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Lee WC, Digbeu BDE, Serag H, Sallam H, Kuo YF. Utilization of diabetes self-management program among breast, prostate, and colorectal cancer survivors: Using 2006-2019 Texas Medicare data. PLoS One 2023; 18:e0289268. [PMID: 37498914 PMCID: PMC10374119 DOI: 10.1371/journal.pone.0289268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Cancer treatment is associated with inferior health outcomes such as diabetes. Medicare provides Diabetes Self-Management Training (DSMT) program to beneficiaries to achieve normal metabolic control and reduce the risk of micro and macro-vascular complications. This study aimed to examine the trend of DSMT utilization among cancer survivors and assess individual characteristics associated with it. METHODS The data for this study was from Texas Cancer Registry-Medicare linkage data of patients with prostate, breast, or colorectal cancer diagnosed in 1999-2017. Outcome variables include the number of first-time DSMT users, the number of total users, and the average number of DSMT utilization in minutes. We performed logistic regression and gamma regression to obtain a multivariable-adjusted odds ratio for the association between DSMT utilization and individual characteristics. RESULTS The number of first-time users has slowly increased over the years (from 99 to 769 per 1,000) but suddenly dropped after 2016. The number of all users (first-time and follow-up users) has increased (from 123 to 1,201 per 1,000) and plateaued after 2016. Determinants including Hispanic ethnicity (O.R. = 1.10) and Medicare-Medicaid dual eligibility (O.R. = 1.25) are positively associated with both the initiation and retention of the DSMT. A barrier to both initiation and retention of DSMT is living in a metropolitan area (O.R. = 0.90). CONCLUSIONS Multi-level strategies to enhance accessibility and availability of DSMT programs for Medicare beneficiaries are highly recommended. Examining the determinants of initiation and retention of DSMT over 14 years provides insights on strategies to meet the needs of cancer survivors and reduce the burden of diabetes on them.
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Affiliation(s)
- Wei-Chen Lee
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Biai Dominique Elmir Digbeu
- Department of Biostatistics & Data Science, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Hani Serag
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Hanaa Sallam
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Yong-Fang Kuo
- Department of Biostatistics & Data Science, University of Texas Medical Branch, Galveston, Texas, United States of America
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Sallam H, Lenga L, Solbach C, Becker S, Vogl TJ. Correlation of background parenchymal enhancement on breast MRI with breast cancer. Clin Radiol 2023:S0009-9260(23)00218-0. [PMID: 37330320 DOI: 10.1016/j.crad.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 03/05/2023] [Accepted: 05/11/2023] [Indexed: 06/19/2023]
Abstract
AIM To evaluate the prognostic value of background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI) in women referred to radiological department as a high risk for breast cancer. MATERIALS AND METHODS A retrospective, cross-sectional study included 327 consecutive patients (mean age: 60 years, age range: 30-90 years) who underwent breast MRI and tissue biopsy between 2007 and 2016. All MRI images (T1, T2, and subtraction images) were evaluated visually. The relationship of BPE with patient age, fibroglandular tissue (FGT), Breast Imaging Reporting and Data System (BIRADS) categories, presence of breast cancer, and expression of human epidermal growth factor receptor 2 (HER2), progesterone receptor (PR), oestrogen receptor (ER), and Ki67 were analysed. Furthermore, all variables were correlated with pre- and postmenopausal status. RESULTS BPE of bilateral breast showed a weak correlation with FGT (right BPE: r=-0.14, p=0.004; left BPE: r=0.16, p=0.003), a weak negative correlation with patient age (right BPE: r=-0.14, p=0.007; left BPE: r=-0.15, p=0.006), and significant correlation with HER2 (right BPE, p=0.02), left BPE with HER2 was not significant. Among the correlations between BPE and BIRADS, only between right BPE and right BIRADS was significant (p=0.031). No clear evidence of an association between breast MRI BPE and breast cancer in premenopausal and postmenopausal status was observed, and no difference was found between the right and left breasts. CONCLUSIONS The results of the present study showed no significant correlations between BPE and breast cancer. In addition, there was no significant difference between the right and left breast. Hence, BPE of MRI may not be a reliable biomarker of breast cancer development.
