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Nawfal K, Baba RE, Khalife D, Awwad J. Robotic Assisted Laparoscopic Repair of Isthmocele. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Farra C, Choucair F, Awwad J. Non-invasive pre-implantation genetic testing of human embryos: an emerging concept. Hum Reprod 2019; 33:2162-2167. [PMID: 30357338 DOI: 10.1093/humrep/dey314] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
The accurate genetic screening of pre-implantation embryos currently entails the use of technically challenging and biologically invasive biopsies of the human embryos. Investigating a more conservative sampling approach has emerged as a timely and desired alternative. Circulating cell-free embryonic DNA is present in the blastocoel fluid and spent culture media of blastocysts, and this has lately been sought as an attractive source of genetic information. The genetic analysis of cell-free embryonic DNA has been reported, to be useful in evaluating the genetic constitution of embryos; thus, providing a potential alternative to conventional biopsy-derived pre-implantation genetic testing (PGT). In this review, we have summarized these non-invasive alternative applications of PGT and discussed their current limitations and future clinical implications.
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Affiliation(s)
- C Farra
- Department of Pathology and Laboratory Medicine, Medical Genetics Unit, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
| | - F Choucair
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
| | - J Awwad
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
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Farra C, Choucair F, Awwad J. Corrigendum. Non-invasive pre-implantation genetic testing of human embryos: an emerging concept. Hum Reprod 2019; 34:590. [PMID: 30597000 DOI: 10.1093/humrep/dey385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Farra
- Department of Pathology and Laboratory Medicine, Medical Genetics Unit, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
| | - F Choucair
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
| | - J Awwad
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, American University of Beirut Medical Center, Riad El-Solh, Beirut, Lebanon
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Massaad E, Tfayli H, Awwad J, Nabulsi M, Farra C. Char Syndrome a novel mutation and new insights: A clinical report. Eur J Med Genet 2018; 62:103607. [PMID: 30579973 DOI: 10.1016/j.ejmg.2018.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/12/2018] [Accepted: 12/19/2018] [Indexed: 11/15/2022]
Abstract
Transcription Factor AP-2 Beta (TFAP2B) functions in the differentiation of neural crest cell derivatives and contributes to the embryogenesis of the ductus arteriosus. Mutations of TFAP2B produces Char syndrome. Char syndrome is an autosomal dominant disorder comprising facial dysmorphism, hand anomalies, and patent ductus arteriosus (PDA). In this report, we describe a proband with a de novo TFAP2B frameshift mutation c.650delG p.(Gly217Alafs*32) in the basic domain. The proband presented mainly with musculoskeletal features of Char syndrome. No PDA was identified at presentation suggesting that this syndrome may prove to be phenotypically heterogeneous. This report will help illustrate the genotype/phenotype correlation of TAFB2 mutations and better delineate the clinical features in Char syndrome.
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Affiliation(s)
- E Massaad
- Medical Genetics Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - H Tfayli
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Lebanon
| | - J Awwad
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Lebanon
| | - M Nabulsi
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Lebanon
| | - C Farra
- Medical Genetics Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon; Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Lebanon.
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Ghazeeri G, Abbas HA, Skaff B, Harajly S, Awwad J. Inadequacy of initiating rosuvastatin then metformin on biochemical profile of polycystic ovarian syndrome patients. J Endocrinol Invest 2015; 38:643-51. [PMID: 25722221 DOI: 10.1007/s40618-015-0237-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 12/31/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) afflicts at least 5% of women. Both metformin and statin have been used as methods to ameliorate symptoms and improve prognosis. AIM To test the efficacy of concomitant usage of metformin and statins in PCOS patients. MATERIALS AND METHODS This is a prospective, randomized, double-blinded, placebo controlled study. 37 patients received rosuvastatin (10 mg/day) for a period of 3 months, then the patients were randomly allocated to one of two groups: the first group (or intervention group) received rosuvastatin (10 mg/day) plus metformin (850 mg twice daily after meals), and the second group (referred to as control group hereafter) received rosuvastatin (10 mg/day) plus placebo for a period of 3 months. Biochemical and clinical data were collected at each time point. RESULTS There were no significant differences between the intervention and control groups for baseline lipid profile (LDL, HDL, triglycerides, total cholesterol), CRP, homocysteine, DHEAS, testosterone and insulin (p > 0.05 for all variables). There were no significant differences in lipid profile, CRP, homocysteine, DHEAS, testosterone and insulin between the intervention and placebo groups at 3 and 6 months after treatment (p > 0.05 for all). Significant differences in the outcome variables of LDL, total cholesterol and FBS emerged within the intervention group, with significantly higher levels at 6 months compared to 3 months. We also did not find any significant group differences in unit change of the outcome variables between baseline and 3 months. CONCLUSIONS We found that the combination of statin and metformin has no advantage in PCOS management. In fact, the increase of LDL, total cholesterol and FBS within the intervention group warrants reassessment of current regimens to avoid any patient harm.
