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Biomedical subjects

L Hassan

Publications and source records attributed to L Hassan.

16 recordsLinked to original sources

Early postoperative response of cytokines in liver transplant recipients.

We evaluated the early postoperative response of several cytokines (IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma) prior to liver transplantation (T(0)) as well as 1, 6, and 12 hours and 1, 2, 3, 5, and 7 days afterward. Cytokine concentrations were correlated with serum levels of bilirubin as a predictor of postoperative complications. Cytokine levels were determined in plasma samples from 16 liver transplant recipients (13 men, 3 women) aged 43 to 61 years. IL-6 and IL-10 reached their maximum concentrations 1 hour after transplantation. Each increase in IL-6 correlated to a rise in IL-10. IL-2, IL-4, TNF-alpha, and IFN-gamma had a particular time-course for each patient studied. Bilirubin fell to almost normal values but not in cases of postoperative complications, where IL-6 showed values four times higher compared to those of liver transplant recipients who did not show postoperative complications. IL-6 and IL-10 plasma concentrations and serum bilirubin level might be useful as a predictive factor of postoperative complications in liver transplant recipients.

Adult↗

Time course of intraoperative cytokine levels in liver transplant recipients.

We evaluated the levels of several cytokines (interleukin [IL]-2, IL-4, IL-6, IL-10, tumor necrosis factor [TNF]-alpha, and interferon [IFN]-gamma) in plasma samples obtained before surgical intervention (T0) and during intraoperative liver transplantation: after induction of anesthesia (I-1), 15 minutes of anhepatic phase (I-2), 5 minutes before reperfusion (I-3), 10 minutes after reperfusion (I-4), 20 minutes after reperfusion (I-5), 60 minutes after reperfusion (I-6), and 1 hour after liver transplantation (I-7). Cytokine levels were determined using a technique which combines ELISA technique and flow cytometry. The study was approved by the local clinical research (ethics) committee. Written informed consent was obtained from patients' relatives. Twenty patients (14 men, 6 women) aged 23 to 61 years, recipients of a liver transplantation were studied. The cytokine IL-2 plasma values were maintained during the whole study period, with a slight increase at 15 minutes of anhepatic phase (I-2). IL-4 showed a peak value 20 minutes after reperfusion (I-5). IL-6 increased its plasma value starting at 15 minutes of anhepatic phase (I-2), maintaining high concentrations during the whole intraoperative period. IL-10 increased progressively, reaching a maximum 1 hour after transplantation (I-7). TNF-alpha reached maximum plasma levels 20 minutes after reperfusion (I-5), whereas IFN-gamma showed a peak at 15 minutes of anhepatic phase (I-2). Our results indicate that the anhepatic phase (I-2) is the earliest phase during which proinflammatory and anti-inflammatory cytokines, such as IL-6 and IL-10, respectively, are involved during liver transplantation. We conclude that IL-6 is the first cytokine involved in the inflammatory response during liver transplantation.

Adult↗

Condemnation of lungs in abattoirs in peninsular Malaysia due to parasitic infection from 1998-2004.

A study on causes of lung condemnation in 25 abattoirs from peninsular Malaysia for a period of seven years (1998-2004) was conducted by examining the records at the Department of Veterinary Services headquarters in Kuala Lumpur. A total of 5.3% of lungs from 233,417 cattle and buffaloes were condemned from 1998 to 2004. The main cause of condemnation was congestion (2.98%). The percentage of lungs that were condemned due to parasitic infection among the total population slaughtered was low (0.11%). Parasitic infection contributed to 2.1% of all lungs condemned. It was also found that the prevalence of parasitic infection in the lungs was generally much higher in buffaloes than in cattle.

Abattoirs↗

Time course of antioxidant enzyme activities in liver transplant recipients.

