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Biomedical subjects

R Hussein

Publications and source records attributed to R Hussein.

10 recordsLinked to original sources
PubMed2005

Soft tissue sarcomas: are current referral guidelines sufficient?

INTRODUCTION: To investigate the adequacy of current early referral guidelines for patients with extremity soft tissue sarcomas. PATIENTS & METHODS: 365 patients with confirmed soft tissue sarcomas were evaluated. Data were collected prospectively and included the length of history and the presence of features in current guidelines suggestive of malignancy (pain, rapidity of growth, depth and tumour size). Statistical analysis included the t-test, ANOVA and the Chi test. RESULTS: Deep tumours were the commonest (306 patients with deep tumours). Pain was the least consistent feature (176 patients with pain). 345 patients with one or more of the guideline features had an average history of 19.86 months, 238 of these were seen after more than 3 months. CONCLUSION: Although the majority of soft tissue sarcomas in our patients had one or more of the clinical guideline features, there was still an unacceptable delay in referring these patients to a specialist unit. The referral guidelines should be modified with special emphasis on depth, which is the most sensitive, followed by size and a history of rapid growth. This combined with increased awareness of these guidelines and a well-advertised, open-access clinic linked to a specialist unit should allow for a more rapid evaluation of soft tissue tumours.

Adolescent↗
PubMed2004

Internationalization of healthcare applications: a generic approach for PACS workstations.

OBJECTIVES: Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations. METHODS: The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation. RESULTS: The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports. CONCLUSIONS: In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.

Germany↗
PubMed2001

Management of knee arthroscopy portals.

Although the use of suture material for closure of knee arthroscopy portals has decreased, many surgeons continue to use adhesive tape, assuming this is superior to leaving them open. We have investigated two modalities of portal management after knee arthroscopy, the open method and the use of adhesive tape, documenting wound healing, complications and patient satisfaction. Eighty-seven patients (92 knees) were included in this study, 183 portals were involved. Sixty portals (30 knees) were closed with adhesive tape and 123 portals (62 knees) were left open. Follow up was at 2 weeks and at a further 6 weeks post operatively for those with a complication. In the adhesive tape group there were 6 portals with a complication (10%). In the open group there were 13 portals with a complication (10.56%). There were no major or long term complications and no significant difference between the two methods of treatment (P = 0.908 for portals, P = 0.954 for knees). We concluded that leaving knee athroscopy wounds open is an acceptable method of management when compared to adhesive tape.

Arthroscopy↗
PubMed2001

Expedient microdetermination of itraconazole and hydroxyitraconazole in plasma by high-performance liquid chromatography with fluorescence detection.

The authors describe a useful and rapid micromethod for the analysis of itraconazole (ITZ) and its active metabolite hydroxyitraconazole (HIT) in human plasma. After a simple deproteinization of 100 microL plasma with acetonitrile, the drug, its metabolite, and an internal standard (IS, ketoconazole) were separated on an 8 mm x 10 cm NovaPak (Waters Associates; Milford, MA) C(18) 4-microm particle-size radial compression cartridge. The compounds of interest were detected using a fluorescence detector with the excitation wavelength set at 260 nm and the emission at 365 nm. The mobile phase consisted of 420 mL water adjusted to a pH of 2.5 with phosphoric acid, 580 mL acetonitrile, and 100 microL triethylamine, which was delivered at a flow rate of 3.0 mL/min. This expedient and rugged method is being used to monitor therapeutic levels in bone marrow transplant recipients who are taking the drug for prophylaxis.

Antifungal Agents↗
PubMed2001

Population pharmacokinetics of perhexiline from very sparse, routine monitoring data.

Using NONMEM, the population pharmacokinetics of perhexiline were studied in 88 patients (34 F, 54 M) who were being treated for refractory angina. Their mean +/- SD (range) age was 75 +/- 9.9 years (46-92), and the length of perhexiline treatment was 56 +/- 77 weeks (0.3-416). The sampling time after a dose was 14.1 +/- 21.4 hours (0.5-200), and the perhexiline plasma concentrations were 0.39 +/- 0.32 mg/L (0.03-1.56). A one-compartment model with first-order absorption was fitted to the data using the first-order (FO) approximation. The best model contained 2 subpopulations (obtained via the $MIXTURE subroutine) of 77 subjects (subgroup A) and 11 subjects (subgroup B) that had typical values for clearance (CL/F) of 21.8 L/h and 2.06 L/h, respectively. The volumes of distribution (V/F) were 1470 L and 260 L, respectively, which suggested a reduction in presystemic metabolism in subgroup B. The interindividual variability (CV%) was modeled logarithmically and for CL/F ranged from 69.1% (subgroup A) to 86.3% (subgroup B). The interindividual variability in V/F was 111%. The residual variability unexplained by the population model was 28.2%. These results confirm and extend the existing pharmacokinetic data on perhexiline, especially the bimodal distribution of CL/F manifested via an inherited deficiency in hepatic and extrahepatic CYP2D6 activity.

