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Biomedical subjects

E Hassan

Publications and source records attributed to E Hassan.

At least 19 recordsLinked to original sources
PubMed2001

Plasma carnitine levels of pregnant adolescents in labor.

STUDY OBJECTIVE: To determine the concentration of plasma carnitine (total, free, and acylcarnitine) during the delivery of uncomplicated pregnancies of adolescent women. To investigate the relationship between maternal and neonatal levels of carnitine and to compare these carnitine levels between pregnant and nonpregnant adolescents. DESIGN: Samples of maternal and umbilical blood were taken at the time of delivery and examined for the determination of the carnitine-total, free, and acylcarnitine-concentration by the use of an enzymatic-radioisotope method. Twenty-two cases of uncomplicated adolescent pregnancies with a normal labor and without perinatal complications were examined. The plasma level of carnitine was also examined in 17 healthy nonpregnant adolescent women, which constituted the control group. RESULTS: The concentrations of plasma carnitine in adolescent pregnancies at the time of delivery were calculated at 19.6 +/- 2.15 microMol/L (total), 12.62 +/- 1.31 microMol/L (free), and 6.98 +/- 1.55 microMol/L (acylcarnitine). The corresponding mean values in umbilical plasma were 30.31 +/- 2.06 microMol/L, 22.39 +/- 1.64 microMol/L, and 7.92 +/-.96 mucroMol/L. There is a statistically significant difference between the mean values in maternal and umbilical plasma (P <.0001 for total and free carnitine and P <.012 for acylcarnitine). The correlations between adolescent pregnant women and their infants as regards total, free, and acylcarnitine were 0.137, 0.018, and 0.33, respectively. Neither of these parameters was statistically significant. The corresponding mean values of carnitine in nonpregnant adolescent women were statistically significantly higher than in adolescent pregnant women (total carnitine: 41.61 +/- 3.09 microMol/L, free: 31.39 +/- 2.81 microMol/L, acylcarnitine: 10.22 +/- 1.88 microMol/L, P <.0001). CONCLUSIONS: The concentration of plasma carnitine at the end of adolescent pregnancy is low compared to the levels of umbilical carnitine at birth and that found in nonpregnant adolescent women. It may not have an obvious impact on the utilization of fatty acids in an uncomplicated full-term pregnancy; however, it suggests the potential risk for neonatal fatty-acid oxidation in a preterm or complicated pregnancy.

Adolescent↗
PubMed2001

The eICU: it's not just telemedicine.

Intensive care units (ICUs) are major sites for medical errors and adverse events. Suboptimal outcomes reflect a widespread failure to implement care delivery systems that successfully address the complexity of modern ICUs. Whereas other industries have used information technologies to fundamentally improve operating efficiency and enhance safety, medicine has been slow to implement such strategies. Most ICUs do not even track performance; fewer still have the capability to examine clinical data and use this information to guide quality improvement initiatives. This article describes a technology-enabled care model (electronic ICU, or eICU) that represents a new paradigm for delivery of critical care services. A major component of the model is the use of telemedicine to leverage clinical expertise and facilitate a round-the-clock proactive care by intensivist-led teams of ICU caregivers. Novel data presentation formats, computerized decision support, and smart alarms are used to enhance efficiency, increase effectiveness, and standardize clinical and operating processes. In addition, the technology infrastructure facilitates performance improvement by providing an automated means to measure outcomes, track performance, and monitor resource utilization. The program is designed to support the multidisciplinary intensivist-led team model and incorporates comprehensive ICU re-engineering efforts to change practice behavior. Although this model can transform ICUs into centers of excellence, success will hinge on hospitals accepting the underlying value proposition and physicians being willing to change established practices.

Hospitalists↗
PubMed2000

Clinical implications of the ovarian/endometrial renin-angiotensin-aldosterone system.

New organ-specific functions of angiotensin II have recently been described: the importance of its role in the regulation of secretory epithelial function in many tissues including components of the reproductive tract has been documented. The source of angiotensin II in these tissues is the reproductive tract itself, and there is considerable evidence to suggest a distinct renin-angiotensin-aldosterone system in the ovary and uterus. Two main subtypes of angiotensin II receptors are recognized as angiotensin-receptor I and II, according to their sensitivity to the angiotensin II antagonists. However, the presence of angiotensin II receptors in the male and female reproductive tract suggests a multiplicity of roles that are unrelated to their primary functions or to each other. The renin-angiotensin-aldosterone system is a major determinant of sodium balance in pregnancy. More recently RT-PCR methods have revealed angiotensinogen transcription in the smooth muscle of spiral anteries of the decidua; a specific allele of this gene may be associated with hypertension in pregnancy as well as in pre-eclampsia. We investigated the evolution of plasma renin activity and aldosterone levels during normal and hypertensive pregnancy. Both were found to increase progressively during all three trimesters of normotensive pregnancy. Plasma renin activity in hypertensive women remained unchanged during all three trimesters of pregnancy. Plasma aldosterone levels in hypertensive women increased progressively during all three trimesters of pregnancy. However, plasma aldosterone levels remained significantly lower than the ones of normotensive pregnant women. These increased aldosterone levels were noticed despite unchanged renin levels. Further clinical studies investigating the renin-angiotensin-aldosterone system in the pathogenesis of pregnancy hypertension are needed. A renin-independent role of aldosterone in this pathological entity is suggested.