Reactive oxygen species (ROS) play a central role in ischemia-reperfusion injury after organ transplantation. They are degraded by endogenous radical scavengers such as antioxidant enzymes. The purpose of this study was to evaluate the temporal variations of antioxidant enzyme activities in liver transplant recipients. The study was performed in 13 liver transplant patients (11 men and 2 women). Blood samples were obtained pre- and postsurgical intervention: before transplant (T(0)), and 1, 6, 12, 24, 48, and 72 hours, as well as 5 and 7 days thereafter. We determined total and specific superoxide dismutase (SOD) activity, catalase (CAT), glutathione peroxidase (GPX), and glutathione reductase (GR) activities as well as malondialdehyde (MDA) and low-density lipoproteins (LDL). The results showed increased SOD and mainly GPX activities after liver transplantation, which correlated with MDA levels. Total SOD activity was mainly represented by Mn-SOD (75%) and Cu,Zn-SOD (25%), whereas Fe-SOD was not detected. In conclusion, the enhanced antioxidant enzyme activities reported in this study indicated a control of oxidative stress generated in liver transplantation. In this sense, although MDA levels showed an enormeous increase at 1 hour after transplantation, the lipid peroxidation was compensated for by GPX activity.

Adult↗

Immediate replacement removable partial dentures with cobalt-chromium frameworks: rationale, technology and a case report.

The advantages of removable partial dentures with cobalt-chromium frameworks over those made entirely of acrylic resin, in oral health and hygiene, are well documented. However, in cases where teeth are to be extracted for fitting the removable partial denture, a difficulty arises because of the need to test the fit of the removable partial denture framework. The advent of two modern technologies-- laser welding and metal bonding agents -- make it possible to test the fit of the major part of the framework prior to adding additional metal components to support artificial teeth. A case is described in which the four lower incisors were extracted. The main part of the framework was constructed and its fit tested. A second casting was laser-welded to the lingual plate of the first casting to support the artificial incisor teeth. This technique avoids the need to make an acrylic resin temporary denture but incurs the cost of the additional technical work and so the advantages may be considered to be economically neutral.

Adult↗

Eclampsia, a major cause of maternal and perinatal mortality: a prospective analysis at a tertiary care hospital of Peshawar.

OBJECTIVE: To observe pregnancy outcome in eclamptics and to explore the avoidable factors contributing to the adverse outcome. SETTING: Department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar. METHOD: This prospective cross-sectional observational study (from 1st Jan 2001 to 31st Mar 2002) included all the patients admitted to the unit with eclampsia. A Sociodemographic and clinical data was collected along with the results of investigations to categorize the complications and data was analyzed using various statistical tests. MAIN OUTCOME MEASURES: Maternal and Perinatal morbidity and mortality. RESULTS: During the study period 71 patients developed eclampsia (frequency: 1.2%). Majority were unbooked (86%), primigravida (69%), < or = 25 years of age (63%), referred from other health facilities (66.2%) and had some delay in seeking medical help (60%). Thirty five percent of patients developed major complications and 16.9% of them died (48% of overall maternal mortality). Mortality was frequent in Afghani women (OR 7.71 p value 0.002) and in women who sought medical help more than 6 hrs after developing seizures (OR 14.6 P value 0.0004). Perinatal mortality was 41.6% having prematurity the main risk factor (OR 13.33 p value 0.0000068). CONCLUSION: To decrease the adverse outcome associated with eclampsia a community-based approach is needed to improve community health education, socioeconomic status and prenatal care. Delivery of proper health care system and emergency obstetrical care facilities are vital for prevention, early detection, proper management and hence to save the mothers and their babies from such a dreadful disease.

Adult↗

Evaluation of a new enzyme immunoassay for the detection of Helicobacter pylori in stool specimens.

