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Biomedical subjects

A Abdulla

Publications and source records attributed to A Abdulla.

At least 19 recordsLinked to original sources
PubMed2000

The clinical spectrum of Clostridium sordellii bacteraemia: two case reports and a review of the literature.

Clostridium sordellii is rarely associated with disease in humans. Since its first report in 1922 only a few cases of bacteraemia have been reported. This report describes two cases of C sordellii bacteraemia; the oldest and youngest patients reported to date. The first, is a previously well 81 year old woman presented with perianal infection, which was later complicated by thrombosis of the aorta, and the second is a 12 year old boy with epilepsy who presented with an ear infection. These cases are also highlighted to demonstrate the wide spectrum of presentation of sordellii bacteraemia.

Aged↗
PubMed2000

U.S. medical students choice of careers and its future impact on health care manpower.

During the last 10-15 years, the health care system of this country has faced major challenges, among them, spiraling increases of health care costs, physician manpower maldistribution, excessive production of subspecialists, shortages of primary care physicians (family practice, general internal medicine, and general pediatrics), and lack of access to health care, predominantly among the poor and disadvantaged populations. As a way of shedding light on some of these challenges, the authors conducted a study among junior medical students from the University of Texas Medical School at Houston which focused on some of the factors that might influence medical students' choice of careers. In this article, the authors review the most salient findings for some of the problems that currently plague the health care system of this nation. Certainly, the outcome of this study has important educational and health service delivery implications not only in the United States but abroad as well, particularly among developing nations.

Adult↗
PubMed1999

Interferon-alpha in chronic hepatitis C infection in dialysis patients.

This study assesses the efficacy and adverse effects of interferon-alpha (IFN-alpha) administered at a dosage of 3 million units three times weekly for 1 year in 17 hemodialysis patients with hepatitic C virus (HCV)-associated chronic hepatitis (biopsy proven). The patients were prospectively followed up for a period of 18 months. Liver biopsy was repeated after 6 months of treatment in 13 patients. Patients were classified according to the histological activity index. Biochemical and virological responses were evaluated at the end (end-of-treatment response) and 6 months after completion of therapy (sustained response). HCV RNA became negative in 76% of the patients after 12 weeks of treatment, in 88% after 12 months of treatment, and in 71% of the patients 6 months after completion of therapy. HCV genotype 4 was found in 60% of our population. Alanine aminotransferase (ALT) levels were initially increased in only 6 patients and normalized in 4 of these patients after 12 weeks of therapy, with end-of-treatment and sustained biochemical responses of 83% and 67%, respectively. Of 13 patients who underwent liver biopsies after 6 months of therapy, 11 patients (85%) showed histological improvement. One patient could not tolerate therapy because of marked lethargy and myalgia; the other patients had minor side effects that did not require discontinuation of treatment. Two patients received a cadaveric renal transplant after 1 year of IFN treatment, and they continued to maintain biochemical and virological responses after a follow-up of 17 and 28 months, respectively.

Adult↗
PubMed1999

Benign recurrent intrahepatic cholestasis in a Saudi child.

We report a case of benign recurrent intrahepatic cholestasis (BRIC) in an 11-year-old Saudi girl who developed three episodes of pruritus and jaundice at the ages of 4, 8, and 9 years. These episodes were almost stereotypic and lasted 5-8 weeks. Although she had elevated liver enzymes and serum bile acids in her blood during the attacks, they returned to normal between attacks. Thorough investigation excluded other causes of liver disease and her recurrent attacks were shortened by cholestyramine therapy. A diagnosis of BRIC should be kept in mind in patients with cholestasis.

Bile Acids and Salts↗
PubMed1997

Women's advancement in medicine and academia: barriers and future perspectives.

Although women made early advancements in the field of medicine during the second half of the 19th century, they were not able to make relevant strides in both medicine and academia until the 1960s. Despite women's recent advancements, obstacles and barriers to their hope of achieving fairness and equality in their professional and academic careers still exist. These practices include professional discrimination, blatant sexism, lack of appropriate mentors, and unfair faculty promotion processes. In this article, we address the most common problems affecting women physicians' advancement in academic medicine. We also focus on the role of mentorship as a relevant and beneficial factor for progress in their medical and academic careers. Finally, we provide a perspective designed to resolve most of the barriers confronting women physicians in their quest for advancement in academic medicine.

