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Marques MO, Abdo A, Silva PB, Junior AS, Alves LBO, Bachour P, Baiocchi OCG. APOPTOSE NO COVID-19 GRAVE E POTENCIAIS BIOMARCADORES PROGNÓSTICOS. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Marques MO, Abdo A, Silva PB, Junior AS, Alves LBO, Arruda GN, Brasil LMCR, Bachour P, Baiocchi OC. A TEMPESTADE DE CITOCINAS E O DESBALANÇO IMUNE NO COVID-19 GRAVE. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Zalewski P, Beltrame J, Abdo A, Wawer A, Tvorogova Z, Tavella R. Prevalence of Zinc Deficiency in Patients With Suspected Coronary Artery Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aioub M, Gee T, Mutter O, Harmon K, Abdo A, Prescott S, Zhao H, Diaz J, Ayala-Crespo A. Development and Implementation of a Robotic Surgery Training Curriculum. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alhetheel A, Albarrag A, Hakami A, Shakoor Z, Alswat K, Abdo A, Al-Hamoudi W, Alomar S. In the peripheral blood mononuclear cells (PBMCs) of HCV infected patients the expression of STAT1 and IRF-1 is downregulated while that of caspase-3 upregulated. Acta Virol 2021; 64:352-358. [PMID: 32985214 DOI: 10.4149/av_2020_313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Several peripheral blood mononuclear cell (PBMC) defects have been linked with hepatitis C virus (HCV) infection, including alterations in cytokine secretion and increased cell death. This study was performed to investigate the expression levels of signal transducer and activator of transcription 1 (STAT1), interferon regulatory factor 1 (IRF-1), and caspase 3 in PBMCs of patients infected with HCV. STAT1, IRF-1, and caspase 3 expression levels were compared in PBMCs from 19 untreated (naïve) HCV+ patients, 8 treated (sustained responder [SR]) HCV patients, and 20 HCV- healthy controls. Moreover, PBMCs from naïve HCV+ patients and SR-HCV patients were also evaluated for HCV RNA expression. The expression levels of STAT-1 and IRF-1 were significantly downregulated in PBMCs from naïve HCV+ patients (P Keywords: PBMC; hepatitis C virus; STAT1; IRF-1; caspase-3.
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Ibrahim H, El Kerdawy AM, Abdo A, Sharaf Eldin A. Similarity-based machine learning framework for predicting safety signals of adverse drug–drug interactions. Informatics in Medicine Unlocked 2021. [DOI: 10.1016/j.imu.2021.100699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Bailly MT, Vasile T, Berthelot E, Abdo A, El Hatimi S, Jourdain P, Assayag P. [Saw tooth cardiomyopathy: How to better diagnose?]. Ann Cardiol Angeiol (Paris) 2020; 71:115-117. [PMID: 32782066 DOI: 10.1016/j.ancard.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
With the increasing use of cardiac MRI, several cases were described as "sawtooth cardiomyopathy" or "tiger heart". The pathological aspects of these rare forms of myocardial dysplasia, frequently assimilated to non-compaction of the left ventricle, and its prognostic implications remain unclear. We present a case of "sawtooth cardiomyopathy" in a patient with a transient ischemic attack. This article aims to determine, with the other clinical cases in the literature, the MRI and echocardiography criteria for the diagnosis of this cardiomyopathy. Sawtooth cardiomyopathy is probably under diagnosed and deserves to be better known.