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Affiliation(s)
- G Ghazeeri
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - H A Abbas
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - B Skaff
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - S Harajly
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
| | - J Awwad
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon
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Awwad J, Usta IM, Ghazeeri G, Yacoub N, Succar J, Hayek S, Saasouh W, Nassar AH. A randomised controlled double-blind clinical trial of 17-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestation (PROGESTWIN): evidence for reduced neonatal morbidity. BJOG 2014; 122:71-9. [PMID: 25163819 DOI: 10.1111/1471-0528.13031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether 17 alpha-hydroxyprogesterone caproate (17OHPC) prolongs gestation beyond 37 weeks of gestation (primary outcome) and reduces neonatal morbidity (secondary outcome) in twin pregnancy. DESIGN Randomised controlled double-blind clinical trial. SETTING Tertiary-care university medical centre. POPULATION Unselected women with twin pregnancies. METHODS Participants received weekly injections of 250 mg 17OHPC (n = 194) or placebo (n = 94), from 16-20 to 36 weeks of gestation. Randomisation was performed using the permuted-block randomisation method. Data were analysed on an intention-to-treat basis. MAIN OUTCOME MEASURE Preterm birth (PTB) rate before 37 weeks of gestation. RESULTS There were no significant differences in the average gestational age at delivery, or in the rates of PTB before 37, 32, and 28 weeks of gestation, between the two groups. The proportion of very-low-birthweight neonates (<1500 g) was significantly lower in the 17OHPC group (7.6%) compared with placebo (14.3%) (relative risk, RR 0.5; 95% confidence interval, 95% CI 0.3-0.9; P = 0.01). Progestogen-treated neonates had a significantly lower composite neonatal morbidity (19.1%) compared with placebo (30.9%) (odds ratio, OR 0.53; 95% CI 0.31-0.90; P = 0.02), with significantly lower odds for respiratory distress syndrome (14.4 versus 23.4%; OR 0.55; 95% CI 0.31-0.98; P = 0.04), retinopathy of prematurity (1.1 versus 4.6%; OR 0.21; 95% CI 0.05-0.96; P = 0.04), and culture-confirmed sepsis (3.4 versus 12.8%; OR 0.24; 95% CI 0.10-0.57; P = 0.00). CONCLUSIONS Intramuscular 17OHPC therapy did not reduce PTB before 37 weeks of gestation in unselected twin pregnancies. Nonetheless, 17OHPC significantly reduced neonatal morbidity parameters and increased birthweight.
