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Biomedical subjects

S Attia

Publications and source records attributed to S Attia.

At least 19 recordsLinked to original sources

Linear pattern of West Nile virus-associated chorioretinitis is related to retinal nerve fibres organization.

PURPOSE: To clarify the reason for the linear pattern of West Nile virus (WNV)-associated chorioretinitis. METHODS: The study included 12 patients (24 eyes) with WNV-associated chorioretinitis. All the patients underwent a complete ophthalmic evaluation, including dilated fundus examination, fundus photography, fluorescein angiography, and indocyanine green angiography. Characteristics of linear streaks, particularly their relationship to the course of retinal and choroidal vessels, and pattern of retinal nerve fibres, were analysed. RESULTS: All patients had bilateral multifocal chorioretinitis with linear clustering of chorioretinal lesions associated with a variable number of scattered lesions. Linear streaks, variable in number and length, originated from the optic disc or its vicinity in most cases. Their course in all cases appeared to closely follow the course of retinal nerve fibres, rather than that of retinal or choroidal vessels. CONCLUSIONS: Results of our study show that the linear pattern of WNV-associated chorioretinitis is related to retinal nerve fibres organization, suggesting a contiguous spread of WNV virus from central nerve system via the optic nerve fibres to the outer retina, retinal pigment epithelium, and choroid.

Adult↗

Pattern of uveitis in a referral centre in Tunisia, North Africa.

AIM: To analyse the pattern of uveitis in a referral centre in Tunisia, North Africa. METHODS: The study included 472 patients with uveitis examined at the Department of Ophthalmology of Monastir (Tunisia) from January 1992 to August 2003. All patients had a comprehensive ocular and systemic history, including an extensive review of medical systems. Complete ophthalmic examination was performed in all cases, including best-corrected Snellen visual acuity, slit-lamp examination, applanation tonometry, and dilated fundus examination with three-mirror lens. Standard diagnostic criteria were employed for all syndromes or entities of uveitis. RESULTS: The mean age at onset of uveitis was 34 years. The male-to-female ratio was 1:1.1. Uveitis was unilateral in 282 patients (59.7%) and bilateral in 190 patients (40.3%). Anterior uveitis was most common (166 patients; 35.2%), followed by posterior uveitis (133 patients; 28.2%), panuveitis (100 patients; 21.2%), and intermediate uveitis (73 patients; 15.5%). A specific diagnosis was found in 306 patients (64.8%). The most common cause of anterior uveitis was herpetic uveitis (56 patients; 33.7%). Toxoplasmosis was the most frequent cause of posterior uveitis (51 patients; 38.3%). Intermediate uveitis was most commonly idiopathic (63 patients; 86.3%). Behçet's disease was the most common cause of panuveitis (36 patients; 36%), followed by Vogt-Koyanagi-Harada (VKH) disease (15 patients; 15%). A total of 16 patients (3.4%) suffered from blindness, and 59 (12.5%) from uniocular blindness. CONCLUSIONS: In a hospital population in Tunisia, the most common causes of uveitis were Behçet's disease, herpes simplex infection, toxoplasmosis, and VKH disease.

Acute Disease↗

[Broncholithiasis].

INTRODUCTION: Broncholithiasis is defined as the presence of calcified material in the bronchial lumen. The aim of our work was to study the clinical, radiological and therapeutic aspects of broncholithiasis. OBSERVATIONS: We report the histories of 6 patients identified over 14 years (1990-2004). They included 4 men and 2 women with an average age of 50 years. A past history of pulmonary tuberculosis was found in 2 cases. The presenting symptom was haemoptysis in 4 patients. Fibreoptic bronchoscopy was performed in all patients and broncholiths were found in two. Thoracic CT scan was performed in 5 patients and in 3 showed hilar and parenchymal calcification, suggesting the diagnosis of broncholithiasis. The diagnosis was confirmed in 2 patients by bronchoscopy, in 2 others by surgical biopsy and in the remaining 2 by the CT appearances. Three patients were operated on: 2 for diagnosis and the third for haemostasis. Pulmonary tuberculosis was discovered in 2 patients, one by culture and the other by surgical biopsy. The outcome was satisfactory in all cases. CONCLUSIONS: Broncholithiasis presents a problem of differential diagnosis from other pulmonary pathologies on account of misleading clinical, endoscopic and radiological features.