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Affiliation(s)
- H Sallam
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
| | - L Lenga
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - C Solbach
- Department Gynaecology and Obstetrics, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - S Becker
- Department Gynaecology and Obstetrics, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - T J Vogl
- Department of Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
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Evangelista LS, Jose MM, Sallam H, Serag H, Golovko G, Khanipov K, Hamilton MA, Fonarow GC. High-protein vs. standard-protein diets in overweight and obese patients with heart failure and diabetes mellitus: findings of the Pro-HEART trial. ESC Heart Fail 2021; 8:1342-1348. [PMID: 33502122 PMCID: PMC8006643 DOI: 10.1002/ehf2.13213] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/16/2020] [Accepted: 01/02/2021] [Indexed: 01/11/2023] Open
Abstract
AIMS The intermediate-term effects of dietary protein on cardiometabolic risk factors in overweight and obese patients with heart failure and diabetes mellitus are unknown. We compared the effect of two calorie-restricted diets on cardiometabolic risk factors in this population. METHODS AND RESULTS In this randomized controlled study, 76 overweight and obese (mean weight, 107.8 ± 20.8 kg) patients aged 57.7 ± 9.7 years, 72.4% male, were randomized to a high-protein (30% protein, 40% carbohydrates, and 30% fat) or standard-protein diet (15% protein, 55% carbohydrates, and 30% fat) for 3 months. Reductions in weight and cardiometabolic risks were evaluated at 3 months. Both diets were equally effective in reducing weight (3.6 vs. 2.9 kg) and waist circumference (1.9 vs. 1.3 cm), but the high-protein diet decreased to a greater extent glycosylated haemoglobin levels (0.7% vs. 0.1%, P = 0.002), cholesterol (16.8 vs. 0.9 mg/dL, P = 0.031), and triglyceride (25.7 vs. 5.7 mg/dL, P = 0.032), when compared with the standard-protein diet. The high-protein diet also significantly improved both systolic and diastolic blood pressure than the standard-protein diet (P < 0.001 and P = 0.040, respectively). CONCLUSIONS Both energy-restricted diets reduced weight and visceral fat. However, the high-protein diet resulted in greater reductions in cardiometabolic risks relative to a standard-protein diet. These results suggest that a high-protein diet may be more effective in reducing cardiometabolic risk in this population, but further trials of longer duration are needed.
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Affiliation(s)
| | - Mini M. Jose
- School of NursingUniversity of Texas Medical BranchGalvestonTX77555‐1132USA
| | - Hanaa Sallam
- Diabetes Prevention and Care ProgramUniversity of Texas Medical BranchGalvestonTXUSA
| | - Hani Serag
- Diabetes Prevention and Care ProgramUniversity of Texas Medical BranchGalvestonTXUSA
| | - George Golovko
- Department of Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTXUSA
| | - Kamil Khanipov
- Department of Pharmacology and ToxicologyUniversity of Texas Medical BranchGalvestonTXUSA
| | - Michele A. Hamilton
- Department of Medicine/CardiologyUniversity of California, Los AngelesLos AngelesCAUSA
- Heart Failure ProgramCedars‐Sinai Heart InstituteLos AngelesCAUSA
| | - Gregg C. Fonarow
- Ahmanson‐UCLA Cardiomyopathy Center and CardiologyUniversity of California, Los AngelesLos AngelesCAUSA
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Balala M, Seleem M, kotb M, Sallam H, Abd El-Rahman H. Fracture Behavior of Concretes Incorporating Bone Powder(Dept.C). MEJ Mansoura Engineering Journal 2020; 33:66-77. [DOI: 10.21608/bfemu.2020.127077] [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: 09/02/2023]
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Mousa S, Abd-Elhady A, Abu-Sinna A, Enab T, Alhazmi W, Sallam H. Mixed Mode Crack Growth in Functionally Graded Material Under Three-Point Bending. Procedia Structural Integrity 2019; 17:284-291. [DOI: 10.1016/j.prostr.2019.08.038] [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: 09/02/2023]
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Sallam H, Soliman T, Sallam N. HMG as a treatment for unexplained recurrent early pregnancy loss. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.02.084] [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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Sallam H, El-Kaffash, Farrag A, Sallam N. Measurement of oxidative stress in the spent culture medium of individual embryos - a possible method for embryo selection. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.02.083] [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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Abate N, Sallam H, Rizzo M, Nikolic D, Obradovic M, Bjelogrlic P, Isenovic E. Resistin: An Inflammatory Cytokine. Role in Cardiovascular Diseases, Diabetes and the Metabolic Syndrome. Curr Pharm Des 2014; 20:4961-9. [DOI: 10.2174/1381612819666131206103102] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/02/2013] [Indexed: 11/22/2022]
