PubMed Health⌕ Search

Biomedical subjects

M Tarawneh

Publications and source records attributed to M Tarawneh.

12 recordsLinked to original sources

Nebulized glyceryl trinitrate exerts acute bronchodilator effects in patients with acute bronchial asthma.

Glyceryl trinitrate (GTN) is a potent smooth muscle relaxant and vasodilator. There are conflicting reports regarding its efficacy as a bronchodilator. The aim of this study was to examine whether nebulized GTN has bronchodilating effects in patients with acute bronchial asthma. We studied 18 patients (five female, 13 male) who were admitted to the hospital with acute severe asthma on two occasions, administering either 6 mg nebulized GTN or placebo (saline) in a double-blind, randomized, crossover fashion. Bronchial response was assessed by measurement of peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). A systematic effect of this dose of GTN was demonstrated by a mean increase in heart rate of 38.1% (SEM=7.6%) after GTN administration from supine to erect posture, compared with 10.2% (SEM=1.8%) after placebo (P<0.005). Systolic blood pressure decreased by 8.7% (SEM=1.1%) after GTN, compared with 4.0% (SEM=2.1%) after placebo (P<0.05). Diastolic blood pressure did not change significantly. Baseline PEF, FEV1 and FVC did not differ on the two experimental days; however, acute bronchodilating effects were seen: PEF (l/min); 368 (21) pre-GTN, 411 (22) post-GTN and 384 (23) post-placebo (P<0.001). FEV1 (l); 2.12 (0.13) pre-GTN, 2.46 (0.15) post-GTN and 2.25 (0.16) post-placebo (P<0.001). FVC (l); 3.31 (0.17) pre-GTN, 3.75 (0.2) post-GTN and 3.54 (0.2) post-placebo (P<0.001). In conclusions, nebulized GTN has bronchodilating effects in patients with acute bronchial asthma. The exact mechanism of bronchodilation is not known, but it may be due to local effect on bronchial smooth muscles through nitric oxide or by systemic vasodilatation which leads to a decrease in pulmonary artery pressure and pulmonary vascular resistance, or an increase in systemic catecholamine release.

Acute Disease↗

Congenital muscular dystrophy in Jordanian children.

This is a consecutive study on 28 patients who have been diagnosed as having congenital muscular dystrophy at Jordan University Hospital in the period from January 1990 to February 1997. Of 75 patients diagnosed as having muscle disease, 55 (73.3%) had muscular dystrophy. Of 55 muscular dystrophy patients, 28 (50.9%) had congenital muscular dystrophy, 11 (20%) had Duchenne muscular dystrophy, 9 (16.4%) had Becker muscular dystrophy, 4 (7.3%) had myotonic dystrophy, 2 (3.6%) had limb-girdle dystrophy, and 1 (1.8%) patient had facioscapulohumeral dystrophy. Age of onset of symptoms of congenital muscular dystrophy (hypotonia and weakness) was documented antenatally or in the first few months in the majority (92.9%) of patients. Parental consanguinity was documented in 21 (75%) of congenital muscular dystrophy cases, and family history of possible similar cases in 15 (53.6%). Congenital muscular dystrophy patients with normal cognitive milestones (n = 16; 57.1%) were slightly more common than patients with cognitive delay. In contrast to previous reports, congenital muscular dystrophy is probably more common in communities with high rates of parental consanguinity than other dystrophies. Our study adds significant support to the most recent literature on this finding.

Child, Preschool↗

Red cell aplasia resembling Diamond-Blackfan anemia in seven children in a family.

PATIENTS AND METHODS: Seven children of the same family with a possible variant of Diamond-Blackfan anemia (DBA) are reported. Five were male siblings, and the other two were their cousins, one male and one female. All were products of consanguineous marriages of healthy parents. All cases occurred within one generation. Anemia was present at birth or shortly after birth. Hepatosplenomegaly was present in all. Four had short stature. Hematological findings included normochromic, normocytic, or macrocytic anemia, marked reticulocytopenia, with initial normal white blood cell and platelet count, and absent or markedly decreased erythroid precursors on bone marrow examination. All were treated initially with prednisolone; in one patient oxymetholone was added. RESULTS: Three children failed to respond to the initial treatment, and also failed to respond to cyclosporin A and pulse doses of methylprednisolone. Myelofibrosis occurred in two siblings, 9 and 11 years from diagnosis. In two children the disease recurred 9 and 12 years after initial diagnosis. CONCLUSIONS: Our cases point to a possible variant of DBA characterized by the presence of normochromic normocytic anemia, hepatosplenomegaly, absent skeletal malformations, and unusual long- term complications.

Child↗

Spectrum of renal involvement in familial Mediterranean fever.

