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T Abraham

Publications and source records attributed to T Abraham.

At least 19 recordsLinked to original sources
PubMed2006

Reno-protective effect of N-acetyl cysteine in patients with impaired renal function undergoing coronary angiography and interventions.

BACKGROUND: The increasingly frequent use of contrast enhanced imaging for diagnosis or interventions in patients with CAD has generated concern about avoidance of contrast induced nephropathy (CIN). Reactive oxygen species have been shown to cause CIN. OBJECTIVES: Angiographic contrasts worsen the renal function in patients with renal failure. We studied the reno-protective action of the antioxidant N-Acetyl cysteine (NAC) in patients undergoing coronary procedures. METHODS: Retrospective analysis of 51 patients with elevated serum creatinine levels (> or = 15mg%) was done, 24 of whom received NAC prior to the procedure(NAC group) and 27 who did not (Non NAC group). NAC was administered in a dose of 400 mg twice daily for four doses starting on the day prior to the procedure. Both groups of patients were hydrated with 0.45% saline at 1 ml/kg/hr for 12 hours prior to and 12 hours following the procedure. Both groups were comparable with regard to age, sex, coronary risk profile, myocardial infarction history, left ventricular function and the drugs received. Serum urea and creatinine were measured on the day prior to and the day following the angiographic procedure. RESULTS: Nine out of 51 patients developed more than 0.5mg% rise in serum creatinine level; 1 in the NAC group and 8 in the non NAC group (p<0.05), 24 hours after injection of the contrast medium. In the NAC group mean serum creatinine level decreased from 1.94 +/- 0.56 to 1.67 +/- 0.56 and blood urea from 47.58 +/- 20 to 41.58 +/- 15.1. In the non NAC group serum creatinine increased from 1.75 +/- 0.31 to 1.98 +/- 0.56 and blood urea from 44.96 +/- 15.5 to 52.85 +/- 20.1 (p<0.05). This corresponds to an increase in creatinine clearance from 30ml/min to 35.92ml/min in the NAC group and a decrease from 34.42ml/min to 29.87ml/min in the non NAC group. There was no significant difference in the levels of sodium and potassium before and after the procedure in both the groups. CONCLUSION: We conclude that prophylactit administration of N-Acetyl Cysteine along with hydration diminishes the incidence of deterioration of renal function induced by contrast agents in patients with renal insufficiency during coronary angiographic procedures.

Acetylcysteine↗
PubMed1997

Caring for the community: development of the advanced practice nurse role.

In a collaborative effort with a large metropolitan hospital in Boston, a community assessment was conducted to determine ways in which an advanced practice nurse (APN) could enhance delivery to a nearby small urban community. The authors attended healthcare delivery meetings, interviewed community leaders, visited various community sites, and became familiar with the community and its residents. The assessment included evaluation with proposed intervention strategies, development of a model for enhancing delivery of care based on Orem's Self-Care Theory, and a role description for an APN that incorporated collaboration between the APN and the community health nurse. A community assessment enabled the APN to become a vital healthcare leader.

Boston↗
PubMed1997

The retroisthmic cleft. Scintigraphic appearance and clinical relevance in patients with low back pain.

This article describes the scintigraphic appearance of both a symptomatic and asymptomatic retroisthmic cleft in two athletes with low back pain. This lesion, which involves the lamina, is the least common of the neural arch defects of which spondylolysis is the most common. The anatomy of the lesion is discussed and illustrated. The literature about the possible cause of these lesions is reviewed. The report emphasizes the valuable role of radionuclide bone imaging in patients who have pain of potentially osseous origin, and who have a lesion of uncertain physiologic significance seen on an anatomic study such as a plain x-ray, CT scan, or MRI.

Adult↗
PubMed1996

An epidemiological study of dementia in a rural community in Kerala, India.

BACKGROUND: This community-based epidemiologic study of dementia in a rural population in India investigated the prevalence of various dementing disorders in the community, psychosocial correlates of the morbidity, and assessment of the risk factors associated with dementia. METHOD: A door to door survey was conducted to identify elderly people aged 60 and above. A total of 2067 elderly persons were then screened with a vernacular adaptation of the MMSE. All those who scored 23 and below had a detailed neuropsychological evaluation by CAMDEX-Section B, and the care-givers of the people with confirmed cognitive impairment were interviewed using CAMDEX-Section H to confirm the history of deterioration or impairment in social or personal functioning. In the third phase the subjects with confirmed cognitive impairment were evaluated at home as to whether they satisfied the DSM-III-R criteria for dementia. Subcategorisation of dementia was done based on ICD-10 diagnostic criteria. Five percent of those whose screening was negative were randomly selected and evaluated during each stage. RESULTS: Sixty-six cases of dementia were identified from 2067 persons aged 60 and above, a prevalence rate of 31.9 per thousand. After correction this rate was 33.9 per thousand. Fifty-eight percent of the dementia cases were diagnosed as vascular dementia and 41% satisfied the criteria for ICD-10 dementia in Alzheimer's disease. There were more women in the Alzheimer's disease group; smoking and hypertension were associated with vascular dementia while a family history of dementia was more likely in the Alzheimer's group. CONCLUSION: Dementia is an important cause of morbidity in the geriatric population in this community, where families take responsibility for the care of relatives with dementia.

