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Biomedical subjects

S Mroueh

Publications and source records attributed to S Mroueh.

11 recordsLinked to original sources
PubMed2000

Aspergillus vertebral osteomyelitis in a child with a primary monocyte killing defect: response to GM-CSF therapy.

We report the first case of vertebral aspergillosis in a child with a primary defect in monocyte killing, an extremely rare immunodeficiency The diagnosis of defective monocyte killing was made by an in vitro assay that showed normal killing of Staphylococcus aureus by the patient's neutrophils but impaired killing by his monocytes. Importantly, the extensive granulomatous infection that involved the vertebral column, posterior mediastinum, pleura, and lung was not responsive to aggressive treatment with a combination of liposomal amphotericin B. intralesional amphotericin B. itraconazole, and granulocyte transfusions. Dramatic clinical and radiological improvement was only seen after the addition of granulocyte macrophage-colony stimulating factor (GM-CSF) to his treatment regimen. The use of GM-CSF in the treatment of invasive aspergillosis in immunocompromised patients requires further evaluation.

Amphotericin B↗
PubMed1999

Treatment of severe status asthmaticus with nitric oxide.

The paper reports on a 13-year-old girl with chronic asthma who presented in acute respiratory failure following an exacerbation of her disease. Nitric oxide was added to the ventilator circuit at 7 ppm and then 15 ppm after the patient failed to respond to bronchodilators and steroids. This was followed by rapid improvement in respiratory mechanics and blood gases with no adverse effects. Nitric oxide appears to have a direct relaxing effect on the bronchial smooth muscle.

Administration, Inhalation↗
PubMed1999

Selected abstracts

Explore the source record for details and available documents.

Journal Article↗
PubMed1998

Dextrocardia and corrected transposition of the great arteries (I,D,D) in a case of Kartagener's syndrome: a unique association.

Kartagener's syndrome (KS) usually includes mirror-image dextrocardia. The incidence of congenital heart disease in KS is comparable with that in the general population. This paper reports on a case of Kartagener's syndrome associated with dextrocardia, corrected transposition of the great arteries (I,D,D), ventricular septal defect, and valvar pulmonary stenosis in an 8-year-old girl.

Cardiac Catheterization↗
PubMed1997

Alpha-interferon in the treatment of subacute sclerosing panencephalitis.

Subacute sclerosing panencephalitis is an inexorably progressive disease with no effective therapy. Recent trials of intrathecal and intraventricular alpha-interferon yielded controversial results. We tried intrathecal or intraventricular alpha-interferon in four patients with subacute sclerosing panencephalitis. None of them had evidence of improvement. We reviewed the previously published studies on the use of alpha-interferon in subacute sclerosing panencephalitis. Further international collaborative studies are needed to determine the role of alpha-interferon in the treatment of subacute sclerosing panencephalitis.

Adult↗
PubMed1994

Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis.

In order to determine the incidence of allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (CF), we reviewed the records of 236 patients followed up at the Duke CF Center. Sixty patients (25 percent) had colonies of Aspergillus fumigatus. These patients were older and had more severe disease as assessed by lower Shwachman-Kulczycki (S-K) scores than the patients who did not have evidence of A fumigatus. In 15 of the patients with A fumigatus (6.5 percent of the total population), the diagnosis was ABPA. Age and S-K scores were not significantly different from those of the patients with A fumigatus without ABPA. Diagnostic features of the affected patients included wheezing refractory to bronchodilator therapy, persistent pulmonary infiltrates, peripheral eosinophilia, positive skin reactivity to an A fumigatus antigen and elevated total serum IgE levels. Steroid therapy was started for all patients, and clinical improvement was noted within 1 month as evidenced by decreased symptoms and weight gain. Chest x-ray films usually showed improvement. Vital capacity improved in all but two patients. Total IgE did not consistently decrease in response to therapy. Although the diagnosis of ABPA may be difficult to establish, ABPA commonly is associated with CF. Most patients respond to steroid therapy; however, the effect of therapy on the course of the disease is difficult to assess.

Adolescent↗
PubMed1992

Management of an unusual presentation of foreign body aspiration.

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

Bronchi↗
PubMed1989

Risk factors for the development of posterior subcapsular cataracts in patients with cystic fibrosis and allergic bronchopulmonary aspergillosis treated with corticosteroids.

Posterior subcapsular cataracts (PSCC) occur in a high percentage of patients treated with long-term systemic corticosteroids (Naumann Gott, Apple DJ, eds: Pathology of the Eye. New York: Springer-Verlag, 1986). Fifteen patients with cystic fibrosis treated at Duke University Medical Center between January 1982 and October 1987 required prednisone for treatment of allergic bronchopulmonary aspergillosis (ABPA). Two of these patients (13.3%) were noted to have PSCC during prednisone therapy. We retrospectively examined factors associated with steroid administration that may have been predictive of the development of PSCC in these patients including: 1) steroid therapy for longer than 2 years, 2) steroid dose of 10 mg/day or greater for longer than 6 months, 3) steroid dose of 40 mg/day or greater for longer than 2 months, and 4) change in linear growth pattern during steroid therapy. None of these factors predicted the risk of developing PSCC. Therefore, we recommend that all patients with cystic fibrosis who receive steroids for the treatment of a concomitant condition such as ABPA should undergo careful examination for opacities of the ocular lens at each clinical visit regardless of the duration or dose of steroids.

Adolescent↗
PubMedDate not supplied

Asthma in primary care.

Asthma is a chronic disease that cannot be cured but can be effectively controlled. Control is achieved through education of the patient, monitoring of symptoms and pulmonary functions, environmental modification and pharmacologic therapy. The latter should aim at providing control with the least amount of medications. Any form of asthma more severe than mild intermittent requires the use of long term anti-inflammatory medications.

Administration, Inhalation↗