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Affiliation(s)
- M T Bailly
- Service de cardiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
| | - T Vasile
- Service de radiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - E Berthelot
- Service de cardiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - A Abdo
- Service de radiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - S El Hatimi
- Service de cardiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - P Jourdain
- Service de cardiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | - P Assayag
- Service de cardiologie, hôpital Bicêtre, AP-HP, Le Kremlin Bicêtre, France
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Abdo A, Jaghoori A, Tran H, Jakobczak R, Beltrame J, Zalewski P. Zinc Modulates Endothelin-1 and Nitric Oxide Signalling in Vascular Endothelial and Smooth Muscle Cells. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abdo A, Pérez-Bernal J, Hinojosa R, Porras F, Castellanos R, Gómez F, Gutiérrez J, Castellanos A, Leal G, Espinosa N, Gómez-Bravo M. Cerebral Hemodynamics Patterns by Transcranial Doppler in Patients With Acute Liver Failure. Transplant Proc 2016; 47:2647-9. [PMID: 26680061 DOI: 10.1016/j.transproceed.2015.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 09/26/2015] [Accepted: 10/06/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION About half of patients with acute liver failure (ALF) show clinical signs of cerebral edema and intracranial hypertension. Neuroimaging diagnostics and electroencephalography have poor correlation with intracranial pressure measurement. OBJECTIVE The objective of this study was to characterize the cerebral hemodynamics patterns with transcranial Doppler (TCD) sonography in patients with ALF. METHOD We studied 21 patients diagnosed with ALF, admitted to the intensive care unit (ICU) at the Centro de Investigaciones Médico Quirúrgicas of Cuba. All of these patients had a TCD performed on arrival at ICU, evaluating the following: systolic (SV), diastolic (DV), and medium (MV) flows velocities and pulsatility index (PI) in right middle cerebral artery (RMCA) via temporal windows. RESULTS The sonographic patterns of cerebral hemodynamics were as follows: low-flow, 12 patients (57.1%); high resistance, 5 patients (23.8%); and hyperemic, 4 patients (19%). Patients who died while waiting had lower MV RMCA (56.1 vs 58.1 cm/s) and higher PI (1.71 vs 1.41) than patients who could undergo transplantation (P = .800 and P = .787, respectively). CONCLUSIONS In patients diagnosed with ALF admitted to the ICU the predominating cerebral hemodynamic pattern was low-flow with resistance increase. The TCD was shown to be a useful tool in the initial evaluation for prognosis and treatment.
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Affiliation(s)
- A Abdo
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba.
| | - J Pérez-Bernal
- Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R Hinojosa
- Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F Porras
- Intensive Care Unit, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R Castellanos
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - F Gómez
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - J Gutiérrez
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - A Castellanos
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - G Leal
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - N Espinosa
- Intensive Care Unit, Centro de Investigaciones Médico Quirúrgicas, La Habana, Cuba
| | - M Gómez-Bravo
- Liver Transplantation Unit, Hospital Universitario Virgen del Rocío, Sevilla, España
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Mourad Z, Hassab H, Younan D, Abdo A. Human leucocyte antigen alloimmunisation in repeatedly transfused thalassemic Egyptian children and its relation to febrile non-haemolytic transfusion reactions. Transfus Med 2015; 25:380-4. [PMID: 26578338 DOI: 10.1111/tme.12261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 06/06/2015] [Accepted: 10/24/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To document the incidence of lymphocytotoxic antibodies (LCA) in chronically transfused children with β thalassemia major and the relationship between alloimmunisation and febrile non-haemolytic transfusion reactions. We also compared the effect of leucoreduced-packed red blood cells (RBCs) by bed-side filtration and washed RBCs in preventing FNHTRs and in inducing haemoglobin rise. BACKGROUND Alloimmunisation to human leucocytic antigens is one of the common complications of transfusions, particularly in chronically transfused patients as those with thalassemia major, a common disease in Northern Egypt. METHODS/MATERIALS LCA were screened for in 45 chronically transfused β thalassemia major children (group I), 20 splenectomised ones (group II) and 20 healthy controls (group III), using qualitative lymphocytotoxic antibody (LCA) enzyme-linked immunosorbent assay (ELISA) kit. RESULTS Nine out of 65 thalassemic children (∼14%) were positive for LCA antibodies. Frequency of transfusions and LCA positivity were significantly higher in group I than group II (p = 0.036 and 0.014). There was no statistically significant difference between LCA positive and negative cases regarding age of starting transfusion, frequency of transfusions or FNHTRs. There was no statistically significant difference between washed and filtered RBCs in reducing FNHTRs (p = 1.000) and in inducing haemoglobin rise in positive LCA cases (p = 0.409). CONCLUSION Human leukocyte antigen (HLA) alloimmunisation was only 14% in the children with β thalassemia major we studied. Surprisingly FNHTRs were not more common in those with HLA antibodies. Splenectomy plays a role in reducing the frequency of transfusion and HLA alloimmunisation. Washed and filtered RBCs are comparable in reducing FNHTRs and in inducing haemoglobin rise.
