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Search Results: 1 - 10 of 35359 matches for " Ali Al-Khafaji "
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Epinephrine: Is it really the black sheep of vasoactive agents?
Ritwick Agrawal, Ali Al-Khafaji, Sachin Yende
Critical Care , 2010, DOI: 10.1186/cc8998
Abstract: Edited by Eric B Milbrandt. University of Pittsburgh Department of Critical Care MedicineAnnane D, Vignon P, Renault A, Bollaert PE, Charpentier C, Martin C, Troche G, Ricard JD, Nitenberg G, Papazian L, Azoulay E, Bellissant E: Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 370:676-684 [1].International guidelines for management of septic shock recommend that dopamine or norepinephrine are preferable to epinephrine. However, no large comparative trial has yet been done.To compare the efficacy and safety of norepinephrine plus dobutamine (whenever needed) with those of epinephrine alone in septic shock.Prospective, multicenter, randomized, double-blind study.19 participating intensive care units in France.330 adult patients with septic shock. Inclusion criteria were the presence for less than 7 days of: evidence of infection; at least 2 of the 4 criteria of systemic inflammatory response syndrome (SIRS); and at least two signs of tissue hypoperfusion or organ dysfunction. Additionally, subjects had to have had to meet the three following criteria for less than 24 hours: systolic blood pressure less than 90 mm Hg or mean BP less than 70 mm Hg; administration of fluid bolus of at least 1000 mL or capillary wedge pressure between 12 and 18 mm Hg; and need for more than 15 μg per kg bodyweight per min of dopamine or any dose of epinephrine or norepinephrine. Specific exclusion criteria were established to ensure other causes of shock were excluded.Participants were assigned to receive epinephrine (n = 161) or norepinephrine plus dobutamine (n = 169), which were titrated to maintain mean blood pressure at 70 mm Hg or more.The primary outcome was 28-day all-cause mortality. The secondary outcomes were survival distribution from randomization to day 90; mortality rates at day 7, 14, at discharge from intensive care and from hospital, and at day 90; systemic hemodynamics; arterial pH and lactate; SOFA score
Is albumin use SAFE in patients with traumatic brain injury?
Christopher R Brackney, Luis A Diaz, Eric B Milbrandt, Ali Al-Khafaji, Joseph M Darby
Critical Care , 2010, DOI: 10.1186/cc8940
Abstract: Edited by: Eric B Milbrandt. University of Pittsburgh Department of Critical Care MedicineMyburgh J, Cooper DJ, Finfer S, Bellomo R, Norton R, Bishop N, Kai LS, Vallance S: Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N Engl J Med 2007, 357:874-884 [1].The Saline versus Albumin Fluid Evaluation study suggested that patients with traumatic brain injury resuscitated with albumin had a higher mortality rate than those resuscitated with saline. The SAFE investigators conducted a post hoc follow-up study of patients with traumatic brain injury who were enrolled in the study.The aims of the study were to document baseline characteristics that are known to influence outcomes from traumatic brain injury in the albumin and saline groups and to compare death and functional neurologic outcomes in the two groups 24 months after randomization.A post hoc follow-up study of patients with traumatic brain injury who were enrolled in the SAFE study. Setting: Intensive care units of 16 academic tertiary hospitals in Australia and New Zealand.460 patients 18 years or older with traumatic brain injury (i.e., a history of trauma, evidence of head trauma on a computed tomographic [CT] scan, and a score of ≤ 13 on the Glasgow Coma Scale [GCS]).231 (50.2%) received four percent albumin and 229 (49.8%) received saline.The primary outcome measures were the mortality rate and functional neurologic outcome 24 months after randomization. Multivariate logistic-regression was used to adjustment for baseline covariates known to be associated with increased mortality from traumatic brain injury (age older than 60 years, GCS score of 8, systolic pressure of <90 mm Hg, and traumatic subarachnoid hemorrhage). Analyses were conducted in all patients and in subgroups according to severity of traumatic brain injury.The subgroup of patients with GCS scores of 3 to 8 were classified as having severe brain injury (160 [69.3%] in the albumin group and 158 [69.0%] in the s
CORTICUS: The end of unconditional love for steroid use?
