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Biomedical subjects

J Y Kassab

Publications and source records attributed to J Y Kassab.

11 recordsLinked to original sources
PubMed1992

Fluoridation in Anglesey: a clinical study of dental caries in mothers at term.

A study of dental caries was carried out involving 1537 mothers who attended St David's Hospital, Gwynedd, between July 1986 and July 1987 for their confinement. The study was 'blind' in respect of residence. The mean DMFT value for mothers with continuous residence in the non-fluoridated Gwynedd mainland was 13.6 and the mean DMFT value for mothers living in the Anglesey Health Unit who had consumed fluoridated mains water from birth was 30% lower at 9.5 (P less than 0.0001). The confidence interval for the difference between means was 3.4-4.9. The samples from the two areas showed no significant differences in social class and age group structures. The percentage of Anglesey mothers with DMFT exceeding 15 was less than one-sixth of that for mainland mothers and the percentage of those with DMFT less than 6 was three times greater. The mean DMFS value for occlusal sites in premolars was 3.9 for mainland Gwynedd and for Anglesey 52% less at 1.9 (P less than 0.0001) with a confidence interval of 1.6-2.4. For smooth surface sites in posterior teeth, the difference was not as pronounced, with a mean DMFS value for mainland of 20.3 and for Anglesey 42% less at 11.8 (P less than 0.0001) with a confidence interval of 7.5-9.6. The results showed that child-bearing women continued to enjoy important benefits from water fluoridation into their early thirties.

Adult↗
PubMed1992

Concomitance of psoriasis and atopic dermatitis.

There is a widespread belief that psoriasis (Ps) and atopic dermatitis (AD) are clinically mutually exclusive. A prospective study was undertaken to record the concurrent and/or consecutive coincidence of the two conditions and any shared clinical features. Patients attending a dermatology clinic were systematically examined for the presence of Ps and/or AD. Nine hundred and eighty-three patients were studied--428 with Ps, 224 with AD, 45 with both Ps and AD, and 286 controls. Of AD patients 16.7% had Ps, and 9.5% of Ps patients had AD. In consecutive occurrences, Ps generally followed AD. The ratio of concurrent to consecutive incidences was 3:1. The two diseases are shown not to be mutually exclusive and may coexist in the same individual.

Adolescent↗
PubMed1991

Topical glyceryl trinitrate and eutectic mixture of local anaesthetics in children. A randomised controlled trial on choice of site and ease of venous cannulation.

One hundred and four children aged between 1 and 11 years were studied in a double-blind randomised controlled trial of glyceryl trinitrate ointment versus placebo, when used in addition to standard eutectic mixture of local anaesthetics cream. Each child received glyceryl trinitrate ointment on one hand and placebo on the other, and thus acted as his/her own control. A group of 30 children who received only the eutectic mixture on both hands (60 measurements) was also studied. The choice of site and ease of cannulation was scored. Skin colour and venous dilatation under the eutectic mixture were scored on a visual analogue scale. The addition of topical glyceryl trinitrate ointment to the standard eutectic mixture positively affected venous dilatation (p less than 0.01), choice of cannulation site (p less than 0.001), and ease of cannulation (p less than 0.001) of topical anaesthetic-treated skin.

Administration, Topical↗
PubMed1990

Gastric cancer in Gwynedd. Possible links with bracken.

One hundred and one histologically confirmed gastric cancer patients in Gwynedd, North Wales, were matched by sex, age and social class to two hospital inpatients without cancer. Seventy-seven of the gastric cancer cases were also matched, using the same criteria, to a patient with a confirmed cancer of a different site (excluding oesophagus). A questionnaire was used to determine bracken exposure and source of water in childhood. Residential and occupational histories were obtained and the consumption of buttermilk, a potential vector of the bracken carcinogens, was quantified. Comparison of the gastric cancer patients with the non-cancer controls indicated that exposure to bracken in childhood had an increased risk (RR = 2.34, P less than 0.001) compared to no exposure and that length of residence in Gwynedd was associated with increased risk (RR = 2.46 for durations of 61 years and over, P less than 0.01). Consumption of buttermilk in childhood and adulthood was attended by increased risk (RR = 1.61 and 1.86 respectively, the latter being statistically significant, P less than 0.05). Neither the residence effect nor consumption of buttermilk in adulthood remained significant when considered in a multivariate analysis with bracken exposure.

Adult↗
PubMed1986

A comparison of mercury and digital clinical thermometers.