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Affiliation(s)
- Z Mourad
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - H Hassab
- Pediatric Hematology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - D Younan
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - A Abdo
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Al-Qahtani A, Alarifi S, Al-Okail M, Hussain Z, Abdo A, Sanai F, Al-Anazi M, Khalaf N, Al-Humaidan H, Al-Ahdal M, Almajhdi FN. RANTES gene polymorphisms (-403G>A and -28C>G) associated with hepatitis B virus infection in a Saudi population. Genet Mol Res 2012; 11:855-62. [PMID: 22576913 DOI: 10.4238/2012.april.10.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Besides the host immune response, genetic and environmental factors play crucial roles in the manifestation of hepatitis B virus (HBV) infection. "Regulated on activation normal T-cell expressed and secreted" factor (RANTES) plays a vital role in CD4(+), CD8(+) T-lymphocyte and dendritic cell activation and proliferation in inflammation. Single nucleotide polymorphisms (SNPs) in the RANTES gene are associated with several viral and non-viral diseases. Association studies have invariably indicated a lack of association between RANTES gene SNPs and HBV infection in ethnic populations, even though RANTES gene SNPs exhibit distinct ethnic distributions. Despite the high prevalence of HBV infections in Saudi Arabia, no studies have been made concerning a possible relationship between RANTES gene polymorphisms and susceptibility to and progression of HBV infection. We examined -403G>A and -28C>G RANTES gene variants in 473 healthy controls and 484 HBV patients in ethnic Saudi populations. Significant differences were found in the genotype and allele distributions of the SNPs between the controls and the HBV patients. Both SNPs were significantly linked to viral clearance in these subjects. Our data demonstrate for the first time in a Saudi population, a relationship between the RANTES gene polymorphisms and the clinical course of HBV infection and underscore the importance of evaluating the genetic background of the affected individual to determine how it may affect disease progression.
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Affiliation(s)
- A Al-Qahtani
- Department of Biological and Medical Research, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Sun M, Abdollah F, Shariat S, Schmitges J, Trinh QD, Tian Z, Jeldres C, Abdo A, Bianchi M, Briganti A, Montorsi F, Perrotte P, Karakiewicz P. Propensity-score matched comparison of complications, blood transfusions, length of stay, and in-hospital mortality between open and laparoscopic partial nephrectomy: A national series. Eur J Surg Oncol 2012; 38:80-7. [DOI: 10.1016/j.ejso.2011.09.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 08/12/2011] [Accepted: 09/15/2011] [Indexed: 01/31/2023] Open
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Budäus L, Morgan M, Abdollah F, Zorn KC, Sun M, Johal R, Thuret R, Abdo A, Schmitges J, Isbarn H, Jeldres C, Perrotte P, Graefen M, Karakiewicz PI. Impact of annual surgical volume on length of stay in patients undergoing minimally invasive prostatectomy: a population-based study. Eur J Surg Oncol 2011; 37:429-34. [PMID: 21492776 DOI: 10.1016/j.ejso.2011.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 01/29/2011] [Accepted: 02/28/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND On average, patients remain hospitalized no more than 2 days after MIRP. The aim of our study was to examine the temporal trends in length of stay ≥ 3 days and to test the relationship between annual surgical volume (ASV) and annual hospital volume (AHV) and length of stay ≥ 3 days in patients undergoing MIRP. MATERIAL AND METHODS Within the Florida Hospital Inpatient Datafile, 2439 men who were treated with MIRP for prostate cancer between 2005 and 2008 were identified. Temporal trends were assessed and uni and multi-variable logistic regression models tested the relationship between ASV, AHV and length of stay ≥ 3 days. RESULTS The average length of stay decreased from 2.4 in 2005 to 1.7 days in 2008. Length of stay ≥ 3 days was recorded in 13.6% of patients and the proportion of patients staying more than ≥ 3 days decreased over time (25.5-12.2%; Chi Square trend p < 0.001). After stratification into low (<1-15 MIRPs) vs. intermediate (16-63 MIRPs) vs. high ASV tertiles (≥ 64 MIRPs) the proportion of patients with length of stay ≥ 3 days were 29.1; 13.2 and 11.1%. In multivariable logistic regression models predicting length of stay ≥ 3 days, ASV, year of surgery and comorbidities achieved independent predictor status and MIRP patients operated by highest ASV tertile surgeons were 71% (p < 0.001) less likely to be hospitalized for more than 3 days. CONCLUSION The length of stay after MIRP decreased between 2005 and 2008. Surgical expertise represented one of the main determinants of shorter length of stay.
