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Medawar N, Abdallah R, Kobaiter Maarawi S, Maarawi J. Intrathecal Baclofen therapy for refractory spasticity: a case series. World Neurosurg 2024:S1878-8750(24)00762-9. [PMID: 38734171 DOI: 10.1016/j.wneu.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/14/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Management of refractory spasticity symptoms remains a challenging task for clinicians. ITB therapy has emerged as a promising option for treating this condition. This study evaluates the effectiveness of ITB therapy in managing refractory spasticity symptoms. MATERIALS AND METHODS A retrospective chart review was conducted on 34 patients with refractory spasticity symptoms who underwent ITB therapy at a single institution. The patients' demographics, clinical characteristics, and dosages were recorded. The primary outcome measures were the reduction in pain, improvement in mobility, decrease in spasm frequency, and alleviation of spasticity. RESULTS ITB therapy successfully reduced pain, improved mobility, decreased spasm frequency, and alleviated spasticity. The mean daily administered dose was 245μg (range: 88-510μg, SD:104). However, it was observed that the appropriate dosage of ITB therapy was patient-specific and time-sensitive. Moreover, side effects were observed when an incorrect dose was administered. CONCLUSION Intrathecal baclofen therapy is an effective and safe option for managing refractory spasticity symptoms. However, the appropriate dosage should be individualized and monitored closely to avoid side effects. This study highlights the importance of carefully considering the potential risks and benefits of ITB therapy for each patient.
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Affiliation(s)
- Nicolas Medawar
- Faculty of medicine, Saint Joseph University, Beirut, Lebanon.
| | - Ralph Abdallah
- Faculty of arts and sciences, University of Toronto, Toronto, Canada
| | - Sandra Kobaiter Maarawi
- Laboratory of Research in Neuroscience (LAREN), Pôle Technologie Santé (PTS), Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Maarawi
- Department of Neurosurgery, Hôtel-Dieu de France Hospital, Beirut, Lebanon
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Yammine K, Abdallah R, Stiban S, Helou M, Hayek F, Assi C. Monitoring negative pressure wound therapy for diabetic foot ulcers using WhatsApp. J Tissue Viability 2024; 33:1-4. [PMID: 38220561 DOI: 10.1016/j.jtv.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
Foot complications of patients with diabetes could lead to amputations and early death. Diabetic foot ulcers (DFU) are usually difficult to treat and impose huge financial burden. Monitoring wound progress is the mainstay of any treatment and alternatives to face-to-face consultations such as tele-medicine have been proposed. Very few papers explored the utility and effectiveness of monitoring DFU through instant messaging application such as WhatsApp. The aim of this study is to evaluate the validity of WhatsApp in monitoring diabetic wounds treated with negative pressure wound therapy (NPWT). Twenty-two patients were prospectively recruited. All patients had an initial face-to-face consultation and debridement. Dressings were changed twice per week at patient's residence and media files were sent by the wound nurse via Short Message Service (SMS). A subsequent face to face consultation was scheduled whenever a complication was suspected. The primary outcomes were the percentages of accurate cases a) where a new or recurrent infection was suspected, and a b) where a debridement was thought to be needed. Complete healing of the defect using NPWT was achieved in 10 patients and a skin graft procedure was needed in another 4 patients. Five patients needed further surgical debridement. Failure to heal was observed in 3 patients. Out of the seven cases where a new infection was suspected, five (71.5%) were confirmed on face-to-face consultation. No confirmed cases of infection were observed during follow-up for those estimated as clean. Out of the 11 cases where debridement was favored based on WhatsApp media files, confirmation of a needed debridement was recorded in 8 (73%) cases. NPWT monitoring of for diabetic foot and leg ulcers using WhatsApp application was found to be an excellent method to document and track the wound process and complications. The excellent specificity and high sensibility should encourage for common use by healthcare. The results of this study could be also valuable for patients living in rural areas and in case of future pandemics.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon; Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon.