Aldosterone↗
PubMed2000

Potential for integrating eleven agricultural insecticides with the predatory bug Pristhesancus plagipennis (Hemiptera: Reduviidae).

A problem for growers attempting to implement integrated pest management programs is the lack of information regarding the compatibility of insecticides with natural enemies. To provide information about this problem, we evaluated the acute and residual effects of 11 commonly used insecticides on nymphs of Pristhesancus plagipennis (Walker) under both laboratory and field conditions. For each insecticide, the length of time that weathering residues caused > 50% mortality was evaluated and compared against the LC50 (acute-toxicity) divided by the recommended field rate. Plots thus combined the acute and residual toxicity of each insecticide. Results suggested that carbaryl, esfenvalerate, endosulfan, and deltamethrin had low residual and acute toxicity to P. plagipennis, whereas chlorpyrifos, methomyl, and monocrotophos were highly toxic at low concentrations and left persistent harmful residues. Cypermethrin, methidathion, malathion, and dimethoate were moderately toxic. The potential use of these insecticides to supplement the control activity of P. plagipennis is discussed.

Animals↗
PubMed1999

Combined oral and vaginal treatment of severe vulvovaginitis during childhood.

STUDY OBJECTIVE: To evaluate the efficacy and safety of combined oral and vaginal administration of antibiotics. DESIGN: Treatment and follow-up examination of 54 cases of severe vulvovaginitis. SETTING: Division of Pediatric and Adolescent' Gynecology, Second Department of Obstetrics and Gynecology, University of Athens, Greece. PARTICIPANTS: Girls aged 1-10 years seen at the clinic of the above-listed institution. INTERVENTIONS: Vaginal application of antibiotics. MAIN OUTCOME MEASURES: Vaginal culture and vaginoscopy. RESULTS: Treatment achieved microbial eradication in 51 of 54 patients (94%). In most patients, relief of symptoms was achieved after 2-3 days. No adverse effects were reported. CONCLUSIONS: Treatment was highly effective and simple to administer, and no complications were observed. A further advantage of this approach is the shorter duration of treatment.

Administration, Oral↗
PubMed1999

Ovarian tumors during childhood and adolescence. A clinicopathological study.

Ovarian tumors during the first two decades of life represent the most frequent tumors of the female genital tract at this age. Clinical and therapeutical particularities differentiate them from the same tumors of older women. During the period 1993-1997, 57 ovarian tumors were diagnosed and managed in the Divisions of Pediatric and Adolescent Gynecology of the 1st and 2nd Departments of Obstetrics and Gynecology, University of Athens. Benign tumors were found to be 77.2%, malignant 15.8% and borderline 7%. Germ cell tumors were the most common 49.1%, epithelial 35.1%, stromal 12.3%, lymphoma 1.75% and mixed tumors 1.75%. Of all the malignancies germ cell carcinomas consisted of 44.5%.

Adolescent↗
PubMed1999

Genital tumors during childhood and adolescence. A clinical and pathological study of 71 cases.

Genital tumors during the first two decades of life are not common and they constitute 5-10% of all tumors. During the period 1993-1997, 71 cases of genital tumors were diagnosed and managed in the Divisions of Pediatric and Adolescent Gynecology of the 1st and 2nd Departments of Obstetrics and Gynecology, University of Athens. Ovarian tumors were found to be the most common uterine tumors -16.9% and cervical -28%. From the ovarian tumors -80.3% of all tumors; -77.2% of cases were found to be benign; 15.8% malignant and 7% borderline. Malignant tumors were found to be germ cell -44.5%, epithelial -22.2%, stromal -11.1%, lymphoma 11.1%, and mixed -11.1%.

Adolescent↗
PubMed1999

Laparoscopic evaluation and management of chronic pelvic pain during adolescence.

Chronic pelvic pain (CPP) is a common symptom and a difficult condition to manage especially during adolescence. The aim of this study was to evaluate the role of laparoscopy in the diagnosis and treatment of CPP during this period of life. From January 1993 to December 1997, 98 patients, selected from a group of 180 patients who were referred to our clinic underwent laparoscopy. In most cases (60%) no abnormalities were observed. Endometriosis was found in 25% of cases, followed by ovarian cysts 7%, parovarian cysts 3%, pelvic inflammatory disease 3% and adhesions 2%. Laparoscopic treatment was performed as indicated by laparoscopic findings. We conclude that laparoscopy is a valuable and effective procedure in the diagnosis and management of CPP in a selected group of patients.

