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Biomedical subjects

S Haddad

Publications and source records attributed to S Haddad.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Delivery of women with cicatricial uterus].

Cesarean section rate has risen dramatically, particularly in the U.S., over the past 20 years, with results on maternal and perinatal mortality or morbidity and increase of delivery cost. To curb this inflation, trial of labor after cesarean section is proposed. Trial of labor often involves use of oxytocics. Regional analgesia is indicated for this high risk delivery. There are few absolute contra-indications to trial of labor and each case has to be analysed separately. Induction of labor leads to several advantages. The repeat cesarean section rate decreases significantly; this high risk delivery can take place during daytime with complete obsetetrical, anaesthetic and pediatric staff. The use of medication such as vaginal prostaglandins or mifepristone can also help lower this rate. X-ray pelvimetry must no longer be the major criterion for choosing the mode of delivery. Normality of labour must be judged according to previous vaginal delivery or not. Revision of uterine scar remains important for the diagnosis of dehiscence or rupture. This exploration should only be done if symptoms appear.

Cesarean Section↗
PubMed1996

A methodology for solving physiologically based pharmacokinetic models without the use of simulation softwares.

The objective of the present study was to develop and validate a methodology for solving physiologically based pharmacokinetic (PBPK) models without the use of simulation software. The approach involves keying the parameter values and model equations into Microsoft Excel spreadsheets, and conducting simulations by solving the model equations according to Euler's method of numerical integration. This approach was applied to simulate the pharmacokinetics of styrene in rats exposed to 80 and 600 ppm for 6 h. The simulation results were plotted along with experimental data using the regular graphic features available in Excel, and validated by comparing them with simulation results obtained using a commercially available software (Advanced Continuous Simulation Language, ACSL). The simulations obtained with ACSL and Excel, in general, differed by <1%. The methodology developed in the present study should help informed individuals understand and solve PBPK models, without having to use "black-box' kind of computer programs and simulation softwares.

Algorithms↗
PubMed1996

Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993.

OBJECTIVE: To review and analyze records on heterotopic pregnancy occurring after ovulation induction and assisted reproductive technologies. DATA IDENTIFICATION: Case reports in the English literature related to the topic were identified through a computerized bibliography search up to December 1993. CONCLUSIONS: The incidence of heterotopic pregnancies increased in recent years because of the escalating use of new reproductive technologies in infertile patients and has stabilized at approximately 1:100 pregnancies with these procedures. The main reasons for development of such a condition in these patients are past tubal or pelvic disease and multiple ovulations or multiple ET. Progress has been made in diagnosis of heterotopic pregnancy during the last two decades, mainly because of development of ultrasonographic techniques, especially transvaginal ultrasonography. Treatment of heterotopic pregnancy should be prompt to avoid maternal morbidity and mortality from extensive intraperitoneal bleeding. No increased intrauterine fetal mortality due to hemoperitoneum has been proven in the present review, except in advanced cornual pregnancies. More experience is needed for application of new treatment modalities such as salpingocentesis, which are used successfully for ectopic pregnancy, in treatment of heterotopic pregnancy. With early diagnosis and skillful treatment, the outcome of the intrauterine pregnancy is favorable and its survival rate should increase in the future.

Female↗
PubMed1996

Neurenteric cyst: antenatal diagnosis and therapeutic approach.

We hereby report the second case of antenatally diagnosed "neurenteric cyst" in the literature. The patient we describe presented as a neonatal respiratory distress syndrome (NRDS) which did not respond to a vigorous resuscitation. Anomaly of the antenatal ultrasonography and of the initial chest x-ray added to the non-response to therapy, led us to an urgent thoracic scan and to a lifesaving thoracotomy. We think that every posterior mediastinal cystic mass, with or without vertebral malformations, diagnosed antenatally, should raise the possibility of neurenteric cyst. The perinatal management of the newborn to be, will thus be simplified. This will lead to a better outcome.

Humans↗
PubMed1996

Direct effect of low-intensity pulsed ultrasound on pubertal rat seminal vesicle.

Pubertal male Wistar rats were submitted to bilateral castration and killed 7 or 14 days later; an additional group of castrated rats was submitted to ultrasound stimulation of the ventral region lying above the accessory sex glands, for 20 min a day from the 7th to the 14th day postcastration. Control intact rats were age-matched to the different treated groups. Seminal vesicle growth and secretory activity were investigated on the basis of weight and fructose content, respectively. A progressive fall in seminal vesicle weight was observed over a period of 7 (83% decrease) to 14 (92% decrease) days following castration; ultrasound treatment beginning on the 7th day prevented this additional weight reduction. Castration caused also a marked decrease (50-60%) in the fructose content of the seminal vesicle and the ultrasound energy promoted a partial recovery of the secretory activity of the gland. The results revealed a direct ultrasound stimulation of the seminal vesicle secretory activity in pubertal rats deprived of testicular androgens.

