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Biomedical subjects

M Haddad

Publications and source records attributed to M Haddad.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Treatment of traumatic false aneurysm of the thoracic aorta with stent graft].

UNLABELLED: The treatment of traumatic false aneurysm of the thoracic aorta by endovascular stent graft may have advantages over conventional surgery. This is a case study of two women suffering from false aneurysm of the thoracic aorta caused in one by a knife injury and in the other by a car accident. After the patients became hemodynamically stable, a commercially available endothelial stent graft (Talent, Gor) was deployed. Recovery was rapid in the first patient. The second patient required emergency laparotomy for venous bleeding one day after stent placement; she died two weeks later, mainly from organ failure. CONCLUSIONS: Endovascular techniques can be used in selected cases to treat thoracic false aneurysms thereby avoiding the complexity and morbidity of conventional surgery.

Accidents, Traffic↗
PubMed2001

[Surgery of the carotid body tumors].

Carotid body tumor is a rare tumor of obscure origin, usually benign, and commonly present as a non-painful cervical mass. Resection is the treatment of choice. When the tumor is very adherent to the carotid artery, it may be necessary to also resect the artery and to reconstruct the arterial continuity using a saphenous or synthetic interposition graft. The most common complication of surgery is damage to the cranial nerves in the vicinity of the artery. We present 8 patients with carotid body tumor who underwent surgery in our department in 1996-1999. Two had a large tumor penetrating the intima which mandated resection of the involved carotid artery and a saphenous interposition graft reconstruction. Our experience with resection of carotid body tumors is detailed, with emphasis on precautions taken to prevent damage to the adjacent cranial nerves.

Adult↗
PubMed2001

Cerebrospinal fluid rhinorrhea: an unusual presentation of domestic violence.

The incidence of "battered woman syndrome" is increasing over the past few years affecting as many as one in every four families. Most of these cases present to the emergency room with mostly head and maxillofacial injuries. We are describing three cases of battered women with cerebrospinal fluid rhinorrhea as the only presenting symptom of domestic violence. The different etiologies, work up and treatment strategies are all discussed and reviewed.

Adult↗
PubMed2001

[Imaging features of retained surgical foreign bodies].

PURPOSE: To study the clinical and radiological manifestations in patients with retained surgical foreign bodies. PATIENTS AND METHODS: Over the last five years, seven patients were found to have retained surgical foreign bodies after abdominal surgery. An analysis of the clinical signs, laboratory findings and imaging features was performed. RESULTS: The clinical and laboratory data were non-specific. The diagnosis of textiloma was suggested based on imaging findings and surgical history before surgical exploration. The characteristic imaging findings at ultrasound and computed tomography consisted of a fluid collection with internal wavy structures. The differential diagnosis includes pyogenic abscesses, hematomas and ruptured hydatid cysts. CONCLUSION: Ultrasonography and computed tomography are essential for the diagnosis and management of retained surgical foreign bodies after abdominal surgery.

Abdomen↗
PubMed2000

[Elective repair of infra-renal aortic aneurysm in octogenarians].

Age over 80 years is generally considered an independent risk factor in elective surgery for abdominal aortic aneurysm (AAA). As the general population increases in age, more elderly are likely to be candidates for such surgery. We studied prospectively 100 consecutive patients undergoing elective AAA surgery between 1992-1995. All were operated on by the same team of anesthetists and surgeons and all were transferred to the general ICU for at least the first 24 hours. 16 were above the age of 80 (Group I) and 84 below (Group II). We recorded preoperative factors (demographics, medical history, risk factor indices, EKG findings, as well as left ventricular ejection fraction (LVEF) and stress imaging when indicated); intraoperative factors (duration of surgery, size of aneurysm, complications and units of blood transfused); postoperative factors (length of ICU stay, duration of ventilation, APACHE II [Acute Physiological and Chronic Health Evaluation] and TISS [Therapeutic Intervention Scoring System] scores; complications in the ICU, need for readmission to the ICU, and mortality). In Group I LVEF was greater (p = 0.03) and aneurysm size significantly larger (p = 0.036), but there were no other significant differences between the 2 groups with regard to pre- and intraoperative data. Group I patients were not ventilated as long (p = 0.038), but there were no significant differences in outcome factors. Mortality for the whole group was 5% and was not significantly different in the 2 groups (1/16 in Group I and 4/84 in Group II). We conclude that there is no excess morbidity or mortality in octogenarians undergoing AAA surgery. However risk of the aneurysms rupturing is significantly greater since they are larger. We suggest that age not be considered the sole criterion for aneurysm repair, or at least not in selected patients with normal LVEF.

APACHE↗
PubMed2000

Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS.