Aged↗
PubMed2000

Sensitive assay for the determination of cefazolin or ceftriaxone in plasma utilizing LC.

A rapid, specific and very sensitive liquid chromatographic assay using standard ultraviolet detection has been developed to measure cefazolin (CFZ) or ceftriaxone (CFX) in small samples (200 microl) of plasma using either drug as the internal standard for measurement of the other. A rapid extraction was performed using C18 bonded Sep Pak cartridges with high extraction efficiency for both drugs. The chromatographic system employed the use of a Nova-Pak C18 4-microm cartridge with a radial compression system preceded by a Guard-Pak with a C18 insert. The mobile phase consisted of an aqueous solution containing 10 mM of dibasic potassium phosphate and 10 mM cetyltrimethylammonium bromide (pH 6.5) with acetonitrile (73:27 v/v). The drug and internal standard (CFZ/CFX) were detected using a UV detector set at a wavelength of 274 nm. Assay results were linearly related to the concentration (r > 0.997) for the wide range which was examined (0.005-120 microg/ml) for either drug. We report the precision, accuracy, recovery, linearity, sensitivity and specificity of this assay. The intra-run and inter-run CV was less than 9.02%. This method is currently being used for clinical therapeutic monitoring and pharmacokinetic studies of CFZ and CFX in patients undergoing cesarean section.

Cefazolin↗
PubMed1997

Effect of repeated dosing on the pharmacokinetics of oral fluconazole in bone marrow transplant patients.

We examined the pharmacokinetics of fluconazole in 11 bone marrow transplant patients after multiple oral daily dose of 200 mg of this drug. Blood was sampled at different intervals on day 1, day 13, and day 27. No dose was given on day 2, day 14, and day 28 to allow the concentration-time data to be collected over 48 hours. The 24 hour urine was also collected, and fluconazole was analyzed in both plasma and urine by a high performance liquid chromatography. The plasma concentration-time data were best described by the one-compartment model with first-order absorption. The overall inter-day change and the difference between day 1 and day 27 in the rate constant for absorption (ka), peak plasma concentration (Cmax), through plasma concentration (Cmin), time-to-peak (tmax), area-under-the-curve 0-24 (AUC0-24), rate constant for elimination (ka), mean residence time after oral administration (MRTor), and fraction of the dose excreted unchanged in urine 24 hours (fu24) were significant (P < or = 0.0029 and P < or = 0.01, respectively). However, the difference between day 1 and day 13 was significant (P < or = 0.05) only in ka, tmax, Cmax, Cmin, and AUC0-24, and between day 13 and day 27 was significant (P < or = 0.05) only in ka, Cmin, ka, and MRTor. There was no significant inter-day change in the renal clearance. The significant (P < or = 0.05) increases in Cmax, Cmin, and AUC0-24 after the dose given on day 13 as compared with day 1, and in Cmin on day 27 as compared with day 13 indicate that, in contrast to volunteers, the steady state condition was not reached on day 13 and possibly not on day 27 in these patients. This perhaps should be taken into account when prescribing fluconazole to seriously ill patients.

Adolescent↗
PubMed1997

Experience with methicillin resistant Staphylococcus aureus at the Nairobi Hospital.

The problem of MRSA was recognised in mid year of 1996 among both in and out patients at the Nairobi Hospital. The Infection Control Committee, through the microbiology section of the laboratory, immediately accelerated the surveillance programme which included culturing all the wards, beddings, sinks, utensils, furniture and staff. The source was identified and disinfectant methods were modified to eradicate the infection from the community. Relentless fight against the micro-organism through the recommended methods resulted in no more cases at the end of the year. Nosocomial infections must be recognised by all hospitals which must have viable infection control programmes. The Nairobi hospital has an active and on-going infection control programme which enabled this problem to be identified and solved in a timely manner.

Cross Infection↗