Animals↗
PubMed1996

The antenatal diagnosis of fetal atrial septal aneurysm.

Fetal atrial septal aneurysm (ASA) is uncommon and little is known regarding its prevalence and clinical significance. In this report we describe 2 cases of fetal ASA diagnosed by ultrasonography. They were referred for examination because of fetal tachyarrhythmia in 1 case, and polyhydramnios in the other. The first case had a normal outcome, while the other was associated with other congenital heart malformations. The literature as regards the diagnosis, prevalence, pathology, and clinical implications of ASA is discussed.

Adult↗
PubMed1996

The effects of a 4-year program promoting bicycle helmet use among children in Quebec.

OBJECTIVES: This study assessed the effectiveness of a 4-year program of bicycle helmet promotion that targeted elementary school children in one region of Quebec. The program revolved primarily around persuasive communication and community organization, combining standard educational activities and activities to facilitate helmet acquisition and use. METHODS: Helmet use was compared between more than 8000 young cyclists in municipalities exposed or not exposed to the program. Factors influencing helmet use were controlled through the use of multivariate analyses. RESULTS: Helmet use increased from 1.3% before program implementation to 33% in 1993. The program was clearly effective in most cycling circumstances and for various groups of children. However, the benefits of the program were unequally distributed; the program was one third as effective in poorer municipalities as in "average-rich" ones. CONCLUSIONS: This community-based program that combined various types of activities appeared to be effective. New intervention models are needed to ensure an equitable distribution of benefits.

Accidents, Traffic↗
PubMed1996

Spontaneous resolution of cholelithiasis in an infant.

Cholelithiasis is an extremely unusual finding in infancy. Hemolytic disease, bile duct abnormalities, intestinal malabsorption have been implicated. Recently, an association of prematurity, bronchopulmonary dysplasia, total parenteral nutrition and furosemide has been reported. Rarely, sonographic discovery of idiopathic gallstones and their subsequent spontaneous disappearance has been reported. We report a case of an 11-week-old infant whose initial sonogram displayed evidence of true gallstone, that later showed resolution on follow-up examinations. In the absence of clinical or imaging evidence of biliary tract disease, we suggest an initial conservative management and follow-up sonograms.

Age Factors↗
PubMed1995

Carbohydrate-deficient glycoprotein syndrome type II. An autosomal recessive N-acetylglucosaminyltransferase II deficiency different from typical hereditary erythroblastic multinuclearity, with a positive acidified-serum lysis test (HEMPAS).

Carbohydrate-deficient glycoprotein syndromes (CDGS) are a family of multisystemic congenital diseases resulting in underglycosylated glycoproteins, suggesting defective N-glycan assembly. Fibroblast extracts from two patients with a recently described variant of this disease (CDGS type II) have previously been shown to have over 98% reduced activity of UDP-GlcNAc:alpha-6-D-mannoside beta-1,2-N-acetylglucosaminyltransferase II [GlcNAc-TII; Jaeken, J., Schachter, H., Carchon, H., De Cock, P., Coddeville, B. & Spik, G. (1994) Arch. Dis. Childhood 71, 123-127]. We show in this paper that mononuclear cell extracts from one of these CDGS type-II patients have no detectable GlcNAc-TII activity and that similar extracts from 12 blood relatives of the patient, including his father, mother and brother, have GlcNAc-TII levels 32-67% that of normal levels (average 50.1% +/- 10.7% SD), consistent with an autosomal recessive disease. The poly(N-acetyllactosamine) content of erythrocyte membrane glycoproteins bands 3 and 4.5 of this CDGS patient were estimated, by tomato lectin blotting, to be reduced by 50% relative to samples obtained from blood relatives and normal controls. Similar to patients with hereditary erythroblastic multinuclearity with a positive acidified-serum lysis test (HEMPAS), erythrocyte membrane glycoproteins in the CDGS patient have increased reactivities with concanavalin A, demonstrating the presence of hybrid or oligomannose carbohydrate structures. However, bands 3 and 4.5 in HEMPAS erythrocytes have almost complete lack of poly(N-acetyllactosamine). Furthermore, CDGS type-II patients have a totally different clinical presentation and their erythrocytes do not show the serology typical of HEMPAS, suggesting that the genetic lesions responsible for these two diseases are possibly different.

