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Biomedical subjects

F Habib

Publications and source records attributed to F Habib.

At least 19 recordsLinked to original sources
PubMed2006

Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis?

BACKGROUND: Laparoscopic cholecystectomy (LC) is safe in acute cholecystitis, but the exact timing remains ill-defined. This study evaluated the effect of timing of LC in patients with acute cholecystitis. METHODS: Prospective data from the hospital registry were reviewed. All patients admitted with acute cholecystitis from June 1994 to January 2004 were included in the cohort. RESULTS: Laparoscopic cholecystectomy was attempted in 1,967 patients during the study period; 80% were women, mean patient age was 44 years (range, 20-73 years). Of the 1,967 LC procedures, 1,675 were successful, and 292 were converted to an open procedure (14%). Mean operating time for LC was 1 h 44 min (SD +/- 50 min), versus 3 h 5 min (SD +/- 79 min) when converted to an open procedure. Average postoperative length of stay was 1.89 days (+/- 2.47 days) for the laparoscopic group and 4.3 days (+/- 2.2 days) for the conversion group. No clinically relevant differences regarding conversion rates, operative times, or postoperative length of stay were found between patients who were operated on within 48 h compared to those patients who were operated on post-admission days 3-7. CONCLUSIONS: The timing of laparoscopic cholecystectomy in patients with acute cholecystitis has no clinically relevant effect on conversion rates, operative times, or length of stay.

Adult↗
PubMed2005

[Narrow band UVB phototherapy in the treatment of widespread lichen planus].

INTRODUCTION: UVA phototherapy, acitretin and oral corticosteroids are currently the front-line treatment of disseminated cutaneous lichen planus. We studied the efficacy of narrow band UVB therapy in this indication. PATIENTS AND METHODS: We retrospectively studied the dossiers of patients suffering from disseminated cutaneous lichen planus, treated with narrow band phototherapy in the Phototherapy Unit of the University hospital in Montpellier, from May to November of the year 2001. Disseminated lichen planus was defined as lichen involving at least 20p. 100 of the skin surface. Twenty patients were included. UVB were applied thrice weekly using a Philips TL01 cubicle (311-313 nm). The protocol was that used for the treatment of psoriasis. We defined 4 types of response: complete response (disappearance of more than 90p. 100 of the lesions), partial response (disappearance of at least 50p. 100) poor response (improvement in 20 to 50p. 100) and failure (less than 20p. 100 reduction in the lesions). Assessment of relapses in the long term was made using a telephone survey among the patients treated or their physicians. RESULTS: Complete response was obtained in 11 out of the 20 patients (55p. 100) and partial response in 4 (20p. 100), corresponding to 75p. 100 of the responders. Response was obtained with a median delay of 3 months, ranging from 2 to 6 months, following a median of 30 sessions (12 to 50) and accumulated dose of UVB of 36 +/- 4.8 joules/cm2. The phototype, gender, age and duration of evolution before treatment did not influence the response. The relapse rate was and estimated 18p. 100 (2/11) 42 months after treatment had been stopped. DISCUSSION: In our opinion, these results underline the efficacy of narrow band UVB in the treatment of disseminated cutaneous lichen planus. They confirm those of earlier studies and are superimposable with those of oral UVA phototherapy.

Adult↗
PubMed2001

cyp7b1 catalyses the 7alpha-hydroxylation of dehydroepiandrosterone and 25-hydroxycholesterol in rat prostate.

Dehydroepiandrosterone (DHEA) is the most prominent circulating steroid in humans, and it is a precursor for sex-steroid synthesis in peripheral tissues, including the prostate. Recently, enzyme-mediated pre-receptor metabolism has been recognized as a key step in determining steroid action in vivo. Hydroxylation of 3beta-steroids at the 7alpha-position has been reported in rat and human prostate to be a major inhibitory pathway to sex-steroid synthesis/action. However, the molecular identity of the enzyme responsible is so far unknown. We recently described a novel cytochrome P450 enzyme, cyp7b1, strongly expressed in the hippocampus of rodent brain, which catalyses the metabolism of DHEA, pregnenolone and 25-hydroxycholesterol to 7alpha-hydroxy products. In the light of this new enzyme, we have examined its possible role in 7alpha-hydroxylation conversion in rat prostate. NADPH-dependent 7alpha-hydroxylation was confirmed for 3beta-hydroxysteroids including DHEA and androstenediol, as well as 25-hydroxycholesterol. Kinetic analysis yielded an apparent K(m) of 14+/-1 microM for 7alpha-hydroxylation of DHEA in the prostate gland, a value similar to that recorded for recombinant cyp7b1 enzyme [13.6 microM; Rose, Stapleton, Dott, Kieny, Best, Schwarz, Russell, Bjoorkheim, Seckl and Lathe (1997) Proc. Natl. Acad. Sci. U.S.A. 94, 4925-4930]. The V(max) value of the prostate was 46+/-2 pmol/min per mg, and this activity was inhibited by clotrimazole, a P450-enzyme blocker. Moreover, RNA analysis (reverse-transcription PCR, Northern blotting and in situ hybridization) revealed a high expression of cyp7b1 mRNA in the rat prostate, restricted to the epithelium, suggesting that cyp7b1 catalyses oxysterol 7alpha-hydroxylation in the prostate gland.

