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Biomedical subjects

A Abyad

Publications and source records attributed to A Abyad.

32 records · Page 2Linked to original sources
PubMed1992

Arthritis and aging.

Thirty-seven million Americans suffer from some form of arthritis and the prevalence of arthritis among the elderly is particularly high. Therefore it is not surprising that there is a large new literature directed toward the epidemiology and health services for the older individual with arthritis. Many studies in osteoarthritis have refined the minutia or confirmed earlier work. Osteoarthritis increases with age and accounts for 46 million patient visits each year, with knee arthritis accounting for the most common complaint initiating such visits. Late stage rheumatoid arthritis has again been strongly associated with shortened life span, and factors predicting early death have been identified. Meanwhile, the "pyramid model" of rheumatoid arthritis treatment has been challenged. Of interest is the identification of obesity as a major risk factor for disability in elderly patients with arthritis and the fact that the incidence of hip fracture in the elderly, already known to be high, may be increasing. A provocative report suggests that mass screening for osteoporosis followed by selective treatment may be more cost effective than empirical treatment of all postmenopausal women.

Aged↗
PubMed1991

Screening for asymptomatic bacteriuria in pregnancy: urinalysis vs urine culture.

BACKGROUND: Asymptomatic bacteriuria is common during pregnancy. Its average prevalence is 6%. It is an important risk factor for acute pyelonephritis, hypertension, preeclampsia, fetal wastage, low birthweight, and prematurity. This study was performed to determine the usefulness of urine microscopy as a substitute for doing a screening urine culture. METHODS: The medical records of all first trimester obstetric visits from 1984 to 1990 were reviewed at a major university. The results of 888 screening urinalyses were recorded and compared with those of subsequent urine cultures. RESULTS: Fifty-four cultures had growth of a single organism with a bacteria level of at least 1000 organisms per milliliter. In the prediction of a positive culture, the microscopic findings of five or more leukocytes per high-power field (HPF) showed a sensitivity of 94.4% and a specificity of 95.0%. CONCLUSION: Physicians should test the urine of all prenatal patients at their first visit and send to the laboratory only those specimens with 5 or more leukocytes per HPF. Using this method, unnecessary screening urine cultures will be substantially reduced.

Adolescent↗
PubMedDate not supplied

Cost-effectiveness of antenatal screening for syphilis.

Routine obstetric screening for all prenatal checkups is an important issue. A study was conducted to ascertain the effectiveness of an antenatal screening program for syphilis. Charts of pregnant women for a 9-year period from 1982 to 1990 at the American University of Beirut were reviewed. Demographic data and the results of screening for syphilis were collected. In a total of 23,145 patients screened (with a biological false-positive rate of 0.3%), serological evidence of Treponema pallidum infection occurred in 0.27% of patients. The outcome in infants was satisfactory in all cases where appropriate antibiotic therapy was instituted antenatally. Thus antenatal screening for syphilis in our setting is a cost-effective program.

Adult↗
PubMedDate not supplied

Routine prenatal screening revisited.

Routine obstetric screening for all prenatal checkups is an important issue. This article is an attempt to answer the value of such screening in the case of hematocrit. Charts of pregnant women in the Family Medicine Practice Center at the American University of Beirut (AUB) over the last eight years were reviewed. Demographic data and hematocrit values were collected. The mean value of the hematocrit in our sample was 35.87. The prevalence of anemia was 7%; 31% of the sample were primigravida. The age group 15 to 19 years had the highest risk for developing anemia. Increased parity was associated with increased risk for anemia. Intake of iron on presentation was common (17%), and it reached statistical significance in the presence of anemia. It is concluded that there is need for more critical consideration of iron supplementation. The question of routine screening with hematocrit in the first prenatal visit should be reevaluated and patients who are at high risk should be screened.

Adolescent↗
PubMedDate not supplied

Primary polycythaemia vera in the elderly.

At presentation the history of an 87-year-old woman included progressive memory loss, repeated transient ischaemic attack, increasing fatigue, dizziness, palpitations and frequent falls. Investigations revealed erythrocytosis, leukocytosis, thrombocytosis, normal arterial oxygen concentration and an increased red cell volume. Polycythaemia vera was diagnosed and was successfully managed by phlebotomy with half a unit twice a week and rechecks of her haematocrit, initially; she reported marked improvement after 2 weeks of treatment. The alternative treatments for polycythaemia vera are discussed; in addition to venesection, conventional treatments include bone-marrow depressive agents such as phosphorus-32 and chemotherapy with agents such as hydroxyurea. More recent developments include isovolumic erythrocytophoresis, alpha-interferon and ticlopidine. All of the treatments are associated with complications, or other disadvantages, thrombotic complications in the case of phlebotomy, malignancies in the case of most myelosuppressive treatments, and problems of compliance in others. The optimal treatment for polycythaemia vera is a judicious combination of the alternatives, depending on the phase of the disease, the age of the patient, and other prognostic factors.