Aged↗
PubMed1996

Combination antiretroviral chemotherapy: a potential strategy in AIDS-related malignancy.

There has been considerable interest and controversy over the potential clinical role of combination antiretroviral therapy, primarily in the treatment of patients with established HIV infection. In order to model the hematologic toxicity of high-dose combination antiretroviral therapy, the HL60 myeloid leukemia cell line was exposed to zidovudine, dideoxycytidine and/or didanosine. The results suggest that the myelotoxicity of high-dose combination antiretroviral therapy may be controlled by using very brief periods of drug exposure. Brief intense antiretroviral therapy may offer a useful approach, particularly in the treatment of patients with AIDS-related neoplasms who are also receiving myelotoxic antineoplastic drugs.

Analysis of Variance↗
PubMed1995

Paclitaxel effect on a leukemia cell line: importance of paclitaxel concentration.

The efficacy of a drug may be a complex function of the length of drug exposure and the drug concentration. One traditional way to model these variables together has been to look at the area under the curve (AUC) when drug concentration is plotted against time. Experiments in an HL60 leukemia cell model suggest that, for the antineoplastic drug paclitaxel, AUC is not a good predictor of efficacy.

Animals↗
PubMed1995

AZT modulation of trimetrexate myelotoxicity: evidence from an HL60 model.

AZT is widely used in combination with other potentially myelotoxic drugs. Bone marrow suppression may limit the vigor of therapy directed at HIV itself, opportunistic infections, and/or AIDS-associated malignancies. Evidence from an HL60 model suggests that toxicity is of most concern with simultaneous use of multiple agents, and that staggered use of different agents may in some cases be a more effective strategy.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas.

Data are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an O- and/or H-titre of > or = 1 in 40 (sensitivity 89%; specificity 89%). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of O and H (> 1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP-CN patients really were typhoid but were missed by culture. The TYP-CN patients showed a very similar clinical and age profile to TYP-CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific 'fever screen' for typhoid although it will not identify all cases. In children, lower cut-off points for O- and H-titres should be used than are generally recommended.

Agglutinins↗
PubMed1992

Interferon and interleukin-2 induced spontaneous cell-mediated cytotoxicity: a preliminary evaluation.

The contribution of natural cell-mediated cytotoxicity and its modulation with biological response modifiers in antitumour immunity was evaluated in patients with precancers and cancers of the oral cavity. The results were compared to those in normal controls. Both groups of patients showed highly significant depression of the natural killer cell activity. This depression was stage-related, suggesting an influence of tumour or tumour products on this activity. Depression in augmentation of this cytotoxicity was evident in both patient groups with cancers and precancers, suggesting a defect in the response of killer cells to biological response modifiers for reasons other than the tumour per se.

Cells, Cultured↗
PubMed1992

Arrhythmogenic mechanisms.

The arrhythmogenic mechanisms are the basis for the genesis of a wide variety of complex dysrhythmias that can arise in both pacemaker and nonpacemaker cells. Automaticity, or the ability to rhythmically and spontaneously depolarize cardiac cells, is normally the domain of the sinus node. Altered automaticity takes place when conduction is enhanced or abnormal. A second mechanism, reentry, refers to a phenomenon that occurs when an impulse is delayed within a pathway of slow conduction and then reenters surrounding tissue and produces another impulse. One-way conduction is necessary to produce a return route for the reentrant circuit. Lastly, late potentials are fragmented, low-amplitude electrical currents that occur at the terminal portion of the QRS complex or during the ST segment. Supraventricular and ventricular beats and tachydysrhythmias are the consequences of these mechanisms. Common contributing factors include but are not limited to hypoxia, hypercapnia, electrolyte disturbance, catecholamines, and pharmacotherapy.

Action Potentials↗
PubMed1990

Acute glomerulonephritis in Kelantan--a prospective study.

A prospective study of acute nephritis in children was conducted at the Universiti Sains Malaysia Hospital, Kubang Kerian between July 1987 and June 1988. One hundred and twenty four children were admitted with acute glomerulonephritis. The aim of the study was to determine the clinical pattern of the nephritis as well as its aetiology. The majority of our patients came from the lower socio-economic group and 54% of the families had incomes below the poverty line. Preceding skin infection was much more common than throat infection. The children showed a high incidence of complications: severe hypertension (43.6%), hypertensive encephalopathy (11.3%), clinical pulmonary oedema (36.3%), severe azotaemia (10.5%), and prolonged gross haematuria (13.7%). By using immunologic indices such as ASOT, anti-DNase B and complement 3, it was concluded that 121 of the 124 patients had post-streptococcal nephritis.

Acute Disease↗
PubMed1989

Immunocompetence in lung cancer. Relationship to extent of tumor burden and histologic type.