Animals↗
PubMed1998

Low-affinity nerve growth factor receptors (p75LNGFR) in human prostate tissue: stromal localisation.

Beta-nerve growth factor (beta-NGF) acts on high- and low-affinity receptors to effect sympathetic innervation. It is produced in the human prostate. This study aimed to demonstrate the presence of beta-NGF receptors and the distribution of p75LNGFR receptor protein in the human prostate. Radioligand binding assays were performed using microsomal preparations from benign prostatic hypertrophy (BPH) tissues but no specific binding of beta-NGF was demonstrated (n = 20). Furthermore, BPH and prostate cancer tissues were stained immunohistochemically for p75LNGFR. Immunohistochemistry localised p75LNGFR to tiny areas of prostate stroma postulated to be sympathetic nerves (BPH, n = 15; prostate adenocarcinoma, n = 15). Our results suggest that beta-NGF in the human prostate acts on stromal elements which, most likely, represent prostatic nerves. Beta-NGF may be an epithelial-stromal mediator of sympathetic nerve growth in the human prostate.

Adenocarcinoma↗
PubMed1998

A novel coculture model for benign prostatic hyperplasia expressing both isoforms of 5 alpha-reductase.

We have developed a coculture system for primary fibroblast and epithelial cells derived from benign prostatic hyperplasia (BPH) that retained many of the characteristics of the intact human prostate. In contrast to separately cultured prostate fibroblast and epithelial cells, cocultures of fibroblasts and epithelial cells maintained messenger ribonucleic acid expression and functional activity for both isoenzymes of 5 alpha-reductase (type I and type II) as well as maintained expression of androgen receptors and prostate-specific antigen. Furthermore, levels of prostate-specific antigen secreted by cocultured epithelial cells were increased by treatment with androgens, mimicking the situation in the human gland. This contrasted with conventionally cultured fibroblasts or epithelial cells, which failed to express 50 alpha-reductase type II and rapidly lost expression of androgen receptors and androgen sensitivity upon being placed into culture. Electron microscopy demonstrated intracellular structures indicative of the differentiated state of the cocultured cell types, including round nuclei, tonofibrils, and microvilli in epithelial cells and elongated nuclei; large amounts of Golgi and cilia; along with immature collagen fibers in fibroblasts. The present study demonstrates that the coculture model reflects more closely the in vivo system for human BPH and is thus a far more suitable model for investigating the molecular and cellular events that underlie BPH than current in vitro systems.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1998

Typhoid fevers: treatment with lomefloxacin.

Typhoid group of fevers pose a major threat and are a cause of high morbidity and mortality in the tropical countries. Over the last decade there has been a steady increase in the development of multiresistant strains of Salmonellae all over the world. Multiresistance ranges between 5% to 86%. In a recent study in Pakistan multidrug resistance in Salmonellae has increased to over 39%. Hence alternative therapy is needed. Fluroquinolones are an effective alternative requiring a shorter course of treatment than conventional antimicrobial agents. Lomefloxacin because of its longer half life and convenient BD dose was used in a multicentre study to treat cases of typhoid group of fevers including cases due to multiresistant isolates. In order to overcome the challenge presented by the multiresistant salmoneallae, a dual purpose multicentre study was conducted in two stages. The first stage included a vitro study and the second in vivo study. Two hundred local salmonellae isolates were collected and their sensitivity and minimum inhibitory concentrations were determined by standard methods. Two hundred and fourteen patients clinically suspected of suffering from typhoid groups of fevers were given Lomefloxacin 200 mg. BD for 14 days. Forty percent of Salmonellae isolates were found to be multiresistant while only 2% were found to be resistant to Fluroqunilones. The mean MIC 90 was found to be 0.06 mg/L Lomefloxacin was found to be effective in over 97% cases for treating typhoid group fevers including the ones due to multiresistant isolates. The side effects were found to be minimal and transient.

Adolescent↗
PubMed1997

Etiology and response to antibiotic therapy of community-acquired pneumonia in French children.