Adult↗

[Intravitreal injection of triamcinolone acetonide for the treatment of macular edema].

PURPOSE: To study the efficacy and safety of intravitreal injection of triamcinolone acetonide for the treatment of macular edema (ME). METHODS: Thirty-five eyes of 33 patients with ME were studied. The causes of ME included diabetes (24 eyes), postoperative ME (four eyes), intraocular inflammation (three eyes), retinal vein occlusion (three eyes), and Coats disease (one eye). All patients underwent a complete ophthalmic examination and fluorescein angiography before and after treatment. Treatment consisted of a single intravitreal injection of 2 or 4 mg of triamcinolone acetonide under subconjunctival anaesthesia. Mean follow-up time was 4 months (range, 1-10 months). RESULTS: Mean visual acuity before treatment was 20/200 (range, 20/400-20/70). Visual acuity improved by one line or more on the Snellen visual acuity chart in seven eyes (20%) and remained unchanged in nine eyes (25.7%). In the 19 remaining eyes, visual acuity improved slightly and remained less than 20/200. ME diminished or resolved completely in 32 eyes (91%). This improvement was seen in all eyes with diabetic ME, pseudophakic ME, or inflammatory ME. ME recurred in three eyes 3 months after injection of triamcinolone and in one eye 9 months after injection of triamcinolone. In one diabetic patient, retinal neovascularization associated with ME resolved as a consequence of intravitreal triamcinolone injection. Reversible ocular hypertension occurred in ten eyes (28.6%). No case of endophthalmitis was seen. CONCLUSION: Intravitreal injection of triamcinolone acetonide is an effective treatment of ME. Its best indications seem to be diabetic, pseudophakic and inflammatory ME. Randomized clinical trials are warranted to assess long-term efficacy and safety of this treatment modality of ME.

Adolescent↗

[Etiology of posterior uveitis and panuveitis at the Central University Hospital in Monastir].

The authors conducted a retrospective analysis of 245 patients with posterior uveitis or panuveitis in order to determine their etiologies and collect some epidemiological data. A specific diagnosis was made in 80.4%. Behcet's disease (22.4%), toxoplasmosis (22%), and Vogt-Koyanagi-Harada syndrome (9%) were the most common causes of posterior uveitis or panuveitis. No case of confirmed sarcoïdosis was found in our series.

Adult↗

[Posterior scleritis: six case reports].

PURPOSE: To study the clinical features, management guidelines, and the course of the disease in six patients with posterior scleritis. SUBJECTS AND METHODS: Six patients with posterior scleritis were enrolled in this retrospective study. All patients underwent a complete ophthalmic examination, fluorescein angiography, and B-scan ultrasonography. Systemic evaluation included physical examination and laboratory screening investigations. Medical management included systemic indomethacin (two cases), oral steroids (two cases), intravenous pulses of methylprednisolone followed by tapered oral steroids (two cases). One patient underwent immunosuppressive therapy (azathioprine) because of steroid dependence. RESULTS: The main presenting symptoms were pain (six cases) and decreased vision (four cases). Chorioretinal changes included chorioretinal folds (six cases), retinal folds (five cases), optic disc edema (five cases), serous retinal detachment (two cases), and a subretinal mass (one case). Ultrasonography disclosed sclerochoroidal thickening in all cases and retrobulbar edema in three cases. Systemic evaluation was unremarkable in five cases and revealed Behçet's disease in one case. All patients showed a good response to medical treatment. CONCLUSION: Posterior scleritis has protean manifestations and can be easily overlooked. This diagnosis must be considered in all inflammatory and painful ocular disorders with no obvious etiology. B-scan ultrasonography is the most useful diagnostic tool in such patients. The disease usually shows a good response to systemic anti-inflammatory therapy.

