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N J Shaheen

Publications and source records attributed to N J Shaheen.

23 records · Page 2Linked to original sources

Comparison of the Caldwell needle/cannula with Angiocath needle in large volume paracentesis.

OBJECTIVE: To evaluate the efficacy and safety of a newly designed paracentesis needle, the Caldwell needle/ cannula (CNC), and to compare it with the Angiocath needle for large volume paracentesis (LVP). METHODS: Forty patients (ages, 18-75 yr) with symptomatic non-malignant ascites and serum creatinines < 1.6 were randomized to undergo LVP with either the 15-gauge CNC or the 14-gauge Angiocath needle. LVP was considered complete when the ascitic fluid was believed to have been completely removed, a goal of 6 L was attained, or fluid return was poor despite clinically obvious ascites. Outcome parameters measured included time necessary for the LVP, amount of ascitic fluid removed, number of peritoneal punctures, and the reason for termination of LVP. Ascitic fluid from eight patients was used to measure in vitro flow rates for both needles at -80, -120, and -200 mm Hg. RESULTS: Twenty patients underwent LVP with the CNC and 20 with the Angiocath. Patients in whom the CNC was used had significantly faster paracenteses (17.0 +/- 0.8 vs. 34.1 +/- 1.5 min) and required fewer second peritoneal punctures (1 vs. 6, p = 0.046). Fewer LVPs in the CNC group were terminated secondary to poor fluid return (8 vs. 1, p = 0.022). The volume of fluid removed was greater with the CNC than with the Angiocath, but this difference did not reach statistical significance (5205 +/- 209 vs. 4683 +/- 269 ml, p = 0.079). There were no complications in either group. In vitro flow rates were 2.2-3.8 times faster through the CNC than through the Angiocath at all pressures tested (p < 0.05 for all groups). CONCLUSIONS: The CNC provides a faster, more complete paracentesis requiring fewer peritoneal punctures than a single-bore needle.

Adult↗

Passive smoking is associated with an increased risk of developing inflammatory bowel disease in children.

Adult cigarette smoking is associated with the development of Crohn's disease and protection from the development of ulcerative colitis. Children usually are nonsmokers whose risk of developing inflammatory bowel disease (IBD) may be related to passive smoking. The purpose of this matched case-control study was to evaluate passive smoking exposure in 72 nonsmoking children with recently diagnosed IBD (39 with ulcerative colitis and 33 with Crohn's disease), and in an equal number of peer-nominated controls. Passive smoking exposure at birth was significantly associated with the development of IBD (odds ratio 3.02, 95% confidence interval 1.28-7.06). The effect was greater in Crohn's disease (odds ratio 5.32) than in ulcerative colitis (odds ratio 2.19). Maternal smoking at birth also was significantly associated with the development of IBD (odds ratio 2.09, 95% confidence interval 1.02-4.29), an effect that also was greater in Crohn's disease than in ulcerative colitis. There was a dose-response relationship between packs smoked per day and IBD, and packs smoked at home per day and IBD. At symptom onset, the risk of developing IBD from passive smoking exposure was increased but was not significant (odds ratio 1.88, 95% confidence interval 0.84-4.18). The magnitude of the effect was greater in Crohn's disease than in ulcerative colitis, and the association demonstrated dose-response. In conclusion, passive smoking exposure and maternal smoking at birth and, to a lesser extent, passive smoking exposure at symptom onset are associated with an increased risk of developing IBD in children. The association is stronger in Crohn's disease than in ulcerative colitis, and there is a dose-response effect. The specific toxic exposure is more likely to be inhaled rather than passed through the placenta or in breast milk.

Case-Control Studies↗