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Biomedical subjects

H Mansour

Publications and source records attributed to H Mansour.

At least 19 recordsLinked to original sources
PubMed2006

Renal allograft biopsies with borderline changes: predictive factors of clinical outcome.

The clinical outcome and appropriate management for patients showing 'borderline changes' on allograft biopsy after renal transplantation is still controversial. In an attempt to identify predictive factors of clinical outcome of patients with such lesions, we reviewed the clinical course of 91 patients with borderline changes. Multivariate analysis revealed significant and independent effects of histological stage (i + t < or = or > 2) and time to borderline changes (< or = or > 3 months after transplant) on serum creatinine levels at 1 year from borderline changes episodes (respectively, p = 0.04 and p = 0.02) and only a significant effect of time to borderline changes on serum creatinine levels at 2 years (p = 0.005). Renal function at 1 year and 2 years as 5- and 8-year graft survival were not significantly different in the group of patients treated with antirejection therapy (T group, n = 49) compared with the untreated group (UT group, n = 42). This study strongly suggests that borderline changes with histological score (i + t) > 2 and late episodes of borderline changes should be considered to be of poor prognosis.

Adult↗
PubMed2001

Acute hepatitis C without and with schistosomiasis: correlation with hepatitis C-specific CD4(+) T-cell and cytokine response.

BACKGROUND & AIMS: Immune responses during the first few months of acute hepatitis C virus (HCV) infection seem crucial for viral control, but the relationship of these responses to natural history is poorly characterized. METHODS: This prospective study investigated the HCV-specific CD4(+) and cytokine responses in patients with acute HCV hepatitis with or without Schistosoma mansoni coinfection, a parasitic infection with T helper (Th) 2 immune bias. HCV-specific CD4(+) proliferative responses and cytokine production in peripheral blood mononuclear cells were correlated with liver biopsy results at 6 months and at the end of follow-up. RESULTS: Whereas 5 of 15 patients with HCV alone recovered from acute HCV, all (17 of 17) patients with S. mansoni coinfection progressed to histologically proven chronic hepatitis. Coinfected patients had either absent or transient weak HCV-specific CD4(+) responses with Th0/Th2 cytokine production. The magnitude of the HCV-specific CD4(+) response at week 12 was inversely correlated with the fibrosis progression rate in chronically infected patients. CONCLUSIONS: Patients with acute hepatitis C and schistosomiasis coinfection cannot clear viremia and show rapid progression once chronic infection is established. This rapid progression is associated with a strong Th2 response in peripheral immune responses, suggesting that early development of vigorous Th1 responses not only facilitates clearance but delays disease progression.

Acute Disease↗
PubMed2000

Predictive factors of ventricular fibrillation triggered by pause-dependent torsades de pointes associated with acquired long QT interval: role of QT dispersion and left ventricular function.

INTRODUCTION: Death due to acquired torsades de pointes usually is caused by ventricular fibrillation (VF), but the contributing factors to VF triggered by pause-dependent torsades de pointes are not understood. METHODS AND RESULTS: We evaluated 91 patients who fulfilled four criteria: (1) pause-dependent torsades de pointes; (2) prolonged QT interval and/or corrected QT (QTc) (>0.44 sec); (3) long-short initiation sequence; and (4) conditions known to induce pause-dependent torsades de pointes. There were 38 patients with a documented VF (group I) and 53 without VF (group II). Absolute and relative dispersions of QT and QTc were calculated based on the 12-lead standard ECG. Group I differed from group II with regard to myocardial infarction history (32% vs 13%; P = 0.035), left ventricular ejection fraction (44% +/- 14% vs 65% +/- 9%; P < 0.0001), presence of structural heart disease (100% vs 20.8%; P < 0.0001), QT mean (591 +/- 73 msec vs 514 +/- 78 msec; P < 0.0001), QTc mean (563 +/- 76 msec vs 508 +/- 90 msec; P = 0.002), absolute QT dispersion (166 +/- 56 msec vs 84 +/- 49 msec; P < 0.0001), relative QT dispersion (9.9% +/- 3.5% vs 6.3% +/- 3.2%; P < 0.0001), absolute QTc dispersion (158 +/- 57 msec vs 81 +/- 44 msec; P < 0.0001), and relative QTc dispersion (9.9% +/- 3.6% vs 6.2% +/- 3%; P < 0.0001). Multiple regression analysis showed that ejection fraction (P = 0.0001), presence of structural heart disease (P < 0.0001), and relative QTc dispersion (P = 0.038) were the only independent predictors of VF. CONCLUSION: Left ventricular function, presence of structural heart disease, and QTc relative dispersion should be evaluated carefully in patients with conditions susceptible to inducing torsades de pointes.