Adolescent↗
PubMed1999

Evaluation of combined endoscopic and pharmaceutical management of endometriosis during adolescence.

Laparoscopy is the most frequent surgical approach in gynecologic patients with acute or chronic pelvic pain. The symptomatology is frequently related to a specific gynecological pathology such as endometriosis or associated adhesive disease. During an eight year period, January 1990 to December 1997, 26 patients (aged 16-20 years) with endometriosis were diagnosed endoscopically and managed pharmaceutically in our clinic. The disease was evaluated and staged according to the American Society of Reproductive Medicine. The disease was evaluated as first stage in 16 patients (61.6%), as second stage in eight patients (30.8%), as third stage in one patient (3.8%) and as fourth stage in one patient (3.8%). Patients underwent adhesiolysis and management according to their laparoscopic findings. Postoperative pharmaceutical treatment (Danazol, GnRH analogues, Oral Contraceptives) was given. Patients were followed for the evaluation of the treatment. The efficacy of the combination of endoscopic and pharmaceutical management of the disease is discussed.

Adolescent↗
PubMed1999

Reproductive health issues in Greece.

OBJECTIVE: To evaluate reproductive health issues in Greece. METHODS: Analysis of hospital data and national registry reports. RESULTS: The rate of population growth in Greece is declining and is now 0.99% p.a. The maternal mortality ratio is approximately 3.6 per 100,000 live births, and perinatal and infant mortality are approximately 10/1,000 and 16/1,000 respectively. However, only 28-30% of sexually active women use contraception and approximately 300,000 terminations are performed each year. Sexually transmitted diseases are less common than in 1985: the incidence of syphilis is less than 4 per 100,000 population and that of gonorrhoea is less than 25/100,000. Between 1984 and September 1996, 1,421 cases of AIDS were reported; of these, 1,252 (88.1%) were in men and 169 (11.9%) in women. The incidence of human papilloma virus infection increased and at least 30% of sexually active women are infected. CONCLUSION: Good reproductive health is of major importance to women and health agencies but there are still significant obstacles to overcome in some regions.

Family Planning Services↗
PubMed1998

Tenoxicam versus lynestrenol-ethinyl estradiol treatment of dysfunctional uterine bleeding cases during adolescence.

BACKGROUND: The purpose of this study was to compare the effectiveness of tenoxicam versus lynestrenol-ethinyl estradiol (L-EE) in the treatment of severe cases of dysfunctional uterine bleeding (DUB) during adolescence. METHODS: Forty-eight patients with objective DUB completed a randomized comparative trial of treatment with tenoxicam (20 mg daily, n = 23) or L-EE (1 tablet containing 0.05 mg + 2.5 mg, respectively, 3 times daily, n = 25). Treatment was given during menorrhagia until bleeding ceased. Mean age of the patients was 13.74 +/- 2.1 years (range, 11-18 years). RESULTS: A significantly higher level of hematocrit (35.9% v 32.6%, t = 2.1, P = 0.0217) and hemoglobin (11.5 v 10.4 g%, t = 1.7, P = 0.0495), and significantly less hospitalization (5.75 v 8.33 days, t = 2.45, P = 0.0106) was seen in the tenoxicam group in comparison to L-EE group after completion of the treatment. Three patients were submitted to curettage and seven to transfusion in the group receiving L-EE, but no patients in the tenoxicam group required these procedures. CONCLUSIONS: Tenoxicam is considered an effective medication for the management of DUB during adolescence.

Adolescent↗
PubMed1998

Congenital capillary hemangioma and its therapeutic approach in infants: a case report.

Hemangiomas, common congenital lesions in infants and children, are thought to arise when islands of angioblastic tissue fail to connect with the developing vascular system. They are not usually life-threatening. A case of congenital capillary hemangioma in an infant, which was surgically excised, is reported, and therapeutic approaches are discussed.

Blood Vessels↗
PubMed1998

Effects of some beta-adrenergic blockers on male fertility parameters in rats.