Administration, Oral↗

Intrinsic aging vs. photoaging: a comparative histopathological, immunohistochemical, and ultrastructural study of skin.

Cutaneous aging is a complex biological phenomenon affecting the different constituents of the skin. To compare the effects of intrinsic and extrinsic aging processes, a total of 83 biopsies were collected from sun-exposed and protected skin of healthy volunteers representing decades from the 1st to the 9th (6-84 years of age). Routine histopathology coupled with computer-assisted image analysis was used to assess epidermal changes. Immunoperoxidase techniques with antibodies against type I and type III collagens and elastin were used to quantitatively evaluate changes in collagen and elastic fibers and their ultrastructure was examined by transmission electron microscopy. Epidermal thickness was found to be constant in different decades in both sun-exposed and protected skin; however, it was significantly greater in sun-exposed skin (P = 0.0001). In protected skin, type I and III collagen staining was altered only after the 8th decade, while in sun-exposed skin the relative staining intensity significantly decreased from 82.5% and 80.4% in the 1st decade to 53.2% and 44.1% in the 9th decade, respectively (P = 0.0004 and 0.0008). In facial skin the collagen fiber architecture appeared disorganized after the 4th decade. The staining intensity of elastin in protected skin significantly decreased from 49.2% in the 1st decade to 30.4% in the 9th decade (P = 0.05), whereas in sun-exposed skin the intensity gradually increased from 56.5% in the 1st decade to 75.2% in the 9th decade (P = 0.001). The accumulated elastin in facial skin was morphologically abnormal and appeared to occupy the areas of lost collagen. Collectively, the aging processes, whether intrinsic or extrinsic, have both quantitative and qualitative effects on collagen and elastic fibers in the skin.

Adolescent↗

Effect of chemicals on the duration of male meiosis in mice detected with laser scanning cytometry.

Aneuploidy studies in sperm such as the sperm-FISH assay require a precise knowledge of the duration of spermatogenesis, especially of the meiotic stages. This is important in order to sample sperm from the epididymis at appropriate intervals after animal treatment. However, aneugens may delay the cell cycle. The progression from meiotic divisions to epididymal sperm was determined by labelling the last S-phase before meiosis with the thymidine analogue 5-bromo-2'-deoxyuridine (BrdU) and treating the animals 13 days later with the test chemicals. In a time frame of 20--24 days after treatment, BrdU-containing sperm were identified with a FITC-labelled anti-BrdU antibody and green fluorescent sperm were scored with a laser scanning cytometer (LSC). We studied the effects of the chemicals acrylamide, colchicine, diazepam, griseofulvin, taxol, thiobendazole, trichlorfon and vinblastine on the duration of meiotic divisions in male mice. Colchicine treatment prolonged the duration of meiotic divisions by about 48 h. On days 21 and 22, the frequencies of BrdU-labelled sperm in the colchicine group were 11.7 and 9.4%, respectively, while they were 28.4 and 30.6%, respectively, in the concurrent controls (P > 0.01). On day 24 after treatment, the frequency of labelled sperm in the colchicine group reached the control level. Etoposide treatment resulted in an elevation of BrdU-labelled sperm at 23 rather than 22 days. The other chemicals showed no significant effect of prolonging meiotic cell cycle progression. On the basis of the colchicine and etoposide data, it is suggested that the effect of a chemical on the meiotic cell cycle progression is determined first in order to chose the appropriate sperm sampling time to detect aneuploidy induction.

Animals↗

A spermine-deoxycholic acid conjugate based lipid as a transfecting agent.

