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Biomedical subjects

S Alam

Publications and source records attributed to S Alam.

At least 73 records · Page 4Linked to original sources
PubMed1993

The role of anticoagulation in the development of pericardial effusion and late tamponade after cardiac surgery.

This study aimed at elucidating the role of anticoagulation in the genesis of late pericardial effusion and tamponade after cardiac surgery. Using serial 2-D echocardiography, 141 patients undergoing surgery for coronary artery bypass (56), valvular (69) or congenital (16) [corrected] heart disease were studied postoperatively. Group 1 (74 patients) received full anticoagulation (warfarin 73; heparin 1) and group 2 (67 patients) received either antithrombotic agents (aspirin plus dipyridamole), or no treatment. Fifty percent (70/141) of patients developed effusion. There was no significant difference between the two groups in the incidence of either effusion in general (43/74; 58% vs 27/67; 40%, respectively) or small or medium sized effusion. However, a large effusion was significantly more common in group 1 than in group 2 (32% vs 4%, P < 0.005). Twelve patients (12/141; 8.5%) developed late tamponade, 7 to 33 (15 +/- 7.3 mean +/- SD) days after surgery. All had a large effusion demonstrated by echo, drained by pericardiocentesis, and none died. All 12 patients with tamponade belonged to group 1 (P < 0.001). Excess anticoagulation was detected at least once in 41 of the 74 group 1 patients (55%). When compared to properly anticoagulated patients, excessively anticoagulated patients had a similar overall incidence of effusion and a similar incidence of small or moderate effusion, but a higher incidence of large effusion (18% vs 44%, [corrected] P < 0.05) and tamponade (3% vs 27%, P < 0.025). We conclude that, unlike small or medium-sized effusions, large pericardial effusions and tamponade are more likely to occur among anticoagulated patients, especially if they are excessively anticoagulated.

Adult↗
PubMed1993

Hemobilia due to gallbladder contusion following blunt trauma--sonography and CT scanning for early detection: case report.

Gallbladder injury following blunt trauma is rare and early diagnosis is difficult when it is associated with other injuries. Clinical symptoms and signs alone are not necessarily helpful in diagnosing such cases. However, modern diagnostic imaging procedures such as ultrasonography and CT scanning are valuable for investigating possible gallbladder injuries. Patients with blunt trauma should be carefully examined by US and CT for early detection and treatment of gallbladder injuries.

Cholecystography↗
PubMed1992

Deleterious cardiac effects of captopril during acute myocardial ischaemia in the dog.

OBJECTIVE: The aim was to evaluate the effects of the angiotensin converting enzyme inhibitor captopril on acute myocardial ischaemia. METHODS: Seventeen anaesthetised open chest dogs were randomised to 3 minute angioplasty balloon occlusions of the left circumflex coronary artery before and after intravenous infusion of captopril (n = 8) or placebo (n = 9). RESULTS: There was apparent worsening of ischaemia during balloon inflation after captopril infusion, when compared with control inflation, as suggested by further ST segment elevation of 1.8 (SD 1.8) mm, p less than 0.03, and by further lowering of regional myocardial pH [-0.05(0.05), p = 0.06], and peak positive and peak negative dP/dt [-439(337)mm Hg.s-1, p less than 0.008; -470(316) mm Hg.s-1, p less than 0.004, respectively]. The increase in ischaemia occurred despite reduced double product after captopril administration. Regional myocardial blood flow in the ischaemic artery distribution was lower during post captopril balloon occlusion [-0.1(0.06) ml.min-1.g-1, p less than 0.005] than during control balloon inflation, while coronary vascular resistance increased by 161(172)% (range 45 to 497%, p less than 0.04). There were no significant differences in ST segments, pH, haemodynamic variables, or blood flow during balloon inflations before and after saline infusion. CONCLUSIONS: Despite lower myocardial metabolic demands, acute intravenous administration of captopril was associated with increased ischaemia during transient coronary artery occlusion.

Acute Disease↗
PubMed1991

Hemodynamic assessment of chronic venous insufficiency.

To study the pathogenesis of chronic venous insufficiency (CVI), photoplethysmography and strain-gauge plethysmography were simultaneously performed in 84 patients. Of the 128 limbs studied, 24 were normal, 64 had primary varicose veins and 40 had post-thrombotic syndrome. Venography was also performed in all patients. The results of this study indicate that reflux in the superficial veins is the main pathophysiology involved in the development of CVI, though incompetence of the perforators and deep veins plays some role. In post-thrombotic syndrome, however, CVI is mainly a sequel of deep venous incompetence, the condition being complicated by incompetent perforators and superficial venous reflux.

Chronic Disease↗
PubMed1991

Wartime determinants of arteriographically confirmed coronary artery disease in Beirut.