The effects of atenolol (9 and 18 mg/kg.b.wt.), metoprolol (3.5 and 7 mg/kg.b.wt.) and propranolol (7.5 and 15 mg/kg.b.wt.) on male rate fertility were investigated following repeated oral administrations for 60 consecutive days. Repeated administrations of atenolol (9 and 18 mg/kg.b.wt.) induced non significant effects on weights of testes, epididymis and seminal vesicle at the first day, 30 and 60 days after the last repeated oral administration for 60 days. Administration of atenolol (9 and 18 mg/kg.b.wt.), metoprolol (3.5 and 7 mg/kg.b.wt.) and propranolol (15 mg/kg.b.wt.) to male rats induced significant decrease in percent of progressive motility of sperm at first day after the last oral administration for 60 days. Atenolol (18 mg/kg.b.wt.), metoprolol (7 mg/kg.b.wt.) and propranolol (7.5 and 15 mg/kg.b.wt.) induced significant increase in sperm head and tail abnormalities at first day after the last repeated dose. All rats treated with atenolol (9 mg/kg.b.wt.), metoprolol (7.5 and 15 mg/kg.b.wt.) and propranolol (7.5 and 15 mg/kg.b.wt.) induced significant decrease in the level of testosterone hormone at first and 30 days after the last dose. Repeated administrations of atenolol, metoprolol and propranolol in therapeutic and double therapeutic doses for 60 days induced nearly similar histopathological alterations in testis, epididymis and seminal vesicles. The induced hazard effects by the tested drugs on the male rat fertility were reversible as they returned to normal values 60 days after discontinuation of therapy.

Adrenergic beta-Antagonists↗
PubMed1998

Low-malignant potential epithelial tumors of the ovary: a clinicopathological study.

Low-malignant potential (LMP) epithelial tumors of the ovary are a group which occupy an intermediate position between the benign and those of the frankly malignant ovarian neoplasms. The actual incidence, present age and treatment are still being discussed. During the period 1991-1996, from the 650 ovarian tumors which were diagnosed and treated in our institution, 401 were epithelial tumors. The LMP serous epithelial tumors consisted of 4.36% of all serous tumors while LMP mucinous tumors were 9.70% of all mucinous tumors. The LMP serous tumors had an 8 cm diameter on average, 83% were unilocular and 76.5% unilateral. The LMP mucinous tumors had a 17 cm diameter on average, 95% were multilocular and 95% unilateral. The mean age at diagnosis was 39 years for LMP serous tumors and 48 years for LMP mucinous tumors.

Adenocarcinoma, Mucinous↗
PubMed1998

Conservative treatment of multiple pregnancies after delivery and a fetal miscarriage: two case reports.

Due to the increased availability of infertility treatment, multiple pregnancies, with various resulting complications, have become more common. Two cases of triplet pregnancies with delayed delivery--interval ranged from 6 to 56 days--are reported. The first woman in the 23rd week of a triplet pregnancy came to the hospital because of premature rupture of membranes of one amniotic sac and had a miscarriage of one of the fetuses the same day. The second woman in the 26th week of a triplet pregnancy also came to the hospital because of bleeding and contractions and had vaginal delivery of the first triplet a few hours later. After confirming that the remaining two fetuses were in good condition, both patients were kept under observation with only antibiotic therapy for the first one and antibiotic and tocolysis for the second. Fifty-six days following admission to our hospital the first woman gave birth to twins while in her 32nd week. The second woman gave birth six days following admission (in her 27th week). The successful outcome of these cases demonstrates that non-intervening conservative methods could be a feasible alternative to invasive intervention. We hope that our cases will encourage more physicians to try out and report non-intervening methods so that enough information can be gathered to help make correct management decisions in the future.

Abortion, Spontaneous↗
PubMed1997

Cervical cytology in adolescence.

The prevalence of cervical intraepithelial neoplasia in young women is increasing worldwide. Frequency of the abnormal Papanicolau smears was examined in sexually active young females aged 13 to 19 years. The smears were reported as within normal limits or with benign cellular changes due to inflammation in 96.2% of cases. The cytological changes were related in 2.5% of cases of HPV infection, in 1.0% of cases to CIN I and in 0.3% of cases to CIN II. These results show a frequency of 3.8% of abnormal smears.

Adolescent↗
PubMed1997

Adolescent laparoscopy.

Laparoscopy is a useful and safe diagnostic procedure that provides excellent visualization of the pelvic structures and often permits the diagnosis of gynecologic disorders and pelvic surgery without laparotomy. During the period 1994-1996 40 laparoscopies were performed as a diagnostic procedure on adolescents aged between 14-19 years. In 21 cases of primary amenorrhea the laparoscopy showed 12 cases of Rokitanski-Kuster-Hauser syndrome (57.2%), hematocolpos-hematometra 4 (19.0%), polycystic ovarian disease 2 (9.5%), late onset of puberty 2 (9.5%) and gonadal dysgenesis 1 (4.8%). Laparoscopy which was performed in 12 cases of pelvic pain showed 6 with normal genitalia (50%), endometriosis in 2 (16.7%, infection in 2 (16.7%), fibroma in 1 (8.3%) and torsion in 1 (8.3%). Four laparoscopies were performed for ovarian mass; three cystic masses and one case of endometriosis were detected.

Adolescent↗