H. pylori infects the gastric mucosa and causes many digestive disorders such as peptic ulcer, chronic gastritis and gastric cancer. H. pylori infection relates neither to functional health status, nor to intensity of dyspepsia. There is evidence that in most patients with H. pylori positive functional dyspepsia do not improve with eradication of the organism.This study evaluated the diagnostic accuracy of HpSA by determining the sensitivity and specificity of the stool antigen test in predicting successful eradication during and after anti microbial therapy. The work was conducted on patients who underwent upper gastrointestinal endoscopy at Al-Azhar University hospitals. Fifty patients (34 male & 16 female) with dyspepsia were selected, the exclusion criteria included use of antibiotics and proton pump inhibitors up to one month before the study. All cases were submitted to, full history, general and local examination and upper gastrointestinal endoscopy. Biopsies were taken from the antrum and body of the stomach for rapid urease test and histopathology. Stool samples were taken to detect H. pylori stool antigen. Positive patients received eradication treatment for one month and H. pylori status was re-determined by rapid urease test, histological examination and HpSA test one month later. H. pylori was detected by rapid urease test in 29 (58%) dyspeptic patient by histology in 26(52%) dyspeptic patient, while H. pylori was detected by HpSA immunoassay in 16 (32%) dyspeptic patient. The sensitivity and specificity of HpSA were 57.7% and 95.8% respectively. After successful eradication of H. pylori, reassessment by rapid urease test and histology revealed curative rate of 86.2% and 84.6% respectively, while HpSA immunoassay revealed curative rate 75%. Based on these results, the HpSA immunoassay gave sensitivity (75%) and specificity (100%). The H. pylori stool test represents an accurate and novel non-invasive concept for diagnosis of infection and can be used for daily routine in clinical practice. HpSA is a promising non-invasive test for diagnosis of H. pylori infection but may be hampered by low patient acceptability. So, HpSA is a valuable test in the pre-and post eradication assessment of infection. HpSA can be profitably employed in the primary diagnosis of H. pylori infection. This non invasive test could be very useful in investigating dyspeptic young patients. Also, it could be used profitably in epidemiological studies to determine the prevalence of H. pylori infection in the asymptomatic subjects in different communities.

Adult↗

Farm-management and milking practices associated with the presence of Listeria monocytogenes in New York state dairy herds.

Knowledge of the relationship between dairy herd management and milking practices with the occurrence of Listeria monocytogenes on dairy farms might assist in the development of intervention strategies aimed at eliminating this organism at the pre-harvest dairy-food-production level. This paper represents a first step towards that goal. We carried out a cross-sectional study to identify farm factors that were associated with isolation of L. monocytogenes from on-farm in-line milk-filters. Data on these factors were collected by personal interview of the farm owners or managers. Logistic regression was used to evaluate the significance of association of each factor while simultaneously controlling for the presence of other factors. A systematic approach was developed in which the bivariable association of the hypothesized factors initially was evaluated. All significant factors were then jointly evaluated in a multivariable logistic model. Farms that used a bucket system had significantly higher odds of L. monocytogenes as compared to farms that used a round-the-barn pipeline milking system (OR=0.35,P=0.05) or milking parlor (OR=0.21,P=0.01). There was a significant association between pre-milking teat disinfection (OR=0.26,P=0.001) and pre-milking examination of abnormal appearance of milk (OR=0.4,P=0.01) against the occurrence of L. monocytogenes. We also found a significant association between the use of E. coli J5 vaccine (OR=3.3,P=0.03) and how long dry-cow therapy had been used on farm (OR=0.34,P=0.04).

Animal Husbandry↗

A cross-sectional study on the prevalence of Listeria monocytogenes and Salmonella in New York dairy herds.

As part of our long-term objective of assessing risk for Listeria monocytogenes and Salmonella spp. in dairy herds, we carried out a cross-sectional study to determine the prevalence of the two organisms. The study population consisted of a sample of dairy herds enrolled in the Quality Milk Promotion Services at Cornell during the period of April 1998 to March 1999. The sample was stratified by geographical region to assure representation. Four hundred and four dairy farms were enrolled in the study. In-line milk filters were collected from each farm for bacteriological examination of L. monocytogenes and Salmonella spp. Four hypothesized risk factors were evaluated for their association with the likelihood of the presence of each of the two organisms using logistic regression analysis. Listeria monocytogenes was isolated from 51 (12.6%) of the milk filters. We found region-specific differences in the rate of farms with positive milk filters for this pathogen. Salmonella spp. were isolated from 6 (1.5%) milk filters. One isolate was confirmed as Salmonella enterica Serotype Typhimurium DT 104. There was no significant association between any of the hypothetical risk factors and the likelihood of Salmonella spp. isolation. Our study demonstrated that both L. monocytogenes and Salmonella spp. were prevalent in milk filters in New York dairy herds and that Salmonella was isolated at a significantly lower rate then L. monocytogenes.

Animals↗

A pre-search estimation algorithm for MEDLINE strategies with qualifiers.