Phillip E Mason, Ali Al-Khafaji, Eric B Milbrandt, Brian P Suffoletto, David T Huang
Critical Care , 2009, DOI: 10.1186/cc7986
Abstract: Hydrocortisone is widely used in patients with septic shock, even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin.To evaluate the efficacy and safety of low-dose hydrocortisone therapy in a broad population of patients with septic shock – in particular, patients who had had a response to a corticotropin test, in whom a benefit was unproven.Multi-center, prospective randomized, double-blind, placebo-controlled trial.International study involving 52 intensive care units.499 patients 18 years or older with the diagnosis of septic shock.251 patients received 50 mg of intravenous hydrocortisone and 248 patients received placebo every 6 hours for 5 days; the dose was then tapered over a 6-day period. A short corticotropin test was performed from blood samples taken immediately before and 60 minutes after an intravenous administration of 250 mcg of cosyntropin prior to administration of hydrocortisone.Primary outcome was the mortality rate at 28 days in patients who did not have a response to corticotropin. Secondary outcomes included 28-day mortality in corticotropin responders and in all patients; length of stay; reversal of organ failure; and rates of new infection, hypernatremia and hyperglycemia.Of the 499 patients in the study, 233 (46.7%) did not have a response to corticotropin (125 in the hydrocortisone group and 108 in the placebo group). At 28 days, there was no significant difference in mortality between patients in the two study groups who did not have a response to corticotropin (39.2% in the hydrocortisone group and 36.1% in the placebo group, P = 0.69) or in patients who had a response to corticotropin (28.8% in the hydrocortisone group and 28.7% in the placebo group, P = 1.00). Mortality at 28 days included 86 of 251 patients in the hydrocortisone group (34.3%) and 78 of 248 pa
Study of Symmetry Process Behavior in Fractal Gray Image Compression by Traditional Method  [PDF]
Eman A. Al-Hilo, Kawther H. Al-Khafaji
Journal of Signal and Information Processing (JSIP) , 2013, DOI: 10.4236/jsip.2013.43B032

This paperstudiesthe effect of symmetry process on the compression parameters of thefractal image compression technique proposed by Jacquin.Two kinds of tests have been conducted. The first all kind of the symmetry operations [0-7] were taken; while the second tests were concentrated on studying the effect of the following parameters Block Size, Step Size, Domain Size on the probability distribution of symmetry operation. The results show that the higher value of PSNR and the lower value of ET occur atevensymmetry operation only, but compression ratio is not affected with symmetry process. Also the occurrence probability of even symmetry is more than odd symmetry for all compression parameters. This behaviour can be utilized to reducethe encoding time to 50% with preserving PSNR.


General Type-2 Fuzzy Topological Spaces  [PDF]
Munir Abdul Khalik AL-Khafaji, Mohammed Salih Mahdy Hussan
Advances in Pure Mathematics (APM) , 2018, DOI: 10.4236/apm.2018.89047
Abstract: In this paper, a presented definition of type-2 fuzzy sets and type-2 fuzzy set operation on it was given. The aim of this work was to introduce the concept of general topological spaces were extended in type-2 fuzzy sets with the structural properties such as open sets, closed sets, interior, closure and neighborhoods in topological spaces were extended to general type-2 fuzzy topological spaces and many related theorems are proved.