Adolescent↗
PubMed1995

Quality, cost and utilization of health services in developing countries. A longitudinal study in Zaïre.

Many developing countries, particularly in Africa, have recently introduced payment schedules based on the selling of essential drugs. This is one of the main elements of the Bamako Initiative according to which the income generated would ensure a reliable supply of drugs and would improve other aspects of the quality of the services offered. Thus, quality improvements would compensate for the financial barrier and as a result the utilization of public health services would be increased or at least maintained. These hypotheses have proven to be partially valid, since there have been cases where the utilization of health services has increased and others where it has decreased; these inconclusive results have fuelled criticisms concerning the inequitable nature of these measures. This longitudinal study in a rural community of Zaïre shows that the utilization of health services had diminished by close to 40% over 5 yr (1987-1991) and that 18-32% of this decrease is explained by cost. The regular supply of drugs and the improvement in the technical quality of the services--technical qualification of the staff, allocation of microscopes, and renovation of the infrastructures--was not enough to compensate for the additional financial barriers created by the increased cost of services. However, on a local level, the interpersonal qualities displayed by some of the nurses sometimes helped to compensate for the negative effects of the costs, and even to increase the level of utilization of some health centres. The quality of public services has often been neglected in developing countries. While some attention is given to technical qualities, the interpersonal components of the quality of the services are generally ignored or underestimated by planners and they are the very components which are most resistant to change. It will be a major challenge for health systems to address this issue of quality of care in order to minimize the negative impact of the introduction of user payment schemes. Therefore, now is the time to place quality next to coverage in planners' agendas.

Adult↗
PubMed1995

Fetal urine production and micturition and fetal behavioral state.

The rate of fetal urine production and the incidence of fetal micturition was compared in periods of fetal sleep and awakeness. Sonography and fetal heart rate monitoring were concomitantly performed on 12 normal term pregnancies. Fetal bladder volumes were serially calculated, and the rate of urine production and micturition were compared between the periods of fetal sleep and awakeness. Fetal micturition occurred almost exclusively during periods of fetal awakeness (p = 0.001). There were no demonstrable differences in the rates of urine production during periods of fetal sleep and awakeness. Fetal micturition is behavioral-state dependent. Nevertheless, the fetal behavioral state is not a necessary consideration when applying urine production measurements as a test of fetal well-being.

Female↗
PubMed1995

Refractoriness to platelet transfusions in children with acute leukemia.

PURPOSE: We evaluated the incidence of clinically significant refractoriness to platelet transfusions in children with acute leukemia. PATIENTS AND METHODS: We reviewed the complete transfusion records up to July 1993 of all 213 patients diagnosed with acute leukemia at our institution over the 4-year period 1987 to 1990. The transfusion protocol called for all patients requiring transfusion of red cell and/or platelet concentrates to initially receive components that were not leukocyte reduced. Patients suspected clinically to be refractory to platelets were tested for anti-human leukocyte antigen (HLA) antibodies and those that tested positive were switched to HLA-matched platelets. RESULTS: Of 184 patients diagnosed with acute lymphoblastic leukemia (ALL), 133 (72%) required platelet support, whereas all 29 patients with acute myeloid leukemia (AML) were transfused with platelets. The incidence of clinically suspected refractoriness to non-leukocyte-reduced platelets, which was confirmed by a positive test for anti-HLA antibodies and which resulted in a switch to HLA-matched platelets, was nine of 29 (31%) for patients with AML but only three of 133 (2.3%) for patients with ALL. CONCLUSIONS: The results of this study indicate that clinically significant platelet refractoriness requiring transfusion of HLA-matched platelets occurs infrequently in childhood ALL. For this group of patients, use of leukocyte-depleted cellular components for the purpose of preventing platelet refractoriness cannot be justified. This approach may be appropriate for children with AML.

Adolescent↗
PubMed1995

Paromomycin-associated pancreatitis in HIV-related cryptosporidiosis.

OBJECTIVE: To report a case of pancreatitis related to paromomycin administration. CASE SUMMARY: A 39-year-old man with AIDS developed pancreatitis concurrent with successful treatment of intestinal cryptosporidiosis with paromomycin. The hyperamylasemia resolved with discontinuation of the agent and recurred when paromomycin treatment was reinstituted. DISCUSSION: To our knowledge, this is the first reported case of pancreatitis believed to be induced by paromomycin. Although pancreatitis in HIV-infected patients has multiple causes, the nature of this case suggests the involvement of paromomycin. The mechanism of action is unclear. CONCLUSIONS: Pancreatitis should be considered in the differential diagnosis of abdominal pain in patients who are treated with paromomycin.