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Affiliation(s)
- J Awwad
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Schuit E, Stock S, Rode L, Rouse DJ, Lim AC, Norman JE, Nassar AH, Serra V, Combs CA, Vayssiere C, Aboulghar MM, Wood S, Çetingöz E, Briery CM, Fonseca EB, Worda K, Tabor A, Thom EA, Caritis SN, Awwad J, Usta IM, Perales A, Meseguer J, Maurel K, Garite T, Aboulghar MA, Amin YM, Ross S, Cam C, Karateke A, Morrison JC, Magann EF, Nicolaides KH, Zuithoff NPA, Groenwold RHH, Moons KGM, Kwee A, Mol BWJ. Effectiveness of progestogens to improve perinatal outcome in twin pregnancies: an individual participant data meta-analysis. BJOG 2014; 122:27-37. [PMID: 25145491 DOI: 10.1111/1471-0528.13032] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In twin pregnancies, the rates of adverse perinatal outcome and subsequent long-term morbidity are substantial, and mainly result from preterm birth (PTB). OBJECTIVES To assess the effectiveness of progestogen treatment in the prevention of neonatal morbidity or PTB in twin pregnancies using individual participant data meta-analysis (IPDMA). SEARCH STRATEGY We searched international scientific databases, trial registration websites, and references of identified articles. SELECTION CRITERIA Randomised clinical trials (RCTs) of 17-hydroxyprogesterone caproate (17Pc) or vaginally administered natural progesterone, compared with placebo or no treatment. DATA COLLECTION AND ANALYSIS Investigators of identified RCTs were asked to share their IPD. The primary outcome was a composite of perinatal mortality and severe neonatal morbidity. Prespecified subgroup analyses were performed for chorionicity, cervical length, and prior spontaneous PTB. MAIN RESULTS Thirteen trials included 3768 women and their 7536 babies. Neither 17Pc nor vaginal progesterone reduced the incidence of adverse perinatal outcome (17Pc relative risk, RR 1.1; 95% confidence interval, 95% CI 0.97-1.4, vaginal progesterone RR 0.97; 95% CI 0.77-1.2). In a subgroup of women with a cervical length of ≤25 mm, vaginal progesterone reduced adverse perinatal outcome when cervical length was measured at randomisation (15/56 versus 22/60; RR 0.57; 95% CI 0.47-0.70) or before 24 weeks of gestation (14/52 versus 21/56; RR 0.56; 95% CI 0.42-0.75). AUTHOR'S CONCLUSIONS In unselected women with an uncomplicated twin gestation, treatment with progestogens (intramuscular 17Pc or vaginal natural progesterone) does not improve perinatal outcome. Vaginal progesterone may be effective in the reduction of adverse perinatal outcome in women with a cervical length of ≤25 mm; however, further research is warranted to confirm this finding.
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Affiliation(s)
- E Schuit
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Obstetrics and Gynaecology, Academic Medical Centre Amsterdam, Amsterdam, the Netherlands
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Farra C, Nassar A, Arawi T, Ashkar H, Monsef C, Awwad J. The utilization of pre-implantation genetic testing in the absence of governance: a real-time experience. Clin Genet 2013; 86:177-80. [DOI: 10.1111/cge.12250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Farra
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - A. Nassar
- Department of Obstetrics and Gynecology
| | - T. Arawi
- Salim El-Hoss Bioethics and Professionalism Program; American University of Beirut Faculty of Medicine; Beirut Lebanon
| | - H. Ashkar
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - C. Monsef
- Human Genetics Unit, Department of Pathology and Laboratory Medicine
| | - J. Awwad
- Department of Obstetrics and Gynecology
