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Biomedical subjects

H E Fadel

Publications and source records attributed to H E Fadel.

At least 37 records · Page 2Linked to original sources
PubMed1985

The unreliability of amniotic fluid bilirubin measurements in isoimmunized pregnancies in sickle cell disease patients.

Amniotic fluid spectrophotometric analysis for bilirubin (delta optical density [delta OD450], at 450 nm) is used to assess the severity of fetal involvement in isoimmunized pregnancies. Two patients presented with sickle cell anemia and hyperbilirubinemia who also were isoimmunized. The first patient had anti-kell and anti-e antibodies, whereas the second patient had anti-Lewisa and anti-Coltonb antibodies. Delta OD450 was elevated in both patients. The difficulty in interpretation of high delta OD450 in the presence of maternal hyperbilirubinemia is stressed. Sickle cell diseased patients are particularly prone to present with this problem. These patients always have hyperbilirubinemia and a relatively high incidence of irregular antibodies because of the numerous blood transfusions they receive. The management of these two patients is presented with suggestions for the use of alternative modalities of monitoring isoimmunized pregnancies in patients with hyperbilirubinemia.

Adult↗
PubMed1984

Glycosylated hemoglobin and plasma protein in newborns of normal and diabetic women.

The glycosylated hemoglobin (glyco Hb) and the glycoprotein of the plasma were determined using affinity chromatographic techniques in cord blood and maternal blood of normal (Group I), White's Class A diabetic (Group II), and insulin-dependent diabetic (Group III) mothers. The results revealed significant increase of glyco Hb (P less than 0.005) and glycoprotein (P less than 0.005) in the newborns of Group III mothers in comparison to those of Group I. The glyco Hb of maternal blood in this group also showed significant increase (P less than 0.005) while the increase in Hb A1 and plasma glycoprotein were nonsignificant. All values for cord blood and maternal blood of White's Class A diabetics revealed no significant change from the normal group. We conclude that the fetuses of insulin-dependent diabetic mothers are hyperglycemic in utero.

Blood Glucose↗
PubMed1984

Glycosylated and acetylated hemoglobins in relation to gestational age and red cell age.

Cord blood samples were obtained at delivery from women at gestational periods of 30 to 36 weeks (preterm) and from a control group at 40 weeks of gestational age (term). Total glycosylated hemoglobin (GHb) was determined by affinity chromatography and the percentages of the minor Hbs FIa+b and FIc (of total Hb F) were determined by Bio-Rex 70 chromatography in whole blood samples and in red cell populations separated by Dextran 40 density gradient centrifugation. The absolute levels and the increase due to red cell aging of GHb, Hb FIa+b and Hb FIc were significantly reduced in the preterm samples compared to the term samples indicating decreased glycosylation in preterm fetus. When the nonglycosylated Hbs from term and preterm newborns were separated by Bio-Rex 70 chromatography after removal of the GHb by affinity chromatography, the acetylated form of Hb FIc also showed an increase with red cell aging indicating posttranslational enzymatic or nonenzymatic acetylation of Hb F during the entire life span of red cells. Moreover, as with GHb, the acetylated Hb was also decreased in the preterm newborns.

Cation Exchange Resins↗
PubMed1983

Benign intracranial hypertension in pregnancy: current diagnostic and therapeutic approach.

Four cases of benign intracranial hypertension (BIH) in pregnancy are presented. Literature regarding this rare entity is reviewed. Various diagnostic and therapeutic approaches in the management of BIH are described, with special emphasis on the newer neurodiagnostic and neurosurgical approaches. Guidelines have been suggested in diagnosing and managing this syndrome in pregnancy.

Adolescent↗
PubMed1983

Isolation of amniotic fluid erythrocytes and their possible use in prenatal diagnosis.

Many of the components of amniotic fluid have been found to be valuable in prenatal diagnosis; however, the presence of erythrocytes is usually considered undesirable. The authors have used buoyant density centrifugation on 96 amniotic fluid specimens from 70 subjects to isolate small numbers of erythrocytes from a majority of these specimens. Through immunofluorescence, these specimens were found to have higher levels of fetal hemoglobin-containing cells than the adult, indicating that the erythrocytes were at least in part fetal in origin. Thus, erythrocytes present in amniotic fluid could also be used in prenatal diagnosis.

Amniocentesis↗
PubMed1983

Pregnancy in a patient with type II polyendocrinopathy. A case report.

The rare association of Addison's disease and autoimmune hypothyroidism (Schmidt's syndrome) occurred during two pregnancies in the same woman. The association of Addison's disease and pregnancy is serious, and affected patients should be followed closely for electrolyte homeostasis.

Addison Disease↗
PubMed1983

Cryptococcal meningitis in pregnancy.

Cryptococcal meningitis was diagnosed in a pregnant woman at 21 weeks' gestation. The availability of fetal tissues, blood, and amniotic fluid in such a patient receiving therapy with amphotericin B plus flucytosine afforded the opportunity to study the effects of the disease and therapeutic agents on the developing fetus. The amphotericin B concentration in amniotic fluid was 0.25 micrograms/ml and that of flucytosine was 168 micrograms/ml. The concentrations in cord blood were 0.3 micrograms/ml and 64.7 micrograms/ml, respectively. No evidence was found of amphotericin B or flucytosine toxicity in fetal tissues, although exposure of the fetus to these compounds was of brief duration.