Career Mobility↗
PubMed1994

Acute renal failure occurring in scleroderma treated with cyclosporin A: a report of three cases.

Cyclosporin A, which is a nephrotoxic agent, has been a mainstay antirejection drug in heart, kidney and lung transplant programmes for about 10 yr. Renal transplant physicians have become adept in balancing its powerful immunosuppressive effects with its undoubted potential nephrotoxicity. Here we report three of eight systemic sclerosis (SSc) patients treated with cyclosporin A who developed acute renal failure. Consideration is given to the evidence of benefit from this agent in SSc and to the management of acute hypertensive renal failure in this disease.

Acute Kidney Injury↗
PubMed1986

Noninvasive identification of left main and triple vessel coronary artery disease: improved accuracy using quantitative analysis of regional myocardial stress distribution and washout of thallium-201.

The capabilities of visual and quantitative analysis of stress redistribution thallium-201 scintigrams, exercise electrocardiography and exercise blood pressure response were compared for correct identification of extensive coronary disease, defined as left main or triple vessel coronary artery disease, or both (50% or more luminal diameter coronary narrowing), in 105 consecutive patients with suspected coronary artery disease. Extensive disease was present in 56 patients and the remaining 49 had either less extensive coronary artery disease (n = 34) or normal coronary arteriograms (n = 15). Although exercise blood pressure response, exercise electrocardiography and visual thallium-201 analysis were highly specific (98, 88 and 96%, respectively), they were insensitive for identification of patients with extensive disease (14, 45 and 16%, respectively). Quantitative thallium-201 analysis significantly improved the sensitivity of visual thallium-201 analysis for identification of patients with extensive disease (from 16 to 63%, p less than 0.001) without a significant loss of specificity (96 versus 86%, p = NS). Eighteen (64%) of the 28 patients who were misclassified by visual analysis as having less extensive disease were correctly classified as having extensive disease by virtue of quantitative analysis of regional myocardial thallium-201 washout. When the results of quantitative thallium-201 analysis were combined with those of blood pressure and electrocardiographic response to exercise, the sensitivity and specificity for identification of patients with extensive disease was 86 and 76%, respectively, and the highest overall accuracy (0.82) was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Slow regional clearance of myocardial thallium-201 in the absence of perfusion defect: contribution to detection of individual coronary artery stenoses and mechanism for occurrence.

As a result of the "spatially relative" nature of perfusion defect analysis of stress-redistribution thallium-201 (201Tl) scintigrams, hypoperfused myocardial segments may not appear as perfusion defects but they may demonstrate a slow washout rate of 201Tl that can be analyzed in a "spatially nonrelative" manner. Quantitative analysis of perfusion defects and slow washout rate of 201Tl was performed on scintigrams from 116 consecutive patients with adequate exercise tests, defined as achievement of 85% or more of age-predicted maximum heart rate or development of angina or ST segment depression. A total of 232 diseased and 116 nondiseased vessels were found in the patients. Additional analysis of slow washout rate significantly (p less than .05) improved sensitivity for detection of disease in the left anterior descending (from 74% to 82%), left circumflex (from 40% to 61%), and right coronary arteries (from 78% to 90%) without significant loss of specificity. This improvement resulted from the additional detection of 32 of 232 (14%) diseased vascular distributions when the isolated slow washout rate of 201Tl was also determined. In nine of these 32, isolated slow washout rate was associated with another region with isolated slow washout rate in the contralateral myocardial segment. Coronary arteriography revealed similar degrees of stenosis in the vessels supplying these segment pairs. In 13 of 32 cases, a perfusion defect and a slow washout rate were found in the contralateral segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Management of cardioinhibitory hypersensitive carotid sinus syncope with permanent cardiac pacing--a seventeen year prospective study.