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Affiliation(s)
- L Budäus
- Martiniclinic, Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Abstract
The role of Helicobacter pylori infection in the development of iron deficiency anaemia has been the focus of attention over the past decade. However, confirmation of a relationship has not confirmed the pathophysiological mechanisms involved in the phenomenon. The aim of the present work is to study the levels of fasting gastric acidity (free and total) as well as the level of tumour necrosis factor-alpha (TNF alpha) in male refractory iron deficiency anaemia patients seropositive for H. pylori infection versus those who are seronegative. Thirty adult patients with iron deficiency anaemia and gastroduodenitis were subdivided into two groups of matched age and haemoglobin value. Group 1 was H. pylori-seropositive for infection and these patients did not receive prior treatment for eradication of H. pylori infection. Group 2 comprised patients seronegative for H. pylori infection (control group). Patients with active bleeding or previous medical problems were excluded from the study. All patients and controls were subjected to the following at presentation: history taking and thorough clinical examination, complete blood picture, reticulocytes (%), assessment of serum iron, total iron binding capacity, serum ferritin, IgG anti-Helicobacter antibody and TNF alpha, stool for occult blood and measurement of gastric acidity (total and free). Upper endoscopy was performed and multiple biopsies were taken and tested for expression of cytotoxin-associated gene A (cagA) by the polymerase chain reaction (PCR). Results showed significantly higher values of free and total gastric acidity as well as TNF alpha levels in Group 1 compared to controls (Group 2). Among those in Group 1, higher TNF alpha levels were seen in seven H. pylori cagA-positive patients than in eight cagA-negative patients. Haemoglobin values were inversely correlated with TNF alpha levels. Thus, elevated serum TNF alpha in the H. pylori-seropositive group may be one of the underlying pathophysiological mechanism for iron deficiency anaemia observed in these patients.
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Affiliation(s)
- M T Afifi
- Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, Alexandria University, Egypt
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González-Rapado L, Abdo A, Hernández H, Cepero M, Samada M, Ramos L, Ysla R, Gómez F, Delgado D, Melián K, González C, Pérez J, Bernardos A. Results of liver transplantation at the Cuban Center for Medical and Surgical Research. Transplant Proc 2009; 40:2983-4. [PMID: 19010167 DOI: 10.1016/j.transproceed.2008.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
From July 4, 1999, when a liver transplantation program was started in Cuba, to December 30, 2007, we performed 125 procedures in 115 patients. The most frequent reasons for transplantation were cirrhosis caused by hepatitis C virus (29%) and alcoholic cirrhosis (17.2%). Two patients received simultaneous liver-kidney transplants. Sixty-seven patients were males, and the patient ages ranged from 12 to 74 years. The average surgical time was 6 hours, and cold ischemia time was 4 to 14 hours. The average blood consumption was 1630 mL; 2900 mL of plasma and 8 units of platelets were used in 7 cases. Immunosuppression was mainly cyclosporine, mycophenolate mofetil, and prednisone. Acute cellular rejections were treated in almost all cases with 3 doses of methylprednisolone. The most frequent complications were biliary (15%), hepatic arterial thrombosis (6%), postsurgical bleeding (8%), acute cellular rejection (20%), and ductopenic rejection (2%). The overall 1-year survival was 74.7%.
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Petrofsky J, Suh HJ, Fish A, Hernandez V, Abdo A, Collins K, Mendoza E, Yang TN. A multi-channel stimulator and electrode array providing a rotating current whirlpool for electrical stimulation of wounds. J Med Eng Technol 2009; 32:371-84. [PMID: 18821415 DOI: 10.1080/03091900601116994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
When electrical stimulation is used on wounds, the electrical current has difficulty penetrating areas where there is necrotic tissue. Further, for an irregularly shaped wound, current distribution is poor in some areas of the wound since conventional two-electrode delivery systems provide the greatest current in a line directly between the electrodes. A new stimulator and electrode system is described which uses three electrodes spaced around a wound to disperse current more evenly. The stimulator senses tissue impedance and then redirects current by altering its Thevenin's output impedance for each electrode; each of the three electrodes becomes the active one in sequence while the remaining are the sink electrodes. Eight subjects were examined to test the stimulator. Electrical stimulation was applied to the skin above the quadriceps muscle at currents of 15 mA in six subjects without wounds and in two subjects with wounds. The relationship between electrode position and current dispersion on the skin was examined with a two-electrode vs. a three-electrode system to set stimulation parameters for the computer. The results showed that the three-electrode system could (1) detect areas of the skin with high impedance; (2) compensate by altering the Thevenin's output impedance at each of the three electrodes to shift current to high impedance areas; (3) provide uniform current across the skin as assessed by skin current and blood flow measurements with a laser Doppler flow imager.
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Affiliation(s)
- J Petrofsky
- Department of Physical Therapy, Loma Linda University, Loma Linda, CA 92350, USA.
