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Biomedical subjects

K Hassanein

Publications and source records attributed to K Hassanein.

At least 19 recordsLinked to original sources

Low dose cyclosporin-A therapy in Behçet's disease.

The effect of systemic low dose cyclosporin-A (5 mg/kg/day as initial dose) combined with 0.2 to 0.6 mg/kg/day prednisolone (when necessary) in clinical course of 22 patients suffering from severe forms of Behçet's disease are reviewed. All the patients had received other drugs previously and had either no response to them or developed intolerable side effects, therefore, pre treatment visual acuity (VA) was compared to post treatment VA as "self control". The average age of our patients was 30.6 years (range 19-51 years). The average duration of our therapy was 19.5 months (range 4-32 months). Improvement or stabilization of vision was achieved in 21 patients (95%). The intraocular inflammation was controlled in all of the eyes and most of the non-ocular signs and symptoms were also improved. Serious side effects included rise in creatinine in 10 (45%) of the patients, rise in bilirubin in 6 (27%) and hypertension in 1 (4.5%). These side effects disappeared as the dose of cyclosporin-A was tapered. We believe this form of therapy is of great value in the management of severe forms of Behçet's disease.

Administration, Oral

The effect of corneal thickness on applanation tonometry.

Simultaneous manometry and Perkins tonometry were performed at 10.0, 20.0, and 30.0 mm Hg on 15 eyes on which intraocular procedures were performed. There was a statistically significant relationship between corneal thickness and the error of Perkins tonometry. Thin corneas produced underestimations of the intraocular pressure by as much as 4.9 mm Hg, whereas thick corneas produced overestimations by as much as 6.8 mm Hg. Measuring the corneal thickness is necessary to interpret properly the results of Goldmann applanation tonometry, particularly in eyes with thin corneas.

Anthropometry

Effect of buckling material on ocular rigidity.

Enucleated human eyes were banded with metal and silicone bands to produce reductions in their diameter of 2 mm and 4 mm. The ocular rigidity produced by each banding material at each diameter was measured in the pressure range of 10 mmHg to 40 mmHg. Metal bands produced mild reductions in ocular rigidity that were significantly (P less than 0.05 to 0.01) lower than the control ocular rigidities in some pressure ranges. Silicone bands produced large reductions in ocular rigidity that were significantly (P less than 0.01) lower than ocular rigidities observed in metal-banded or control conditions in all pressure ranges. The influence of the elastic silicone banding material on ocular rigidity was greater than the influence of altered shape and wall stress that occurred with metal banding.

Aged

The effect of Perkins, Tono-Pen, and Schiötz tonometry on intraocular pressure.

We studied the intraocular pressure changes produced in five eye bank eyes by Perkins, Tono-Pen, and Schiötz tonometry performed by experienced and inexperienced personnel. When all users were considered together, Perkins tonometry produced a mean intraocular pressure increase of 0.7 mm Hg, significantly less than the mean increase of 12.1 mm Hg produced by Tono-Pen tonometry (P less than .05) or the mean increase of 16.5 mm Hg produced by Schiötz tonometry (P less than .01). There was no statistically significant difference between the intraocular pressure increase produced by Tono-Pen or Schiötz tonometry. Tonometry performed by inexperienced Tono-Pen users and experienced or inexperienced Schiötz users produced a significantly greater increase in intraocular pressure than that performed by experienced Tono-Pen users (P less than .05), and an extremely significant increase compared to tonometry performed by experienced or inexperienced Perkins users (P less than .01). The marked increase in intraocular pressure produced by Tono-Pen tonometry suggests that hand-held electronic applanation tonometers should be used with caution in eyes with a weakened cornea or sclera.

Humans

Low-intensity anticoagulation in mechanical cardiac prosthetic valves.