BACKGROUND: Highly active antiretroviral therapy is associated with improved health outcomes for people living with HIV/AIDS. Unfortunately, full therapeutic benefit from HAART may require near-perfect adherence to prescribed regimens. OBJECTIVES: To determine the effectiveness of patient support and education interventions for improving adherence to highly active antiretroviral therapy (HAART) in people living with HIV and AIDS. SEARCH STRATEGY: Studies were identified using AIDSLINE, MEDLINE, CINAHL, HEALTHSTAR, PSYCHLIT, SOCIOLOGICAL ABSTRACTS, INTERNATIONAL PHARMACEUTICAL ABSTRACTS, SCIENCE CITATION INDEX, EMBASE, and abstracts from global AIDS meetings, ICAAC, and other major meetings from January 1996 to April 1999. Further information was sought through contact with authors, reference lists, and Collaborative Review Group databases. SELECTION CRITERIA: To be included, studies had to describe a supportive or educational intervention to improve adherence to a HAART regimen in HIV positive patients, and include a comparison group. Eligible HAART regimens were defined as consisting of at least three anti-HIV drugs one of which must be a protease inhibitor or non-nucleoside reverse transcriptase inhibitor. At least one measure of adherence was also required. DATA COLLECTION AND ANALYSIS: Data on study design, participants, interventions, and outcomes were extracted from the reports onto specifically designed data collection forms by at least two reviewers. MAIN RESULTS: One study satisfied the eligibility criteria. It compared a pharmacist-led intervention consisting of educational counseling and availability of follow-up telephone support with conventional dispensing of HAART pills. This intervention significantly improved adherence to HAART, and adherence to HAART significantly predicted undetectable viral load at 24 weeks. However, participating in the intervention did not significantly predict a subsequently undetectable viral load at 24 weeks. REVIEWER'S CONCLUSIONS: Implications for practice Currently a pharmacist-led program of educational and supportive counseling is the only available intervention which has been shown in a controlled study to improve adherence to HAART, with less evidence that viral load is subsequently reduced. Implications for research Controlled trials are urgently needed to determine which interventions can significantly improve adherence to HAART. Whether interventions that improve adherence also suppress viral load and improve clinical outcomes should also be considered.

Acquired Immunodeficiency Syndrome↗
PubMed2000

External fixation of distal radial fractures: 3 or 5 weeks of external fixation.

In a retrospective study we compare the functional and radiographical results of 2 groups of patients with unstable distal radial fractures treated with external fixation. In Group 1, 20 patients with 21 fractures were treated with external fixation for 3 weeks followed by a cast for 2 weeks. In Group 2, 16 patients were treated with external fixation for 5 weeks. The functional outcome was good in both treatment groups with no significant difference between the results in the two groups. Radiologically, Group I had less radial shortening than Group II, but there was no difference in the degree of dorsal angulation.

Aged↗
PubMed2000

Femorofemoral bypass, even in pregnancy--a case report.

A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.

Abdominal Injuries↗
PubMed2000

Lipedema complicated by lymphedema of the abdominal wall and lower limbs.

We describe a 52 year-old woman in whom lymphedema primarily of the abdominal wall was superimposed on lipedema resulting in an abdomen of enormous dimensions with marked impairment of ambulation. Treatment consisted of preoperative compression of the legs by an external pneumatic device (Lympha-Press) followed by excision of the lymphedematous abdominal fat pad in conjunction with "debulking" of the right leg. The patient illustrates the extremes of lipedema complicated by lymphedema and the technical difficulties associated with its management.

Abdominal Muscles↗
PubMed1999

Prostate secretory protein (PSP94) suppresses the growth of androgen-independent prostate cancer cell line (PC3) and xenografts by inducing apoptosis.

BACKGROUND: PSP94 (prostate secretory protein of 94 aa; also called PIP), one of the predominant proteins secreted into the seminal fluid, was proposed as an independent diagnostic/prognostic marker for prostate cancers. It was also shown to inhibit rat prostate cancer growth. In this study, we investigated the effect of purified PSP94 on the growth of androgen-independent human prostate cancer cells (PC3) and its potential mechanism of action. METHODS AND RESULTS: PSP94, in a dose- and time-dependent manner, inhibited the growth of PC3 cells. The protein demonstrated a stronger inhibitory effect on the colony-forming ability of PC3 cells in soft agar. A daily injection of PSP94 at 5 microg/kg/body weight resulted in a 50-60% inhibition in the growth of PC3 xenografts in athymic mice. PC3 cell growth inhibition by PSP94 resulted from cell death characteristic of morphological apoptosis, which was confirmed by dual fluorescence microscopy, electron microscopy, and DNA fragmentation assays. Mechanistic studies indicated that PSP94 enhanced the expression of proapoptotic protein Bax without affecting Bcl-2 levels. CONCLUSIONS: This study suggests that PSP94 may represent a novel, apoptosis-based, antitumor agent applicable to the treatment of hormone-refractory human prostate cancers.