Deoxycholic acid-spermine conjugate (DAS), which is composed of natural components (deoxycholic acid and spermine), was incorporated in liposomes and evaluated for its interaction with plasmid DNA (pDNA) and in vitro transfection efficiency. Electromicrographs demonstrated that DAS-pDNA complexes are spherical, compact and electronically dense compared to the toroidal shapes formed by the monovalent lipid 1,2-dioleoyl-3-trimethylammonium propane (DOTAP) and pDNA. In comparison to the singly charged, non-cholesterol based lipid (DOTAP), the multivalent lipid DAS had similar transfection efficiency in two cell lines. The monovalent sterol, deoxycholic acid propyldiamine conjugate (DAP) was not effective as a transfecting agent. This suggests that multivalent facial amphiphiles such as DAS may serve as excellent candidates for non-viral gene transfer and warrant further study.

Animals↗

In vitro myotoxicity of selected cationic macromolecules used in non-viral gene delivery.

PURPOSE: Cationic lipid/DNA complexes have been proposed as a method of in vivo gene delivery via intravenous or intramuscular injection. A concern with using these polycationic molecules is whether they are associated with tissue toxicity at the injection site. Therefore, the objective of these studies was to investigate the myotoxic potential of selected non-viral gene delivery macromolecules (e.g., cationic lipids and polymers) with and without plasmid DNA (pDNA) in vitro. METHODS: Myotoxicity was assessed by the cumulative release of creatine kinase (CK) over 90 minutes from the isolated rodent extensor digitorum longus muscle into a carbogenated balanced salt solution (BBS, pH 7.4, 37 degrees C) following a 15 microL injection of the test formulation. Phenytoin (Dilantin) and normal saline served as positive and negative controls, respectively. RESULTS: The myotoxicity of plasmid DNA (pDNA, approximately 5000bp, 1 mg/ml) was not statistically different from normal saline. However, the myotoxicity of Dilantin was 16-times higher than either normal saline or pDNA (p < 0.05). Cationic liposomes were found to be less myotoxic than polylysine and PAMAM dendrimers. Polylysine's myotoxicity was found to be dependent upon concentration and molecular weight. The myotoxicity of formulations of cationic liposomes(s), lower molecular weight polylysine (25,000) and higher concentration of PAMAM dendrimers with pDNA were found to be statistically less significant than those formulations without pDNA. CONCLUSIONS: The cationic liposomes were less myotoxic compared to the dendrimers and polylysine. Myotoxicity was dependent upon the type of cationic lipid macromolecule, concentration, molecular weight and the presence of pDNA. A possible explanation for this reduced tissue damage in cationic lipids complexed with pDNA is that the formation of complex reduces the overall positive charge of the injectable system resulting in less damage.

Animals↗

Nonemergent forcible medication in an acute hospital.

Nonemergent forcible medication is a controversial procedure that has received somewhat less study in acute hospitals and in states where a simple in-house "treatment-driven" clinical review procedure is followed. We reviewed the charts of all patients so medicated by the New Jersey "Rennie" process on a large general acute adult psychiatric service, finding 43 (3%) of 1420 admitted patients so treated. Compared with a population of next-admitted individuals, these "Rennie" patients more frequently had previously required extended emergent forcible medication, had significantly longer hospitalizations (70 versus 26 days), not accounted for by the duration of treatment refusal, but improved with treatment so that almost all were discharged directly back to the community. Rennie patients appeared more likely to be diagnosed with schizophrenia and were significantly more likely to have a known history of assault, threatened assault, or property damage, but significantly less likely to have a known history of suicide threat or attempt. They were also significantly less likely to have a principal or secondary diagnosis of personality disorder or substance use disorder.

Adult↗

HLA-antigens in Guillain-Barré syndrome.

A microlymphocytotoxicity test determined serologically the frequency of HLA antigens in 32 patients with Guillain-Barré syndrome and in 234 healthy control subjects. The results demonstrated significantly increased frequencies of A3 and B8. The relative risk was estimated to be 9.6 and 4.6 for the A3 and B8 antigens, respectively. Study of the gametic association revealed weak positive linkage disequilibrium and biological association. The results are discussed, and it is concluded that the aberrant genetic make-up of the patients makes them more susceptible to develop the syndrome after exposure to the environmental factor(s).

Child↗