A primarily clinical trial has been undertaken to investigate and compare the use of mercury and digital thermometers in a ward situation. Both laboratory and clinical studies show that there is no significant difference in the average accuracy of the two types of thermometers, however there is a greater fluctuation of readings of temperature when using electronic thermometers. In clinical studies between 9 and 23% of repeated measurements using an electronic thermometer differ by 0.5 degrees C or more whilst the corresponding range for mercury thermometers is 0.6%. It is also shown that when making clinical measurements with mercury thermometers there is no clinical advantage in using a measurement time longer than 3 minutes.

Body Temperature↗
PubMed1986

Nasal response of rhinitic and non-rhinitic subjects to histamine and methacholine: a comparative study.

The nasal responses to provocation with histamine and methacholine were compared in 20 subjects with and 20 without rhinitis. Two variables were measured: nasal airways resistance and the development of rhinorrhoea. Histamine had a greater effect than methacholine in increasing nasal airways resistance while the converse was true for rhinorrhoea. Rhinitic subjects had a significantly greater response to histamine induced changes in nasal airways resistance (p less than 0.05), rhinorrhoea (p less than 0.05) and methacholine induced rhinorrhoea (p less than 0.01) than those without rhinitis. No significant differences were found between the two groups in methacholine induced changes in nasal airways resistance. The findings show that, like the lower airways of patients with asthma, the nasal mucosa of rhinitic subjects shows a greater responsiveness to non-specific agonists than that of non-rhinitic subjects.

Adolescent↗
PubMed1986

Trochanteric fractures of the femur. A randomised prospective trial comparing the Jewett nail-plate with the dynamic hip screw.

In a randomised prospective trial 98 elderly women with trochanteric fractures of the femur were treated with either a 135 degrees Jewett nail-plate or a 135 degrees Dynamic hip screw. The results at six weeks, three months and six months were statistically analysed. There were no significant differences in the two groups with regard to pain, length of hospital stay, morbidity or mortality. Although operative difficulties and open reduction were more common with the Dynamic hip screw, at the end of six months more patients in this group were mobile and there was significant radiological evidence of better compression without loss of fixation.

Aged↗
PubMed1986

An investigation into private sector nursing and residential home care for the elderly in north Wales.

In January 1984 two questionnaires were sent to private homes for the elderly in an area of north Wales with a high concentration of private beds. The first questionnaire was completed by eight nursing homes and 13 residential homes for the elderly and the second questionnaire for each of 321 residents - 154 in the former and 167 in the latter.The two types of homes were compared for staffing levels, facilities available and the degree of dependency of residents. As expected the degree of dependency of the residents in nursing homes was higher than in residential homes but even so the degree of dependency in residential homes was found to be high. The isolation of many residents was evident. Twenty three per cent of residents had come directly to the homes on moving into the area. The problems arising for general practitioners visiting a number of different homes and for homes having many different doctors visiting are highlighted.The need for adequate consultation and assessment prior to admission and periodic reassessment is demonstrated in the light of the recent changes to the supplementary benefit regulations. It was found that at least 20% of the residents had their fees supplemented by the Department of Health and Social Security. The need for greater collaboration between the two different registration authorities under the new legislation (Registration of Homes Act 1984) and with the general practitioners providing general medical services is demonstrated.

Aged↗
PubMed1985

Management of gallstones in a district general hospital.

This survey reviews 815 consecutive patients undergoing surgery for benign biliary disease. There were no deaths following elective operations and the overall mortality was 0.7 per cent. One-third of patients had one or more complications. The mortality in patients having common bile duct exploration (n = 160) by one or more methods was 2.5 per cent (4 patients) with 46 per cent of these patients having complications. Of 95 patients undergoing duct exploration and postoperative T-tube cholangiography, 7 had unexpected residual calculi after initial cholecystectomy. Five have had further surgery to clear the duct. All patients having duct surgery alone for retained stones (n = 24) had previously had cholecystectomy with or without supraduodenal duct exploration. Of all patients undergoing choledochoduodenostomy or transduodenal sphincter exploration only one has returned with evidence of retained calculi. Patients with choledocholithiasis were examined in an attempt to identify a high risk group. These were found to be elderly patients, having emergency surgery for sepsis and on whom more than one duct procedure was performed (mortality 10 per cent).

Adolescent↗
PubMed1985

Early elective cholecystectomy--an alternative to early cholecystectomy in acute cholecystitis?

Currently there are two forms of management for patients with acute cholecystitis. Conservative treatment during the acute episode and readmission after 6-8 weeks for elective surgery and early cholecystectomy during the emergency admission. An alternative treatment would be elective surgery before the acute episode which should reduce morbidity and mortality. This study has identified those patients who are likely to present with acute biliary disease so that they can be selected for elective surgery shortly after their attendance in outpatients.

Acute Disease↗