Treatment of Patients with Vitiligo by Intradermal Pricking of Vitiligenous Skin Using Sharp and Blunt Needle  [PDF]
Khalifa E. Sharquie, Adil A. Noaimi, Zahraa N. Al-Khafaji
Journal of Cosmetics, Dermatological Sciences and Applications (JCDSA) , 2018, DOI: 10.4236/jcdsa.2018.84027
Abstract: Background: Vitiligo is a well known autoimmune disease, both cell mediated and humeral reaction are implicated in its etiopathogensis. Pricking of marginal pigmented of vitiligo skin to stimulate normal melanocytes to migrate into vitiligenous area and induce new melanogenesis and this is well known mechanism to induce repigmentation and supported by publications. Objective: To use needling technique by using blunt and sharp needle by doing pricking completely white vitiligo skin in order to stimulate residual melanocytes of basal layer and or the melanocytes of outer root sheath of hair follicles to proliferate and induce active melanogenesis. Patients and Methods: This is an interventional, therapeutic, comparative, study that was done in Department of Dermatology-Baghdad Teaching Hospital, Medical City, Baghdad, Iraq from April 2014-March 2015. Thirty five patient with vitiligo were enrolled in this study, their ages ranged from 5 - 55 (22.28 ± 12.09) years; 15 patients treated with sharp needle, 2 males and 13 females and 20 patients treated with blunt needle, 4 males and 16 females. All clinical types of vitiligo including the generalized, localized and segmental were treated. The number of vitiligo patches varied between patients and the treated patches by sharp needle were 22 and by blunted needle were 20 patches. In both groups, needling was done geometrically, softly and rapidly in systemic horizontal rows away from pigmented margin and pigmented spot inside the patches and was not repeated. In Group A needle gauge 18 hold at 45° to skin surface and the distance between each pricking was 5 - 10 mm and similarly was done in Group B by using blunt needle. Each patient was advised to have daily sun light exposure for at least 15 min. Measuring the surface area of the lesions and calculating the reduction rate was done by using transparent with square paper and this was carried out every month till the end of the 4
Phase-Induced Intensity Noise Reduction with Improved Group Velocity Dispersion Tolerance in SAC-OCDMA Systems
Hamza M. R. Al-Khafaji,S. A. Aljunid,Angela Amphawan,Hilal A. Fadhil
International Journal of Engineering and Technology , 2013,
Abstract: The demand for efficient optical communication systems has fuelled considerable research in developing techniques for eradicating phase-induced intensity noise (PIIN) in spectral-amplitude coding optical code-division multiple-access (SAC-OCDMA). This paper investigates the use of modified-AND subtraction detection technique to mitigate PIIN in SAC-OCDMA systems. The simulation results show that the modified-AND subtraction detection demonstrates better performance over the conventional AND detection approach. Furthermore, we have found that, from a transmission length of 40 km onwards, group velocity dispersion (GVD) degrades SAC-OCDMA system performance apparently. Dispersion compensating fiber (DCF) is used to lessen the influence of GVD caused by single mode fiber (SMF).
Direct Transplant of Melanocytes from Normal Donor Area into Vitiligenous Recipient Area by Intralesional Injection of Melanocytes Using Spade Like Needle Technique  [PDF]
Khalifa E. Sharquie, Adil A. Noaimi, Zahraa N. Al-Khafaji
Journal of Cosmetics, Dermatological Sciences and Applications (JCDSA) , 2016, DOI: 10.4236/jcdsa.2016.64022
Abstract: Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simple technique by direct melanocytes transplant by spade needle technique in treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study was done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April 2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included. Full history and examination for each patient was done with 4 (20%) males and 16 (80%) females and their ages ranged from 9 - 40 (23.15 ± 11.44) years. Forty one patches in 20 patients treated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia done by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable needle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with medical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site and transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing normal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between injection points. The surface area of the lesions was calculated and the reduction rate was estimated every month till the end of the 4th month period of the treatment
Prevalence of β-hemolytic groups C and F streptococci in patients with acute pharyngitis
Alaa H. Al-Charrakh,Jawad K. T. Al-Khafaji,Rana H. S. Al-Rubaye