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Nadeem A, Salahuddin N, ElHazmi A, Joseph M, Bohlega B, Sallam H, Elsheikh Y, Broering D. Hypotonic fluids after liver transplantation may be associated with prolonged ICU stay. Crit Care 2014. [PMCID: PMC4068630 DOI: 10.1186/cc13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Coughlan C, Ledger W, Wang Q, Liu F, Demirol A, Gurgan T, Cutting R, Ong K, Sallam H, Li T. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014; 28:14-38. [DOI: 10.1016/j.rbmo.2013.08.011] [Citation(s) in RCA: 331] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 05/05/2013] [Accepted: 08/06/2013] [Indexed: 12/29/2022]
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Sallam N, Sallam A, Ezzeldin F, Farrag A, Agameya AF, Sallam H. Defining poor responders in ART using objective cut-off points. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1513] [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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van der Poel S, Sallam H, Ezzeldin F, Sallam N, Agameya A, Sallam S, Farrag A, Patel M, Woodward BJ, Otoo MA, Yakass MB, Hiadzi EK. Developing countries and infertility. Hum Reprod 2013. [DOI: 10.1093/humrep/det208] [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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14
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Sallam A, Sallam N, Ezzeldin F, Farrag A, Agameya A, Sallam H. Toward an Objective Definition of Poor Responders in Assisted Reproduction. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.01.035] [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: 10/27/2022]
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Abstract
The purpose of the study was to analyze microstrains around small- versus standard-diameter implants used in restoration of thin wiry ridge through different bridge designs. Additionally, influence of the site of occlusal vertical loading was evaluated using strain gauges. Two models simulating mandibular unilateral free-end saddle were fabricated. Two standard-size implants (3.75 × 13 mm) were inserted in one model in the position of the second premolar and first molar to support 2 3-unit cantilever bridges (NiCr alloy). On the other model, a standard implant and a mini implant (3.0 × 13 mm) were inserted in the position of the second premolar and second molar, respectively, to support 2 fixed-fixed 3-unit NiCr bridges. Four strain gauges were mounted buccally, lingually, mesially, and distally adjacent to each implant. The prostheses were temporarily cemented. A 300 N vertical load was applied on the middle of the horizontal runner bar connecting the prosthetic units and on the center of the pontics. Microstrains were recorded and analyzed. Cantilever bridges recorded higher microstrains than fixed-fixed bridges for both loading conditions. Yet, for both designs, loading on the horizontal runner bars, which apply an equal load on all bridge units simultaneously, resulted in significantly lower microstrain values than applying the load only on the pontics. Mini implant revealed greater strain values than standard implant supporting the same fixed partial denture. The best treatment option that produced the least microstrains was the fixed-fixed bridge with a mini implant as a terminal abutment. Mini implants induced higher microstrains than standard implants.
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Affiliation(s)
- Hanaa Sallam
- Fixed Prosthodontics Department, Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Lamia Sayed Kheiralla
- Fixed Prosthodontics Department, Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Alzahra Aldawakly
- Fixed Prosthodontics Department, Oral and Dental Medicine, Cairo University, Cairo, Egypt
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El Mansy H, Ismail H, Kharboush I, Tawfik M, El Sharkawy O, Mamdouh H, Abdel-Baqy M, Sallam H. 3522 POSTER Personal and Economic Barriers to Breast Cancer Screening Among Egyptian Females. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71178-9] [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: 11/26/2022]
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El-Mansy HME, Ismail HM, Kharboush IF, Tawfik MM, El Sharkawy OG, Mamdouh H, Sallam H. Health care service barriers to breast cancer screening among Egyptian females. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1585] [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: 11/20/2022] Open
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Sallam H, El-Kaffash D, Abou-Heif M, El-Abd M, Sallam A, Agameya A. Prediction of Ovarian Hyperstimulation in Patients With Polycystic Ovary Syndrome (PCOS) Treated With Human Menopausal Gonadotrophins. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.01.056] [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: 11/24/2022]
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Sallam H, Ezzeldin F, Sallam N, Agameya A, Farrag A. HMG-Only Protocol, a Practical Option for Developing Countries. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.01.057] [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]