Kidney biopsies were performed on fifteen patients with a long-standing history of familial Mediterranean fever (FMF) and evidence of renal involvement. On light microscopy, seven patients were found to have amyloidosis, six mesangial proliferative glomerulonephritis (MsPGN) and two patients rapid progressive glomerulonephritis (RPGN). Immunofluorescent studies of the six biopsies with MsPGN were positive for mesangial IgA deposits (IgA nephropathy) in three patients and IgM mesangial deposits in three (IgM nephropathy). We conclude that in patients with FMF and renal involvement, non-amyloid renal lesions (IgA nephropathy, IgM nephropathy and RPGN) should be considered in the differential diagnosis in addition to amyloidosis.

Adolescent↗

Membranoproliferative glomerulonephritis associated with multicentric angiofollicular lymph node hyperplasia. Case report and review of the literature.

A 14-year-old boy presented with fever, anemia, hepatosplenomegaly, generalized lymphadenopathy and nephrotic syndrome. Lymph node biopsy showed angiofollicular lymph node hyperplasia (generalized Castleman's disease) of the plasma cell type. Kidney biopsy showed membranoproliferative glomerulonephritis type 1. Complete remission was achieved with corticosteroid treatment and repeat kidney biopsy 22 months later showed complete resolution of the renal pathology. The association between membranoproliferative glomerulonephritis and multicentric angiofollicular lymph node hyperplasia, plasma cell type, has not previously been reported.

Adolescent↗

Congenital malignant melanoma of the eye.

Twenty-three cases of congenital malignant melanoma have previously been reported. Here the authors report the first case of a congenital malignant melanoma arising in the eye. A newborn girl had a large pigmented ocular tumor, hepatomegaly, and multiple pigmented skin and choroidal lesions. The histopathologic diagnosis was of a malignant melanoma with hepatic metastases. The skin and choroidal lesions were considered to be congenital melanocytic nevi. The most plausible pathogenetic link between these two conditions was that the malignancy had arisen as a second-hit mutation within a choroidal congenital melanocytic nevus. Despite widespread metastases the baby, treated by surgery and chemotherapy, survives in good health, aged 2 years, 10 months.

Eye Neoplasms↗

Rapid progressive glomerulonephritis in patients with familial Mediterranean fever.

Two patients with a long-standing history of familial Mediterranean fever (FMF) presented with gross hematuria, oliguria, and acute renal failure; both required dialysis support. Kidney biopsies from both patients revealed crescentic rapid progressive glomerulonephritis (RPGN) without amyloidosis. One patient recovered renal function with methylprednisolone pulse therapy and cyclophosamide. The second patient did not improve and required regular hemodialysis. He is asymptomatic on colchicine therapy. To our knowledge, these are the first cases documenting the presence of RPGN in patients with FMF.

Adolescent↗

Recurrent hydatid pulmonary emboli.

A 30-yr-old healthy male presented with recurrent pulmonary emboli without clinical or radiologic evidence of deep venous thrombosis. He was found to have an isolated hydatid cyst in the pelvis with invasion and thrombosis of the inferior vena cava to the level of the renal veins, which caused recurrent hydatid pulmonary emboli. The patient died because of postoperative intractable respiratory failure.

Adult↗

IgA nephropathy in patients with familial Mediterranean fever.

Two patients with a long-standing history of familial Mediterranean fever were found to have both microscopic hematuria and proteinuria during the acute attacks. Kidney biopsies from both patients revealed diffuse mesangial proliferative glomerulonephritis with intense mesangial IgA and C3 deposits and no evidence of amyloidosis. To our knowledge these are the first 2 cases documenting the presence of mesangial IgA nephropathy in patients with familial Mediterranean fever.

Adolescent↗

Neonatal limb gangrene and renal vein thrombosis. Case report with review of literature.

A 3-day-old male infant born to a non-diabetic mother was admitted to the University Hospital with gangrene of the right forearm and some gangrenous patches of the left forearm. This was associated with left renal vein thrombosis. Screening tests for coagulation disorders gave normal results. The gangrenous right forearm was amputated and subsequently grafted. The skin lesions of the left forearm were successfully grafted. The renal system recovered well on supportive measures. The course of hospitalization and subsequent follow-up assessment at 3 months of age were satisfactory.

Forearm↗

The whistling face syndrome, or craniocarpotarsal dysplasia. Report of two cases in a father and son and review of the literature.

Two cases of "whistling face syndrome" with the typical manifestations in the face, hands, and feet in a father and son are presented. From studying them over a 3-year period and from reviewing 46 reported cases, we conclude that (a) hand and foot deformities do not improve spontaneously with growth and better results are achieved by early surgery, (b) decreased intermaxillary distance contributed more than intercommissural distance to feeding and anesthetic difficulties in our patients, and (c) thickened and contracted joint capsules and myopathic changes are thought to form the basic pathology in this syndrome.

Abnormalities, Multiple↗

Laryngocele: an acquired condition.

A 20-year-old female underwent excision of the submandibular gland for chronic sialadenitis and salivary calculus. She developed a wound hematoma which became infected. A wound abscess occurred which discharged spontaneously into the larynx and led to the formation of a combined laryngocele. This was excised, and the patient made a smooth recovery. There is no evidence of recurrence after two years.

Abscess↗