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Van Parys H, Wyverkens E, Provoost V, Ravelingien A, Raes I, Somers S, Stuyver I, De Sutter P, Pennings G, Buysse A, Anttila VS, Salevaara M, Suikkari AM, Listijono DR, Mooney S, Chapman MG, Res Muravec U, Pusica S, Lomsek M, Cizek Sajko M, Parames S, Semiao-Francisco L, Sato H, Ueno J, van den Wijngaard L, Mochtar MH, van Dam H, van der Veen F, van Wely M, Derks-Smeets IAP, Habets JJG, Tibben A, Tjan-Heijnen VCG, Meijer-Hoogeveen M, Geraedts JPM, van Golde R, Gomez-Garcia E, de Die-Smulders CEM, van Osch LADM, Habets JJG, Derks-Smeets IAP, Tibben A, Tjan-Heijnen VCG, Geraedts JPM, van Golde R, Gomez-Garcia E, Kets CM, de Die-Smulders CEM, van Osch LADM, Gullo S, Donarelli Z, Coco GL, Marino A, Volpes A, Sammartano F, Allegra A, Nekkebroeck J, Tournaye H, Stoop D, Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Coffaro F, Allegra A, Diaz DG, Gonzalez MA, Tirado M, Chamorro S, Dolz P, Gil MA, Ballesteros A, Velilla E, Castello C, Moina N, Lopez-Teijon M, Chan CHY, Chan CLW, Leong MKH, Cheung IKM, Chan THY, Hui BNL, van Dongen AJCM, Huppelschoten AG, Kremer JAM, Nelen WLDM, Verhaak CM, Sun HG, Lee KH, Park IH, Kim SG, Lee JH, Kim YY, Kim HJ, Cho JD, Yoo YJ, Frokjaer V, Pinborg A, Larsen EC, Heede M, Stenbaek DS, Henningsson S, Nielsen AP, Svarer C, Holst KK, Knudsen GM, Emery M, DeJonckheere L, Rothen S, Wisard M, Germond M, Stenbaek DS, Toftager M, Hjordt LV, Jensen PS, Holst K, Holland T, Bryndorf T, Bogstad J, Hornnes P, Frokjaer VG, Dornelles LMN, MacCallum F, Lopes RCS, Piccinini CA, Passos EP, Bruegge C, Thorn P, Daniels K, Imrie S, Jadva V, Golombok S, Arens Y, De Krom G, Van Golde RJT, Coonen E, Van Ravenswaaij-Arts CMA, Meijer-Hoogeveen M, Evers JLH, Geraedts JPM, De Die-Smulders CEM, Ghazeeri G, Awwad J, Fakih A, Abbas H, Harajly S, Tawidian L, Maalouf F, Ajdukovic D, Pibernik-Okanovic M, Alebic MS, Baccino G, Calatayud C, Ricciarelli E, de Miguel ERH, Stuyver I, Wierckx K, Verstraelen H, Van Glabeke L, Van den Abbeel E, Gerris J, T'Sjoen G, De Sutter P, Monica B, Calonge RN, Peregrin PC, Cserepes R, Kollar J, Wischmann T, Bugan A, Pinkard C, Harrison C, Bunting L, Boivin J, Fulford B, Boivin J, Theusink-Kirchhoff N, van Ravenswaaij-Arts CMA, Bakker MK, Volks C, Papaligoura Z, Papadatou D, Bellali TH, Thorn P, Wischmann T, Wischmann T, Thorn P, Jarvholm S, Broberg M, Thurin-Kjellberg A, Weitzman G, Van Der Putten-Landau TM, Chudnoff S, Panagopoulou E, Tarlatzis B, Tamhankar V, Jones GL, Magill P, Skull JD, Ledger W, Hvidman HW, Specht IO, Pinborg A, Schmidt KT, Larsen EC, Andersen AN, Freeman T, Zadeh S, Smith V, Golombok S, Whitaker LHR, Reid J, Wilson J, Critchley HOD, Horne AW, Zadeh S, Freeman T, Smith V, Golombok S, Peterson B, Pirritano M, Schmidt L, Volgsten H, Wyverkens E, Van Parys H, Provoost V, Ravelingien A, Raes I, Somers S, Stuyver I, Pennings G, De Sutter P, Buysse A, Hudson N, Culley L, Law C, Denny E, Mitchell H, Baumgarten M, Raine-Fenning N, Blake L, Jadva V, Golombok S, Lee KH, Sun HG, Park IH, Kim SG, Lee JH, Kim YY, Kim HJ, Kim KH. Psychology and counselling. Hum Reprod 2013. [DOI: 10.1093/humrep/det218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Usta IM, Awwad J, Nassar AH. Design and statistical analysis of observational studies. BJOG 2013; 120:901-2. [PMID: 23659329 DOI: 10.1111/1471-0528.12144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2012] [Indexed: 11/26/2022]
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Awwad J, Farra C, Hannoun A, Abou-Abdallah M, Isaacson K, Ghazeeri G. Idiopathic premature ovarian failure: what is the most suitable ovarian stimulation protocol? CLIN EXP OBSTET GYN 2013; 40:327-330. [PMID: 24283158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate the ovarian response to ovarian stimulation in women with idiopathic premature ovarian failure (POF) in a prospective, controlled, and sequential crossover pilot study. MATERIALS AND METHODS Ten women with idiopathic premature ovarian failure and normal karyotype were included in the study. Phase I was comprised of three consecutive control cycles consisting each of estrogen progestin sequential therapy. Phase II was comprised of three consecutive treatment cycles combining the use of gonadotropin-releasing hormone agonist (GnRHa) in the background of estrogen priming, followed by gonadotropin ovarian stimulation and corticosteroid immunosuppression. RESULTS Ovulation rates in the treatment cycles (0/10; 0%) did not differ from control cycles (0/10; 0%). CONCLUSIONS The findings of this pilot study showed that the combination of estrogen priming, corticosteroid immune-suppression, GnRHa pituitary desensitization, and followed by gonadotropin ovarian stimulation is ineffective in restoring ovarian function in women with idiopathic POF.