Retrospectively, we reviewed the charts of 101 patients at the University of Kansas Medical Center who received low-intensity anticoagulation for mechanical prosthetic valves implanted over a 17-yr period. The mean duration of follow-up was 4.6 yr, and the total duration of follow-up was 466.5 patient-yr. The patients' records were evaluated for evidence of hemorrhagic or thromboembolic complications. A prothrombin time ratio of 1.3 to 1.5 times control was considered to be low-intensity anticoagulation. There were three thromboembolic events or 2.9/100 patient-yr of follow-up at a prothrombin time ratio of less than 1.3, four thromboembolic events or 2.5/100 patient-yr of follow-up at 1.3 to 1.5 times control, four thromboembolic events or 2.2/100 patient-yr of follow-up at 1.6 to 2.0 times control, and no thromboembolic events at prothrombin time ratios greater than 2.0 times control. Hemorrhagic events occurred in three patients at a prothrombin time ratio of less than 1.3 times control or 2.8/100 patient-yr of follow-up, in six patients at 1.3 to 1.5 times control or 3.8/100 patient-yr of follow-up, in ten patients at 1.6 to 2.0 times control or 5.5/100 patient-yr of followup, and in two patients at 2.1 to 2.5 times control or 12.2/100 patient-yr of follow-up. The rate of hemorrhagic events at 2.5 times control was 470/100 patient-yr follow-up. While not providing definitive proof, we believe that our retrospective study provides supportive evidence for the use of low-intensity anticoagulation in patients with mechanical cardiac prostheses.

Adult

Relationship of age to histologic grade in prostate cancer.

We studied 4,968 cases of prostatic carcinoma to determine if there is a relationship between tumor grade and patient age at diagnosis. Cases were stratified into arbitrary age groups and classified as either better differentiated (Grades I and II) or worse differentiated (Grades III and IV). The 4,596 graded cases were distributed by stage as follows: Local 3,451 (75%), Regional 509 (11%), and Distant 636 (14%). When patients in all stages were considered together, the percentage of men with better differentiated tumors dropped from 77.8% of patients under 60 to 67.5% of patients 80 or older (P less than 0.00001). This trend for older patients to have more poorly differentiated tumors was also seen in patients with localized disease (P less than 0.0005). The fact that occult, biologically inactive prostate cancer is common in older men has led some to extrapolate that clinically apparent disease follows a more benign course in the elderly. Our findings suggest that, on the contrary, elderly men with clinically apparent disease have worse differentiated tumors than their younger counterparts.

Age Factors

Comparison of droperidol 0.01 mg/kg and 0.005 mg/kg as a premedication in the prevention of nausea and vomiting in the outpatient for laparoscopy.

Patients undergoing outpatient laparoscopy and general anesthesia have a high incidence of postoperative nausea and vomiting. It is essential that anesthesia techniques accommodate the special needs of these outpatients. Droperidol is an effective antiemetic but larger doses above 1-1.25 mg may cause unwanted side effects which may prolong recovery and discharge. The current trend is to decrease the dose of droperidol to prevent side effects while still retaining the antiemetic properties. This experimental study compares droperidol 0.010 mg/kg and 0.005 mg/kg as a premedication for the prevention of nausea and vomiting in 32 female outpatients undergoing laparoscopy and general anesthesia. The patients were randomized into two groups. Group I received droperidol 0.010 mg/kg and Group II received 0.005 mg/kg as a preoperative antiemetic in double-blind fashion. Both groups received the same anesthetic for induction and maintenance of anesthesia. The patients were observed in the postanesthesia room for the incidence of nausea and vomiting. They were transported to the outpatient department and were also observed for nausea and vomiting. The t-test was used to show that there were no significant differences between groups in population characteristics. Chi-square analysis was used to determine statistical significance in the incidence of nausea or vomiting between the two groups. Analysis showed there was no statistically significant difference in the incidence of nausea or vomiting in the postanesthesia room or the outpatient department, although there was a significant clinical difference between the groups especially in the incidence of nausea in the outpatient department.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Hemodynamic effects of dopexamine hydrochloride infusions of 48 to 72 hours' duration for severe congestive heart failure.

