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Biomedical subjects

F Ismail

Publications and source records attributed to F Ismail.

At least 19 recordsLinked to original sources
PubMed2006

Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness.

BACKGROUND: Organ transplant recipients (OTRs) have 100-fold increased risk of developing squamous cell carcinomas. Cumulative exposure to ultraviolet radiation is the main risk factor and there is evidence that lack of dermatological surveillance may be responsible for poor levels of knowledge and photoprotection among OTRs. OBJECTIVES: This study evaluated whether routine consultation in a specialist OTR dermatology clinic improves understanding of skin cancer risk and compliance with photoprotection measures. METHODS: A cross-sectional questionnaire-based study was performed in a specialist OTR dermatology clinic at Bart's and the London NHS Trust, London, U.K. The subjects were 399 white-skinned patients under surveillance in a renal transplant clinic, who were sent a postal questionnaire from the renal transplant clinic. The main outcome measures were responses to the questionnaire regarding photoprotective practices and skin cancer risk awareness. RESULTS: Two hundred and ninety-two of 399 (73%) responded, of whom 89% had previously attended the specialist dermatology clinic. Ninety-six per cent recalled receiving photoprotection advice at least once (85% from dermatologists); 92% reported use of sunscreen; 88% specifically dressed to photoprotect themselves; 96% directly avoided sun exposure during summer; 68% were aware that an increased risk of skin cancer was the reason that extra photoprotective measures were important after a transplant. Photoprotective measures and level of skin cancer awareness were significantly lower in those responders who had never attended the specialist clinic. No obvious bias was identified among nonresponders. CONCLUSIONS: Skin cancer awareness and compliance with photoprotective measures in our patient population is generally greater than previously reported, suggesting that delivery of educational messages regarding skin cancer may be improved if provided in a specialist dermatological setting.

Cross-Sectional Studies↗
PubMed2001

Effect of ambient temperature on analytical and clinical performance of a blood glucose monitoring system: Omnitest Sensor glucose meter.

The effect of ambient temperature on the analytical and clinical performance of a glucose meter was examined. A total of 114 venous whole blood samples were analysed for glucose by a reference method, and by a glucose meter at 21-22 degrees C, room temperatures, 26-27 degrees C and 33-34 degrees C. Glucose meter readings at each temperature were compared with the reference values and evaluated by analysis of variance, Spearman's correlation, the percentage of glucose meter readings within +/- 10% of the reference value and error grid analysis. Analysis of covariance was used to determine the effect of temperature on glucose meter readings. There were no significant differences in the glucose meter readings and in accuracy of the meter readings between different temperatures. Temperature was not a significant independent determinant of the glucose meter readings. For each glucose concentration, the precision of the meter and clinical performance were comparable between the different temperatures. In conclusion, ambient temperature does not affect the accuracy, precision and clinical performance of the Omnitest Sensor.

Blood Glucose↗
PubMed1997

[The alcohol-dependent outpatient: a clinical typology].

The aim of this study was to construct a typology integrating sociodemographic, clinical and personality data of alcohol-dependent patients. We studied a consecutive population attending an alcohol-dependent outpatient psychiatric department, assessed by instruments that measured psychiatric, psychopathological, personality and sociodemographic characteristics of alcohol-dependent patients. The factorial analysis allowed us to define three main expressions of alcoholism: physical, psychological and social. In the elicited typology, both physical and social appear mixed in their expression. The psychological expression is divided into two main categories: the alexithymic (with a depressive personal and family history) and the psychopathologic type (with actual depression and anxiety). This typology should allow us to correlate these types with neurophysiological and biochemical patterns and could be particularly useful in building an etiologic model of alcohol dependence which could contribute to a better prediction of prognosis and choice of the best therapeutic intervention.

Adult↗
PubMed1994

[The elderly at the General Hospital and liaison psychiatry].

It is known that in general hospitals there is an increasingly high percentage of elderly patients that frequently develop psychiatric morbidity during hospital stay. This has lead the authors to perform a comparative study involving patients referred to Consultation/Liaison Psychiatry, in order to establish guidelines for a future approach. The first 1.000 referrals to the Consultation/Liaison Psychiatry Unit of the Santa Maria Hospital were analysed by comparing patients aged 65 or above to other observed patients. The results indicate a clearly lower percentage of elderly patients referred and a longer average length of stay at the moment of referral. Medical diagnoses show a preponderance of cardiologic, malignant and respiratory diseases, whereas intoxication, the prime diagnosis in the younger group, is much less represented above the age of 65. Identically, referrals due to suicide attempt were significantly less frequent in this group. Psychiatric diagnoses show a greater prevalence of organic mental disorders, followed by mood disorders, while in the younger the latter prevail. The post-discharge plan shows a higher percentage of elderly patients referred to general practitioners and medical specialties and a lower one for psychiatric care, as opposed to the younger group. The conclusions point towards the need for programs directed to early detection and treatment of psychopathological disorders (organic and depressive mental disorders) of elderly people admitted to a general hospital. This will be achieved through a close collaboration between C/L psychiatrists and medical staff, families and community facilities.

Aged↗
PubMed1993

The clinical usefulness of the platelet aggregation test for the diagnosis of heparin-induced thrombocytopenia.

