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Biomedical subjects

M Mourad

Publications and source records attributed to M Mourad.

At least 55 records · Page 3Linked to original sources
PubMed1998

Association of fasting insulin with serum lipids and blood pressure in Kuwaiti children.

To examine the association of hyperinsulinemia with the atherogenic risk profile in children, we studied the relationships of the fasting plasma insulin level with indices of obesity (body mass index [BMI] and sum of triceps and subscapular skinfold thickness [SFT]), body fat distribution (waist to hip ratio [WHR]), serum lipid, lipoprotein, and apolipoprotein levels, and blood pressure in a case-control study of 460 Kuwaiti prepubertal obese children aged 6 to 13 years matched by age and sex to 460 prepubertal non-obese controls. Obese children were ascertained in a representative cross-sectional study of 2,400 school children. Fasting insulin levels were positively correlated (P < .001) with serum triglyceride (TG) and very-low-density lipoprotein (VLDL) cholesterol levels and negatively correlated with high-density lipoprotein (HDL) cholesterol levels. No significant associations were observed between insulin and total cholesterol (TC), cholesterol, low-density lipoprotein (LDL) or apolipoprotein A-I (apo A-I). Stronger associations of insulin levels with lipoprotein fractions were observed in obese versus non-obese controls. Obese children had a higher concentration of apo B and a lower apo A-I:B ratio (P < .001). Insulin and the insulin to glucose ratio increased with age in obese children, whereas there were slight changes in non-obese children. TG and HDL cholesterol levels and systolic blood pressure (SBP) were significantly different across insulin quartiles in boys and girls. We conclude that the fasting plasma insulin level may be used as a marker for the development of obesity-associated metabolic disorders and elevated blood pressure in children.

Adipose Tissue↗
PubMed1998

Apolipoproteins A-I and B in Kuwaiti children.

To assess the relation of apolipoproteins (Apos) A-I and B (the carrier proteins for high and low density lipoprotein cholesterol, respectively) with the degree of obesity, body fat distribution, serum lipids, glucose and insulin levels, a case-control study was carried out and included 460 Kuwaiti obese children, 6-13 years old, matched by age and sex to 460 normal-weight controls. Obese children were ascertained in a representative cross-sectional study of 2,400 school children. The Apo A-I levels were not different between obese and non-obese boys, while they were significantly lower in obese girls (p < 0.01). The Apo B mean concentrations were significantly higher in obese boys and girls (p < 0.001), while the Apo A-I:B ratio was significantly lower in obese children (p < 0.001). Apo A-I levels were positively correlated with total cholesterol, high- and low-density lipoprotein cholesterol, but were not correlated with very low-density lipoprotein cholesterol, triglycerides, insulin, glucose or insulin:glucose ratio. Apo B levels were negatively correlated with high-density lipoprotein cholesterol and positively correlated with insulin and insulin:glucose ratio (p < 0.01) in obese children. The study documented an adverse Apo profile in obese Kuwaiti children. Since Apo changes are correctable through management of obesity, their identification in childhood offers prospects for prevention of early onset atherogenesis in adulthood.

Adolescent↗
PubMed1996

Transjugular intrahepatic portosystemic shunt and liver transplantation.

Transjugular intrahepatic portosystemic stent shunting (TIPSS) appears to be an attractive, nonsurgical procedure to overcome complications of end-stage liver disease. During the period August 1992 to February 1995, 23 adults who had previously undergone TIPSS received liver transplants. These patients were compared to 36 cirrhotic patients, grafted during the same time period, in relation to the implantation technique, the intraoperative use of blood products, and the length of their hospital stay. These groups were comparable for previous right upper quadrant surgery, splanchnic vein modifications, and Child-Pugh classification. Liver transplantation was performed electively in all TIPSS patients. Ten patients (43.4%) presented with a significant shunt stenosis at a median follow-up time of 4.5 months (range 2.5 to 30 months). At transplantation 8 of the 23 TIPSS patients (34.8%) had specific TIPSS-related modifications i.e., extrahepatic portal vein aneurysm formation (n = 2), dislocation of the distal end of the stent into the inferior vena cava (n = 4) or into the main portal vein trunk (n = 1), bilioportal fistula (n = 1), and pronounced phlebitis of the inferior vena cava and hepatic veins due to redilation of shunt stenosis (n = 4). The intraoperative blood product requirement at transplantation was similar in the 23 TIPSS-patients and in the 36 cirrhotic patients who received transplants without the TIPSS procedure during the same time period [median 800 ml (range 0-20300 ml) vs median 620 ml (range 0-7600 ml), respectively]. There was also no difference between the two groups in length of hospital stay [median 18 days (range 0-34 days) vs median 19 days (range 0-66 days), respectively]. We conclude that TIPSS plays an important role in the management of life-threatening complications of end-stage liver disease arising in potential liver transplant candidates. TIPSS should be considered as a temporary, effective bridge to elective transplantation and not as a means to lower the blood product requirement at transplantation. Specific TIPSS-related modifications should be recognized early by the transplant surgeon in order to adapt the technique of graft implantation.