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Affiliation(s)
- J Awwad
- Reproductive Endocrinology and Infertility, American University of Beirut Medical Center, Beirut, Lebanon
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Awwad J, Usta IM, Succar J, Musallam KM, Ghazeeri G, Nassar AH. The effect of maternal fasting during Ramadan on preterm delivery: a prospective cohort study. BJOG 2012; 119:1379-86. [DOI: 10.1111/j.1471-0528.2012.03438.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Farra C, Awwad J, Fadlallah A, Sebaly G, Hage G, Souaid M, Ashkar H, Medlej R, Gannageh MH, Halaby G. Genetics of autoimmune thyroid disease in the Lebanese population. J Community Genet 2012; 3:259-64. [PMID: 22392440 DOI: 10.1007/s12687-012-0085-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 02/16/2012] [Indexed: 12/17/2022] Open
Abstract
This study aims to investigate the association of human leukocyte antigen (HLA) class II genes and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) with autoimmune thyroid diseases in the Lebanese population. A total of 128 patients with autoimmune thyroid disease (55 with Graves' disease (GD) and 73 with Hashimoto's thyroiditis (HT)) were typed for HLA DQA1 (0301 and 0501) and DQB1 (0201, 0302, and 0303) and for 49A/G CTLA-4 using PCR-based sequence-specific priming methods. A total of 186 matched controls were typed for the same alleles and compared to the diseased population. Results showed no significant differences in HLA DQB1*0201 or DQB1*0301 allelic frequencies or CTLA-4 polymorphisms between patients and controls. For GD, there was a weak association with HLA DQB1*0302 [34.6% (19 of 55) vs. 21.5% (40 of 186), P = 0.048, odds ratio (OR) = 1.926, confidence interval (CI) = 0.999-3.715] and HLA DQB1*0302-DQA1*0501 haplotype [56.36% (31 of 55) vs. 40.8% (76 of 186), P = 0.042, OR = 1.870, CI = 1.018-3.433]. For HT, the frequencies of DQB1*0302-DQA1*0501 haplotype [28.8% (21of 73) vs. 14.5% (27 of 186), P = 0.008, OR = 2.378, CI = 1.241-4.558] and DQB1*0302-DQA1*0301 haplotype [60.2% (44 of 73) vs. 38.7% (72 of 186), P = 0.002, OR = 2.402, CI = 1.381-4.180] were significantly higher in patients. On the other hand, weak association was found between HT and DQA1*0301 allele [32.9% (24 of 73) vs. 20.9% (39 of 186), P = 0.044, OR = 1.846, CI = 1.011-3.373]. Findings show that DQB1*0302-DQA1*0501 and DQB1*0302-DQA1*0301 haplotypes may play a role in the pathogenesis of HT in the Lebanese population. For the 49A/G CTLA-4 polymorphism, no significant difference was found between patients and controls.