Aged↗
PubMed2000

Junctional rhythm during slow pathway radiofrequency ablation in patients with atrioventricular nodal reentrant tachycardia: beat-to-beat analysis and its prognostic value in relation to electrophysiologic and anatomic parameters.

INTRODUCTION: Junctional rhythm usually is considered a sensitive but nonspecific marker of successful ablation of the slow pathway in AV nodal reentrant tachycardia. Nevertheless, this junctional rhythm has been little studied, and its relations to recognized predictors of successful radiofrequency (RF) application were never established in any study. METHODS AND RESULTS: Thirty-nine patients underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia. Ninety RF applications were delivered, and each ablation site was determined using three different fluoroscopic projections. Six anatomic zones were defined from low posterior septum to the site of distal His-bundle recording (P1, P2, M1, M2, A1, and A2). Characteristics of junctional rhythm during RF applications were analyzed. Atrial electrogram characteristics at the ablation sites also were studied. All patients had successful slow pathway ablation, without any complication. The ablation sites were located as follows: 41 at P1, 26 at P2, 20 at M1, and 3 in M2. Forty RF applications were successful: 14 of 41 attempts at P1, 7 of 26 at P2, 16 of 20 at M1, and 3 of 3 at M2. Mid-septal ablation site (M1 and M2) was associated with higher occurrence of junctional rhythm (P < 0.0001), earlier first junctional beat (P = 0.008), and earlier occurrence of the longest junctional burst (P = 0.03) compared with posterior ablation site (P1 and P2). The combination of a mid-septal ablation site and a first junctional beat occurring < or = 3 seconds after onset of RF application identified successful RF application with 100% accuracy. Using multivariate analysis, the ablation site, duration of atrial electrogram (including slow pathway potential when present), and occurrence of junctional rhythm were independent predictors of success. CONCLUSION: Successful slow pathway ablation depends on many factors. Junctional rhythm characteristics are related to the site of RF delivery and can be helpful in assessing successful slow pathway ablation.

Adolescent↗
PubMed2000

Evaluation of Egyptian sheep production systems: I. Breed crosses and management systems.

Our objective was to evaluate life-cycle performance of flocks of two Egyptian breeds, Rahmani (R) and Ossimi (O), and their crosses with Finnish Landrace (F) in two management systems. Management systems were one mating season per year (1M) and three mating seasons per 2 yr (3M). Breeds and crosses studied included purebred R and O, F1 crosses 1/2F-1/2R (FR) and 1/2F-1/2O (FO), and inter se matings of 1/4 F-3/4 R (RFR) and 1/4 F-3/4 O (OFO). A dynamic computer model was used to simulate animal performance and enterprise efficiency and profit. Two measures of lifecycle feed conversion (biological efficiency) were computed: kilograms of TDN input per kilograms of empty body weight output (TDN/EBW) and kilograms of TDN input per kilogram of carcass lean output (TDN/CLN). Profit was measured as gross margin (income minus variable costs per ewe per year, GM/EWE). Input parameters for the model were obtained from published results and analyses of data collected from experimental flocks of the same genetic stocks in Egypt. Profit for FR and RFR was 42 and 6% higher in 1M than in 3M. However, profit for all other genetic types was 4 to 8% greater in 3M than in 1M. Breed rankings changed depending on the measure of evaluation (i.e., biological efficiency or profit). Maximization of system output did not necessarily improve efficiency. Under accelerated lambing systems, greater overhead costs associated with labor and feed offset gains in ewe productivity. Genetic stocks should be matched to resources and management systems.

Animal Husbandry↗
PubMed2000

Evaluation of Egyptian sheep production systems: II. Breeding objectives for purebred and composite breeds.

