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Biomedical subjects

I Adam

Publications and source records attributed to I Adam.

At least 37 records · Page 2Linked to original sources
PubMed2004

Colonoscopic resection of lateral spreading tumours: a prospective analysis of endoscopic mucosal resection.

BACKGROUND: Lateral spreading tumours are superficial spreading neoplasms now increasingly diagnosed using chromoscopic colonoscopy. The clinicopathological features and safety of endoscopic mucosal resection for lateral spreading tumours (G-type "aggregate" and F-type "flat") has yet to be clarified in Western cohorts. METHODS: Eighty two patients underwent magnification chromoscopic colonoscopy using the Olympus CF240Z by a single endoscopist. All patients had received a previous colonoscopy where an endoscopic diagnosis of lateral spreading tumour was made. All lesions were examined initially using indigo carmine chromoscopy to delineate contour followed by crystal violet for magnification crypt pattern analysis. A 20 MHz "mini probe" ultrasound was used if T2 disease was suspected. Following endoscopic mucosal resection, patients were followed up at 3, 6, 12, and 24 months using total colonoscopy. RESULTS: Eighty two lateral spreading tumours were diagnosed in 80 patients (32% (26/82) F-type and 68% (56/82) G-type). G-type lesions were larger than F-type (G-type mean 42 (SD 14) mm v F-type 24 (6.4) mm; p<0.01). F-type lesions were more common in the right colon (F-type 77% (20/26) compared with G-type 39% (22/56); p<0.01) and more often associated with invasive disease (stage T2) (66% (10/15) v 33% (5/15); p<0.001). Fifty eight lesions underwent endoscopic mucosal resection (G-type 64% (37/58)/F-type 36% (21/58)). Local recurrent disease was detected in 17% of patients (10/58), all within six months of the index resection. Piecemeal resection and G-type morphology were significantly associated with recurrent disease (p<0.1). Overall "cure" rates for lateral spreading tumours using endoscopic mucosal resection at two years of follow-up was 96% (56/58). CONCLUSIONS: Endoscopic mucosal resection for lateral spreading tumours, staged as T1, is a safe and effective treatment despite their large size. Endoscopic mucosal resection may be an alternative to surgery in selected patients.

Adult↗
PubMed2004

Low-dose quinine is effective in the treatment of chloroquine-resistant Plasmodium falciparum malaria in eastern Sudan.

In November-December 2002, 98 patients presented at the Elhara Eloula health centre, in the New Halfa area of eastern Sudan, with Plasmodium falciparum malaria that had failed to respond to chloroquine treatment. After informed consent was obtained, 93 of these patients were randomly allocated to one of three regimens for quinine treatment, being given the drug, orally and sometimes intravenously, for 7 days, at doses of 10 mg/kg thrice daily (32 patients), 10 mg/kg twice daily (31 patients) or 15 mg/kg once daily (30 patients). All the patients were followed daily until day 7 and then weekly until day 28. There was no significant difference in the parasite-clearance times observed in the three groups. Parasitaemias re-occurred by day 28 in 12 patients: two (6.3%) of the patients treated thrice daily, five (16.1%) of those treated twice daily, and five (16.7%) of those treated once daily (P > 0.05). Genotyping indicated that in nine of these 12 patients the parasitaemias that developed post-treatment represented true recrudescences and not re-infections. In the treatment of chloroquine-resistant, P. falciparum malaria in Sudan, once-daily treatment with quinine, in a relatively low daily dose (15 mg/kg. day), appears as effective as the thrice-daily treatment (at 30 mg/kg. day) often recommended.

Adolescent↗
PubMed2004

Attractiveness of pregnant women to the malaria vector, Anopheles arabiensis, in Sudan.

The attractiveness of pregnant women for mosquitoes was investigated in a peri-urban site in New Halfa, eastern Sudan, in September-October 2003. For 20 nights, the mosquitoes feeding on nine pregnant and nine non-pregnant women sleeping under untreated bednets were collected. The women slept outdoors, in the yards of nine houses, each yard holding one pregnant and one non-pregnant woman. In general, each pregnant woman attracted significantly more Anopheles arabiensis (the main vector of Plasmodium falciparum in the area) than each non-pregnant women, with mean biting rates of 0.94 and 0.49 bites/woman-night, respectively (P = 0.005). In contrast, the two groups of women attracted similar numbers of the other mosquito species collected, which were all culicine. Impregnated bednets need to be used in the study area, at least by the pregnant women (who appear to be at particularly high risk of acquiring malaria).

Adult↗
PubMed2004

Efficacies of chloroquine, sulfadoxine-pyrimethamine and quinine in the treatment of uncomplicated, Plasmodium falciparum malaria in eastern Sudan.