Aged↗
PubMedDate not supplied

Friedreich's ataxia in the elderly.

Friedreich's ataxia is one of the best defined and most common forms of hereditary ataxia of unknown aetiology. It is transmitted in an autosomal recessive manner, appearing sporadically, usually in childhood or adolescence. The case of an elderly patient with a possible diagnosis of late-onset Friedreich's ataxia is reported; this is thought to be the only such case in the literature. The 91-year-old Anglo female presented with ataxia that had been progressive over the last 5 years. Magnetic resonance imaging scans of the head revealed mild peripheral cerebellar atrophy and moderate cerebral atrophy. The patient's parents were unaffected but two of her six siblings had had Friedreich's ataxia starting in childhood, and four of her grandfather's siblings had had an undiagnosed illness that left them in wheelchairs early in life. Friedreich's ataxia was diagnosed in view of the strong family history and non-revealing magnetic resonance imaging of the brain.

Age of Onset↗
PubMedDate not supplied

Budd-Chiari syndrome: a review of ten cases.

The cases of ten patients with Budd-Chiari syndrome who were admitted to our medical centre between 1974 and 1986 were reviewed. There were three survivors; the remaining seven died after their disease had taken a rapid downhill course. The clinical course of Budd-Chiari syndrome and the various modalities of medical and surgical treatment are outlined.

Adolescent↗
PubMedDate not supplied

Family medicine in Lebanon: the 10th anniversary.

Developing a family practice residency program was a logical step in addressing the needs for primary care in Lebanon. The American University of Beirut initiated a family practice residency program in 1979. The curriculum was structured following the guidelines of the American Academy of Family Physicians. Since its establishment, the program has participated in the design, launching, and maintenance of the family practice residency in Bahrain. Future plans include establishing other programs in the region and increasing community participation.

Delivery of Health Care↗
PubMedDate not supplied

The Middle-East Academy for Medicine of Ageing.

The first session of the Middle-East Academy for Medicine of Ageing, the MEAMA, started with a focus on demographic aspects in the region and the problems the participants meet in their own countries related to the services for health related problems in older people. Also several medical topics were discussed. The MEAMA uses the methods of the EAMA, which have been proven to be attractive for participants and speakers. In the discussions the question was raised how to start the process to develop and enhance the services. It was suggested to start with the organization of national societies and interact with neighbouring countries before presenting measures needed at the national level. The MEAMA might be an excellent forum for the discussion how to stimulate the development of the services for older people in the Middle-East area.

Academies and Institutes↗
PubMedDate not supplied

A comparison of pregnancy care delivered by family physicians versus obstetricians in Lebanon.

BACKGROUND: The provision of prenatal and intrapartum care is an important issue in family practice. Physician specialty as a risk factor for adverse perinatal outcome is of interest to both educators and patients. The purpose of this study is to compare perinatal care provided by family practice and obstetrics residents for low-risk women in Lebanon. METHODS: A study of 400 matched pairs of low-risk pregnant women was conducted at the American University of Beirut Medical Center to compare outcomes of perinatal care provided by family physicians and obstetricians. The medical records of women admitted for delivery at the American University of Beirut Medical Center between October 1, 1986, and October 1, 1990, were reviewed. RESULTS: Obstetricians used oxytocin induction significantly more frequently than family physicians (43% versus 7%, P < .01). A similar significant difference was also noted for artificial rupture of membranes. There were similar episiotomy rates (63%), with a greater number of lacerations reported among women cared for by obstetricians (28% versus 15%, P < .05). The use of forceps was similar in both groups. Vacuum extraction was not used by family physicians. Neonatal outcomes were comparable, although meconium-stained amniotic fluid was more common in the obstetrics group (21% versus 6%, P < .05). During the postpartum period, significantly more women breast-fed (62% versus 45%, P < .01) and used oral contraceptives in the family practice group. CONCLUSIONS: When caring for low-risk pregnant women, family physicians appear to provide comparable care with less intervention than obstetricians.

Adolescent↗