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N Matar

Publications and source records attributed to N Matar.

26 records · Page 2Linked to original sources
PubMed1992

Bilateral pneumothoraces hasten mortality in AIDS patients receiving secondary prophylaxis with aerosolized pentamidine. Association with a lower Dco prior to receiving aerosolized pentamidine.

We have administered aerosolized pentamidine (AP) to 48 AIDS patients for secondary prophylaxis of Pneumocystis carinii pneumonia (PCP). Pentamidine 60 mg was administered by ultrasonic nebulization (Fisoneb) five times during the first two weeks and then every two weeks. The mean follow-up was 343 +/- 22 days. PCP recurred in ten patients, 297 +/- 33 days after starting AP therapy. All responded to anti-Pneumocystis therapy but two patients died of unrelated reasons (20 percent mortality). Five patients developed bilateral pneumothoraces 260 +/- 35 days after starting AP therapy. Recurrence of PCP could be documented in only one patient. All died 66 +/- 27 days after the onset of the first pneumothorax. Only 5 of 33 patients without recurrence of pneumonia or pneumothorax died during the study period (15 percent mortality). No association was found between the development of pneumothorax and age, smoking, previous respiratory or infectious problems, time from last PCP and the initiation of AP therapy, and treatment duration of last PCP. Patients with pneumothoraces had a significantly lower Dco (58.6 +/- 2.6 percent predicted) prior to AP therapy than patients with recurrence of PCP without pneumothoraces (81.1 +/- 2.1 percent predicted) or patients with no recurrence of PCP (67 +/- 2.5 percent predicted) (p less than 0.05, ANOVA). In conclusion, bilateral pneumothoraces are associated with a hastened mortality in patients receiving AP for secondary prophylaxis of PCP. Low Dco before AP therapy is associated with an increased risk of bilateral pneumothoraces in patients treated with AP for secondary prophylaxis of PCP.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Flow resistance in patients with chronic obstructive pulmonary disease in acute respiratory failure. Effects of flow and volume.

The flow and volume dependence of the total resistance of the respiratory system (Rrs) was investigated in six mechanically ventilated patients with chronic obstructive pulmonary disease (COPD) using a simple, rapid method. Isovolume Rrs-flow (V) relationships obtained at different inflation volumes (range 0.1 to 1 L) fitted (p less than 0.001) the following function: Rrs = a/V + b + cV, where a, b, and c are constants. The term "a/V" in this equation represents the hyperbolic decrease in thoracic tissue resistance with increasing flow; the term "cV" represents the linear increase in airway resistance with increasing flow. Rrs initially decreased with increasing V because at low flow the weight of the a/V was greater than that of the cV. At higher flow, however, cV became predominant and hence Rrs tended to increase. At an inflation volume of 0.5 L, minimum Rrs occurred at average inflation flow of 1.28 L/s. At low flow, Rrs increased progressively with increasing inflation volume; at inflation V greater than 1 L/s, the highest values of Rrs were obtained at low inflation volumes. The flow and volume dependence of Rrs implies that, for comparative purposes, measurements of Rrs should be standardized to a fixed inflation flow and volume.

Aged↗
PubMed1991

Effects of positive end-expiratory pressure on alveolar recruitment and gas exchange in patients with the adult respiratory distress syndrome.

The effects of different levels of positive end-expiratory pressure (PEEP) (zero to 15 cm H2O) on the static inflation volume-pressure (V-P) curve of the respiratory system and on gas exchange were studied in eight patients with the adult respiratory distress syndrome (ARDS). Alveolar recruitment with PEEP was quantified in terms of recruited volume, i.e., as difference in lung volume between PEEP and zero end-expiratory pressure (ZEEP) for the same static inflation pressure (20 cm H2O) from the V-P curves obtained at the different PEEP levels. In addition, static compliance of the respiratory system at fixed tidal volume (0.7 L) was determined at the different PEEP levels. The results suggest that: (1) in some patients with ARDS the V-P curves determined on ZEEP exhibit an upward concavity reflecting progressive alveolar recruitment with increasing inflation volume, and PEEP results in alveolar recruitment (range of recruited volume at 15 cm H2O of PEEP: 0.11 to 0.36 L); (2) in other patients with ARDS the V-P curves on ZEEP are characterized by an upward convexity, and PEEP results in a volume displacement along this curve without alveolar recruitment and with enhanced risk of barotrauma; (3) the PEEP-induced increase in arterial oxygenation is significantly correlated to the recruited volume but not to the changes in static compliance. The shape of the static inflation V-P curves on ZEEP allows the prediction of alveolar recruitment with PEEP.