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Allam N, Al-sofayan M, Helmy A, Al-saghier M, Medhat Y, Khalaf H, Abdo A, Sebayel M. EVALUATION OF 368 LIVING RELATED LIVER DONORS: SINGLE CENTER EXPERIENCE. Transplantation 2008. [DOI: 10.1097/01.tp.0000331436.50207.5a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khalaf H, Mourad W, El-Sheikh Y, Abdo A, Helmy A, Medhat Y, Al-Sofayan M, Al-Sagheir M, Al-Sebayel M. Liver transplantation for autoimmune hepatitis: a single-center experience. Transplant Proc 2007; 39:1166-70. [PMID: 17524922 DOI: 10.1016/j.transproceed.2007.02.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To present our experience with deceased donor liver transplantation (DDLT) and living-donor liver transplantation (LDLT) for autoimmune hepatitis (AIH). PATIENTS AND METHOD Between April 2001 and November 2006, a total of 116 LT procedures were performed (73 DDLTs and 43 LDLTs) in 112 patients (4 retransplants). Of the 112 recipients, 16 patients (14.3%) were transplanted for AIH (15 DDLTs and 1 LDLT). All recipients received FK506- and steroid-based immunosuppressive regimens. RESULTS The male/female ratio was 3/13, median age was 22 years (range, 15 to 35), and the median MELD score was 25 (range, 11 to 40). Arterial reconstruction was needed in four DDLTs due to severe steroid-induced angiopathy. After a median follow-up period of 530 days (range, 11 to 2016), the overall patient and graft survival rates were 93.8%. Only one patient died following LDLT due to primary graft nonfunction. Histopathologic recurrence was seen in three patients (18.7%) and was successfully treated by optimizing immunosuppression. Markedly elevated serum CA19-9 levels (median, 1069; range, 217 to 2855) was seen in four patients (28%), malignancy was ruled out and all patients normalized serum CA19-9 levels within the first 3 months posttransplant. Steroids withdrawal failed in all recipients and was always accompanied with almost immediate elevation of liver enzymes. CONCLUSIONS In our experience, LT for AIH shows excellent long-term outcomes, patients are usually young women who present with acute deterioration and high MELD scores, and usually require long-term steroids to prevent rejection and disease recurrence. Some patients have markedly high CA19-9 in absence of malignancy. Some patients also have severe steroid-induced hepatic artery angiopathy necessitating arterial reconstruction during the transplant surgery.
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Affiliation(s)
- H Khalaf
- Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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González L, Abdo A, López O, Samada M, Ramos L, Castillo J, Fernández A, Ysla R, Hernández JC, Cepero M, Castellanos R, Wilford M, Gómez F, Díaz J, Collera SA, Domínguez J, Benítez PP, Rodríguez H, Avalo FD. Liver Transplantation at the Cuban Center for Medical and Surgical Research. Transplant Proc 2005; 37:1505-6. [PMID: 15866656 DOI: 10.1016/j.transproceed.2005.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
From July 4, 1999, when a liver transplantation program was started in Cuba, to October 2003, 66 procedures had been performed in 60 patients. The most frequent reason was cirrhosis caused by hepatitis C virus (29%), and alcoholic cirrhosis (22%). Two patients received simultaneous liver-kidney transplants. Half of the patients were men. Patient ages ranged from 12 to 62 years; the average surgical time was 6 hours; and cold ischemia time was 4 to 14 hours. The average blood consumption was 2033 mL; 2900 mL of plasma and 8 units of platelets were used in 7 cases. Immunosuppression was mainly cyclosporine (Neoral), mycophenolate mofetil or azathioprine, and prednisone. Acute cellular rejections were treated in almost all cases with 3 doses of methylprednisolone. The most frequent complications were biliary (24%), hepatic arterial thrombosis (12%), post-surgical bleeding (10%), acute cellular rejection (24%), and ductopenic rejection (2%). The overall 1-year survival rate was 73.7%.
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Affiliation(s)
- L González
- Medical-Surgical Research Center, Havana, Cuba.
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Abdo A, López O, Fernández A, Santos J, Castillo J, Castellanos R, González L, Gómez F, Limonta D. Transcranial Doppler sonography in fulminant hepatic failure. Transplant Proc 2003; 35:1859-60. [PMID: 12962825 DOI: 10.1016/s0041-1345(03)00592-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
UNLABELLED The clinical course of patients with fulminant hepatic failure (FHF) is often worsened by the presence of cerebral edema and endocranial hypertension. In spite of the multiple studies using Transcranial Doppler Sonography (TCDS), few have shown the cerebral blood flow (CBF) pattern among patients with encephalopathy resulting from FHF. OBJECTIVE Our objective was to characterize the CBF pattern in these patients through the use of TCDS to provide therapeutic strategies. METHOD The TCDS pattern was assessed in five patients diagnosed with FHF and compared with a control group who displayed critical neurologic conditions not associated with FHF. Pulsatile index, systolic, diastolic, and mean velocity of the middle cerebral artery were measured. RESULTS The mean age of patients with FHF was 45.4 years. One hundred percent were women, with viral hepatitis as the predominant etiology. A cerebral hypoperfusion pattern was found in 80% of the FHF group and 40% of the control group. In the former group there was no evidence of hyperemia, as there was among 20% of the control group. The mean values of velocity and pulsatile index were 36.6 cm/sec and 2.4, respectively, in the FHF group and 47.8 cm/s and 1.8 in the control group (P=0.268, P=0.402). CONCLUSIONS FHF patients show a predominance of cerebral hypoperfusion pattern with mean velocities lower than normal values and an increased pulsatile index. We recommend that clinicians take appropriate measures to improve cerebral perfusion and avoid hypoxia. Hyperventilation as a first level measure is contraindicated.