Dopexamine hydrochloride, a new dopaminergic derivative with potent beta 2-agonist activity, was administered to 10 patients with severe congestive heart failure. Initially, the drug was infused at increasing dosage to achieve a maximal tolerated dose and then titrated to maintain acceptable clinical parameters over the next 48 to 72 hours. Cardiac index increased significantly during the initial titration and at peak effect. Tolerance over the duration of the study was noted in most patients, although further increases in cardiac index could usually be achieved by modest increases in the infusion rate. The peak hemodynamic effect was noted at an average infusion rate of 4.8 micrograms/kg/min. Both stroke volume and stroke work indexes increased during dopexamine hydrochloride infusion in association with decreases in mean arterial, right atrial, mean pulmonary artery and pulmonary capillary wedge pressures, systemic vascular resistance and pulmonary arteriolar resistance. Cardiac output increased by 60% during the infusion and this was out of proportion to the 12% increase in heart rate at peak effect. Most of the increase in cardiac index appeared to be due to the strong vasodilatory profile of the medication producing afterload reduction, with direct inotropic and chronotropic effects contributing to a lesser degree. Drug-related side effects occurred in 4 patients and were easily controlled by down-titration. Dopexamine hydrochloride is an effective and well-tolerated sympathomimetic agent that increases cardiac index while promoting vasodilatation.

Adult

Methods to assess relative reliability of diet records: minimum records for monitoring lipid and caloric intake.

A total of 252 diet records of 18 outpatients attending a lipid clinic were analyzed by a computer-assisted method to determine the minimum number of daily diet records that would be reliable for monitoring dietary adherence. Each subject recorded food intake in special diaries for 14 consecutive days between two clinic visits. All possible randomly selected combinations of 3, 4, 5, 7, 9, and 11 consecutive days of records in the 14-day period were analyzed for calories and lipids. Sets of records were said to be within a 95% confidence interval when the information yielded on any parameter differed by 5% or less from the mean values for the entire 14 days' records. All sets of records for 7, 9, and 11 days were in the 95% confidence range; therefore, 7 consecutive days of food recording were considered the minimum requirement for a 95% confidence limit. Out of 11 possible combinations of 4 consecutive day-sets of records, all but 3 sets were within 95% confidence limits. Consequently, 4 consecutive days of records were deemed acceptable as a reasonable compromise for minimal, reliable monitoring of diet compliance in outpatients for the nutrients studied.

Adult

Female gender is a major determinant of changing subsite distribution of colorectal cancer with age.

Distribution by subsite and sector of 948 colorectal cancers diagnosed in Kansas in 1982 was analyzed in respect to sex and age in a population-based study. Regression analysis of percentage versus age showed decreasing left, increasing right, and unchanged transverse colon occurrence of cancer for both sexes. However, this was statistically significant only for women; left, -0.7066% per year (P = 0.0088) and right +0.6023% per year (P = 0.0012). Regression for seven subsites showed significant changes only for women; with rectosigmoid and sigmoid decreasing and cecum and ascending colon increasing. Similar results were obtained in analysis of the 5822 cases available in the Kansas cancer registry for the years 1978 to 1982. These findings have important implications for screening and diagnosis of colorectal cancer in the elderly, particularly women, and also provide a useful clue in the investigation of colorectal carcinogenesis.

Adult

Methapyrilene kinetics and dynamics.

A study was undertaken to characterize the H1 receptor blockade, central nervous system depressant properties, and kinetic parameters of methapyrilene in man. Eight healthy subjects received, in random order at weekly intervals, placebo and methapyrilene 20 mg intravenously and 50 mg and 25 mg orally. Methapyrilene exhibited a moderate antihistaminic effect as measured by the reduction of histamine-provoked skin wheals. Sedation and drowsiness were detected only at the first sampling time (0.75 hr) after intravenous doses. The terminal plasma half-life ranged from 1.1 to 2.1 hr, apparent volume of distribution from 2.14 to 6.61 1/kg, and plasma clearance from 0.013 to 0.048 1/min/kg. Systemic bioavailability was low and showed large interindividual differences, ranging from 4% to 46%. Recovery of unchanged drug from the 24-hr urine was under 2% of the doses.