The aim of this study was to determine the etiologic agents associated with community-acquired pneumonia in 104 French children ages 18 months to 13 years. Potential respiratory pathogens were identified in 87 (85%) cases; these included respiratory syncytial virus in ten, other viruses in 20, Streptococcus pneumoniae in 14 and Mycoplasma pneumoniae (diagnosed by serologic procedures) in 43. Of 32 patients with Mycoplasma pneumoniae infection who were initially treated with beta-lactam antibiotics, 30 failed treatment. Recovery from mycoplasma infection occurred rapidly in patients treated with macrolide antibiotics (which included spiramycin in 31 patients, josamycin in 7, and erythromycin in 3); however, cough persisted in 12 patients for one month. The high frequency of Mycoplasma pneumoniae in children over 18 months of age must be considered when selecting an antibiotic for initial therapy.

Adolescent↗
PubMed1996

Assessment and diagnosis of heart failure.

Diagnosis is the first essential step in the provision of good management of heart failure. Diagnosis of heart failure by clinical means alone may be fairly accurate in advanced heart failure but will only be correct in about 50% of milder cases; little better than guessing. The number of patients with mild heart failure in whom the diagnosis is not even considered is unknown. In at risk groups, such as those who have had a myocardial infarction, symptoms alert the clinician to a possible diagnosis of heart failure which must be confirmed by further investigation. The echocardiogram is the single most useful diagnostic tool for heart failure in widespread use at the present. Once it is established that the patient has heart failure, its cause must be sought out. As the majority of patients with heart failure are elderly, concomitant diseases may complicate management and should be sought out. European Society Guidelines on the Diagnosis of Heart Failure have been published and provide a minimum data set of investigations that should be carried out in all patients.

Cardiac Catheterization↗
PubMed1996

Stability of plasma concentrations of N and C terminal atrial natriuretic peptides at room temperature.

BACKGROUND: Plasma concentrations of atrial natriuretic peptide (ANP) are increased in patients with ventricular dysfunction and could have a diagnostic role in heart failure. ANP may be unstable after collection, however, limiting any practical diagnostic role. METHODS: Blood samples were obtained from 18 patients with various conditions. Aliquots were either processed optimally or kept as blood or plasma at room temperature for 6-72 h before processing. RESULTS: Concentrations of C-terminal ANP were lower in specimens kept as blood for 24 and 72 h (mean difference from control -43% and -76%, respectively, (P < 0.001) but N-terminal ANP (extracted) seemed to be stable under all conditions studied (-2% at 24 h and -7% at 72 h, not significant). CONCLUSIONS: N-terminal ANP (extracted) is stable and potentially has a role in the diagnosis of heart failure in routine clinical practice.

Aged↗
PubMed1995

[Failure of the treatment with antibiotics in severe Salmonella infections in children and use of quinolones].

BACKGROUND: Quinolone antibiotics are effective in the treatment of Salmonella infections in adults. Their use in children is limited by their side-effects. POPULATION AND METHODS: Forty-two patients (21 girls and 21 boys), aged 1 month to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for severe Salmonella infections. Criteria of severity were persistent diarrhea and fever for more than 3 days. Thirty-one of these patients were less than 5 years of age. Blood culture was positive in 7 out of 35 patients: culture of the stools was positive in all patients. Five of the 42 patients had presented an acute episode of Salmonella infection a few weeks earlier and had remained asymptomatic carriers until the new acute and severe episode of diarrhea. All patients were given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime-sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12 mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and fever. RESULTS: Diarrhea and fever disappeared within less than 2 days in the group of patients given pefloxacin, even though in 6 patients the infecting Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients remained asymptomatic carriers of Salmonella in the group treated by pefloxacin vs 47% in the group without it. There was no difference in species of Salmonella between both groups. None of the patients treated by pefloxacin developed side-effects during the six months following its administration. CONCLUSIONS: Short treatment by pefloxacin may be an alternative choice for treating severe Salmonella infections in children.

Amoxicillin↗
PubMed1995

[Eradication of asymptomatic carrier state of non-typhoid Salmonella with two doses of pefloxacin].

BACKGROUND: The carrier state of Salmonella may represent a source of contamination for other people. Its treatment is unsatisfactory so that a carrier may shed organisms for numerous months. POPULATION AND METHODS: From 1990 to 1993, 17 children aged 1.5 months to 8 years were seen because they were asymptomatic carriers of non-typhoid Salmonella, confirmed by three successive stool cultures. All had presented earlier acute severe infection having required treatment with amoxicillin (13 cases) and ceftriaxone or cefotaxime (four cases). They were given one dose of pefloxacin, 12 mg/kg, 4 to 8 weeks after the initial episode. This unique dose was administered again 4 days later. Stool cultures were performed before the first administration and 10, 30, 45 and 60 days after, with a last control 3 to 4 months later. RESULTS: Eradication of the Salmonella was obtained by the 10th day in 13 patients and within the 3 following weeks in 2 others. Those children who excreted a few number of organisms were early eradicated while the 2 patients who did not respond to pefloxacin shed larger number of bacteria. There was no side-effects of treatment. CONCLUSION: A short treatment with pefloxacin appears to be effective and safe in eradicating the carrier state when stool excretion of Salmonella is moderate.