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Affiliation(s)
- A Abdo
- Centro de Investigaciones Medico Quirúrgicas, Unidad de Cuidados Intensivos, Servicio de Transplantes, Havana, Cuba.
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22
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Abdo A, Ugarte JC, Castellanos R, González L, López O, Hernández JC, Valdivia J, Almora E, Suárez O, Diaz J, Collera S, Enamorado A, Vázquez A, Beníte P, Dominguez J, Wilford M, Falcon J. The transplantation donation process in the Centro de Investigaciones Medico Quirurgicas of Cuba: 1999-2002. Transplant Proc 2003; 35:1636-7. [PMID: 12962738 DOI: 10.1016/s0041-1345(03)00696-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In 1998 in the Centro de Investigaciones Medico Quirurgicas the Transplant Coordination Office (TCO) was created, with the aim to organize a system to support a hepatic transplantation program. This organization, which changed the transplantation-donation process not only in our center but in the whole country, is described in this article. METHOD The files of donors generated in our hospital were studied together with the transplant coordination records, from 1999 till the first half of 2002. RESULTS In the period studied, 21 potential donors were diagnosed with brain death, yielding a donation rate of 71.4%. Brain death was most frequently caused by vascular brain disease; however, in the realized donor group, the cranioencephalic trauma predominated. The typical donor was a man of average age 39.2 years (range, 18-86 years). Among the potential donors, 24% were excluded based on medical criteria, and 5% due to family objections. Forty liver transplantation were performed in 36 patients including 1 liver-kidney simultaneous procedure. The principal etiologies for transplant included hepatitis C virus cirrhosis, 22%; alcoholic, 19%; and acute hepatic failure, 13%. Kidney transplantations were performed in 70 patients, including 41 from cadaveric donors (53.6%) and 29 from living related donors (41.4%). In 2001, a pancreas-kidney transplantation program was started. CONCLUSION The creation of the TCO has been of paramount importance to optimize transplantation program functions.
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Affiliation(s)
- A Abdo
- Centro de Investigaciones Medico Quirurgicas, Unidad de Cuidados Intensivos, Servicio de Trasplantes, Ciudad Habana, Cuba.
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23
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Myers RP, Abdo A, Poynard T. Pegylated interferon alfa for chronic hepatitis C. Hippokratia 2003. [DOI: 10.1002/14651858.cd004035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Yousufuddin M, Starling R, Tuzcu E, Haji S, Ratliff N, Cooke D, Abdo A, McCarthy P, Young J, Yamani M. Cardiac angiotensin II receptors predict allograft vasculopathy in heart transplant recipients. J Heart Lung Transplant 2003. [DOI: 10.1016/s1053-2498(02)00977-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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25
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Abdo A, Raboud J, Freeman HJ, Zetler P, Tilley J, Chaun H, Whittaker JS, Amar J, Halparin L, Enns R. Clinical and histological predictors of response to medical therapy in collagenous colitis. Am J Gastroenterol 2002; 97:1164-8. [PMID: 12014722 DOI: 10.1111/j.1572-0241.2002.05688.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Collagenous colitis (CC) is an uncommon form of inflammatory bowel disease. The response to typical medical therapies (antimotility agents, 5-aminosalicylic acid [5-ASA], and corticosteroids) is variable. We aimed to determine if there are clinical or histological variables that can predict response to medical therapy. METHODS All cases of CC were identified in three tertiary care medical centers. All charts of included patients were reviewed and clinical variables (age, gender, duration of symptoms, frequency of bowel movements, and the use of nonsteroidal anti-inflammatory drugs [NSAIDs]) were recorded. Available histology slides were reviewed by one GI pathologist. Intraepithelial inflammation, epithelial loss or detachment, inflammation in the lamina propria, presence of eosinophilia, crypt inflammation, Paneth's cell metaplasia, and collagen layer thickness were recorded. Depending on their response to therapy, patients were divided into three groups: 1) spontaneous recovery or response to antidiarrheal agents alone, 2) response to 5-ASA agents, and 3) response to corticosteroids after failure of antidiarrheal agents and 5-ASA. RESULTS Ninety-four patients with CC were identified. Of these, 62 patients were included. The median age was 58 (range = 20-85), and 88% were female. Among the histological parameters only the degree of inflammation in the lamina propria significantly differed between the three response groups (p = 0.007). Patients who required corticosteroids had greater inflammation. Among the clinical parameters age at presentation and use of NSAIDs significantly differed between groups. In the antidiarrheal group, patients tended to be more elderly, and in the corticosteroid group, more patients were on NSAIDs. CONCLUSIONS 1) The degree of lamina propria inflammation can be used as a histological predictor to guide treatment in patients with CC. 2) Patients who responded to antidiarrheal agents or had spontaneous remissions were significantly older than those patients requiring 5-ASA compounds or corticosteroids. 3) Patients who were taking NSAIDs were more likely to require corticosteroid therapy, presumably reflecting more severe disease.