Objectives for this study were to estimate relative economic weights for performance traits for two native and two composite sheep breeds under two management systems in Egypt. Breeds studied were Rahmani (R), Ossimi (O), 3/4R-1/4Finnish Landrace (RFR), and 3/4O-1/4Finn (OFO); OFO and RFR were composite breeds. Management systems were one mating season per year (1M) and three mating seasons per 2 yr (3M). A dynamic computer model was used to simulate animal performance and enterprise efficiency and profit. Input parameters for the model were obtained from published results and analyses of data collected from experimental flocks of the same genetic stocks in Egypt. Responses for two measures of life-cycle feed conversion and one measure of enterprise profit were evaluated. Life-cycle feed conversion was calculated as kilograms of TDN input per kilogram of empty body weight output (TDN/EBW) and kilograms of TDN input per kilogram of carcass lean output (TDN/CLN). Profit was measured as annual gross margin/ewe (GM/EWE). Traits evaluated were conception rate (CR), lambing rate (LR), mortality rate (MR), mature weight (MW), and milk production (MK). Based on responses to percentage changes in trait means, CR was most important for TDN/EBW, followed by LR and MR. For TDN/CLN, LR, MR, and CR were most important. For GM/EWE, CR was most important, followed by LR, MW, and MR. In the systems studied, there was little response to changes in MK. Based on changes in GM/EWE per genetic standard deviation change, LR was most important, followed by CR, MR, MW, and MK in all systems. Relative economic weights for O and OFO were similar, as were weights for R and RFR. Differences in economic weights between management systems for the same breed were not large enough to justify separate selection lines within breeds.

Animal Husbandry↗
PubMed1999

Electrocardiographic predictive factors of long-term clinical improvement with multisite biventricular pacing in advanced heart failure.

Biventricular pacing has recently been proposed for treating patients with drug refractory heart failure and intraventricular conduction delay. The purpose is to restore ventricular relaxation and contraction sequences as homogeneously as possible. The aim of this study was to determine if some factors could predict the long-term clinical effectiveness of that new treatment. This study included 26 patients, aged 66 +/- 7 years, with drug refractory heart failure and wide QRS. Patients were implanted with a biventricular pacemaker. The left ventricle was paced through a coronary sinus tributary. New York Heart Association functional class, exercise tolerance, and left ventricular (LV) ejection fraction were collected at baseline and after pacemaker implantation. Patients were divided into 2 groups: group I = responders; group II = nonresponders. QRS duration and axis at baseline and during biventricular pacing, interventricular conduction time, and LV and right ventricular lead positions were compared between the 2 groups. Group I patients (n = 19) had a mean reduction of 1.3 in functional class and an increase in peak oxygen consumption rate by a mean of 50%. The only parameter that differed between the 2 groups was the QRS duration during biventricular pacing, with a significantly shorter value in group I than in group II (154 +/- 17 vs 177 +/- 26 ms; p = 0.016). Thus, a positive response to biventricular pacing is correlated with the quality of electrical resynchronization. The optimal positions of the right and LV leads would be those that could induce the greatest shortening of QRS duration.

Aged↗
PubMed1999

Echocardiographic and Doppler study of patients with heatstroke and heat exhaustion.

This is a two-dimensional and Doppler echocardiographic study of the hemodynamic changes in patients with heatstroke and heat exhaustion. It demonstrates that the hemodynamic changes in severe heat exposure reflect a hyperdynamic circulation with tachycardia and high cardiac output states. Relative hypovolemia was more pronounced in patients with heatstroke compared to patients with heat exhaustion. Signs of peripheral vasoconstriction were more often present in patients with heatstroke, while patients with heat exhaustion more often demonstrated peripheral vasodilatation.

Cardiac Output↗
PubMed1996

[Contraception with levonorgestrel subdermal implants. A Tunisian study].

OBJECTIVES: We report our experience in Tunisia with contraception by subdermal levonogestrel implants. METHODS: From January 1, 1990 through June 30, 1994 we inserted 1021 implants at our family planning center in Ariana. RESULTS: Our experience with this pure progesterone implant showed that this method provides effective long-duration contraception. There was only one case of ectopic pregnancy among our 1021 patients. The most frequent undesirable effect and the first cause of discontinuing treatment was disturbed menstrual cycle with irregular discharge. CONCLUSION: Our results underline the importance of counselling before implant insertion. A 10-day estrogen regimen may provide a solution for menstrual disorders.

Adult↗
PubMed1995

Hemophilus influenzae and Streptococcus pneumoniae as causative agents of pneumonia in Egyptian preschool children: analysis and serotyping of Hemophilus isolates from hospital patients in Cairo, 1991-93.