Aged↗
PubMedDate not supplied

[Induction of labor by misoprostol, an analog of PGE1. A prospective study of 200 cases].

We carried out a prospective study of 200 pregnant women who required induction of labor at full term, at the Lalla Meryem maternity unit of the Ibn Rochd University Hospital, Casablanca, between January 1st 1996 and June 30th 1997. The aim of this study was to evaluate the efficacy, tolerance and acceptance of misoprostol (Cytotec) as a drug for inducing labor in unfavorable conditions (Bishop < 5). Misoprostol (a PGE1 analog) was administered to the women via the vagina, with a dose of 1/4 tb (50 mg) given every 6 hours, and a maximum of 3 doses (150 mg). If labor had not begun 18 h after the start of the protocol, misoprostol induction was considered to have failed. We found that misoprostol failed to induce labor in 5% of cases, Syntocinon was required in 40% of cases and the interval between misoprostol insertion and vaginal delivery was 13.3 + 11.1 h. The rate of delivery by cesarean section was 22% and the mean amount of misoprostol required was 1.3 doses (66 mg). The mean cost of labor induction was 0.6 FF, the frequency of uterine hyperstimulation was 3.5% and maternal, fetal and neonatal tolerance was good. Our results confirm that intravaginal misoprostol is very effective and well tolerated for the induction of labor in pregnant women at full term, in unfavorable obstetric conditions.

Administration, Intravaginal↗
PubMedDate not supplied

[Maternal complications of cesarean section: retrospective analysis of 3,231 interventions at the Casablanca University Hospital, Morocco].

We carried out a retrospective analysis of 3,231 cases of cesarean section between 1994 and 1997, to assess the maternal mortality and morbidity associated with this intervention. The frequency of cesarean delivery was 12.4%. The indications for cesarean section were of three types: elective indications (627 cases, 19.4%), emergency indications (454 cases, 14.1%), failure of normal labor (2,150 cases, 66.5%). Nine maternal deaths were noted (2.8 per thousand), one of which was directly linked to surgery. The peroperative complications were primarily major hemorrhagia (39 cases, 1.2%), visceral lesions such as bladder rupture (3 cases, 0.1%) and intestinal lesions (3 cases, 0.1%). Postoperative morbidity was predominated by infectious complications, particularly endometritis (5.1%). Thromboembolism was reported in 7 cases (0.2%). Cesarean section is used to preserve the life of both the mother and the child. However, maternal morbidity and mortality rates are higher with cesarean section than with vaginal delivery and therefore its indications must be justified.

Adult↗
PubMedDate not supplied

[Pathogenicity of artificial mineral fibers: are they as dangerous as asbestos?].

Man-Made Mineral Fibres (MMMF) are starting to replace asbestos in the insulation industry. The popularity of these fibres has increased since the demonstration, in man, of the fibrogenicity and carcinogenicity of asbestos. A fear of human toxicity of MMMF has followed the demonstration of toxicity in animals after injection or instillation. This review of the litterature discusses the toxicity and side effects of MMMF. These fibres seem to have less toxicity than asbestos for the following reasons: 1. A lower concentration of fibres found in the air of the MMMF industry. 2. The cleavage of fibres in a perpendicular and non-parallel way. 3. The dissolution of fibres in the lung. Very fine fibreglass and mineral wool seem to be more toxic than continuous filaments and ordinary fibreglass.

Asthma↗