The efficacies of several antimalarial drugs in the treatment of uncomplicated Plasmodium falciparum malaria were compared, during an open, randomized trial, in New Halfa, eastern Sudan. The 96 patients who completed the 28 days of follow-up were treated with chloroquine (N = 26), sulfadoxine-pyrimethamine (N = 38) or quinine (N = 32). No treatment failures were observed among the patients given sulfadoxine-pyrimethamine. Only 23.1% of the patients given chloroquine showed adequate clinical response, however, the rest showing early (15.4%) or, more frequently, late (61.5%) treatment failure. In terms of parasitological failure, 54.1% of the patients given chloroquine showed early RI resistance, 7.7% showed late RI, and 15.1% showed RIII. Most (90.6%) of the patients treated with quinine had adequate treatment responses, the rest having late treatment failures (and late RI). The frequency of treatment failure was significantly higher, however, among the patients given chloroquine than in the quinine-treatment arm. The present results and those of earlier investigations indicate that the problem of chloroquine resistance is worsening in eastern Sudan, and that the use of chloroquine as the first-line drug for the treatment of uncomplicated malaria in this area is now compromised. The response to quinine may also be faltering.

Adolescent↗
PubMed2004

Ceftriaxone versus ampicillin/cloxacillin as antibiotic prophylaxis in elective caesarean section.

We carried out a prospective, randomized, controlled clinical trial to evaluate the clinical efficacy of ceftriaxone and ampicillin/cloxacillin prophylaxis in decreasing the frequency of post-caesarean section infection-related morbidity. Two hundred patients randomly received either ceftriaxone (single dose) or ampicillin/cloxacillin (3 doses) intravenously at induction of anaesthesia. There was no statistical difference in incidence of endometritis (P = 0.34), wound infection (P = 0.44), or other febrile morbidity (P = 0.5). Eleven babies had a low Apgar score (< 8) in the ceftriaxone group and 13 in the ampicillin/cloxacillin group (P = 0.82). There were 2 perinatal deaths in each group. One dose of ceftriaxone was as effective as ampicillin/ cloxacillin in preventing post-caesarean section complications and is easier to administer.

Ampicillin↗
PubMed2004

Efficacy of sulfadoxin pyrimethamine for uncomplicated Plasmodium falciparum malaria in a small sample of Sudanese children.

A prospective clinical trial was carried out to determine in vivo efficacy of sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in children in New Halfa. Forty patients were enrolled; 31 completed the 28-day follow-up. Six (19.4%) patients showed recurrence of parasitaemia during follow-up, while the rest (80.6%) cleared the parasites and responded fully to treatment. All the failures were late treatment failures. Parasite genotyping showed that 1 (16.7%) of the 6 cases of late parasitaemia was due to reinfection while the rest (83.4%) were due to true recrudescence. During the follow-up period 22.6% of patients showed gametocytaemia. The high level of treatment failure as well as gametocytaemia necessitates the introduction of artesunate in this combination therapy.

Adolescent↗
PubMed2003

Improved direct measurement of the parity-violation parameter Ab using a mass tag and momentum-weighted track charge.

We present an improved direct measurement of the parity-violation parameter A(b) in the Z boson-b-quark coupling using a self-calibrating track-charge technique applied to a sample enriched in Z-->bb events via the topological reconstruction of the B hadron mass. Manipulation of the Stanford Linear Collider electron-beam polarization permits the measurement of A(b) to be made independently of other Z-pole coupling parameters. From the 1996-1998 sample of 400,000 hadronic Z decays, produced with an average beam polarization of 73.4%, we find A(b)=0.906+/-0.022(stat)+/-0.023(syst).

Journal Article↗
PubMed2003

Plasmodium falciparum infection during pregnancy in an unstable transmission area in eastern Sudan.

A 1-year prospective community-based study of malaria during pregnancy was conducted in an area of seasonal and unstable malaria transmission in eastern Sudan. At a village antenatal clinic, 89 non-pregnant controls and 86 pregnant women were enrolled and followed every 2 weeks until 6 weeks after delivery. The incidence of Plasmodium falciparum infection was significantly higher among pregnant than control women (17.4% versus 5.6%) with no difference between primigravidae and multigravidae (22.2% versus 15.2%). There was no significant difference in the mean haemoglobin concentration between infected and uninfected mothers (9.1 +/- 1.3 versus 9.5 +/- 0.6 g/dL) but the mean birth weight of their babies was significantly lower (2.72 +/- 0.26 versus 2.95 +/- 0.05 kg) despite prompt case management of infected women.

Adult↗
PubMed2002

Improved direct measurement of A(b) and A(c) at the Z(0) pole using a lepton tag.