The Hemophilus influenzae blood culture and nasopharyngeal isolates, collected during a limited Surveillance of Antimicrobial Resistance in 1991-1993 from 1,635 Egyptian children under 5 years of age, presenting with pneumonia to Embaba and Abbassia Fever Hospitals, were serotyped. The 8 blood culture isolates confirmed H. influenzae to be responsible for 0.5% of the cases of pneumonia, versus 50 Streptococcus pneumoniae blood culture isolates from the same population that confirmed it responsible for 3.1% of the cases. The invasive Hemophilus strains were exclusively isolated from infants below 1 year, from one hospital (Embaba), on one winter season (January to March, 1992). On serotyping, 50% of the blood culture isolates were found to be non-b by latex agglutination. Some 297 nasopharyngeal isolates from cases of pneumonia were also serotyped and 45% were found to be non-b, thus confirming the invasive strains findings. Furthermore, the typing results from ARI-free controls nasopharyngeal isolates--though limited--were consistent with the findings and showed a 43% proportion of non-b. These findings put a question mark on the benefit of a large scale use of the available H. influenzae type b polysaccharide and conjugated vaccines in Egypt. But before interpreting out data in terms of vaccine needs, more specifically designed epidemiological studies need to be conducted to assess the role of H. influenzae as a pathogen in Egypt.

Age Distribution↗
PubMed1991

Astrocytes colonize dorsal root ganglia transplanted into rat brain.

Fragments of dorsal root ganglia (DRG) were grafted into rat brain and examined one month later. The autografts were similar to their normal counterparts when stained with toluidine blue or by indirect immunofluorescence with laminin and neurofilament antibodies. However, a major difference was observed with antibodies to the glial fibrillary acidic protein (GFAP). Normal DRG were GFAP-negative while the autografts were intensely and diffusely stained. The GFAP antibodies used in this study did not decorate Schwann cells or satellite cells in peripheral nerve and DRG, and thus appeared to recognize the "central" form of GFAP (17). Thus reactive astrocytes appear to be capable of migration into grafted nervous tissues without producing apparent neuronal damage.

Animals↗
PubMed1991

Activities of lung NADPH-cytochrome C-reductase and of cytochrome P-450 peroxidase during the protection of rat from hyperoxic injury by polyriboinosinic acid-polyribocytidilic acid.

Rats exposed to normobaric oxygen received a single i.p. injection of 2.5 mg/kg of poly I: poly C at various times (-120 to +36 h) before and after the beginning of oxygen exposure. Hyperoxic lung damage and modifications in cytochrome P-450 system components were evaluated. Our results confirmed the protective effect of poly I: poly C on rats exposed to oxygen, reducing the lung edema and the mortality. This effect was only observed when poly I: poly C was injected 48 or 36 h before the beginning of oxygen exposure. Although oxygen exposure per se decreased the total level of lung cytochrome P-450, poly I: poly C per se induced a deeper decrease to levels similar in air- or oxygen-exposed rats. Poly I: poly C did not modify the NADPH-cytochrome c reductase level nor the cytochrome P-450 peroxidase activity in air-exposed rats. The oxygen exposure induced a decrease of these two enzymes, either in the absence or in the presence of poly I: poly C, except when poly I: poly C was injected 48 or 36 h before the beginning of oxygen exposure, times at which poly I: poly C restored the enzymatic values measured in rats exposed to air. Because the times of injection of poly I: poly C were those at which the protective effect was observed, it suggested that the protective effect of poly I: poly C against oxygen toxicity was associated with a lack of oxygen-induced decrease of both the lung NADPH-cytochrome c reductase level and the lung cytochrome P-450 peroxidase activity.

Animals↗
PubMed1990

Permissive and non-permissive reactive astrocytes: immunofluorescence study with antibodies to the glial hyaluronate-binding protein.