Adult↗
PubMed1982

Use of restriction endonucleases for mapping the allele for beta s-globin.

We have reported the direct analysis of the allele for beta 2-globin by using restriction endonuclease Dde I coupled with blot-hybridization analysis. In that report we predicted that a major use of our analysis could be for the prenatal diagnosis of sickle cell anemia. Here we present such an analysis. In addition, this report also describes the use of a new enzyme Mst II, which also distinguish the beta s allele from the normal beta-globin allele. Blot-hybridization analysis with restriction endonuclease Mst II shows the 5' end of the normal beta-globin gene to reside on a fragment of approximately 1.14 kilobases, whereas the 5' end of the beta s-globin gene resides on a fragment of approximately 1.34 kilobases. Because the fragment sizes generated by Mst II are significantly larger than those generated by Dde I, one can easily perform a prenatal diagnosis for sickle cell by standard blot hybridizations onto nitrocellulose filters.

Amniotic Fluid↗
PubMed1982

Diabetes mellitus and pregnancy: management and results.

A protocol for the diagnosis and management of diabetes mellitus in pregnancy is outlined. It entails frequent prenatal visits, strict metabolic control, a program for antepartum fetal surveillance using estriols and contraction stress testing, liberal hospitalization, fetal lung maturity assessment, individualization of the time of induction of labor and careful intrapartum fetal monitoring. The results of such a protocol over a two-and-a-half-year period involving 84 gestational (GD) and 23 insulin-dependent (IDD) diabetic pregnant women is described. The incidence of preterm labor (less than 37 weeks) was 7.1% in GD and 39% in IDD. The cesarean section rate was 15.4% in GD and 56.5% in IDD. The incidence of macrosomia was 20% in GD and 13% in IDD. There was one antepartum stillbirth in GD due to a true knot of the cord, and there were no neonatal deaths in either group, for a perinatal mortality rate of less than 1%. Neonatal morbidity was also decreased. Respiratory distress syndrome occurred in only one neonate of an IDD. The success of such a protocol in decreasing perinatal morbidity and mortality justifies the effort and cost expended.

Adult↗
PubMed1981

Minor fetal hemoglobins in relation to gestational age.

Cord blood samples were obtained at delivery in 44 normal women, at gestational periods ranging from 27 to 41 weeks. All women had a normal glucose screening test and 15 were delivered preterm. With the use of Biorex 70 chromatography, red cell lysates were analyzed to determine the percentages of the different hemoglobin (Hb) components, i.e., HbF1a+b, HbFlc, HbFo, and HbA. The percentage of HbFla+b in fetal blood was higher than the corresponding percentage in adult blood. The percentages and ratios of the various Hb components were compared in preterm and term fetuses and their correlation to gestational age was tested. HbF and HbF/A ratios were higher in preterm fetuses and were negatively correlated with gestational age. HbA and HbA/F ratios were lower in preterm fetuses than in term fetuses and correlated positively with gestational age. The percentages of minor components HbFla+b, and HbFlc were not significantly different in the preterm and the term fetuses, and they did not have statistically significant correlation with gestational age. However, the ratios of these minor hemoglobins to HbF, i.e., HbFla+b/HbF, and HbFlc/HbF and HbFl/HbF were found to be significantly higher in term fetuses as compared to preterm fetuses and to correlate positively with gestational age. This is probably due to the gradual lengthening of the life span of fetal erythrocytes as term approaches, which results in the erythrocytes' increased exposure to the glycolytic intermediates and possibly to glucose.

Erythrocytes↗
PubMed1981

Minor (glycosylated) hemoglobins in cord blood of infants of normal and diabetic mothers.

The levels of minor (glycosylated) hemoglobins in maternal blood during labor and in cord blood at delivery were determined in four groups of women: 20 normal, 22 probably normal, 20 Class A diabetic, and eight overt diabetic women. Maternal HbA, was not significantly increased in the diabetic patients, thereby reflecting adequate metabolic control. In the cord blood, the percentage of the minor hemoglobin HbF1c, which has been shown to be a mixture of acetylated glycosylated HbF, and the ratios HbF1c/HbF and HbA1/hbA were significantly increased in fetuses delivered of diabetic mothers. This supports the view that these fetuses are hyperglycemic in utero. However, there was no correlation between cord blood glycosylated hemoglobins and the birth weight ratio, a sensitive indicator of relative changes in the birth weight.

Adolescent↗
PubMed1981

Diabetic halo. A reversible ultrasonic sign.

Two pregnant women with poorly controlled diabetes mellitus were noted to have "edematous" fetuses on ultrasonography. There was abdominal wall "edema" in one and scalp "edema" in both fetuses. In light of what is known about the fetal body composition in diabetic pregnancies, we propose that this sonographic appearance reflects increased fat deposition, rather than accumulation of edema fluid, in the fetal subcutaneous tissue; it has been called "diabetic halo." In a patient who had been treated for eight weeks but not in another, in whom treatment was only for 1.5 weeks, these sonographic features were reversed. This is probably in decreased fat deposition in the fetus. We suggest that this ultrasonographic sign be added to our means of diagnosing uncontrolled diabetic pregnancies and of monitoring the degree of control in diabetic pregnancies.

Adult↗
PubMed1981

Postdatism.

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Delivery, Obstetric↗