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Affiliation(s)
- A Abdo
- Department of Medicine, St Paul's Hospital, Vancouver, BC, Canada
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26
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Yamani MH, Cook D, Starling RC, Ratliff NB, McMahon JT, Abdo A, Tuzcu M, McCarthy P, Young JB. Myocardial ischemic injury following heart transplantation is associated with decreased risk of acute cellular rejection in the absence of humoral rejection. J Heart Lung Transplant 2001; 20:238. [PMID: 11250463 DOI: 10.1016/s1053-2498(00)00536-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- M H. Yamani
- Cleveland Clinic Foundation, Cleveland, OH, USA
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27
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Jimenez J, Rosario A, Morales A, Tayara W, Abdo A, Young J, Mccarthy P, Starling R, Cook D. Risk factors and outcome in patients with hemodynamically unstable rejection after heart transplantation. J Heart Lung Transplant 2001; 20:193. [PMID: 11250333 DOI: 10.1016/s1053-2498(00)00405-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- J Jimenez
- Cleveland Clinic Foundation, Cleveland, OH, USA
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28
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Kumpati GS, Cook DJ, Blackstone EH, White J, Abdo A, Young JB, Starling RC, Smedira NG, McCarthy PM. Evolution and significance of HLA allosensitization during ventricular assist device support. J Heart Lung Transplant 2001; 20:210-211. [PMID: 11250383 DOI: 10.1016/s1053-2498(00)00456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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29
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García-Navarro ME, Tacoronte M, Sarduy I, Abdo A, Galvizú R, Torres A, Leal E. [Influence of early stimulation in cerebral palsy]. Rev Neurol 2000; 31:716-9. [PMID: 11082876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
INTRODUCTION Early stimulation is known to be useful, necessary treatment aimed at developing as much as possible the social psychophysical potential of any child at high environmental and/or biological risk. This group includes children with cerebral palsy, a disorder of the nervous system which may cause retardation in the processes of maturation of the central nervous system and be expressed from the earliest months of the child's life as retardation of psychomotor development. OBJECTIVE To show the efficiency of early stimulation in children diagnosed as having cerebral palsy and retardation of psychomotor development. PATIENTS AND METHODS A retrospective study was made of 20 children aged between 9 and 41 months with this diagnosis, in the hospital of CIREN (Cuba). They were treated for a period of 1 to 3 months by a multi-disciplinary team and participated in the programme for Early Stimulation. Assessment was made by the Neuropsychology Department at the start and end of the treatment period, using the first part of the Brunet-Lezine scale for the measurement of psychomotor development in early childhood. RESULTS In all patients there was a favorable course and new abilities were acquired. There was better performance than before the treatment was started and accelerated rate of development during the period of treatment. CONCLUSION Patients with cerebral palsy and psychomotor retardation benefit from application of a programme of Early Stimulation.
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Affiliation(s)
- M E García-Navarro
- Dpto. de Neuropsicología, Centro de Investigaciones Médico Quirúrgicas (CIMEQ), La Habana, Cuba.