Two distinct types of reactive astrocytes were studied in rat CNS. Reactive astrocytes secondary to penetrating trauma (anisomorphic gliosis) were induced by stab wounds to the brain. Reactive astrocytes secondary to Wallerian degeneration (isomorphic gliosis) were induced in spinal cord dorsal columns by dorsal rhizotomy proximal to dorsal root ganglia. Anisomorphic glial scars did not stain with antibodies to the glial hyaluronate-binding protein (GHAP), a structural glycoprotein of white matter extracellular matrix. Conversely, isomorphic glial scars were still GHAP-positive 3 months after dorsal root transection. Only after 5 months did GHAP immunoreactivity start to disappear from the isomorphic glial scar. Extensive dorsal rhizotomy was performed at the lumbar level to produce Wallerian degeneration of spinal cord dorsal columns. One month later, the rats were reoperated and two thoracic dorsal roots were implanted in the degenerated dorsal columns. The rats were examined 1 month after grafting. As expected, there was a dense anisomorphic glial scar at the site of surgery, while the dorsal columns above the graft showed isomorphic gliosis. Extensive axonal growth was observed in the dense glial scar surrounding the graft. Conversely, no axonal growth was observed in the degenerated dorsal columns undergoing isomorphic gliosis above the implant. The findings suggested that GHAP-negative astrocytes responding to traumatic injury are permissive for axonal growth and that GHAP-positive astrocytes responding to Wallerian degeneration are not permissive.

Animals↗
PubMed1989

Neurofilament phosphorylation in neuronal perikarya following axotomy: a study of rat spinal cord with ventral and dorsal root transection.

Rat spinal cord was stained by indirect immunofluorescence with 11 neurofilament monoclonal antibodies that recognize phosphorylated epitopes. All monoclonals were axon-specific in this location. The large motoneurons containing bundles of neurofilaments did not stain and the pattern remained unchanged after transection of the sciatic nerve in the thigh. With nine monoclonals, stained motoneurons were observed in the ventral horns 3 days, 5 days, 1 week, and 2 weeks after transection of the ventral roots close to the spinal cord. The abnormal motoneurons were typically scattered among normal (i.e., nonstained) cells. Even in animals showing the most severe reaction, the whole motoneuron population at the site of rhizotomy was not affected, stained and nonstained perikarya often coexisting side by side. Stained motoneurons were no longer observed 3 weeks after ventral root transection. Changes in neuronal immunoreactivity were also observed after dorsal root transection. However, a different population was affected, i.e., middle-sized neurons in dorsal horns and at the base of ventral horns. With two monoclonals (A9 and D21), cell bodies remained negative following all operations. It is concluded that axotomy in proximity of the cell body may induce certain neurofilament phosphorylation events in motor neuron perikarya, whereas other phosphorylation events remain confined to the axons under these experimental conditions. The absence of changes after transection of the sciatic nerve in the thigh suggests that neurofilament phosphorylation is a reaction to cell injury rather than a cellular event related to nerve regeneration.

Animals↗
PubMed1989

Glial hyaluronate-binding protein in Wallerian degeneration of dog spinal cord.

Wallerian degeneration of spinal cord dorsal columns was produced in three dogs by unilateral extradural dorsal rhizotomy at the lower thoracic level. The spinal cord was studied 1 month, 2 months, and 3 months after surgery. Transverse cryostat sections at the site rhizotomy and at the mid-thoracic level were stained by indirect immunofluorescence with antibodies to the glial fibrillary acidic protein (GFAP) and to the glial hyaluronate-binding protein (GHAP). GHAP immunoreactivity was almost unchanged in the degenerated dorsal column 1 month after rhizotomy. After 2 and 3 months, staining with GHAP antibodies was markedly decreased in the gliosed dorsal column at the site of rhizotomy, but it still persisted at the mid-thoracic level. It is concluded that GHAP persists for long periods of time in dorsal columns undergoing Wallerian degeneration, a finding consistent with its putative role as a nonpermissive substrate preventing nerve regeneration in CNS white matter.

Animals↗
PubMed1989

A new strategy for clinical decision making--II. The circumscription of non-monotonicity and differential diagnosis for thyroid diseases.

The physician or scientist must contend with multiple interactions in medicine. Differential diagnosis, or the determination of which of two or more diseases a patient is suffering from, arises from the complexity of these interactions. Some of these interactions can mask or inhibit the true diagnosis. These inhibiting factors are called censors. Because of censors, switching points are required in non-monotonic reasoning associated with a differential diagnosis. In order to render these censors--and non-monotonic reasoning--susceptible of computation, they must first be circumscribed. This paper examines circumscription as a form of non-monotonic reasoning augmenting first-order logic through censorship in the diagnosis of thyroid patients. This approach to circumscription is inspired by the influential work of John McCarthy at Stanford University.

Artificial Intelligence↗