North American Journal of Medical Sciences , 2011,
Abstract: Background: The roles of group C and F streptococci in causing endemic pharyngitis are still controversial, although group C streptococci are implicated in the outbreaks of pharyngitis and associated disorders. Aim: The aim of this study was to determine the prevalence and the role of these groups of β-hemolytic streptococci in acute pharyngitis with emphasis on the Streptococcus anginosus group. The antimicrobial susceptibility profile of these bacterial isolates and their ability to produce some virulence factors was also determined. Materials and Methods: Throat swab specimens were collected from 177 patients suffering from acute pharyngitis who had been admitted to the Hilla Teaching Hospital, Hilla, Iraq, during October 2009 to January 2010. The necessary biochemical tests were conducted and the organisms identified using standard procedures. Susceptibility of isolates pathogens to several antibiotics was examined using standard susceptibility testing. Virulence factors of these isolates were also determined using standard methods. Results: Results revealed that a total of 67 isolates belonged to β-hemolytic streptococci, of which 11(16.4%) isolates belonged to anginosus group streptococci, which possessed Lancefield group C and F antigens. Most of these bacterial isolates have the ability to produce more than one virulence factor such as capsule, hemolysin, CFA III, and lipase enzyme. The bacterial isolates were highly resistant to ampicillin, cefotaxime, and cefepime while they exhibited moderate resistance to tetracycline, ceftriaxone, and ciprofloxacin. On the other hand, they showed a high sensitivity to vancomycin, ofloxacin, and clindamycin. Conclusion: This study concluded that groups C and F Streptococci were implicated as a cause of acute pharyngitis in 6.2% of the specimens among other groups of streptococci. Most of these isolates have the ability to produce more than one virulence factor. There was a high rate of resistance among isolates for β-lactam antibiotics; however, they were highly susceptible to vancomycin, ofloxacin, and clindamycin.
Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury
Kianoush Kashani, Ali Al-Khafaji, Thomas Ardiles, Antonio Artigas, Sean M Bagshaw, Max Bell, Azra Bihorac, Robert Birkhahn, Cynthia M Cely, Lakhmir S Chawla, Danielle L Davison, Thorsten Feldkamp, Lui G Forni, Michelle Gong, Kyle J Gunnerson, Michael Haase, James Hackett, Patrick M Honore, Eric AJ Hoste, Olivier Joannes-Boyau, Michael Joannidis, Patrick Kim, Jay L Koyner, Daniel T Laskowitz, Matthew E Lissauer, Gernot Marx, Peter A McCullough, Scott Mullaney, Marlies Ostermann, Thomas Rimmelé, Nathan I Shapiro, Andrew D Shaw, Jing Shi, Amy M Sprague, Jean-Louis Vincent, Christophe Vinsonneau
Critical Care , 2013, DOI: 10.1186/cc12503
Abstract: We performed two multicenter observational studies in critically ill patients at risk for AKI - discovery and validation. The top two markers from discovery were validated in a second study (Sapphire) and compared to a number of previously described biomarkers. In the discovery phase, we enrolled 522 adults in three distinct cohorts including patients with sepsis, shock, major surgery, and trauma and examined over 300 markers. In the Sapphire validation study, we enrolled 744 adult subjects with critical illness and without evidence of AKI at enrollment; the final analysis cohort was a heterogeneous sample of 728 critically ill patients. The primary endpoint was moderate to severe AKI (KDIGO stage 2 to 3) within 12 hours of sample collection.Moderate to severe AKI occurred in 14% of Sapphire subjects. The two top biomarkers from discovery were validated. Urine insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2), both inducers of G1 cell cycle arrest, a key mechanism implicated in AKI, together demonstrated an AUC of 0.80 (0.76 and 0.79 alone). Urine [TIMP-2].[IGFBP7] was significantly superior to all previously described markers of AKI (P <0.002), none of which achieved an AUC >0.72. Furthermore, [TIMP-2].[IGFBP7] significantly improved risk stratification when added to a nine-variable clinical model when analyzed using Cox proportional hazards model, generalized estimating equation, integrated discrimination improvement or net reclassification improvement. Finally, in sensitivity analyses [TIMP-2].[IGFBP7] remained significant and superior to all other markers regardless of changes in reference creatinine method.Two novel markers for AKI have been identified and validated in independent multicenter cohorts. Both markers are superior to existing markers, provide additional information over clinical variables and add mechanistic insight into AKI. Trial registration: ClinicalTrials.gov number NCT01209169.
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