This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for ever a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched on age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases (greater than or equal to 70% maximal stenosis) were compared with two control groups: arteriographic controls (entirely normal coronaries) and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls (odds ratio (OR) = 2.4, 95% confidence interval (CI) 1.17-4.90) and arteriographic controls (OR = 2.8, 95% CI 0.93-8.47). Crossing the "green-lines" that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls (OR = 3.25, 95% CI 1.54-6.89) and arteriographic controls (OR = 5.38, 95% CI 1.65-17.6). The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings.

Adult↗
PubMed1989

Receptor-mediated uptake and 'retroendocytosis' of high-density lipoproteins by cholesterol-loaded human monocyte-derived macrophages: possible role in enhancing reverse cholesterol transport.

Human monocyte-derived macrophages (MDM) are cholesterol-loaded, and the rates of uptake, degradation and resecretion of high-density lipoproteins are measured and compared to the rates in control cells. Results show the binding activity of these lipoproteins is upregulated in cholesterol-loaded cells; the bound and internalized lipoproteins are not degraded to any appreciable extent but primarily resecreted as a larger particle. The enhancement of binding activity for high-density lipoproteins is arrested when cycloheximide is added to the medium, suggesting that protein synthesis is involved. Preliminary evidence also indicates that HDL3 (without apoE) after internalisation is converted intracellularly to a larger apoE-containing HDL2-like particles. Thus, MDM appears to possess specific receptors for HDL3 without apoE that may function to facilitate HDL-mediated removal of excess cholesterol from cells.

Biological Transport↗
PubMed1989

Kidney-preserving radical tumor resection in advanced neuroblastoma.

The possibility of kidney-preserving radical tumor resection in advanced neuroblastoma was evaluated. Eighteen patients with stage III and IV adrenal neuroblastoma underwent delayed primary surgery after chemotherapy consisting of high doses of cyclophosphamide (1,250 mg/m2). Radical tumor resection with nephrectomy was performed in 13 patients (group A) and kidney-preserving radical tumor resection was performed in six patients (group B). Macroscopic findings were evaluated in all patients; angiographic and microscopic findings were evaluated in group A patients and tumor recurrence in group B patients. Macroscopically, the tumors were observed within the tumor capsule (C1) in five, outside the tumor capsule but not beyond the midline (C2) in seven, and beyond the midline (C3) in six. In group A, under microscopic examination, the tumor invasion into the renal parenchyma was observed in only three patients among C2 and C3 cases. Tumor vessels from the capsular and/or perforating arteries plus from the intrarenal arteries could be visualized in all patients, three of whom had tumor invasion into the renal parenchyma. In group B, no tumor recurrence around the kidney occurred, and two patients have survived for greater than 2 years. The kidney-preserving radical tumor resection is recommended in surgical treatment of advanced neuroblastoma following preoperative chemotherapy, and is predictable preoperatively by angiography.

Adrenal Gland Neoplasms↗
PubMed1989

Wartime determinants of arteriographically confirmed coronary artery disease in Beirut.

This study investigates the association of wartime stress variables and coronary artery disease as determined by coronary angiography in Lebanon in 1986, a country with an ongoing civil war for over a decade. A total of 127 patients who underwent coronary angiography at the American University of Beirut Medical Center were individually matched on age and sex with visitor controls free from any evidence of clinical coronary artery disease. Arteriographic cases (greater than or equal to 70% maximal stenosis) were compared with two control groups: arteriographic controls (entirely normal coronaries) and visitor controls. Findings suggest that there is a relation between exposure to both acute and chronic war events and coronary artery disease in this patient population. The reporting of exposure to acute war events was significantly higher in cases compared with both visitor controls (odds ratio (OR) = 2.4, 95% confidence interval (Cl) 1.17-4.90) and arteriographic controls (OR = 2.8, 95% Cl 0.93-8.47). Crossing the "green-lines" that separate two belligerent sides, considered as an attribute of war-related chronic stress, was more frequent in cases compared with visitor controls (OR = 3.25, 95% Cl 1.54-6.89) and arteriographic controls (OR = 5.38, 95% Cl 1.65-17.6). The relation observed between wartime stress and coronary artery disease could not be explained by possible overreporting of stressful events in patients with suspected coronary artery disease or by an increase in clinical awareness for the disease for those under continuous stress. Adjusting for the effect of the well-established coronary artery disease risk factors did not alter the above findings.

Adult↗
PubMed1986

Regularity, exposure time and perception of numerosity.

Two experiments are described. In Exp. 1, subjects compared the apparent numerosity of two kinds of dot patterns, regular vs irregular, with two different exposures (160 vs 2000 msec.). In Exp. 2, the subjects had to estimate the numerosity of the same patterns, presented one at a time. Analysis showed a relative overestimation of the regular patterns in Exp. 1 but not in Exp. 2. In general an overestimation occurred with an increase in exposure. Such results support our hypothesis of two separate processes as the basis of the two kinds of performance (estimating vs comparison).

Attention↗