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Bettayeb K, Sallam H, Ferandin Y, Popowycz F, Fournet G, Hassan M, Echalier A, Bernard P, Endicott J, Joseph B, Meijer L. N-&-N, a new class of cell death-inducing kinase inhibitors derived from the purine roscovitine. Mol Cancer Ther 2008; 7:2713-24. [DOI: 10.1158/1535-7163.mct-08-0080] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chen DD, Xu X, Zhao Q, Yin J, Sallam H, Chen JDZ. Effects of audio stimulation on gastric myoelectrical activity and sympathovagal balance in healthy adolescents and adults. J Gastroenterol Hepatol 2008; 23:141-9. [PMID: 18171353 DOI: 10.1111/j.1440-1746.2007.05123.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
AIM The primary aim of this study was to investigate the effects of different audio stimulations on gastric myoelectrical activity and sympathovagal balance in adolescents compared with adults. METHODS The study was performed in 11 adults and 12 adolescents. Each subject underwent two sessions, one for classical music, and the other for noise. Each session consisted of 30 min of baseline, 30 min of fasting audio stimulation, a test meal, 30 min of fed audio stimulation, and 30 min of recovery. Electrocardiogram and electrogastrogram were both recorded throughout each session. RESULTS (i) In the fasting state, both classical music and noise impaired gastric slow wave activity in adolescents. In adults, noise had no effects while classical music moderately improved slow wave rhythmicity. (ii) In the fed state, neither noise nor music had any effects on gastric slow waves. (iii) In the fasting state, both noise and music increased the sympathovagal balance in adolescents; in adults only noise had such an effect. (iv) The test meal increased the sympathovagal balance in all groups. CONCLUSIONS Gastric slow waves and the sympathovagal balance are more strongly affected by audio stimulation in adolescents than in adults. The test meal normalizes the audio stimulation-induced differences between the groups.
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Affiliation(s)
- Dennis D Chen
- Division of Gastroenterology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
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Zhu H, Sallam H, Chen DD, Chen JDZ. Therapeutic potential of synchronized gastric electrical stimulation for gastroparesis: enhanced gastric motility in dogs. Am J Physiol Regul Integr Comp Physiol 2007; 293:R1875-81. [PMID: 17881615 DOI: 10.1152/ajpregu.00821.2006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to determine the effects and mechanism of synchronized gastric electrical stimulation (SGES) on gastric contractions and gastric emptying. The first experiment was designed to study the effects of SGES on antral contractions in four randomized sessions. Sessions 1 (control) and 2 (atropine) were performed in the fasting state, composed of three 30-min periods (baseline, stimulation, and recovery). Sessions 3 (control) and 4 (SGES performed during 2nd 20-min period) were performed in the fed state, consisting of two 20-min periods; glucagon was injected after the first 20-min recording. The second experiment was designed to study the effect of SGES on gastric emptying and consisted of two sessions (control and SGES). SGES was delivered with train duration of 0.5-0.8s, pulse frequency of 40 Hz, width of 2 ms, and amplitude of 4 mA. We found that 1) SGES induced gastric antral contractions in the fasting state. The motility index was 1.3 +/- 0.5 at baseline and 6.1 +/- 0.7 (P = 0.001) during SGES. This excitatory effect was completely blocked by atropine. 2) SGES enhanced postprandial antral contractions impaired by glucagon. 3) SGES significantly accelerated glucagon-induced delayed gastric emptying. Gastric emptying was 25.5 +/- 11.3% without SGES and 38.3 +/- 10.7% with SGES (P = 0.006 vs. control). This novel method of SGES induces gastric antral contractions in the fasting state, enhances glucagon-induced antral hypomotility in the fed state, and accelerates glucagon-induced delayed gastric emptying. The effect of SGES on antral contractions is mediated via the cholinergic pathway.
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Affiliation(s)
- Hongbing Zhu
- Veterans Research Foundation, Oklahoma City, Oklahoma, USA
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Abstract
The mean age of the menopause in Egypt is 46.7 years, which is low compared to many countries, but this age has been rising recently. The incidence of menopause-associated symptoms in Egyptian women is higher than in the West, probably because of the different 'sociocultural attitudes' towards the menopause in different communities. Bone mineral density charts have been constructed for Egyptian women and show that, in general, they have a lower bone mineral density compared to their Western counterparts. After the menopause, they suffer from osteoporosis, particularly at the femoral neck. Egyptian women do not know much about the menopause, except that the incidence of osteoporosis is increased. Their attitude towards the menopause is generally positive and about one-third of them regard the menopause as 'a normal physiological change'. Nevertheless, there exists a need for an awareness campaign in order to educate them about this important stage of their lives.