| | - Ralph Abdallah
- Faculty of Arts and Science, University of Toronto, Canada
| | - Sonia Stiban
- Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Mariana Helou
- Department of Emergency Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
| | - Fady Hayek
- Division Vascular Surgery, Department General Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
| | - Chahine Assi
- Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Lebanon
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Boissiere L, Guevara-Villazón F, Bourghli A, Abdallah R, Pellise F, Pizones J, Alanay A, Kleinstueck F, Larrieu D, Obeid I. Rod angulation does not reflect sagittal curvature in adult spinal deformity surgery: comparison of lumbar lordosis and rod contouring. Eur Spine J 2023; 32:3666-3672. [PMID: 37278877 DOI: 10.1007/s00586-023-07791-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/26/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVE Relationship between rod and spinal shape in the sagittal plane in adult spinal deformity (ASD) surgery. BACKGROUND Corrective surgery for adult spinal deformity (ASD) involves the use of contoured rods to correct and modify the spinal curvatures. Adequate rod bending is crucial for achieving optimal correction. The correlation between rods and spinal shape in long constructs has not been reported previously. METHODS We conducted a retrospective analysis of a prospective, multicenter database of patients who underwent surgery for ASD. The inclusion criteria were patients who underwent pelvic fixation and had an upper instrumented vertebra at or above T12. Pre- and post-operative standing radiographs were used to assess lumbar lordosis at the L4S1 and L1S1 levels. The angle between the tangents to the rod at the L1, L4, and S1 pedicles was calculated to determine the L4S1 and L1S1 rod lordosis. The difference between the lumbar lordosis (LL) and the rod lordosis (RL) was calculated as ΔL = LL-RL. The correlation between this difference (ΔL) and various characteristics was analyzed using descriptive and statistical methods. RESULTS Eighty-three patients were included in the study, resulting in 166 analyzed differences (ΔL) between the rod and spinal lordosis. The values for rod lordosis were found to be both greater and lesser than those of the spine but were mostly lower. The range for total ΔL was -24 °-30.9 °, with a mean absolute ΔL of 7.8 ° for L1S1 (standard deviation (SD) = 6.0) and 9.1 ° for L4S1 (SD = 6.8). In 46% of patients, both rods had a ΔL of over 5 °, and over 60% had at least one rod with a ΔL difference of over 5 °. Factors found to be related to a higher ΔL included postoperative higher lumbar lordosis, presence of osteotomies, higher corrected degrees, older age, and thinner rods. Multivariate analysis correlated only higher postoperative L1S1 lordosis with higher ΔL. No correlation was found between a higher ΔL and sagittal imbalance. CONCLUSIONS Variations between spinal and rod curvatures were observed despite the linear regression correlation. The shape of the rod does not seem to be predictive of the shape of the spine in the sagittal plane in ASD long-construct surgeries. Several factors, other than rod contouring, are involved in explaining the postoperative shape of the spine. The observed variation calls into question the fundamentals of the ideal rod concept.
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Affiliation(s)
- Louis Boissiere
- Elsan, Polylinique Jean Villar Bruges, Bruges-Bordeaux, France
| | | | - Anouar Bourghli
- Spine Surgey Department King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ralph Abdallah
- Elsan, Polylinique Jean Villar Bruges, Bruges-Bordeaux, France
| | - Ferran Pellise
- Spine Surgery Unit, Hospital Vall d'Hebron, Barcelona, Spain
| | - Javier Pizones
- Spine Surgery Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Ahmet Alanay
- Spine Surgery Unit, Acibadem University, Istanbul, Turkey
| | - Frank Kleinstueck
- Department of Orthopedics and Neurosurgery, Spine Center, Schulthess Clinic, Zurich, Switzerland
| | - Daniel Larrieu
- Elsan, Polylinique Jean Villar Bruges, Bruges-Bordeaux, France
| | - Ibrahim Obeid
- Elsan, Polylinique Jean Villar Bruges, Bruges-Bordeaux, France.
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Ghandour M, Semaan K, Saad E, Horsch A, Abdallah R, Semaan D. Clinicodemographic characteristics of extraosseous ewing sarcoma: A comparative meta-analysis of pediatric and adult patients. J Orthop 2023; 44:86-92. [PMID: 37731676 PMCID: PMC10507075 DOI: 10.1016/j.jor.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
Background Evidence suggests different presentation patterns and prognosis of extraosseous Ewing Sarcoma (EES) based on age. Thus, we carried out this study to test the difference between children and adult EES cases regarding clinicodemographic characteristics and prognosis. Methods A total of 4 databases were explored yielding 18 relevant studies for data synthesis. Outcomes included the comparison of demographic and clinical characteristics as well as prognosis between children and adults with EES. Log odds ratio (logOR) and its 95% confidence interval (CI) were pooled across studies. Statistical models/methods were selected based on heterogeneity. Results Our analysis included a total of 1261 children and 1256 adults. When we compared these two age categories, we did not observe a significant difference in the risk of developing EES [logOR = -0.13; 95% CI: -0.65: 0.39; I2 = 88.42%]. No significant differences regarding gender, tumor location, and size (≤5 vs. >5 cm), EWSR1 positivity, or management modality. We did not observe significant difference regarding clinical outcomes, such as 5-year overall survival and event-free survival, recurrence, mortality, no evidence of disease, and secondary metastasis. Conclusions Our findings highlight the absence of an association between the age category of patients and the incidence of EES, as well as its clinical outcomes.
