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Biomedical subjects

K Hussein

Publications and source records attributed to K Hussein.

17 recordsLinked to original sources

Glucose and leucine kinetics in idiopathic ketotic hypoglycaemia.

AIMS: To investigate glucose and leucine kinetics in association with metabolic and endocrine investigations in children with ketotic hypoglycaemia (KH) in order to elucidate the underlying pathophysiology. METHODS: Prospective interventional study using stable isotope tracer in nine children (mean age 4.23 years, range 0.9-9.8 years; seven males) with KH and 11 controls (mean age 4.57 years, range 0.16-12.3 years; four males). RESULTS: Plasma insulin levels were significantly lower in KH compared to subjects in the non-KH group. Plasma ketone body levels were significantly higher in KH than in non-KH. Basal metabolic rate was significantly higher in subjects with KH (45.48+/-7.41 v 31.81+/-6.72 kcal/kg/day) but the respiratory quotients were similar in both groups (KH v non-KH, 0.84+/-0.05 v 0.8+/-0.04. Leucine oxidation rates were significantly lower in children with KH (12.25+/-6.25 v 31.96+/-8.59 micromol/kg/h). Hepatic glucose production rates were also significantly lower in KH (3.84+/-0.46 v 6.6+/-0.59 mg/kg/min). CONCLUSIONS: KH is caused by a failure to sustain hepatic glucose production rather than by increased glucose oxidation rates. Energy demand is significantly increased, whereas leucine oxidation is reduced.

Alanine↗

Angiolymphoid hyperplasia with eosinophilia masquerading as Kimura disease.

Angiolymphoid hyperplasia with eosinophilia is a rare benign vasoproliferative disease of unknown cause, which can present as tumour-like nodules in the head and neck. We treated a patient who showed some of the features of Kimura disease (KD), which is an important differential diagnosis, because of the latter's association with renal disease.

Adult↗

Sweet's syndrome (acute febrile neutrophilic dermatosis) associated with adenocarcinoma of prostate and transitional cell carcinoma of urinary bladder.

Association of Sweet's syndrome (SS) with solid tumours is found in about 15% of all malignancy-associated cases, but an association with two malignancies occurring in the same patient has been rarely reported. In the present report, we describe an 82-year-old male with SS in association with adenocarcinoma of the prostate and transitional cell carcinoma of the urinary bladder.

Adenocarcinoma↗

The effect of antibody against TNF alpha on cytokine response in Jarisch-Herxheimer reactions of louse-borne relapsing fever.

Severe Jarisch Herxheimer reaction (J-HR) precipitated by antibiotic treatment of louse-borne relapsing fever (LBRF) is associated with a transient, marked rise in circulating tumour necrosis factor alpha (TNF alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8). Ovine polyclonal anti-TNF alpha antibody fragments (Fab) were used in a randomized double blind placebo controlled trial in an attempt to prevent this reaction. Within 4 h after penicillin, in controls (n = 29), a several-fold rise in cytokines occurred, concomitant with a fall in spirochaetes and maximal clinical manifestations of the J-HR. An intravenous infusion of anti-TNF alpha Fab, 30 min before penicillin in 20 patients reduced peak plasma levels of IL-6 and IL-8 (but not IL-1 beta) compared with controls (p = 0.01 and < 0.001, respectively) and the incidence of the J-HR, indicating some neutralization of TNF alpha. An apparent fall in TNF alpha reflected interference of anti-TNF alpha in the immunoassay.

Adolescent↗

Comparison of two methods of measurement of whole blood glucose in the neonatal period.

