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Biomedical subjects

A Kaidi

Publications and source records attributed to A Kaidi.

4 recordsLinked to original sources

Prospects in NSAID-derived chemoprevention of colorectal cancer.

There is strong evidence for an important role for increased COX (cyclo-oxygenase)-2 expression and PG (prostaglandin) E2 production in colorectal tumorigenesis. PGE(2) acts through four E-prostanoid receptors (EP1-4). COX-2 has therefore become a target for the potential chemoprevention and therapy of colorectal cancer. However, any therapeutic/preventive strategy has the potential to have an impact on physiological processes and hence result in side effects. General COX (COX-1 and -2) inhibition by traditional NSAIDs (non-steroidal anti-inflammatory drugs), such as aspirin, although chemopreventive, has some side effects, as do some conventional COX-2-selective NSAIDs. As PGE2 is thought to be the major PG species responsible for promoting colorectal tumorigenesis, research is being directed to a number of protein targets downstream of COX-2 that might allow the selective inhibition of the tumour-promoting activities of PGE2, while minimizing the associated adverse events. The PGE synthases and E-prostanoid receptors (EP1-4) have therefore recently attracted considerable interest as potential novel targets for the prevention/therapy of colorectal cancer. Selective (and possibly combinatorial) inhibition of the synthesis and signalling of those PGs most highly associated with colorectal tumorigenesis may have some advantages over COX-2-selective inhibitors.

Anti-Inflammatory Agents, Non-Steroidal↗

Nd Yag laser angioplasty: a safe procedure in peripheral vascular surgery.

BACKGROUND: Thirty-three patients (34 limbs) with peripheral vascular occlusive disease were treated with Nd Yag laser assisted angioplasty over a three-year period (1989-1991). METHODS: Sixteen males and 17 females were included in the study. The mean age of all patients was 70.29 (44-86) years. Twenty-two (66.7%) patients were smokers, 21 (63.6%) had coronary artery disease and 14 (42.4%) had diabetes mellitus. Thirty-three patients (100%) had disabling intermittent claudication, 20 patients (60.6%) had rest pain, 2 patients (6.1%) had ulcers and 10 patients (30.3%) had gangrenous changes. Thirty-nine vessels were treated; 34 (87.2%) superficial femoral arteries, 4 (10.3%) popliteal arteries and 1 external iliac artery. Eleven (28.2%) vessels were totally occluded and the remaining 28 (71.8%) vessels had high grade stenosis of more than 90%. The mean preoperative ABI Index was 0.23+/-12. RESULTS: The preoperative angiogram showed poor out-flow in 24 (70.6%) extremities, 1 patent distal vessel in 7 extremities (20.6%) and at least 2 vessels in 3 extremities (8.8%). The patients were followed up for a period of 9.9 months (20 days-30 months). The procedure could not be done in 2 extremities. All the remaining 32 extremities had patent vessels at the end of the procedure. Fifteen (48.4%) patients stated that they improved but remained symptomatic. Twelve (38.7%) were completely asymptomatic, 3 (9.7%) patients had no change in their symptoms and 2 patients worsened at the end of the follow-up period. The mean postoperative ABI was 0.78. Bleeding from the puncture site requiring closure was the most common complication of the procedure in 6 patients (19.4%). Angioplasty in 5 of these patients was done by the open technique. Other complications included hematoma in 3 (9.7%) patients and one case (3%) of artery perforation. Among those who remained asymptomatic at the end of the follow-up period the mean change in ABI was 0.625+/-0.19, those who improved but remained symptomatic the mean ABI change was 0.43+/-0.25 while those whose symptoms did not change or worsened the mean ABI change was 0.12+/-0.13. The ABI change in the first two groups was significantly higher than the last one (p<0.006 and p<0.001 respectively). There was no significant difference in the outcome of LABA between stenosed and occluded vessels. Smoking was significantly higher in the symptomatic patients (7/20) compared to those who were asymptomatic 5/12, p<0.02. Diabetes mellitus, cardiovascular disease and the preoperative ABI were not significant variables in the outcome of angioplasty. CONCLUSIONS: In conclusion, Nd Yag laser assisted angioplasty is a safe procedure. It could relieve symptoms in 87.1% of cases. Change in the ABI and smoking are predictive of the success of the procedure.

Adult↗

Laparoscopic appendectomy: a viable alternative approach.

Laparoscopic appendectomy (LA) is relatively a new technique and requires comparison to open appendectomy (OA) to determine the more favorable approach in the surgical management of acute appendicitis. We designed this study to compare the course and postoperative complications between LA and OA. We reviewed the charts of both groups of patients and followed their course in the hospital. Seventy-seven patients who underwent LA with one conversion to the open technique (1.3%) were compared to 84 patients who underwent OA. There was no difference in age and sex distribution. The mean hospital stay was shorter in the LA (32.5+/-10 vs 74.2+/-24 h, p < 0.0001). Parenteral analgesia requirement was higher in the OA group (4.7+/-1.4 vs 2.6+/-2, p < 0.0001). The total cost was higher in the OA group ($11,260+/-4000 vs 7,090+/-3500, p < 0.05). There was no significant difference in the OR time, duration of the procedure, and surgery costs between both groups. Normal appendices removed were similar in both OA and LA groups (23.8 vs 28.9%). There was no difference in the rates of postoperative complications between both groups. We conclude that LA is a viable alternative to OA. It is safe, cost effective, and less invasive than the OA with less pain and shorter hospital stay.

Acute Disease↗

Spontaneous duodenal perforation in neonates: a case report and review of literature.

Although duodenal perforation in neonates is an extremely rare entity, it should be suspected in any case with signs of viscus perforation. If found in the absence of possible causes, duodenal perforation is considered to be spontaneous. It is believed to be of multifactorial origin. Once found primary closure with or without omental patching is the treatment of choice. In this article we describe one case of spontaneous perforation and analyze the possible causes.

Duodenal Diseases↗