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Affiliation(s)
- Maher Ghandour
- Orthopedics Department, Heidelberg University Hospital, Germany
- Orthopedics Department, Lebanese University, Lebanon
| | - Karl Semaan
- Medicine, Université Saint Joseph, Beirut, Lebanon
| | - Eddy Saad
- Medicine, Université Saint Joseph, Beirut, Lebanon
| | - Axel Horsch
- Orthopedics Department, Heidelberg University Hospital, Germany
| | | | - Doumit Semaan
- Orthopedics Department, Lebanese University, Lebanon
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Soliman M, Abdallah R, Megahed A, Malik A, Shaibani A, Botts M, Hurley M, Ansari S. Abstract No. 238 General anesthesia versus moderate sedation as predictors of functional outcome after intracranial thrombectomy procedures. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.319] [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: 11/30/2022] Open
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Baboudjian M, Gondran-Tellier B, Abdallah R, Tadrist A, Sichez P, Akiki A, Gaillet S, Delaporte V, Karsenty G, Lechevallier E, Boissier R. Single use and reusable flexible ureteroscopies for the treatment of urinary stones: A comparative study of perioperative complications. Prog Urol 2021; 31:368-373. [DOI: 10.1016/j.purol.2020.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/22/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
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Gondran-Tellier B, Abdallah R, Sichez PC, Akiki A, Toledano H, Gaillet S, Delaporte V, Karsenty G, Bastide C, Daniel L, Garcia S, Rossi D, Lechevallier E, Boissier R, Baboudjian M. Continuous saline bladder irrigation after blue light transurethral resection of bladder tumor increases recurrence-free survival in low- to intermediate-risk non-muscle invasive bladder cancer. Prog Urol 2021; 31:316-323. [PMID: 33663939 DOI: 10.1016/j.purol.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/21/2020] [Revised: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the efficacy of Continuous Saline Bladder Irrigation (CSBI) after blue light transurethral resection of bladder tumor (TURBT) to prevent recurrence of low- to intermediate-risk Non-Muscle Invasive Bladder Cancer (NMIBC). PATIENTS AND METHODS We conducted a retrospective study including patients with low- to intermediate-risk NMIBC who underwent TURBT in two urological centers between January 2017 and December 2018. Each TURBT was performed using blue light after intravesical instillation of hexaminolaevulinic acid. The experimental group included patients who received CSBI while the control group included patients without CSBI. When practice, CSBI was started immediately after the surgery and was interrupted 24 hours thereafter. Low-risk NMIBC had a surveillance while intermediate NMIBC had 8 adjuvant endovesical instillations of Mitomycin. The primary endpoint was bladder tumor recurrence free-survival which was defined as the time between the initial TURBT and the date of TURBT for bladder recurrence. RESULTS A total of 167 patients (median age: 71 years) were included: 20% female, 15% low-risk, 85% intermediate-risk NMIBC. CSBI was performed in 95 cases (57%). No complication related to irrigation was reported. Bladder recurrence was observed in 55 cases (32.9%): 22 (23.1%) in the CSBI group vs. 33 (45.8%) in the control group (P=0.002). Multivariate stepwise logistic regression analysis with backward selection revealed that CSBI (HR 0.47 [0.27-0.81]; P=0.006) and MMC (HR 0.55 [0.31-0.95]; P=0.034) were significantly associated with reduced risk of bladder recurrence. CONCLUSIONS Continuous saline bladder irrigation reduced the risk of bladder recurrence after blue light TURBT in patients with low- to intermediate-risk NMIBC while being safe. Prospective randomized study is needed to confirm these results. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- B Gondran-Tellier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - R Abdallah
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - P C Sichez
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - A Akiki
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - H Toledano
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - S Gaillet
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - V Delaporte
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - G Karsenty
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - C Bastide
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - L Daniel
- Department of Pathological Anatomy and Cytology, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - S Garcia
- Department of Pathological Anatomy and Cytology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - D Rossi
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - E Lechevallier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - R Boissier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - M Baboudjian
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France.