AIDS-Related Opportunistic Infections↗
PubMed1994

Soft tissue signal abnormality associated with eosinophilic granuloma. Correlation of MR imaging with pathologic findings.

Six patients with eosinophilic granuloma were studied retrospectively in order to correlate the MRI appearances with the pathology. Ages ranged from 2 years 6 months to 11 years. The bones involved were the humerus, ulna, radius, femur, clavicle and ilium. Plain films, MRI and pathology specimens were obtained. A lytic lesion with indistinct margins, endosteal erosions and periosteal reaction was seen in all cases on plain radiographs. Bone marrow signal was decreased on T1-weighted images and increased on T2-weighted images throughout the bony lesion in all cases. T2-weighted images showed extensive soft-tissue abnormalities suggesting inflammatory changes in four cases. In two cases abnormalities were limited. Extensive changes correlated histologically with an early phase lesion. Localized minor changes were associated with a mid-phase lesion. Inflammatory soft-tissue changes could be associated with eosinophilic granuloma. The size of the soft tissue mass correlated well with the activity of the bony lesion.

Bone and Bones↗
PubMed1994

Legg-Perthes-Calvé disease: staging by MRI using gadolinium.

Twenty-one patients (26 hips) with typical signs of Legg-Perthes-Calvé (LPC) disease on plain radiographs were explored by MRI. Patients were imaged with a 0.5 T MR unit. Gadolinium-enhanced spin-echo MR images were obtained after nonenhanced T1-weighted (spin-echo) and T2*-weighted (gradient-echo) images. Four different areas were identified in the femoral epiphysis (necrosis, regenerative, cartilaginous and normal fatty bone tissue). The histological evolution of LPC is well described by Catterall and others. Comparing their descriptions with our MR findings, we suggest classification of LPC into five phases: necrosis: regeneration, reconstruction, reossification and sequelae.

Child↗
PubMed1994

Fetal urine production after induction of labor with prostaglandin E2.

The effect of prostaglandin E2 on fetal urine production was examined in women undergoing labor induction. An effect may be expected, because the administration of indomethacin, a potent antiprostaglandin, has been shown to cause a decrease in fetal urine production and subsequent oligohydramnios. The mean hourly fetal urine production before and 4 hours after vaginal application of prostaglandin E2 were similar (38 and 43 ml per hour, respectively). The application of prostaglandin E2 need not be taken into consideration when fetal urine production is assessed.

Administration, Intravaginal↗
PubMed1994

Comparison of a transfusion preparation of newly formed red cells and standard washed red cell transfusions in patients with homozygous beta-thalassemia.

BACKGROUND: Previous studies of transfusions of newly formed red cells (neocytes) demonstrated modest extensions of transfusion interval in patients with homozygous beta-thalassemia. STUDY DESIGN AND METHODS: The clinical benefits of a new system of neocyte preparation (Neocel, Cutter Biological, Berkeley, CA), reported to combine ease of preparation with reduction in the transfusion requirements of thalassemia patients, were evaluated. Sixteen thalassemic patients who had undergone splenectomy received eight consecutive, standard, automated, washed red cell transfusions (standard transfusions), followed by eight transfusions with the neocyte preparation (neocyte transfusions). In each arm of the study, mean pretransfusion hemoglobin and mean red cell mass transfused were carefully controlled and were similar. RESULTS: A significant (p < 0.0001) extension of transfusion interval was observed in patients receiving neocyte transfusions (mean +/- SD; 38.7 +/- 34 days; range, 35.0-44.5), over that in those receiving standard transfusions (32.9 +/- 2.5 days; range, 29.6-38.5). The mean prolongation of transfusion interval by neocyte transfusion corresponded to a mean reduction of 25 mL in packed red cells transfused per kg of body weight per patient per year and a mean reduction in transfused iron of 15 percent per year per patient. During neocyte transfusions, blood preparation costs were considerably increased and donor exposure was significantly (p < 0.0005) higher than during the standard transfusion period. CONCLUSION: These data demonstrate that extension of the transfusion interval, and reduction in transfused iron, may be achieved in thalassemic patients by use of the Neocel system. These benefits are achieved, however, with substantial increases in donor exposure and in component preparation costs.

Adolescent↗