Adult↗
PubMed1996

[Surgical treatment of synchronous hepatic metastases of colorectal cancers. Simultaneous or delayed resection?].

The surgical strategy for resectable synchronous hepatic metastases of colorectal cancer remains controversial. The retrospective analysis of our series of resectable synchronous hepatic metastases focused on the percentage of simultaneous resections, the circumstances, the indications and the results of the one-step procedure compared to the two-step strategy. From January 1, 1982 to December 31, 1995, 129 patients were operated on for resection of hepatic metastases of colorectal cancer. Forty one patients (32%) presented with synchronous hepatic metastases, 20 of whom (49%) underwent simultaneous resection of the primary tumor and the hepatic metastases (simultaneous resection group: SR). For the other 21 patients (51%), the hepatic resection was delayed for a mean interval of 5.2 +/- 4.2 months (delayed resection group: DR). The mean age of the 2 groups was not significantly different (54 years versus 58 years). When the primary tumor was located on the ascending colon, the hepatic excision was performed simultaneously in 9 out of ten cases. The need for blood transfusion and the volume required were not significantly different between the two groups. The length of each surgical operation was comparable between the two groups (331 +/- 76 minutes SR vs 330 +/- 88 minutes DR). Postoperative complications were observed in 20% of patients in the SR group and 10% of patients in the DR group (no significative difference). There was no postoperative mortality in either group. Survival was 83%, 44% and 37% at 1, 2 and 3 years respectively in the SR group and 79%, 59% and 49% in the DR group, with no significant difference between the groups. These results show that simultaneous resection of the primary tumor and the hepatic metastases did not increase either morbidity or mortality in our study, and that it should be proposed especially to patients presenting with a primary tumor of the ascending colon with metastases resectable by means of a minor hepatectomy.

Actuarial Analysis↗
PubMed1996

[Causes of mortality of N'Dama breed cattle on the plateau of Sankaran, Faranah, Guinea 1993-1994].

The principal causes of mortality of 280 N'Dama breed cattle heads are presented with data obtained in the plateau of Sankaran, Faranah, Guinea in 1993-1994. Diarrhea caused 40.81% and 58.62% of calves mortality between birth and six months and between six and 18 months, respectively. Pasteurellosis provoked 61.88% of cattle mortality up to 18 months of age. Hot and rainy seasons clearly increased the mortality rate of calves between birth and six months, whereas that of cattle increased notably up to 18 months of age during the rainy season. The absence of vaccination, sufficient care and new methods of husbandry were also responsible for cattle mortality.

Animals↗
PubMed1995

The investigation of Epstein-Barr viral sequences in 41 cases of Burkitt's lymphoma from Egypt: epidemiologic correlations.