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Abdallah R, Elkhouly A, Soliman R, Motaal A, Assal R, Youness R. 59P Hesperitin halts metastatic breast cancer through tweaking the interplay between the tumour suppressor miR-486-5p and the oncogenic lncRNA H19. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2218] [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] Open
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Belhadef S, Arab A, Belmadi M, Beninal M, Bacha N, Abdallah R, Mechta K, Dahmane A, Mahfouf H, Oukkal M, Bouzid K, Faraqun S, Bentabak K, Younes SA. P-9 A randomized study of panitumumab plus mFOLFOX6 compared with bevacizumab plus mFOLFOX6 as first-line treatment for unresectable metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.091] [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: 11/17/2022] Open
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Auclin E, Marthey L, Mas L, Francois E, Sa Cunha A, Bachet JB, Tougeron D, Vienot A, Lecomte T, Hautefeuille V, Forestier J, Collins M, Abdallah R, Coriat R, Pointet AL, Leroy F, Ksontini F, Williet N, Taieb J. FOLFIRINOX in locally advanced (LA) and borderline resectable (BR) pancreatic adenocarcinoma: Update of the AGEO cohort. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abdallah R, Youness R, El Meckawy N, El Sebaei A, Abdelmotaal A, Assal R. Paradoxical effects of miR-486-5p on the oncogenic and immunogenic profiles in triple negative breast cancer (TNBC). Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30591-4] [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: 10/17/2022]
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Abdallah R, Youness R, El Meckawy N, El Sebaei A, Abdelmotaal A, Assal R. Down-regulated miR-486-5p acts as a tumor suppressor in breast cancer patients by targeting the metastatic mediator ICAM-1. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.058] [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: 11/12/2022] Open
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Chon H, Kang S, Lee J, Gonzalez-Bosquet J, Wenham R, McClung C, Abdallah R. Gene expression signature based prediction of lymph node metastasis in patients with endometrioid endometrial cancer. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.303] [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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Abdou AG, Kandil M, Eldien MS, Abdallah R. Splenic histiocyte-rich pseudotumor following chemotherapy for non Hodgkin diffuse large B cell lymphoma. Pathologica 2016; 108:140-143. [PMID: 28195266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Chemotherapy may induce mass lesion in rare conditions, which can be easily mistaken as a residual tumor mass. In this report, we describe a mass affecting spleen in a patient received chemotherapy for non Hodgkin diffuse large B cell lymphoma. This mass proved histologically to be non neoplastic formed of sheets of histiocytes and xanthoma cells, which is called histiocyte-rich pseudotumor. This report describes this rare lesion and the possible differential diagnosis.
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Affiliation(s)
- A G Abdou
- Pathology Department, Faculty of Medicine, Menofiya University, Shebein Elkom, Egypt
| | - M Kandil
- Pathology Department, Faculty of Medicine, Menofiya University, Shebein Elkom, Egypt
| | - M S Eldien
- Pathology Department, Faculty of Medicine, Menofiya University, Shebein Elkom, Egypt
| | - R Abdallah
- Pathology Department, Faculty of Medicine, Menofiya University, Shebein Elkom, Egypt
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Abdallah R. RM-052 Pancreatic cancer – our experience. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw201.49] [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: 11/13/2022] Open
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Abdallah R, Makhoul R, Yassine H, Youness Z, Torbey G, El Sayed F. Mucinose cutanée juvénile. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.164] [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: 11/25/2022]
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Bush S, Whynott R, Abdallah R, Xiong Y, Chon H, Apte S, Wenham R, Judson P, Lancaster J, Shahzad M. The impact of depression on survival in uterine carcinosarcoma. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.424] [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: 10/23/2022]
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Abstract
BACKGROUND The etiology and laboratory characteristics of large symptomatic pericardial effusion (LSPE) in the Western world have evolved over the years, and vary between regions, community and tertiary hospitals. METHODS We reviewed data of 86 consecutive patients who underwent pericardiocentesis or pericardial window due to LSPE in a community hospital from 2001 to 2010. The characteristics of the PE including chemistry, hematology, bacteriology, serology and cytology have been analyzed. We correlated the etiologies of PE with age, gender and clinical presentation. RESULTS The most frequent etiology of LSPE was idiopathic [36% (77% with a clinical diagnosis of pericarditis)], followed by malignancy (31.4%), ischemic heart disease (16.3%), renal failure (4.6%), trauma (4.6%) and autoimmune disease (4.6%). The average age of all the etiological groups excluding trauma was over 50 years. Laboratory tests did not modify the pre-procedure diagnosis in any of the patients. The most frequent presenting symptom was dyspnea (76.6%). Chest pain was mostly common in patients with idiopathic etiology (58.06%). The most frequent medical condition associated with LSPE was the use of anticoagulant or antiplatelet drugs (31.40%), especially aspirin, and in those, the PE tended to be bloody (73%, P = 0.11). Most of the effusions were exudates (70.9%). PE due to renal failure was the largest (1467 ± 1387 ml). CONCLUSION The spectrum of etiologies of LSPE in a community hospital in the Western world in the contemporary era is continuously evolving. The most frequent etiology is now idiopathic, followed by malignancy. Routine laboratory testing still rarely modifies the pre-procedure diagnosis.