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Affiliation(s)
- H Sallam
- The Suzanne Mubarak Regional Center for Women's Health and Development, Egypt
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Sallam H, McNearney TA, Doshi D, Chen JDZ. Transcutaneous electrical nerve stimulation (TENS) improves upper GI symptoms and balances the sympathovagal activity in scleroderma patients. Dig Dis Sci 2007; 52:1329-37. [PMID: 17372833 DOI: 10.1007/s10620-006-9257-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2005] [Accepted: 02/13/2006] [Indexed: 12/09/2022]
Abstract
To assess the impact of transcutaneous electrical nerve stimulation (TENS) at gastrointestinal (GI) acupoints on GI symptoms and quality of life in scleroderma patients, 17 patients filled out SF-36 and GI symptom questionnaires before the electrocardiogram was recorded for two intervals: baseline and TENS. At home, patients applied TENS for 14 days, then were reassessed. Acutely, TENS application significantly increased sympathetic and vagal activities vs. baseline (P=0.02 and P=0.004), respectively. Prolonged TENS application normalized the sympathovagal balance (P=0.04), decreased GI symptom scores (P=0.02) and increased the physical functioning score (SF36), which strongly correlated with the change in the sympathovagal balance (r=0.6, P=0.02). In conclusion, TENS at GI acupoints offers a potential option in the treatment of upper GI symptoms, but further study is necessary.
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Affiliation(s)
- Hanaa Sallam
- Division of Gastroenterology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas 77555, USA
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Abstract
Gastrointestinal dysmotility in systemic sclerosis (scleroderma) is prevalent in 90% of patients, increasing morbidity and in some cases mortality. The resultant gastrointestinal complications are usually extensive, involving many regions of the gut from the oesophagus to the anus. Collagen replacement of vascular and enteric smooth muscle results in hypomotility, lumen dilatation, tensile rigidity and eventual loss of organ functions. The aim of this paper is to provide an overview of systemic sclerosis-related gastrointestinal dysmotility and available/potential therapeutic options. We evaluated published data on the pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis patients using the MEDLINE database for English and non-English articles from 1966 to July 2005. Based on this systematic review, lifestyle and medical therapy approaches are preferred as they often improve and/or ameliorate symptoms. Surgery is only recommended with serious, rare complications such as bowel perforation or ischaemia. Alternative therapies such as acupuncture-based therapies are well tolerated, with clinical improvement and may be of potential therapeutic benefit for systemic sclerosis gastrointestinal dysmotility. Further elucidation of initiating and persistent mechanisms of systemic sclerosis-related gastrointestinal dysmotility will optimize the development of a multidisciplinary and more directed treatment regimen.
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Affiliation(s)
- H Sallam
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555-0632, USA
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Sadek S, Sallam H, Agameya AF, Sadek S, Sallam H. Does a difficult embryo transfer affect the results of IVF and ICSI? – a meta-analysis of controlled studies. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.02.046] [Citation(s) in RCA: 3] [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: 11/29/2022]
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Abstract
The recognition of embryos suitable for transfer in human assisted reproduction is important, and there is evidence that the morphology of the cells may influence the results achievable. A procedure for this recognition problem has been formulated based on morphological attributes of the images of the embryos, and it is therefore useful to compare the recognition of experts with that of a machine programme. The aim of this paper is to compare the precision in the recognition of viable embryos by a group of experts to that of a machine recognition procedure, both for a basic set of embryos and a blind set. Experts were asked to classify the images of 249 embryos transferred to 73 patients, indicated as the training set and another set of 103 embryos transferred to 35 patients called the blind set. A machine programme was used for the same classification. For all the experts the results were statistically not significantly different from independence, which means that viable embryos are not recognized as such for both data sets. Instead, the machine algorithm recognizes in a statistically significant way, the membership class for the embryos submitted. Cell morphology is important for IVF, but differences do not appear to be discernable by the senses, clinical insight, experience and/or training, while classification by machine methods provides more accurate results, which could be improved by enlarging the training set.