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Affiliation(s)
- C Farra
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Nassar AH, Awwad J, Khalil AM, Abu-Musa A, Mehio G, Usta IM. A randomised comparison of patient satisfaction with vaginal and sublingual misoprostol for induction of labour at term*. BJOG 2007; 114:1215-21. [PMID: 17877674 DOI: 10.1111/j.1471-0528.2007.01492.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare patient satisfaction with two routes of misoprostol for term labour induction. DESIGN Prospective randomised trial. SETTING Tertiary care hospital. POPULATION A total of 170 women admitted at > or = 37 weeks of gestation for induction of labour. METHODS Women were randomised to receive 50 micrograms of either sublingual or vaginal misoprostol. MAIN OUTCOME MEASURES Patient satisfaction with the route of administration. RESULTS Despite a similar proportion reporting the labour induction as more painful than expected in both groups, a significantly lower proportion mentioned that the pelvic examinations were very painful in the sublingual group (19.7 versus 36.1%, relative risk [RR] 0.5, 95% CI 0.3-0.9). Request for analgesia was similar in both groups. More women in the sublingual group thought that the labour experience was better than expected (RR 2.0, 95% CI 1.2-3.3), had a positive attitude towards induction in subsequent pregnancies (RR 1.6, 95% CI 1.1-2.3) and preferred the same route in subsequent pregnancies (RR 3.1, 95% CI 2.2-4.5). Mean number of misoprostol doses, oxytocin augmentation, tachysystole and hyperstimulation, induction to vaginal delivery interval, vaginal delivery after a single dose, vaginal birth within 12 and 24 hours, and caesarean delivery rates were similar in both groups. CONCLUSION Sublingual misoprostol (50 micrograms) is associated with a significantly higher patient satisfaction rate compared with a similar dose of vaginal misoprostol. Sublingual administration offers additional choice to women, in particular those wishing to avoid vaginal administration.
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Affiliation(s)
- A H Nassar
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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Farra C, Awwad J, Valent A, Lozach F, Bernheim A. Complex translocation (8;12;21): a new variant of t(8;21) in acute myeloid leukemia. ACTA ACUST UNITED AC 2004; 155:138-42. [PMID: 15571799 DOI: 10.1016/j.cancergencyto.2004.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2003] [Revised: 03/23/2004] [Accepted: 03/24/2004] [Indexed: 11/27/2022]
Abstract
Variants of the t(8;21)(q22;q22) involving chromosomes 8, 21, and other chromosomes account for approximately 3% of all t(8;21)(q22;q22) in acute myeloid leukemia (AML) patients. In this paper, we report a case of AML-M2 with a t(8;12;21)(q22;p12 approximately p13;q22) associated with chromosomal abnormalities, including loss of the Y chromosome and trisomy 8q22 approximately qter. Using a dual-color fluorescence in situ hybridization (FISH) analysis with ETO and AML1 probes, we demonstrated an ETO/AML1 fusion signal on the derivative chromosome 8. Using whole painting probes for chromosomes 8 and 12, we demonstrated a three-way translocation, t(8;12;21)(q22;p12 approximately p13;q22). Reverse transcription polymerase chain reaction (RT-PCR) analysis showed the presence of AML1/ETO fusion transcript. The present case highlights the importance of the combination of approaches, i.e., standard karyotyping, FISH, and RT-PCR, for the detection of variants of t(8;21)(q22;q22), shedding light on region 8q22 approximately qter which could harbor potential genes responsible for leukemogenesis.
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MESH Headings
- Adult
- Age of Onset
- Bone Marrow/pathology
- Chromosomes, Human, Pair 12
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Codon, Terminator
- Core Binding Factor Alpha 2 Subunit
- DNA Probes
- Electrophoresis, Agar Gel
- Genetic Variation
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/genetics
- Oncogene Proteins, Fusion/genetics
- RUNX1 Translocation Partner 1 Protein
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription Factors/genetics
- Translocation, Genetic
- Trisomy/diagnosis
- Trisomy/genetics
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Affiliation(s)
- C Farra
- Research Genetic Laboratory, Chronic Care Center, Research Genetic Laboratory, Hazmieh, Lebanon.