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30
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Abdo A, Bebb RA, Wilkins GE. Ventricular fibrillation: an extreme presentation of primary hyperaldosteronism. Can J Cardiol 1999; 15:347-8. [PMID: 10202199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Patients with primary aldosteronism often present with hypokalemia and hypertension. Primary aldosteronism presenting as sudden death due to ventricular fibrillation is described in an otherwise healthy 37-year-old woman. After successful direct current cardioversion, serum potassium was 1.4 mmol/L. Investigations revealed a suppressed renin level, elevated serum aldosterone and a right adrenal nodule found on imaging. Ventricular fibrillation has not previously been described as a presention of a biochemically and surgically proven aldosterone-producing adenoma. This case highlights the importance of early detection and proper diagnosis of secondary hypertension before serious sequelae occur.
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Affiliation(s)
- A Abdo
- Division of Endocrinology, St Paul's Hospital, University of British Columbia, Vancouver, Canada
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31
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Abstract
OBJECTIVE To report a case of acute interstitial nephritis (AIN) related to administration of vancomycin for the treatment of Staphylococcus aureus sternal wound infection, osteomyelitis, and infective endocarditis. CASE SUMMARY Reports in the literature regarding vancomycin-induced AIN are scarce. We describe the fifth known case of AIN, in a 64-year-old white man who developed fever, maculopapular rash, acute renal failure, eosinophilia, and eosinophiluria after approximately 1 month of vancomycin treatment. The results of the renal biopsy were consistent with an allergic drug reaction. Four months after his initial episode of AIN, the patient was rechallenged with vancomycin for the treatment of S. aureus septic arthritis. One day after initiation of vancomycin, serum eosinophils started to rise, his urine tested positive for eosinophils, but his serum creatinine remained stable. CONCLUSIONS Our case report and others from the literature suggest vancomycin causes allergic AIN. Clinicians should be aware of this adverse effect in an era of increasing use of vancomycin for treatment of resistant gram-positive organisms.
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Affiliation(s)
- A O Wai
- Faculty of Pharmaceutical Sciences, University of British Columbia, Canada
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Abstract
BACKGROUND Epidermoids of the brain are rare tumors. Their fourth ventricle localization is about the rarest localization. No series of such tumors has been reported. Their manifestations and management are therefore not well understood. METHODS Four epidermoid tumors of the fourth ventricle were collected over a period of 39 years from the neurosurgical units of the American University of Beirut Medical Center and the Orient Hospital. These were retrospectively studied and the medical literature reviewed. RESULTS Epidermoids of the brain form 1% of all brain tumors, and those located in the fourth ventricle are 16.7% of the epidermoids. They rarely present symptoms of increased intracranial pressure. They commonly present in adults with only cerebellar signs. The duration of symptoms may be short, medium, or long. The diagnosis, when clinically suspected, should be confirmed by magnetic resonance imaging. An early diagnosis is the key for a good outcome. CONCLUSION Although a rare condition, these tumors can be lethal if not treated. Total excision should be attempted. Because this tumor is very slow-growing, a near-total excision is acceptable in cases where complete removal may endanger function or life.
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Affiliation(s)
- S I Nassar
- Department of Surgery, American University of Beirut, Lebanon
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33
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Rabell S, Piera OM, Abdo A, Sotolongo R. [Bronchial asthma: clinico-pathological study of fatalities in intensive care units]. Allergol Immunopathol (Madr) 1975; 3:87-94. [PMID: 1155315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Due to the great amount of asthmatic patients presenting complications which could endanger their lives, a revision of the possible threatening factors is carried out. The factors concurring with the base pathologic mechanism are analyzed and it is demonstrated, that some of these factors intervene independently from bronchial asthma. The study is carried out on the basis of age, sex, hospital stay duration, clinical picture, blood gases analysis, complications and pathology findings: 1) Most of the deceased patients presented various pathologies besides bronchial asthma which contributed to the decease. 2) The physician should be alert in order to establish good therapeutic procedure in these patients which could carry other important complications; these complications are responsible for the fatal outcome in a great number of patients. A complication should always be searched for, e.g. pneumothorax. 3) The vast majority of patients who passed away in status were relatively young. 4) A female predominance was found. 5) All patients before entering our Center, presented asthma crisis at least three days prior to admission. 6) The predominant hospital stay duration was 24 hours. 7) The most common pathologic findings were: pulmonary fibroemphysema, acute bronchopneumonia, bronchial mucoid plugging, atelectasia and cerebral edema. 8) Cerebral edema and compression of the amygdale were common brain pathologic findings. 9) Bronchopneumonia was a common necropsy finding. 10) Based on these findings, ICU treatment is extremely important. 11) The critical status of the patient in the moment of admission, is due to the delay in bringing him to the hospital for proper medical surveyance. This justifies the interest of the Public Health Department in ample distribution of proper information to the asthmatic patients.
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