentration of 557+/-70 U (normal 10-60). In group II, values for PTH remained normal throughout the 1st yr, increased modestly between the 12th and the 18th mo, but then did not rise after the 18th mo. In group III, no elevation of PTH levels was observed at any time; however, these animals were hypercalcemic. Histomorphologic analyses of the ribs of these dogs were performed serially throughout the 2-yr period. A linear relationship was obtained between the osteoclastic resorption surface and the concentration of circulating immunoreactive PTH. The osteoid volume was greater in group I animals when compared to those in group II. None of the morphologic abnormalities associated with renal osteodystrophy were observed in the animals in the third group.

Animals↗
PubMed1975

[Action of acebutolol on heart rate and FEV1 in asthmatic patients. Single intravenous administration and long term oral administration].

In 7 asthmatic patients, intravenous injection of acebutolol resulted in a slowing of the heart rate by blocking the cardiac beta-receptors. An aerosol of isoprenaline, which accelerated the heart, is without effect after intravenous injection of acebutolol. On the contrary, isoprenaline caused similar changes in the FEV1 before and after acebutolol injection in the same patients. This effect confirms the slight action of the compound on the beta2-adrenergic receptors. Prolonged oral administration did not cause any adverse clinical effects in 6 asthmatic patients.

Acebutolol↗