The purpose of this study was to compare the performance and accuracy of the HemoCue B-Glucose photometer system and reagent strip tests used in conjunction with reflectance photometry against a reference plasma glucose method. One hundred consecutive babies admitted to the neonatal unit over a 6-month period were enrolled in the study. Each baby had a heelprick capillary glucose measured by HemoCue and reagent strip tests. At the same time venous plasma glucose and haematocrit were measured. The mean difference between the reagent strip test and plasma glucose was significantly less than the corresponding value for the HemoCue (0.015 +/- 1.41 vs 0.837 +/- 1.565 mmol l-1, mean +/- SD); however, the agreement limits between both methods and plasma glucose were wide. No significant effect of haematocrit was detected on either method. The HemoCue photometer does not offer any advantage over the widely used reagent strip tests in the neonatal period. However, the limits of agreement of both methods compared with plasma glucose are too wide to be clinically acceptable in the neonatal period.

Blood Glucose↗

Prevention of Jarisch-Herxheimer reactions by treatment with antibodies against tumor necrosis factor alpha.

BACKGROUND: In patients with louse-borne relapsing fever (Borrelia recurrentis infection), antimicrobial treatment is often followed by sudden fever, rigors, and persistent hypotension (Jarisch-Herxheimer reactions) that are associated with increases in plasma concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-6, and interleukin-8. We attempted to determine whether sheep polyclonal Fab antibody fragments against TNF-alpha (anti-TNF-alpha Fab) could suppress the Jarisch-Herxheimer reaction. METHODS: We conducted a randomized, double-blind, placebo-controlled trial in 49 patients with proven louse-borne relapsing fever. Immediately before the intramuscular injection of penicillin, the patients received an intravenous infusion of either anti-TNF-alpha Fab or a control solution. RESULTS: Ten of the 20 patients given anti-TNF-alpha Fab had Jarisch-Herxheimer reactions with rigors, as compared with 26 of the 29 control patients (P = 0.006). The controls had significantly greater mean maximal increases in temperature (1.5 vs. 0.8 degrees C, P < 0.001), pulse rate (31 vs. 13 per minute, P < 0.001), and systolic blood pressure (25 vs. 15 mm Hg, P < 0.003), as well as higher mean peak plasma concentrations of interleukin-6 (50 vs. 17 micrograms per liter) and interleukin-8 (2000 vs 205 ng per liter) (P < 0.001 for both comparisons). Levels of TNF-alpha were undetectable after treatment with anti-TNF-alpha Fab. CONCLUSIONS: Pretreatment with sheep anti-TNF-alpha Fab suppresses Jarisch-Herxheimer reactions that occur after penicillin treatment for louse-borne relapsing fever, reduces the associated increases in plasma concentrations of interleukin-6 and interleukin-8, and may be useful in other forms of sepsis.

Adolescent↗

Arthritis of leprosy.

An inflammatory polyarthritis has been previously described in leprosy but accounts of the clinical characteristics have varied. All patients with joint symptoms admitted to a leprosy centre over 5 months were examined by a rheumatologist. Of 48 acute admissions, 20 (42%) had a symmetrical polyarthritis affecting the wrists and fingers. This was strikingly similar to RA in appearance. The arthritis occurred exclusively in patients with reactions mainly during anti-mycobacterial treatment. The clinical features of the joint disorder were identical in Type I (associated with alterations in immune status) and Type II (erythema nodosum leprosum) reactions. Synovial tissue from one patient revealed no mycobacteria. Four of five hand X-rays suggested small erosions of the finger joints.

Acute Disease↗

Spectral analysis of cervical cells using the discrete Fourier transform.

This paper contains results from a preliminary study of spectral analysis techniques applied to the classification of cervical cells from routinely prepared Papanicolaou cervical smears. Experiments were conducted using a subset of 110 normals and 110 dyskaryotic single cell images randomly selected from a larger cell image data base. An assessment was made of the contribution of different regions within a cell image to the frequency spectrum. Three image sets were used, the original image itself plus two derived from it. In the first derived set, only nuclear size and shape were used. In the second set nuclear morphology and texture were included. Nuclear masking was performed using an interactive segmentation procedure. The discrete Fourier transform was applied to each image in the three image sets and classification experiments were performed using 80 features derived from the frequency spectra. An optimum set of features was selected for each experiment by canonical analysis. Good classification results were obtained when features extracted solely from nuclear shape were used. The inclusion of information relating to nuclear texture improved the results. However, inclusion of the extra nuclear region degraded the classifier's ability to discriminate between cell groups.