Sudden and unannounced syncope due to increased vagal tone as manifested by hypersensitivity of the carotid sinus mechanism is not uncommon. A 17 year prospective study of 89 patients with cardio-inhibitory (Type 1) hypersensitivity showed that males outnumbered females 4.5:1. The age range at the onset of symptoms was 37 to 88 years with an average of 63 years. Hypersensitivity of the right carotid sinus was 7:1 compared to the left. These patients had unilateral hypersensitivity in 71% and bilateral in 29%. A new classification of Hypersensitive Carotid Sinus Syncope incorporating sinoatrial node (Type 1A) and atriaoventricular node (Type 1B) suppression in the Type 1 syndrome is presented. Many forms of treatment for cardioinhibitory Hypersensitive Carotid Sinus Syncope have been forthcoming but in our hands in these 89 patients over 17 years, there has been no single case of recurrence of syncope after implantation of a permanent VVI electronic cardiac pacemaker. Type 2 (vasodepressor) Hypersensitive Carotid Sinus Syncope is rare, occasionally seen combined with the cardioinhibitory (Type 1) response and it is not helped with cardiac pacing.

Adult↗
PubMed1984

Deciduous tooth dimensions in cleft lip and palate.

The deciduous teeth of 40 subjects with complete unilateral cleft lip and palate (CUCLP) and 42 noncleft controls were measured. The mesiodistal and faciolingual dimensions of several maxillary teeth in the vicinity of the cleft were smaller than their corresponding antimeres. No such differences were apparent in the mandibular arch. In the control sample there were no differences in either maxillary or mandibular arches. The CUCLP group generally demonstrated significantly smaller dimensions for both mesiodistal and faciolingual dimensions for both maxillary and mandibular arches when compared to the control group. These findings lend possible support to the hypothesis that tissue deficiency may be a factor in cleft lip and palate development.

Cleft Lip↗
PubMed1983

Effects of nitroprusside-induced reduction of elevated preload and afterload on global and regional ventricular function in acute myocardial infarction.

To evaluate the effects of nitroprusside infusion on left and right ventricular ejection fractions and left ventricular regional wall motion, radionuclide ventriculography with simultaneous hemodynamic assessment was performed before and during nitroprusside infusion in 20 patients with acute myocardial infarction complicated by left ventricular failure and/or systemic arterial hypertension. Nitroprusside produced significant reductions in pulmonary capillary wedge pressure (21 +/- 6 to 13 +/- 5 mm Hg; -38%; p less than 0.001), mean arterial pressure (107 +/- 19 to 90 +/- 13 mm Hg; -15.9%; p less than 0.001), left ventricular end-diastolic volume index (84 +/- 28 to 75 +/- 23 ml/m2; -10.7%; p less than 0.001), and right ventricular end-diastolic volume index (77 +/- 30 to 67 +/- 27 ml/m2; -13.0% p less than 0.007), and significant increases in left ventricular ejection fraction (0.32 +/- 0.12 to 0.37 +/- 0.13; +15.6%; p less than 0.0001), right ventricular ejection fraction (0.37 +/- 0.11 to 0.45 +/- 0.14; +21.6%; p less than 0.001), and stroke volume index (25 +/- 7 to 27 +/- 7 ml/beat m2; +8.0%; p less than 0.03). These beneficial changes in global ventricular performance were accompanied by no change in the regional contractile function of 90% of the abnormally contracting infarct-related left ventricular segments and improved regional wall motion of 34% of noninfarcted but abnormally contracting left ventricular segments. We conclude that nitroprusside-induced reduction of elevated preload and afterload in acute myocardial infarction results in salutary effects on global ventricular function and improved regional function of noninfarcted left ventricular segments but with less prominent effects on regional function of infarcted segments.

Adult↗
PubMed1982

Physiologic permanent retention following space closure.

Clinical orthodontists recognize that mechanical treatment of excessive space represents a minimum technical challenge. However, retention of this space closure may represent a major challenge to the clinician. With the introduction of direct-bond materials, the patient may benefit from a conservative, noninvasive, fixed retainer. The design described in this article features two main advantages: physiologic action and maximum cleansibility.

Diastema↗