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Affiliation(s)
- R Abdallah
- M.D., Director of Cardiology, Western Galilee Medical Center, 1 Ben Tzvi Blvd., Nahariya 22100, Israel.
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Abdallah R, Zgheib NB, Ramirez-Diaz I, Apte S, Lancaster PJ, Wenham R, Roberts W, Lancaster J, Gonzalez Bosquet J. Predictive role of biology in the feasibility of optimal versus suboptimal cytoreduction in advanced serous ovarian cancer. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.077] [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: 10/26/2022]
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El-Fadel M, Abdallah R, Rachid G. A modeling approach toward oil spill management along the Eastern Mediterranean. J Environ Manage 2012; 113:93-102. [PMID: 22996006 DOI: 10.1016/j.jenvman.2012.07.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 06/20/2012] [Accepted: 07/22/2012] [Indexed: 06/01/2023]
Abstract
This paper examines the temporal and spatial distributions of the largest oil spill along the Eastern Mediterranean and explores management options (boom deployment and fuel upgrade) to reduce potential adverse impacts on the marine environment from similar accidents. For this purpose, the trajectory and weathering of the ~18,000 tons of heavy fuel oil spilled from the Jiyeh thermal power plant were simulated along the coast of Lebanon using the 3D MEDSLIK model, supported with sea water sampling and analysis and field measurements. The base simulation of the spill under existing conditions at the time of occurrence defined the temporal distribution over 90 days of oil spilled in terms of percentage of oil on the surface or evaporated (13.1%), dispersed in the water column or landed on the coast (86.9% landed of which 30.1% were potentially releasable). The spatial distribution defined shoreline stretches with high risk of exposure (located 35 km north of the source and stretching for more than 150 km with medium to low risk exposure). Parametric analysis revealed a relatively higher sensitivity to the drift factor, the current depth, and the time of spill parameters. Deployment of booms reduced shorelines exposure by ~95% in comparison to baseline conditions, and medium or light brands increased evaporation by ~22-42% and reduced oil reaching the coast by ~37-57% in comparison to heavy fuel oil.
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Affiliation(s)
- M El-Fadel
- American University of Beirut, Faculty of Engineering and Architecture, Department of Civil and Environmental Engineering, PO Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon.
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21
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Abdelmalak BB, Bernstein E, Egan C, Abdallah R, You J, Sessler DI, Doyle DJ. GlideScope® vs flexible fibreoptic scope for elective intubation in obese patients*. Anaesthesia 2011; 66:550-5. [DOI: 10.1111/j.1365-2044.2011.06659.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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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22
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Singer T, Schoyer K, Lin S, Huang J, Abdallah R, Rosenwaks Z. A Unique Case of a Cornual Ectopic Pregnancy Following an Ipsilateral Salpingectomy and a Frozen Embryo Transfer. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.401] [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: 10/19/2022]
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23
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Singer T, Abdallah R, Huang J, Williams Z, Kudesia R, Rosenwaks Z, Spandoerfer S. Endometrial Polyps Smaller Than 2 cm Increase the Risk of Biochemical Pregnancy in In-Vitro Fertlization Cycles. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.249] [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: 11/29/2022]
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24
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Huang J, Singer T, Abdallah R, Williams Z, Davis O, Rosenwaks Z. Use of luteal estradiol patch with or without GnRH antagonist suppression before gonadotropin stimulation for IVF in poor responders. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.645] [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: 10/19/2022]
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25
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Friedman L, Abdallah R, Schluchter M, Panneerselvam A, Kunos C. Adherence to Vaginal Dilation following High Dose Rate Brachytherapy for Endometrial Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1191] [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: 11/26/2022]
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26
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Fait M, Abdallah R, Linke D, Kondratenko E, Rodemerck U. A novel multi-channel reactor system combined with operando UV/vis diffuse reflectance spectroscopy: Proof of principle. Catal Today 2009. [DOI: 10.1016/j.cattod.2008.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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27
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de Bellefon C, Abdallah R, Ireland T. Discovering New Water Soluble Catalysts for the Liquid/Liquid Isomerization of Allylic Alcohols Using Microdevices. CHEM-ING-TECH 2004. [DOI: 10.1002/cite.200406169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Dalaly BK, Abd-El-Mottaleb L, El-Shazly A, Abdallah R. The Composition of Buffalo’s Milk in the Mosul Area. MILK the vital force 1986:111-111. [DOI: 10.1007/978-94-009-3733-8_96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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