Cervix Uteri↗

Automation in cervical cytology: an overview.

Cancer of the uterine cervix is one of the more common female cancers and a major source of premature female mortality. UK deaths in 1987 exceeded 2000. To reduce these rates, national screening programmes have been introduced using the Papanicolaou method. In screening for cancer, the examination of specimens is an intensive and expensive task. Its high cost has led to a number of attempts to automate the process, either fully or partially. Over the last 30 years, various experimental prescreening systems have been developed for the diagnosis of cytological samples including the use of image processing techniques. This paper presents a historical overview of automation in cervical cytology and the status of current developments for automated cytological diagnosis.

Automation↗

Phase II evaluation of bisantrene in acute leukemia. A Southwest Oncology Group Study.

Twenty-nine patients with heavily pretreated acute leukemia in relapse were treated with bisantrene (maximum dose 120 mg/m2/day x 5) in a phase II study. Twenty-seven of the 29 patients were evaluable for response, receiving a total of 53 courses of treatment. There were three complete remissions (11%) lasting 27, 107, and 115 days. One brief partial remission of 43 days was also seen for a total response rate of 15%. Toxicity was mainly limited to the expected myelotoxicity with minimal nonhematologic toxicity seen. Although the complete remission rate is low, an antileukemic effect was seen in the majority of the patients treated. Sixty-one percent of the patients had at least a 50% decrease in the circulating blast count and 32% had at least a 50% decrease in the number of bone marrow blasts. We conclude that bisantrene does have an antileukemic effect, but that the optimal starting dose is not yet established.

Acute Disease↗

Rubidazone in combination with Ara-C, vincristine and prednisone (ROAP) in the treatment of adult acute leukemia. A Southwest Oncology Group Study.

In an 18-month period, 340 consecutive adult patients with acute leukemia were treated using a 7-day continuous infusion of Ara-C in combination with rubidazone, vincristine and prednisone (ROAP). Of 334 (96%) evaluable cases, 77% were 50 years of age or older. The complete remission (CR) rate was 51% with a standard error of 3%. After adjustment for known prognostic factors this overall CR rate is 10% higher than the predicted CR rate when compared to the last completed SWOG study which used adriamycin in combination with a similar regimen of Ara-C, vincristine, and prednisone. The CR rate in patients over 50 years of age was particularly noteworthy. Using rubidazone, the CR rate was 46.1% (116/256) compared to 37.4% (91/243) for the adriamycin study in this poorly responding age group. The median survival time achieved was 27 weeks. However, in the age groups 40-49 years and 50-59 years the median survival was 70 and 44 weeks, respectively.

Acute Disease↗

Doxorubicin and ifosfamide combination chemotherapy in previously treated acute leukemia in adults: a Southwest Oncology Group pilot study.

The Southwest Oncology Group did a limited institutional pilot study of the combination of doxorubicin and ifosfamide in the treatment of previously treated adult patients with acute leukemia. Thirty-four patients received one or two courses of the combination. All patients had received prior chemotherapy and 32 had received prior anthracycline chemotherapy. Three patients died before their responses could be fully evaluated. Fourteen patients achieved complete remission (41%) and one patient achieved partial remission. The complete remission rate was 27% for patients with acute myeloblastic leukemia (myelomonoblastic leukemia, monoblastic leukemia, and erythroleukemia) and 89% for patients with acute lymphocytic and undifferentiated leukemia (ALL). Toxic effects included severe hematologic reactions in 33 of 34 patients, hematuria in six patients, altered sensorium in one patient, and congestive heart failure in one patient. The safety of the combination was established and toxic side effects of this therapy were tolerable. The 89% complete remission rate for previously treated patients with ALL suggests that the combination of doxorubicin and ifosfamide may be particularly effective in ALL.

Acute Disease↗