In vitro assays of immunocompetence were done in 60 patients with differing extents of tumor load and various histologic types of lung cancer and were compared to values obtained for 60 normal controls. Profound alterations in monoclonal antibody-defined T-lymphocytes and circulating B-cells were seen. All patients showed impaired blastogenic response to the mitogens used with the exception of a normal response to pokeweed mitogen (PWM) in patients with localized disease. Increase levels of serum IgG were seen in patients with localized disease whereas high levels of IgA was seen in patients with more advanced disease. Distant metastases were associated with low IgM levels. All patients studied regardless of stage and histologic type had elevated levels of circulating immunocomplexes. These findings indicate gross immunologic abnormalities in these patients.

Adenocarcinoma↗
PubMed1989

Immune reactive proteins as prognostic and clinical markers in malignant cervical neoplasia.

The significance of immune reactive proteins in malignant cervical neoplasia, with particular reference to its prognostic and clinical relevance, was studied in 229 patients. All stages of the disease showed elevated levels of circulating immune complexes (CIC). Patients with stages I/IIA showed elevated levels of IgG, whereas those with stages III and IV showed depressed IgM levels. In the case of IgA, the situation was reversed: patients with advanced disease showed increased levels. Radiotherapy resulted in highly elevated levels of CIC, IgG, and IgA. However, in patients who remained disease-free after radiation treatment, levels of these proteins came down, often falling below pretreatment levels. On the other hand, patients developing recurrent disease showed sustained, high levels of CIC and IgA, with IgG as an isolated case in stage I/IIA. The present study therefore shows that although these increases were non-tumour-specific, patients with persistent elevation of CIC and IgA levels were at much greater risk of developing recurrent disease, thereby proving the merit of these substances as markers in prognosticating the course of disease in malignant cervical neoplasia.

Antigen-Antibody Complex↗
PubMed1989

ICU family support group sessions: family members' perceived benefits.

The purpose of this research was to identify the relationship between attending an ICU family support group and the family's appraisal of stress, social support, and hope. In addition, the family members' perceived benefits of attending an ICU family support family support group session does not significantly change stress levels, feelings of hope, and social support. Analysis of data reconfirms that family members of critically ill patients have a tremendous need for information. Although findings revealed that the majority of the family members who attended the support session would recommend attending again, it is unclear whether the support session method is the most beneficial and cost-effective means to support families of critically ill patients.

Adaptation, Psychological↗
PubMed1989

Interleukin 2 and alpha interferon induced in vitro modulation of spontaneous cell mediated cytotoxicity in patients with cancer of the uterine cervix undergoing radiotherapy.

In vitro modulation of spontaneous cell mediated cytotoxicity by interferon and interleukin 2 was carried out using peripheral blood lymphocytes from patients with cancer of the uterine cervix before and at different intervals after commencement of radiation treatment. A total of 150 patients with various stages of the disease were included and cytotoxicity was measured using the single cell cytotoxic assay. These results indicate a beneficial effect in vitro of interleukin 2 and interferon in augmenting spontaneous cell mediated cytotoxicity, a possibly vital antitumour immune mechanism in patients with relatively early cervix cancer. Natural killer cell, lymphokine activated killer cell and interferon activated killer cell activity was depressed immediately following radiotherapy. The activity of these cell types later on increased above pretreatment levels in patients with stages I, IIA and IIB. A similar rebound above pretreatment levels was not observed in patients with stages III and IV.

Carcinoma, Squamous Cell↗
PubMed1988

Immune function in malignant cervical neoplasia: a multiparameter analysis.

Immunological assessment was carried out in 67 patients with various stages and histological grades of squamous cell carcinoma of the uterine cervix and compared with normal controls to discover whether any of these parameters could be used as an indicator of the patient's clinical status. The results show a gross impairment of the various lymphocyte subpopulations and anti-tumor immunity. This impairment was more pronounced in patients with high tumor load and having a histology of poorly differentiated squamous cell carcinomas. None of the parameters studied (total leukocyte numbers, lymphocyte subpopulations, leukocyte adherence inhibition test, natural killer cell activity, circulating immune complexes, and blocking effect of autologous serum) could be used as a clinical indicator, since no correlation could be noted between immune impairment and either the lymphocyte subpopulations or the circulating immune complexes.

Adult↗
PubMed1988

Natural cytotoxicity and serum blocking in malignant cervical neoplasia.

Peripheral blood lymphocytes from 100 patients with various stages and histological types of squamous cell carcinoma of the uterine cervix were assayed for natural killer (NK) cell activity against K562 cells using the single cell cytotoxicity assay in agarose. The effect of autologous serum on NK cell activity and a quantitation of soluble antigen-antibody complexes was also carried out. The cancer patients showed reduced NK activity compared with normal controls, the reduction increasing with tumor load. Another observation was that patients with poorly differentiated tumours showed lower levels of NK activity. Addition of autologous serum resulted in further depression of NK activity in all groups of patients. An increase in circulating immune complexes was also evident in all groups of patients. Here again increase in tumor load and poorly differentiated tumors showed the highest levels. The results point toward a possible disturbance in NK cell activity that could be further depressed by autologous serum factors.

Antigen-Antibody Complex↗