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Biomedical subjects

A Selim

Publications and source records attributed to A Selim.

11 recordsLinked to original sources
PubMed2001

A telephone-linked computer system for COPD care.

The current revolution in communications technology provides an opportunity for novel approaches to management of medical illness. As economic imperatives lead to a progressive reduction in the time that health-care providers spend with their patients, computerized, telephone-linked communication systems offer an inexpensive, widely available alternative with which patients and providers can maintain contact. Such systems may be particularly useful for providing ongoing monitoring and education of patients with chronic illnesses such as COPD. In this article, we describe the general application of telephone-linked communication systems in the health-care setting. We then present in detail one such system, which provides telephone-linked care for COPD (TLC-COPD). The operation of the system is described, as are its theoretical underpinnings in social learning theory. A randomized clinical trial currently is being performed to study the effects of the TLC-COPD system. The rationale for expected improvements in disease control and quality of life, and for a reduction in acute health-care utilization, is discussed.

Algorithms↗
PubMed1998

Health-related quality of life in patients served by the Department of Veterans Affairs: results from the Veterans Health Study.

BACKGROUND: The Department of Veterans Affairs Health Care System (VA) is the largest integrated single payer system in the United States. To date, there has been no systematic measurement of health status in the VA. The Veterans Health Study has developed methods to assess patient-based health status in ambulatory populations. OBJECTIVES: To describe the health status of veterans and examine the relationships between their health-related quality of life, age, comorbidity, and socioeconomic and service-connected disability status. METHODS: Participants in the Veterans Health Study, a 2-year longitudinal study, were recruited from a representative sample of patients receiving ambulatory care at 4 VA facilities in the New England region. The Veterans Health Study patients received questionnaires of health status, including the Medical Outcomes Study Short Form 36-Item Health Survey; and a health examination, clinical assessments, and medical history taking. Sixteen hundred sixty-seven patients for whom we conducted baseline assessments are described. RESULTS: The VA outpatients had poor health status scores across all measures of the Medical Outcomes Study Short Form 36-Item Health Survey compared with scores in non-VA populations (at least 50% of 1 SD worse). Striking differences also were found with the sample stratified by age group (20-49 years, 50-64 years, and 65-90 years). For 7 of the 8 scales (role limitations due to physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, and mental health), scores were considerably lower among the younger patients; for the eighth scale (physical function), scores of the young veterans (aged 20-49 years) were almost comparable with the levels in the old veterans (>65 years). The mental health scores of young veterans were substantially worse than all other age groups (P<.001) and scores of screening measures for depression were significantly higher in the youngest age group (51%) compared with the oldest age groups (33% and 16%) (P<.001). CONCLUSIONS: The VA outpatients have substantially worse health status than non-VA populations. Mental health differences between the young and old veterans who use the VA health care system are sharply contrasting; the young veterans are sicker, suggesting substantially higher resource needs. Mental health differences may explain much of the worse health-related quality of life in young veterans. As health care systems continue to undergo a radical transformation, the Department of Veterans Affairs should focus on the provision of mental health services for its younger veteran.

Adult↗
PubMed1998

Microscopic localization of calcifications in and around breast carcinoma: a cautionary note for needle core biopsies.

OBJECTIVE: To detail the microanatomic localization of microcalcifications (Ca++) occurring in association with breast carcinoma and thereby to determine their reliability as a marker of breast carcinoma in small tissue core biopsies. SUMMARY BACKGROUND DATA: Identification of the pathology associated with Ca++ in mammograms has acquired increasing importance in the early detection of breast carcinoma. With recent advances enabling computer-guided stereoscopic needle biopsy of calcified foci, histopathologic diagnosis is rendered on increasingly small tissue samples, raising the risk of misdiagnosis. Knowledge of the microanatomic distribution of Ca++ in relation to diagnostic epithelial elements is essential for assessing their significance in small tissue biopsies. METHODS: All 32 carcinomas with Ca++ within 1 cm of carcinoma diagnosed by open biopsy at the New England Deaconess Hospital from January 1994 to January 1995 were studied. Ca++ were classified as being within ductal or lobular carcinoma in situ, invasive carcinoma, carcinoma-associated stroma, benign stroma >1 mm from carcinoma, or benign ducts or terminal duct-lobular units. If Ca++ were peritumoral, their distance from the tumor was measured. RESULTS: Ca++ were present only in malignant components in 31%, only in benign components in 34%, and in both in 34% of cases. The most common locations of Ca++ were benign peritumoral ducts (62%) and ductal carcinoma in situ (54%). The microanatomic distribution of benign peritumoral Ca++ in relation to the mass is detailed. CONCLUSIONS: In carcinomas with Ca++ in the area of tumor, Ca++ may not be localized to malignant tissue. Caution should be used when interpreting the finding of Ca++ in benign components of small tissue samples of breast masses.

Adult↗
PubMed1998

A telecommunications system to manage patients with chronic disease.

