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Biomedical subjects

M Daher

Publications and source records attributed to M Daher.

At least 19 recordsLinked to original sources
PubMed2006

Healthcare and workloss costs associated with patients with persistent asthma in a privately insured population.

OBJECTIVE: The objective of this study was to estimate annual healthcare and workloss costs of patients with persistent asthma by severity. METHODS: A persistent asthma patient sample (<65 years) was selected from an employer claims database. Asthma persistence and severity were determined by a novel algorithm based on Health Plan Employer Data and Information Set criteria, Leidy's Reliever and Oral Steroid Method, and Global Initiative for Asthma guidelines. Healthcare costs were compared between asthma patients and demographically matched controls and by asthma severity. RESULTS: Average annual excess costs for persistent patients were $4412 for health care and $924 for workloss (P < 0.01). Although costs for severe patients were higher than moderate patients (P < 0.05), moderate patients' costs were similar to that for mild patients. Persistent use of inhaled corticosteroids was lower in mild (9.0%) relative to moderate (78.1%) and severe (86.4%) patients. CONCLUSIONS: Persistent asthma is expensive. Underutilization of inhaled corticosteroids is higher in patients with mild persistent asthma.

Adolescent↗
PubMed2005

Distance between the skin and the thoracic paravertebral space.

A fundamental requirement for the safe and effective performance of paravertebral blockade is reliable estimates of the depth from skin to paravertebral space at different thoracic levels. This distance was assessed using a nerve stimulator guided paravertebral blockade technique in 527 separate blocks in 186 patients scheduled for various surgical procedures on the trunk. The median skin-paravertebral depth was 55.0 mm. The skin-paravertebral distance at upper (T1-3) and lower (T9-12) thoracic levels were significantly greater than mid-thoracic levels (T4-8) (p < 0.05). Body mass index significantly influences this depth at upper and lower thoracic levels (p < 0.001) but not in the mid-thoracic region.

Adult↗
PubMed1996

[Diagnosis and treatment of hydatid cysts of the liver. Apropos of 87 cases operated on between 1980 and 1992].

Human echinococcosis is still endemic in some areas of the world, including Mediterranean countries and Lebanon. Because there is no effective medical therapy, surgery remains the principal mode of treatment. A consecutive series of 87 patients operated on for liver hydatid disease between January 1980 and March 1992 in the division of General Surgery at Saint George's Hospital, Beirut, were analyzed. Patients with hydatic cysts in other sites than liver were excluded from the study. There were 39 men (45%), and 48 women (55%) aged 12 to 75 years (mean 43). The right lobe of the liver was affected in 67 cases (77%), the left lobe in 18 cases (20.6%), and both lobes in 2 cases (2.4%). Clinical symptomatology consisted of abdominal pain, fever, jaundice, urticaria, and an abdominal mass. Preoperative diagnosis was established using imaging studies: plain abdominal films, ultrasonography, computed tomography, and serologic tests. Cases were classified into 3 groups: G1 (n = 44, 50.5%) had a partial resection of the cyst followed by an external drainage; G2 (n = 15, 17.2%) had a partial resection of the cyst with a filling of the residual cavity; G3 (n = 28, 32.2%) made benefit of complete resection of the cyst (pericystectomy) with or without partial hepatectomy. In this retrospective study we compared the results of these different surgical techniques: postoperative complications and mortality, hospital stay of patient. We noted the better postoperative course of the non-drained patient (G2 and G3). Three patients died during the postoperative period because of septic complications. Conclusions and general recommendations are proposed.

Adolescent↗
PubMed1994

[Silicone implants and breast cancer: real or fictitious problem? A case report and review of the literature].