Carrier State↗
PubMed1994

Enhanced basal nitric oxide production in heart failure: another failed counter-regulatory vasodilator mechanism?

Endothelial dysfunction in heart failure could impair nitric oxide production and lead to increased vascular resistance. If endogenous production of nitric oxide is reduced, NG-monomethyl-L-arginine (L-NMMA), an inhibitor of such production, should have a diminished vasoconstrictor effect. We administered L-NMMA to 12 patients being investigated for heart failure. L-NMMA increased median pulmonary and systemic vascular resistances by 61 (range -3 to 240) and 430 (63 to 1609) dynes s cm-5, respectively (p < 0.03 and p < 0.005). Arterial pressures also increased. Median cardiac output fell by 0.6 (0 to -2.3) L per min (p < 0.005). These data suggest that vascular nitric oxide may be another example of a failed counter-regulatory vasodilator system in heart failure.

Aged↗
PubMed1994

[Abdominal pain in children caused by lactose intolerance. Prospective use of the hydrogen breath test].

OBJECTIVES: We performed the breath hydrogen test in children consulting for abdominal pain in order to determine the minimal quantity of lactose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test. METHODS: The breath hydrogen test after lactose intake was performed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.2 years, range 3 to 15) seen for unexplained abdominal pain. All these children had complained of abdominal pain daily for at least 6 months and no other cause could be identified. Children with acute or chronic diarrhoea or constipation were excluded. Nineteen children had been transferred from the surgery unit and 6 had been followed by the psychiatry unit. All these children drank milk regularly. RESULTS: The diagnosis of lactose intolerance was established in 83 children (76.1%) on the basis of a hydrogen peak in the breath after lactose ingestion. One-fourth of the children were of French origin and the others had at least one grandparent who was of Mediterranean or African origin. A lactose-free diet was proposed and led to the disappearance of abdominal pain in 24% and a clear improvement in 32%. CONCLUSION: The breath hydrogen test is a simple non-invasive test which allows a selection of children who could benefit from a lactose-free diet although it cannot be used to predict the effect of diet.

Abdominal Pain↗
PubMed1994

The pharmacokinetics of once daily gentamicin in neutropenic adults with haematological malignancy.

Seven febrile neutropenic adults with normal renal function were treated with intravenous gentamicin 4.5 mg/kg once a day in combination with azlocillin. Gentamicin serum concentrations 1, 2, 4, 8, and 24 h after a 30 min infusion were 10.9 +/- 0.6, 7.1 +/- 0.4, 4.2 +/- 0.2, 1.8 +/- 0.1 and 0.16 +/- 0.003 mg/L respectively. The pharmacokinetics were best described by a triphasic plot including a distribution phase (about 1/2 h) and two elimination phases, an early and late.

Adolescent↗
PubMed1994

High temperature microwave thermotherapy of the prostate.

Transurethral microwave thermotherapy of the prostate has been touted as a minimally invasive means of treating symptomatic prostatism. High temperatures (>55 degrees C) appear to yield improved results but require general anesthesia. To determine if high temperature thermotherapy of the prostate was feasible in an outpatient, nonanesthetic setting, we subjected men with symptomatic prostatism secondary to benign prostatic hyperplasia to treatment with a newly developed circumferentially cooled transurethral microwave thermotherapy device, the UroWave. Intraprostatic temperatures were measured on-line and treatment was targeted to achieve temperatures ranging from 45 degrees C-65 degrees C. Fifty-five men with benign prostatic hyperplasia underwent transurethral microwave thermotherapy using the UroWave in an outpatient setting without general anesthesia. Baseline mean peak urinary flow rates were 8.0 cc/sec and mean American Urology Association of the prostate displayed three distinct phases: an initial slow heating phase, a plateau phase of variable duration and a rapid secondary heating phase. The final intraprostatic temperature did not correlate with urethral or rectal temperatures or the amount of power applied. At six months, peak flow increased by 50% and symptoms score declined by 52%. Ninety-four percent of patients had a transurethral resection of the prostate-like defect at cystoscopy with a greater proportion at higher temperatures. Side effects were rare and no patients had to be admitted to hospital. Transurethral microwave thermotherapy at high intraprostatic temperatures can be achieved with general anesthesia. Symptom relief was considerable and anatomic changes resembling a transurethral resection of the prostate were noted in the majority of patients. Intraprostatic temperatures are the only means of assessing the thermal damage to the prostate and thus the effectiveness if therapy. Future studies must develop less invasive means of monitoring intraprostatic temperatures and define the role of the bladder neck. Ultimately, randomized controlled trials will define the value of this treatment.

Journal Article↗