The care of patients with chronic disease is a large and growing problem in the United States and other industrialized countries.' it is expensive, and the quality of care received by patients is often sub-optimal, resulting in poor health outcomes. We developed a totally automated computer-controlled telecommunications system, called TLC, that provides--frequent, close monitoring of patients with chronic disease and reports the results to the patients' physicians on a timely basis, so that they can intervene appropriately. TLC also monitors the patients' important self care activities, such as medication-taking, and provides education and counseling to improve the patients' performance of these activities. The system operates through regularly scheduled telephone conversations with patients' in their homes. An evaluation of a TLC chronic disease application for patients with hypertension demonstrated that use of the system was associated with significant improvement of the patients' adherence to their medication regimens and significantly improved blood pressure control. These results show that it is possible to design an information science-based health care delivery system that performs functions usually performed only by health care professionals, and suggests that information science will become an important means of delivering health care services in the next millennium.

Chronic Disease↗
PubMed1996

Attentional performance of children with traumatic brain injury: a quantitative and qualitative analysis of digit span.

Previous studies have indicated that digit span performance is not particularly sensitive to the effects of traumatic brain injury (Baddeley & Warrington, 1970; Brooks, 1975; Sterne, 1969). However, clinical lore posits poorer backward vs. forward performance compared to normals due to the greater attentional demands of the backward task. This study examined qualitative aspects of Digit Span performance including forward/backward span discrepancies and error patterns in children with traumatic brain injury (n = 20) and normals (n = 19). The hypothesis of greater forward/backward discrepancy with traumatic brain injury was not supported. Children with traumatic brain injury make a significantly greater number of preceiling errors than normals, consistent with other findings of increased performance variability. Preceiling errors are errors that occur in trials prior to the two failed trials, resulting in discontinuation of the task. In addition, cognitive correlates of error types, such as WISC-R factor scores, were significantly different between groups. The results of this study suggest that a more detailed analysis of performance on attentional tasks previously described as resilient to brain injury may shed further light on the nature of acquired attentional deficits.

Journal Article↗
PubMed1989

A simple procedure for the isolation of schistosomules for biochemical studies or culture.

Incubation of cercariae of Schistosoma mansoni in a 1:1 mixture of Eagle's Minimal Essential Medium and rat serum at 42 degrees C for only 5 minutes, plus subsequent vortexing, resulted in at least 98% conversion of cercariae to schistosomules. Subsequent centrifugation before or after settling for 30 minutes in an ice bath, resulted in schistosomule preparations with about 20% or 10% contamination with tail segments, respectively.

Animals↗
PubMed1988

Keratoconus, magnesium deficiency, type A behavior, and allergy.

The etiology of keratoconus is still unknown. This project was designed to study, in a group of keratoconic patients and a control group, the following: clinical, endocrinological, immunological, psychological, and ophthalmological factors. We found mean serum magnesium deficiency and type A behavior to be significantly more common in keratoconic patients than in a control group of patients. In addition changes in gluco-mineral corticoids, changes in glucose metabolism, edema of allergic origin, and genetic factors may collaborate in the development of keratoconus. All these factors could affect the osmotic mechanism of the cornea: Na-K and/or Ca ATPase, the collagen structure by alteration of the adenylate cyclase activity, and other mechanisms. This study suggests an association between keratoconus, magnesium depletion, and type A behavior, which together constitute a new clinical syndrome and confirm an association between keratoconus and atopy.

Adult↗
PubMed1982

Laboratory and field evaluation of a direct filtration technique for recovery of schistosome cercariae.

The use of cercariometry in epidemiological studies has been limited by turbidity, difficulty of recovering cercariae at low concentrations in natural waters, and by complex apparatus that requires a power source. The technique of differential filtration developed by Theron has been modified and tested in the laboratory and in the field in Upper Egypt for detection of Schistosoma haematobium cercariae. A recovery filter with a pore size of 30 micrometer was found to give the best results. The recovery rate in the laboratory was 51% on filtration of 5-liter samples of formalin-treated water, and 19-30% with 10- and 20-liter samples. This moderate efficiency is offset by simplicity of the technique, rapid filtration, and ease of reading the recovery filter, permitting sampling of large volumes of water in the field by persons with little training. Average densities of 0.024 cercariae per liter of water were found at the Nile and 0.029 cercariae per liter in the irrigation canals. Most cercariae were recovered between 0.700 and 0900 hours.

Animals↗
PubMedDate not supplied

The potential role of various species of intermediate hosts of Schistosoma haematobium in Saudi Arabia.

The potential role of 3 species of Bulinus in the transmission of Schistosoma haematobium in Saudi Arabia was assessed on the basis of their susceptibility to experimental infection, their geographical distribution and numbers, and the type of habitats in which they were found. B. truncatus, distributed mainly in the mid- and south-western regions, showed extremely low susceptibility to strains of S. haematobium from Yemen, Egypt and Sudan. The same species from one area in the north-west was refractory to a strain of the parasite from Yemen. In contrast, B. wrighti was very susceptible to infection but is found only in a few habitats far from human settlements, thus probably playing little part in the transmission of the disease. As B. beccarii is highly susceptible to the infection and is distributed widely, this snail is probably the main intermediate host of schistosomiasis in Saudi Arabia.

Animals↗