The parity violation parameters A(b) and A(c) of the Zb(b) and Zc(c) couplings have been measured directly, using the polar angle dependence of the polarized cross sections at the Z(0) pole. Bottom and charmed hadrons were tagged via their semileptonic decays. Both the electron and muon analyses take advantage of new multivariate techniques to increase the analyzing power. Based on the 1993-1998 SLD sample of 550,000 Z(0) decays produced with highly polarized electron beams, we measure A(b) = 0.919+/-0.030(stat)+/-0.024(syst), and A(c) = 0.583+/-0.055(stat)+/-0.055(syst).

Journal Article↗
PubMed2002

Comparison of intramuscular artemether and intravenous quinine in the treatment of Sudanese children with severe falciparum malaria.

OBJECTIVES: To compare the efficacy of intramuscular artemether and intravenous quinine in the treatment of severe falciparum malaria. DESIGN: An open randomized controlled clinical trial. SETTING: New Halfa Teaching Hospital, Eastern Sudan, in the period November 2001-January 2002. SUBJECTS: Forty one male and female children; 21 on artemether and 20 on quinine. MAIN OUTCOME MEASURES: Fever clearance time, parasite clearance time, coma resolution time and side effects of the two drugs. RESULTS: The two groups (artemether and quinine) were well matched in the admission variable. The mean +/- (SD) fever clearance time was 30.5 +/- (20.9) hours in the artemether group, while it was 18.0 +/- (8.1) hours in the quinine group; the difference was highly significant (P=0.02). The mean parasite clearance time was shorter in the artemether group than in the quinine group, but it was not statistically significant, (16.0 vs. 22.4 hours; p>0.05). In comatose patients (three in the artemether group, three in the quinine group) the time of recovery from coma was significantly shorter in artemether group than in quinine group (12.5 vs. 20.16 hours; P<0.05). Recrudescence of P. falciparum (confirmed by polymerase chain reaction) occurred in one out of fifteen patients (6.6%) in the quinine group seen on day 28, which was successfully treated by sulphadoxine-pyrimethamine. In the quinine group, one patient died and one patient developed hypoglycaemia. CONCLUSION: Artemether caused faster parasite clearance than quinine, but quinine lowered the temperature in shorter time than artemether. The results obtained show that artemether can be used as safe and effective alternative drug for the treatment of severe falciparum malaria in the wake of the growing resistance to quinine in Sudan.

Animals↗
PubMed2002

Methyldopa versus no drug treatment in the management of mild pre-eclampsia.

OBJECTIVES: To evaluate the efficacy of methyldopa in the treatment of mild pre-eclampsia, to prevent its progress and to investigate its effect on the pregnancy outcomes. DESIGNS: Randomised clinical trial. SETTING: Wad Medani Hospital in the central Sudan. SUBJECTS: Seventy primigravidae with single, alive baby of 28-36 weeks gestational age suffering from true mild pre-eclampsia were enrolled. The patients were randomised in two groups, treatment group who received methyldopa 750-4000 mg/day (n=34) and a control group who received no treatment (n=36). All the (treatment and control) patients were drug followed as in-patients till the delivery, seen with their babies on the days 7, 42 after the delivery. MAIN OUTCOMES MEASURES: The outcomes examined were, rise of the diastolic blood pressure to 110 mm Hg or more, occurrence of imminent eclampsia or the eclampsia, if the maturity could be achieved, occurrence of intrauterine growth retardation, abruptio placentae, mode of delivery, birth weight, placental weight, perinatal death, Apgar score and referral of the babies to the pediatrician. RESULTS: Three out of 34 (8.8%) of the treatment group had a rise in the diastolic blood pressure of 110 mm Hg, 18/36 (50%) of the control had a rise in the diastolic blood pressure of 110 mmHg (p < 0.05). Three out of thirty four (8.8%) of the treatment group developed imminent eclampsia, while 10/36 (27.8) of the control group developed imminent eclampsia (p < 0.05). The maturity was achieved in 82.3% and 88.8% of the treatment and the control, respectively (p > 0.05). There were ten (14.2%) perinatal deaths, four of them in the treatment group, while six in the control (p > 0.05). There was no difference regarding birth weight, occurrence of intrauterine growth retardation, placental weight, mode of delivery, Apgar score, referral of the babies to the paediatrician. No patient developed eclampsia or abruptio placenta; there was no maternal death in both groups. CONCLUSION: Methyldopa can prevent the progress of the mild pre-eclampsia to severe pre-eclampsia, without affecting the maturity, birthweight or the neonatal outcomes.

Abruptio Placentae↗
PubMed2001

Improved direct measurement of leptonic coupling asymmetries with polarized Z bosons.