The platelet aggregation test is widely used for the diagnosis of heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy. We have evaluated its sensitivity and specificity in comparison with those of the 14C-serotonin release test. The sensitivity of the platelet aggregation test was found to vary with the heparin concentration and the donor of the platelets used in the test. The optimal heparin concentrations were between 0.1 and 1.0 U/ml. Using these heparin concentrations, the mean sensitivity varied from 39% (with the least reactive platelets) to 81% (with the most reactive platelets). In comparison, the sensitivity of the release test ranged from 65% to 94%. The specificities of the platelet aggregation test were 82%, 90% and 100% for the following control groups: (1) non-thrombocytopenic patients given heparin, (2) patients with thrombocytopenia due to other causes, and (3) normal controls not given heparin, respectively. The corresponding specificities for the release test was 94%, 90% and 100%. The specificities can be further increased to 100% for all controls with the adoption of a two-point system which defines a positive result as one in which platelet aggregation occurs with a low heparin concentration (0.5 U/ml) but not with 100 U heparin/ml. For optimal results, a two-point platelet aggregation test should be performed with heparin concentrations of 0.5 and 100 U/ml and using platelets of more reactive donors.

Autoimmune Diseases↗
PubMed1992

[Research in child psychiatry].

The research in child psychiatry faces general restrictions related to the observation and interpretation of child psychopathological phenomena. These restrictions are increased by the limits of the methodological credibility of the psychopathological and psychiatric research with adults. The specific form of the emergence of child psychological suffering lies in a great number of factors. These can be derived from the child itself, the interaction that the child has with adults or be related with the mental health of the adults themselves. The research in this field favours the detection of risk situations either individual or social. Assuming the preventive perspective, the early identification of these situations will allow an improvement in medical care. The authors intend to raise pertinent and suggestive questions on child psychiatry research by means of the introduction of update situations. Several areas, which are still being studied, are approached, namely the parental mental pathology and its association with pregnancy and post-delivery, parental drug and alcohol addiction and its relation to the child's development, recent fields of research such as fertilization in vitro and the acquired immunodeficiency syndrome and, lastly, family separation and human communication.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The Mentakab hypertension study project. Part V--Drug compliance in hypertensive patients.

Poor compliance with drug treatment is a barrier to effective management of hypertension. Drug compliance behaviour of 168 patients were studied, their drug compliance was measured by the pill-counting method. The prevalence of non-compliance with medication was 26%. Thirteen variables were examined for their association with compliance; these were age, sex, duration of hypertension since diagnosis, adequacy of blood pressure control, complexity of drug regimen and side-effect of drug, history of previous admission for hypertension related reason, patient's knowledge of hypertensive complications, patient's belief that drug was 'panas' or 'san', previous use of traditional treatment for hypertension, patient's fatalistic attitude, their social support and satisfaction with the health services. None of these variables were significantly related to compliance (p greater than 0.05) except adequacy of blood pressure control. The performance of patient self-report was compared with pill-count as a measure of drug compliance; it was poorly predictive of non-compliance (sensitivity = 71%, specificity = 50%). An inverse relationship was found between non-compliance with medication and patient subsequent drop-out rate. Patients who were compliant were more likely to remain on treatment and vice versa. As a measure of drug compliance, detection of drop-out compared well with pill-count (sensitivity 97%, specificity 66%, positive predictive value 89%, negative predictive value 88%).

Female↗
PubMed1992

Morbidity associated with asthma and audit of asthma treatment in out-patient clinics.

A study was undertaken to determine the extent of morbidity associated with asthma and to audit the management of asthma in two out-patient clinics of two district hospitals. Patients were recruited for the study during a 3-month period from December 1990 to February 1991. Seventy asthmatic patients were studied. Eighty-six percent of the patients had their sleep disturbed by asthma, 77% took daily medication regularly, 63% felt that their activities were restricted by asthma, 60% had at least one acute exacerbation in the preceding six months. Of those who had their peak expiratory flow rate (PEFR) measured, 40% had a PEFR below 50% predicted, and only 11% had normal PEFR (greater than 80% predicted). The morbidity of asthma was thus considerable. On the other hand, the drug treatment of these asthmatics was grossly inadequate. They were prescribed on average 2.1 item of drugs, which for most patients comprised an oral beta agonist and a theophylline. Only 43% of the patients received inhaler therapy, but no patients were given steroids, inhaled or oral. The drug treatment was unrelated to the severity of patients' asthma. Further, objective measurement of severity was under-used in the assessment of asthma, only 8.5% of patients ever had their PEFR recorded. This study has found that asthma is poorly managed in out-patient clinics. We need to improve the training of doctors in the optimal management of asthma.

Adolescent↗
PubMed1992

Comparison of serum fructosamine and blood glucose concentrations as indices of glycaemic control in non-insulin dependent diabetic out-patients.

The usefulness and validity of blood glucose measurement as an index of diabetic control were assessed with reference to serum fructosamine. Two hundred and twenty-eight non-insulin dependent diabetic out-patients were studied in the usual clinical setting. Fasting blood glucose (FBG) concentration was positively correlated with serum fructosamine (r = 0.42, t = 6.78 p less than 0.01). On the basis of their serum fructosamine concentrations, patients were divided into 3 groups. They were good control (fructosamine less than or equal to 288 umol/l), acceptable control (fructosamine less than or equal to 320 umol/l) and poor control groups (fructosamine greater than 320 umol/l). The mean fasting blood glucose concentration was significantly higher in the latter than the former 2 groups. However, at each level of control, there was a wide range of FBG concentrations. Thus, the value of FBG in predicting glycaemic control is limited. Its positive predictive value was only 32%, and its overall accuracy as an index of diabetic control was only 58% though its negative predictive value was high (93%). In 162 patients with poor diabetic control as indicated by their serum fructosamine concentrations, 81 (50%) of them had FBG less than 10 mmol/l on their clinic visit day. Fasting blood glucose is therefore not a reliable measure of good diabetic control, though it is useful in predicting poor control. FBG is simple to measure, cheap and rapidly available on clinic day, thus ensuring its continuing use. Doctors should be aware of its limitations and should not rely solely on FBG to assess diabetic control.

Adult↗