Adult

Uric acid excretion in normal children.

Standard values were established for urinary excretion and clearance of uric acid in 95 normal, nonhospitalized children. We found that urinary uric acid excretion and serum uric values increase throughout childhood; that in early childhood, fractional excretion and clearance of uric acid are higher than adult norms; and that despite an increasing filtered load of uric acid, there is a progressive decrease in fractional excretion and clearance of uric acid with advancing age. Some tubular maturational change, either decreasing secretion or increasing reabsorption, must account for the progressive decline in fractional excretion and clearance of uric acid.

Adolescent

Effects of behavioral and medical variables on fetal growth retardation.

Cigarette smoking, indulging in certain drugs, restricting maternal weight gain in pregnancy, failing to obtain sufficient prenatal care, undertaking pregnancy at too early or too advanced on age, and being underweight for height at conception have in the past been identified with either increased premature births or births of term infants with fetal growth retardation. Each of these seven variables contains an element of maternal choice and has therefore been labeled by us as a behavioral variable. The combined group of mothers having these seven behavior variables was compared to a smaller group of mothers with medical complications and to a control group of mothers with neither behavioral nor medical variables. In the control group, there was a remarkably low incidence of premature births under 37 weeks (1 per cent), of term infants who had short body lengths at birth for their fetal ages (1.4 per cent), and of low-birth-weight infants (1 per cent). As the number of seven behavioral variables increased from none to three or more per pregnancy, the incidences of premature births, of short-for-dates term infants, and of low-birth-weight infants increased proportionately and significantly. The incidences of these seven behavioral variables, occurring either singly or in combination, were inverse to the mothers' socioeconomic status. However, the incidences of premature births, of growth-retarded term infants, and of low-birth-weight infants were high among mothers who had two or more behavioral variables in their pregnancies regardless of the mothers' socioeconomic status. The group of mothers with behavioral variables in comparison to the smaller group of mothers with medical complications had lower incidences but higher absolute numbers of premature infants, of growth-retarded term infants, and of low-birth-weight infants. Mothers who had medical complications as well as behavioral variables had more growth-retarded term infants than mothers with medical complications alone.

Behavior

Postnatal somatic growth in infants with atypical fetal growth patterns.

We differentiate patterns of postnatal physical growth in 61 fullterm newborns with either normal or atypical somatic fetal growth. At birth, 14 normal babies had average ponderal indices, 14 were overweight for length (high ponderal index), 18 were underweight for length (low ponderal index), and 15 had short crown-heel lengths for dates and normal ponderal indices. Appropriate statistical analyses determined attained and velocity growth of the four groups during the first postnatal year. Statistically significant and marked differences in postnatal growth were noted between short babies and babies with low ponderal indices. The slow postnatal growth of the short infants appeared to be a continuum of their fetal growth pattern. On the other hand, infants born with low ponderal indices accelerated their weight gains and reversed the malnourished state in which they were born. These findings suggest that there are two distinct types of fetal growth retardation.

Appetite

Fetal growth retardation in relation to maternal smoking and weight gain in pregnancy.

Two types of fetal growth retardation were recognized in term infants. One type was characterized by an abnormally low ponderal index (defined as birth weight in grams X 100 divided by crown-heel length in cubic centimeters.) The other type of growth-retarded infants had abnormally short crown-heel lengths for fetal age. Both types were observed under all conditions studied. However, mothers who smoked cigarettes during pregnancy were more likely to have infants with short body lengths for dates, whereas mothers who had low weight gain in pregnancy were more likely to have infants with low ponderal indices. Social group, prepregnancy weight, parity, marital status, and fetal sex were found to be less determinant of fetal growth than were maternal weight gain and smoking habits.

Birth Weight