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16
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Abstract
Premature ovarian failure (POF) may be due to a variety of genetic mechanisms. We report here, for the first time, telomere association of the long arms of chromosome 19, identified at low frequency (1%) in the peripheral blood cultures of a 30-year-old female with POF. Repeat cultures identified, in addition, the presence of 16q and 22q associations at a lower frequency (0.5%). These consistent observations are suggestive of a non-random event. Their association with POF may just be coincidental or may hypothetically explain it by an abnormal mechanism of chromosome separation, a constitutional telomere anomaly or an unidentified chromosome instability disorder.
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Affiliation(s)
- L Zahed
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon.
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17
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Abstract
PURPOSE To prospectively follow a group of women with breast cancer on tamoxifen for the development of ovarian cysts. METHODS 72 women were followed every 6 months with pelvic examination and vaginal ultrasound. Chi square and Student's t-test were used for statistical analysis. RESULTS The duration of treatment was 31.5+/-20 months. The mean age was 51.2+/-9.8 years. 55.6% were post-menopausal. Out of 72 women, 18 (25%) developed ovarian cysts. The mean age of women who developed ovarian cysts was significantly lower than in those who did not (47.0+/-7.0 and 52.5+/-10.2 years, respectively, P=0.03), however, the mean duration of treatment was not significantly different (33.3+/-17.4 and 29.3+/-20 months, respectively, P=0.45). Out of 32, 14 (43.8%) pre-menopausal and out of 40, 4 (10%) post-menopausal women developed ovarian cysts (P=0.003). They developed the cysts after an average duration of 33.3+/-18 and 50.7+/-6.2 months, respectively (P=0.7). The average diameter of the cysts was 2.8+/-1.2 cm. All cysts were simple except for one pre-menopausal women. All the cysts in post-menopausal women resolved spontaneously. One pre-menopausal patient had a multi-loculated cyst, was operated and had a serious cystadenoma. In nine patients, the cysts resolved spontaneously and in three after discontinuation of tamoxifen, and one patient was lost to follow-up. All cysts were asymptomatic. CONCLUSION Ovarian cysts frequently develop in women with breast cancer on tamoxifen. The majority of the cysts resolve spontaneously, therefore an expectant management with follow-up ultrasonography is recommended.
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Affiliation(s)
- M Seoud
- Department of Obstetrics and Gynecology, American University of Beirut, Medical Center, C/O NY Office, 850 Third Avenue, New York, NW 10022, USA.
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Khalil A, Ghazeeri G, Chammas M, Usta I, Awwad J, Seoud M. Teflonoma presenting as a cystourethrocele. CLIN EXP OBSTET GYN 2001; 28:58-9. [PMID: 11332593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We report an unusual case of teflonoma which appeared three years after teflon injection and presented as cystourethrocele. The pathology confirmed the presence of a giant cell reaction compatible with a teflonoma.
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Affiliation(s)
- A Khalil
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Lebanon
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Hannoun A, Abu Musa A, Awwad J, Kaspar H, Khalil A. Clomiphene citrate challenge test: cycle to cycle variability of cycle day 10 follicle stimulating hormone level. CLIN EXP OBSTET GYN 1999; 25:155-6. [PMID: 9987578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The clomiphene citrate challenge test (CCCT), a means of assessing ovarian reserve, was shown by several studies to have an excellent predictive value for achieving conception in natural cycles, during ovulation induction and in-vitro fertilization cycles. Accordingly we elected to study the cycle to cycle variability of CCCT so as to determine the reliability of a single CCCT result. Two groups of patients were studied, the first (n = 40) were those patients who were performing the test because it was indicated, and the second (n = 24) were those who were receiving clomiphene citrate for ovulation induction. In both groups CCCT intercycle variability was significant in 75% of the cases, but this variability altered the prognostic values of the test in only 40% of the first group. In conclusion, our study showed a high percentage of intercycle variability of CCCT but further studies are needed to evaluate the influence of this variability on potential conception.
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Affiliation(s)
- A Hannoun
- Department of Obstetrics and Gynecology, American University of Beirut, Medical Centre, Lebanon
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20
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Abstract
With improvements in fetal screening techniques, urachal anomalies can now be detected antenatally. Characteristic sonographic features of a urachal cyst in utero are described.
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Affiliation(s)
- J Awwad
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Lebanon
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