Androgens↗
PubMed1999

Gastric emptying after elective abdominal aortic aneurysm surgery: the case for early postoperative enteral feeding.

OBJECTIVE: To assess gastric emptying with a view to early postoperative enteral nutrition after elective abdominal aortic aneurysm (AAA) surgery. METHODS: The paracetamol absorption test was used to assess gastric emptying in 13 consecutive patients at 6, 18 and 32 h following elective AAA surgery. All patients received postoperative analgesia with marcaine given via an epidural catheter during the first 48 postoperative hours. Normal emptying was defined as an area under the plasma paracetamol concentration curve at 60 min (AUC-60) of > 600 mg/min/l. RESULTS: The median time to normal gastric emptying was 18 +/- 7.7 h. One patient (7.6%) had normal emptying at 6 h, nine (69%) at 18 h and 12 (92%) at 32 h. The nasogastric tubes were removed at a median of 3.2 days after surgery, and enteral feeding was commenced on day 4. CONCLUSIONS: Gastric emptying was normal 18 h post-AAA surgery as assessed by the paracetamol absorption test. In view of the importance of maintaining an intact gastrointestinal mucosa, enteral nutrition may be commenced on the second postoperative day.

Absorption↗
PubMed1998

12(S)-hydroxyeicosatetraenoic acid increases the actin microfilament content in B16a melanoma cells: a protein kinase-dependent process.

12(S)-hydroxyeicosatetraenoic acid [12(S)-HETE], a lipoxygenase metabolite of arachidonic acid, has been shown to be involved in a wide variety of cellular activities (i.e., adhesion, spreading, motility, invasion) which promote metastasis to occur in tumor cells. In this study, several techniques (Western blotting, flow cytometry and DNase I assay) were performed to examine the alterations in the distribution of G- and F-actin expressed in B16a melanoma cells. Each of these methods independently revealed that 12(S)-HETE treatment (0.1 mM, 15 min) resulted in an increase in the F-actin content in the cytoskeletal preparations. Since the integrity of cytoskeletal networks (i.e., actin filaments) can be dynamically regulated through protein phosphorylation, we investigated the potential role of several protein kinases in the 12(S)-HETE-induced actin polymerization. By flow cytometric analysis, 12(S)-HETE was found to increase the actin filament contents. This effect could be inhibited by protein kinase C (PKC) inhibitors (calphostin C and staurosporine) as well as by protein tyrosine kinase (PTK) inhibitor (genistein) but not by protein kinase A inhibitor (H8), suggesting that the 12(S)-HETE effect involves PKC and PTK. This conclusion is consistent with the observations that phorbol 12-myristate-13-acetate (PMA) mimics the biological effect of 12(S)-HETE in promoting the F-actin formation in B16a cells. As a final analysis, direct protein phosphorylation studies indicate that 12(S)-HETE treatment led to enhanced phosphorylation of myosin light chain, which may contribute to the increased stress fiber formation following 12(S)-HETE stimulation.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1998

[Popliteal vascular trauma].

6 cases of popliteal vascular trauma are presented, 3 due to posterior dislocation of the knee and 3 due to crush injury. The patients were referred from another hospital and some had undergone unnecessary angiography when ischemia was present, leading to delay in surgery. All patients presented with distal ischemia and underwent reconstructive surgery; 2 subsequently underwent below-knee amputation because of irreversible ischemia and sepsis. Urgent operation for popliteal vascular trauma is necessary whenever there is ischemia and intraoperative angiography may be necessary. There should be reconstruction of the artery and vein when there is concomitant venous damage, and fasciotomy and debridement are important. The harmful potential of occult popliteal vascular injuries and their ostensible mild presentation present a challenge for the emergency room surgeon.

Adult↗
PubMed1998

Calcium is an equipotent stimulator of stanniocalcin secretion in freshwater and seawater salmon.

Stanniocalcin (STC) is a calcium- and phosphate-regulating hormone produced by the corpuscles of Stannius in fishes. A rise in ion calcium (Ca2+) levels is the principal stimulus for secretion, and the hormone acts on the gills, gut, and kidneys to restore normocalcemia. The STC-producing cells in marine fishes are metabolically more active and secrete more hormone than those in freshwater fishes, which has been attributed to the higher calcium content of seawater placing a greater burden on the organ systems governing Ca2+ homeostasis. In this study we have addressed the question of whether or not the STC cells in marine fishes are more sensitive to Ca2+, by comparing the secretagogic effects of Ca2+ in freshwater- and seawater-adapted coho salmon. The results showed that the STC cells were equally Ca(2+)-sensitive in the two groups. Therefore, in spite of the fact that the STC cells are more active in marine fishes this requires no apparent adjustment in cellular sensitivity to calcium.

Adaptation, Physiological↗