We present final measurements of the Z boson-lepton coupling asymmetry parameters A(e), A(mu), and A(tau) with the complete sample of polarized Z bosons collected by the SLD detector at the SLAC Linear Collider. From the left-right production and decay polar angle asymmetries in leptonic Z decays we measure A(e) = 0.1544+/-0.0060, A(mu) = 0.142+/-0.015, and A(tau) = 0.136+/-0.015. Combined with our left-right asymmetry measured from hadronic decays, we find A(e) = 0.1516+/-0.0021. Assuming lepton universality, we obtain a combined effective weak mixing angle of sin (2)theta(eff)(W) = 0.230 98+/-0.000 26.

Journal Article↗
PubMed2001

First symmetry tests in polarized Z0 decays to bbg.

We have made the first direct symmetry tests in the decays of polarized Z0 bosons into fully identified bbg states, collected in the SLD experiment at SLAC. We searched for evidence of parity violation at the bbg vertex by studying the asymmetries in the b-quark polar- and azimuthal-angle distributions, and for evidence of T-odd, CP-even or CP-odd, final-state interactions by measuring angular correlations between the three-jet plane and the Z0 polarization. We found results consistent with standard model expectations and set 95% C. limits on anomalous contributions.

Journal Article↗
PubMed2000

High-precision measurement of the left-right Z Boson cross-section asymmetry.

We present a measurement of the left-right cross-section asymmetry ( A(LR)) for Z boson production by e(+)e(-) collisions. The measurement includes the final data taken with the SLD detector at the SLAC Linear Collider during the period 1996-1998. Using a sample of 383 487 Z decays collected during the 1996-1998 runs we measure the pole value of the asymmetry, A(0)(LR), to be 0.150 56+/-0.002 39 which is equivalent to an effective weak mixing angle of sin (2)straight theta(eff)(W) = 0.231 07+/-0.000 30. Our result for the complete 1992-1998 data set comprising approximately 537 000 Z decays is sin (2)straight theta(eff)(W) = 0.230 97+/-0.000 27.

Journal Article↗
PubMed1998

Partial clone of the gene for AS protein of the lamprey Petromyzon marinus, a member of the albumin supergene family whose expression is restricted to the larval and metamorphic phases of the life cycle.

AS was previously found to be a liver-synthesized serum protein that is found in the larval (ammocoete), metamorphosing, and juvenile individuals during the life cycle of Petromyzon marinus but not in the sexually mature upstream-migrant individuals (Filosa et al. [1982] Comp. Biochem. Physiol., 72B:521-530; [1986] Comp. Biochem. Physiol., 83B:143-149; Ito et al. [1988] J. Exp. Zool., 245:256-263). In the present work, a partial clone for the gene for the AS protein was isolated from a cDNA expression library made from ammocoete liver. Northern blots using this clone showed hybridization with mRNA from the intervals of the life cycle prior to the upstream-migration period but not from the upstream-migration period itself. The cloned DNA was sequenced and the deduced amino acid sequence was found to have 40% identity with an albumin (our SDS-1 protein) from the upstream migrants of P. marinus (Gray and Doolittle, [1992] Protein Sci., 1:289-302), which is homologous to mammalian serum albumin. Thus the lamprey has two genes, AS and SDS-1, that code for different but similar albumin-like proteins, which predominate at different phases in its life cycle. It is suggested that AS protein, because it is present only at the earlier phases of the life cycle and because its gene is transcribed only during this same period, may be an early version of the alpha-fetoprotein (AFP) of mammals that is found only in the embryonic, fetal, and neonatal phase of their life cycle.

Albumins↗
PubMed1997

[Health-related behavior and coping with problems by adolescents in relation to social change in new unified Germany].

Young people in East Germany are faced with problems specific to their development which are added to through adjusting to conditions caused by transformation. Psychosocial pressure, attitudes to personal health and resources to problem solving in interaction with each other form a significant part of young people's lives. They shall be represented in selected conclusions below. In a questionnaire of 1764 young people themes to relating attitudes to personal health, psychosocial pressure as well as personal problem solving were raised. A main concern of social change raised by parents' new employment situation hasn't led to any negative attitudes to personal health nor to social pressure which surpasses the results of other investigations. At the time of investigation (1993) young people have coped altogether well with the social changes.

Adaptation, Psychological↗
PubMed1997

[Prerequisites to successful conversion to the Swiss model managed care-gatekeeper systems in Germany].

In Switzerland different gatekeeper-systems to improve the capacity and economic efficiency were successfully tried and tested. The systems show clear advantages of the gatekeeper-system concerning the costs and quality of health care over the customary Swiss health insurances. The German as well as the Swiss health care system are facing similar problems. The introduction of the Swiss gatekeeper-system in Germany would offer a promising opportunity to achieve economic efficiency and quality in German Statutory Health Insurance. Thus, greater flexibility is imperative in the subjects of legal conditions, especially the contract, incentive and information systems.

Cost-Benefit Analysis↗