We present a case of breast cancer 9 years after subcutaneous mastectomy for bilateral phylloid tumor with silicone implants. The patient had a stage III adenocarcinoma (T4 N1 M0) at diagnosis; a modified radical mastectomy was done, followed by radiotherapy and chemotherapy. Later on, Tamoxifen was prescribed (positive hormone receptors). Reviewing the literature about this subject in a context of a moratorium of the Food and Drug Administration (FDA) in the United States recommending suspension of silicone breast implantation, we can propose several conclusions: Previous and recent studies did not show any direct relation between cancer and silicone implants for augmentation mammoplasty; on the contrary, a lower incidence of breast cancer is noted. Breast cancer incidence with silicone implants seems to be higher with reconstructive mammoplasty after mastectomy for benign disease (fibrocystic disease, dysplasia, phylloid tumor), or prophylactic reason, or malignancy (carcinoma in situ, lobular and multifocal carcinoma, early breast cancer...). This can be related to recurrence or cancer development on residual breast tissue. Breast cancer with silicone implants is of poorer prognosis because of the later diagnosis of the disease.

Adenocarcinoma↗
PubMed1993

[Cholecystectomies at the Saint-George Hospital. Apropos of 672 operations performed, 1982-1991].

In a retrospective study of a 10-year period (1982-1991), the results of 672 consecutive operations for cholecystectomy were analyzed. 67.7% were females and the medium age was 54.4%. Ultrasound is used to be the test of choice and surgery was done for chronic cholecystitis in 79.9% and in 20.1% for acute cholecystitis. With an overall mortality rate of 1.9% and a morbidity of 16%, conventional cholecystectomy proved to be a safe method. Mortality and morbidity seem to be related to age (> 60 years, median age 70.5), sex (men = 70%), and associated procedures (choledochotomy with exploration, sphincterotomy, biliary derivation). Systematic antibiotic prophylaxis and non drainage of the sub-hepatic area in certain cases lowered the incidence of wound infection, and improved post-operative course. Selective operative cholangiogram also improved per and post-operative course and does not seem to increase the incidence of residual stones. Now, only the new laparoscopic cholecystectomy may represent the alternative to the ideal treatment of cholecystolithiasis.

Age Factors↗
PubMed1992

Chloride transport across rat ileal basolateral membrane vesicles.

The present study was designed to investigate Cl- transport across rat ileal basolateral membranes. Basolateral membrane vesicles were prepared by a well-validated technique. The purity of the basolateral membrane vesicles was verified by marker enzyme studies and by studies of d-glucose and calcium uptake. Cl- uptake was studied by a rapid filtration technique. Neither an outwardly directed pH gradient, nor a HCO3- gradient, or their combination could elicit any stimulation of Cl- transport when compared with no gradient. 4,4-Diisothiocyanostilbene-2,2-disulfonic acid at 5 mM concentration did not inhibit Cl- uptake under gradient condition. Similarly, the presence of the combination of outwardly directed Na+ and HCO3- gradients did not stimulate Cl- uptake compared with the combination of K+ and HCO3- gradients or no HCO3- gradient. This is in contrast to our results in the brush border membranes, where an outwardly directed pH gradient caused an increase in Cl- uptake. Cl- uptake was stimulated in the presence of combined Na+ and K+ gradient. Bumetanide at 0.1 mM concentration inhibited the initial rate of Cl- uptake in the presence of combined Na+ and K+ gradients. Kinetic studies of bumetanide-sensitive Cl- uptake showed a Vmax of 5.6 +/- 0.7 nmol/mg protein/5 sec and a Km of 30 +/- 8.7 mM. Cl- uptake was stimulated by an inside positive membrane potential induced by the ionophore valinomycin in the setting of inwardly directed K+ gradient compared with voltage clamp condition. These studies demonstrate two processes for Cl- transport across the rat ileal basolateral membrane: one is driven by an electrogenic diffusive process and the second is a bumetanide-sensitive Na+/K+/2 Cl- process. Cl- uptake is not enhanced by pH gradient, HCO3- gradient, their combination, or outwardly directed HCO3- and Na+ gradients.

Animals↗
PubMed1992

[How to improve the results in colorectal cancer?].

To improve results in the treatment of colo-rectal cancer, there are four main ways to consider: 1--Earlier diagnosis even presymptomatically (Screening). 2--More radical operations. 3--Adjuvant radiotherapy and chemotherapy in selected cases. 4--More strict follow-up with CEA monitoring and occasional "second look operations".

Aftercare↗