BACKGROUND: Epstein-Barr virus (EBV) is associated with many human neoplasms, including Burkitt's lymphoma (BL). Endemic BL in central Africa is more often EBV-associated than BL in the United States, where seroconversion for EBV occurs somewhat later than in Africa. Therefore, the EBV association rate in BL may correlate more with the socioeconomic status of the population studied, which influences the age of EBV seroconversion, than with such factors as malaria, which may relate to the overall higher incidence rate in endemic regions. METHODS: Forty-one patients with BL in Egypt, which differs both climatically and racially from central African countries (i.e., Kenya, Uganda) where BL is endemic, were analyzed. All biopsies were evaluated for EBV-encoded RNAs (EBER1) by RNA in situ hybridization, analyzed for p53 protein expression using the monoclonal antibody D07, and immunophenotyped using a panel of monoclonal antibodies that included L26 (CD20), Leu 22 (CD43), and A6 (CD45RO). Twelve cases were evaluable for EBV subtype by polymerase chain reaction with EBV-specific primers. RESULTS: The median age at diagnosis was 9 years (range, 2-22 years). The biopsy site was extranodal in 29 patients and nodal in 12 patients. All 41 cases were documented as B-cell neoplasms. A hybridization signal for EBER1 RNA was identified in greater than 95% of the neoplastic cells in 30 of 41 cases (73%), whereas no signal was observed in 11 cases (27%). Epstein-Barr virus subtype 1 was found in 10 patients, subtype 2 in two patients. Immunostaining for p53 was observed in greater than 5% of the neoplastic cells in 9 of 37 cases (24%). No significant correlation was observed between EBV positivity and sex, biopsy site, or p53 immunostaining. CONCLUSIONS: The prevalence of EBV in BL from Egypt is slightly lower than in BL in endemic regions, but significantly higher than in sporadic BL. Epstein-Barr virus positivity probably reflects the socioeconomic status of the patient population, and age at seroconversion. The prevalence of EBV subtype 1 suggests that immunodeficiency does not play a role in Egyptian Burkitt's lymphoma, in contrast to endemic Burkitt's lymphoma, in which holoendemic malaria is thought to contribute to immunodeficiency, a higher incidence rate, and the observed prevalence of subtype 2.

Adolescent↗
PubMed1994

Laparoscopic treatment of lymphoceles following kidney transplantation by intraperitoneal fenestration and omentoplasty.

The recent development of endoscopic surgery and its use in treating several abdominal and thoracic surgical pathologies lead us to suggest its application in the treatment of posttransplant lymphoceles. The authors report two cases treated by the laparoscopic approach. Recurrence occurred in one of them. The technique is described and its place among other therapeutic modalities is discussed.

Adult↗
PubMed1994

An outbreak of Ochrobactrum anthropi bacteraemia in five organ transplant patients.

Nosocomial bacteraemia caused by Ochrobactrum anthropi occurred over a 1-month period in five organ transplant recipients, four of whom were in the same renal and pancreatic transplant unit. Bacteraemia occurred with cyclosporin A, azathioprine and steroids, and with a rabbit anti-thymocyte globulin (RATG) during the induction phase. RATG appeared to be the only common factor among the five cases. Over the period described, 71.4% of all patients receiving RATG developed O. anthropi bacteraemia. Three patients presented with fever and chills during or shortly after RATG infusion. Analysis of residues of the infusion, and the used vials of RATG, showed the presence of O. anthropi in concentrations of between 20 and 1000 cfu ml-1 in 5.3% of samples. Unused vials were found to be heavily contaminated with either O. anthropi or Microbacterium spp. in 23.5% of samples. All positive vials were of one particular lot number suggesting a malfunction in the manufacturing process. Many parenteral drugs such as the RATG used here do not contain preservatives and, although aseptically prepared, will not withstand thermal sterilization. Bacterial contamination of these small volume medications is not always easily detectable by conventional methods. This outbreak highlights the need for accurate quality control testing to detect small inocula that may occur during or after the manufacturing process.

Adult↗
PubMed1994

Evaluation of technetium-99m-L,L-EC in renal transplant recipients: a comparative study with technetium-99m-MAG3 and iodine-125-OIH.

UNLABELLED: The clinical usefulness of kit-formulated 99mTc-L,L-EC, a new renal tubular tracer agent based on a diaminodithiol ligand was evaluated in a large population of renal transplant recipients. METHODS: Fifty patients with transplants were studied. Five patients with renal insufficiency and five normal volunteers were also included to extend the range of renal function values. The labeling efficiency of 99mTc-L,L-EC in routine conditions, i.e., without HPLC purification, and the safety of the tracer were evaluated. RESULTS: The mean radiochemical purity of 99mTc-L,L-EC determined by thin-layer chromatography was 97.4%. No side effects or significant biochemical changes were observed. The clearance of 99mTc-L,L-EC and 125I-OIH ranged from 10.7 to 417.5 and from 27.6 to 602.7 ml/min/1.73 m2, respectively. The clearance of 99mTc-L,L-EC and 99mTc-MAG3 averaged respectively 71% and 52% of that of 125I-OIH. CONCLUSION: The labeling procedure of kit-formulated 99mTc-L,L-EC is easy and efficient. This tracer is safe and suitable for both imaging and quantitative measurement of the renal tubular function. Technetium-99m-L,L-EC represents an excellent alternative to 99mTc-MAG3.

Adult↗