Inexperienced users of online medical databases often have difficulty formulating their queries. Systems designed to assist them usually do not estimate how effective the initial search strategy will be before performing an actual search. Consequently, the search may find an overwhelming number of citations, or retrieve nothing at all. We have developed an estimation algorithm to predict the outcome of a MEDLINE search. The portion of the algorithm described here estimates retrieval for strategies containing qualifiers. In test searches, the estimate reduced the trial-and-error of strategy formulation. However, the accuracy of the estimate fell short of expectations. Our results show that pre-search estimation for strategies with qualifiers cannot be performed effectively with only the occurrence data that is presently available. They further imply that automated search intermediaries can benefit from medical knowledge which expresses the relationships that exist between terms.

Algorithms↗

Representation of nursing terminology in the UMLS Metathesaurus: a pilot study.

To see whether the National Library of Medicine's Metathesaurus (tm) includes terminology relevant to clinical nursing practice, two widely used nursing vocabularies were matched against the Meta. The two nursing vocabularies are 1) the North American Nursing Diagnosis List of Approved Diagnoses; and 2) the Omaha System, a vocabulary of problems and interventions developed by the Omaha Visiting Nurses Association. First, the terms were scanned against Meta in their "native" form, with phrases and combinations intact. This produced a relatively low percentage of exact matches (12%). Next, the terms were separated into "core concepts" and "modifiers" and the analysis was repeated. The percentage of exact matches to terms in Meta increased to 32%. However, the semantic types of the split terms often were not equivalent to the semantic types of the phrases from which the split terms were derived; also, in some cases, terms returned as exact matches had different meanings in Meta. Automatic scanning for lexical matches is a helpful first step in searching for vocabulary representation in Meta, but term-by-term search for context, semantic type and definition is essential. However, it seems clear that representation of nursing terminology in the Metathesaurus needs to be expanded.

Nursing↗

Q & A: a query formulation assistant.

Inexperienced users of online medical databases often do not know how to formulate their queries for effective searches. Previous attempts to help them have provided some standard procedures for query formulation, but depend on the user to enter the concepts of a query properly so that the correct search strategy will be formed. Intelligent assistance specific to a particular query often is not given. Several systems do refine the initial strategy based on relevance feedback, but usually do not make an effort to determine how well-formed a query is before actually performing the search. As part of the Interactive Query Workstation (IQW), we have developed an expert system, Questions and Answers (Q&A), that assists in formulating an initial strategy given concepts entered by the user and that determines if the strategy is well-formed, refining it when necessary.

Expert Systems↗

Interactive Query Workstation: standardizing access to computer-based medical resources.

Methods of using multiple computer-based medical resources efficiently have previously required either the user to manage the choice of resource and terms, or specialized programming. Standardized descriptions of what resources can do and how they may be accessed would allow the creation of an interface for multiple resources. This interface would assist a user in formulating queries, accessing the resources and managing the results. This paper describes a working prototype, the Interactive Query Workstation (IQW). The IQW allows users to query multiple resources: a medical knowledge base (DXplain), a clinical database (COSTAR/MQL), a bibliographic database (MEDLINE), a cancer database (PDQ), and a drug interaction database (PDR). Descriptions of each resource were developed to allow IQW to access these resources. The descriptions are composed of information on how data are sent and received from a resource, information on types of query to which a resource can respond, and information on what types of information are needed to execute a query. These components form the basis of a standard description of resources.

Artificial Intelligence↗

Casebook: a system for tracking clinical encounters.

Casebook is a clinically oriented database, written in MUMPS, and designed for recording the clinical encounters of medical students at Harvard Medical School. Its main goals are to 1) increase student use of computer technology, 2) help faculty evaluate the diversity of clinical experiences on their service, 3) provide data to the faculty on the "typical" experience of medical students on their service to aid in the evaluation of the curriculum and, 4) provide report-generation capabilities for the students to improve dialog with their preceptors. Students are able to enter information on "Problems" and "Procedures" selecting from a pop-up menu of medical terms or by entering free text. Casebook is currently in use in the Medicine, OB/GYN, Pediatric and Ambulatory rotations. At sites where the faculty take an active interest in the use of Casebook students perceive it to be valuable and subsequently use it more frequently. It is currently being expanded for use by medical students in their second, third, and fourth years of school.

Attitude to Computers↗