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Affiliation(s)
- C Manna
- Genesis IVF Centre, 00189 Rome, Italy
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Sallam H, Agameya A, Sallam A, Rahman A, Ezzeldin F. Sperm velocity, strict morphology and the hypo-osmotic swelling test as predictors of the sperm fertilization potential: experience from the IVF model. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02776-5] [Citation(s) in RCA: 3] [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: 11/30/2022]
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Sallam H, Farrag A, Agameya A, Ezzeldin F, Eid A, Sallam A. The use of a modified hypo-osmotic swelling test for the selection of viable ejaculated and testicular immotile spermatozoa in ICSI. Hum Reprod 2001; 16:272-6. [PMID: 11157819 DOI: 10.1093/humrep/16.2.272] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [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: 11/14/2022] Open
Abstract
A modified hypo-osmotic solution was used to select viable ejaculated and testicular spermatozoa to perform intracytoplasmic sperm injection (ICSI) in 27 treatment cycles from patients with total absence of sperm motility. The treatment cycles consisted of 15 cycles in which ejaculated spermatozoa were used and 12 cycles in which testicular spermatozoa were used. The hypo-osmotic solution consisted of 50% culture medium and 50% deionized water and was shown in previous in-vitro studies to be superior to the original solution used in the classical hypo-osmotic swelling test. Fertilization was achieved in 37.3% of the oocytes injected. Embryos were replaced in 70.4% of the cycles with a mean of 2.0 embryos per cycle. There were no statistically significant differences between the ejaculated sperm group and the testicular sperm group in the fertilization rate (42.7 versus 30.1%) or in the cleavage rate (92.7 versus 77.3%). Four pregnancies resulted, two in the ejaculated sperm group and two in the testicular sperm group, a pregnancy rate of 14.8%. All pregnancies were singletons but one pregnancy in each group had an early miscarriage. There were no statistically significant differences between both groups in the pregnancy rates (13.3 versus 16.7%), in the implantation rates (5.3 versus 11.8%) or in the delivery/ongoing pregnancy rates (6.7 versus 8.3%). It is concluded that the use of this solution to select viable but immotile spermatozoa for ICSI is a simple and practical method and is associated with acceptable fertilization and pregnancy rates.
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Affiliation(s)
- H Sallam
- Department of Obstetrics and Gynaecology, the University of Alexandria, Egypt.
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Toppozada M, Medhat I, Sallam H, Ismail AA, el-Badawy ES, Abd Rabbo S. Improving placental blood flow in pre-eclampsia with prostaglandin A1. Acta Obstet Gynecol Scand 1992; 71:22-7. [PMID: 1315092 DOI: 10.3109/00016349209007942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 12/26/2022]
Abstract
Prostaglandin A1 is a potent hypotensive, peripheral vasodilator, a weak oxytocic, antiplatelet aggregator. It improves the renal hemodynamics. Its effect on placental circulation was evaluated (expressed as systolic/diastolic ratio and umbilical artery resistance index) in 20 women with severe pre-eclampsia and 10 normotensive pregnant women, by using the Doppler technique. Moreover, another 10 women with severe pre-eclampsia received dextrose 5% as a placebo for comparative purposes. Significant improvements in both parameters studied were observed in the women with severe pre-eclampsia. The beneficial changes differed significantly from the recorded values when using dextrose in pre-eclampsia or prostaglandin A1 in normotensive subjects. Such promising data add another important perspective to prostaglandin A1 in severe pre-eclampsia and may open up new avenues for its use in other situations with compromised placental flow.
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Affiliation(s)
- M Toppozada
- Department of Obstetrics and Gynecology, University of Alexandria, Egypt
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Souka AR, Sallam H, Zeitoun K, El-tabbakh G, Abul-einin M. Hormone levels in early morning urine during clomiphene cycles. J OBSTET GYNAECOL 1988. [DOI: 10.3109/01443618809151352] [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]
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Abstract
The effects of vaginal administration of an oral contraceptive pill containing 1 mg of norethisterone acetate and 0.05 mg of ethinyl oestradiol were studied in 20 subjects for a total of 57 cycles. The results show effective ovulation suppression in the two dose regimens used. The lower dose regimen was associated with fewer side effects and no breakthrough bleeding. No significant change was observed in the serum concentration of glucose, total proteins, albumin, cholesterol and HDL after several cycles of treatment in both dose regimens used. It is concluded that vaginal administration of this preparation of oral contraceptives is an effective alternative method of hormonal contraception.
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Khalil M, Aziz Y, Tanios A, Moghazy M, Soliman SI, Sallam H. Red cell membrane protein in thalassemia and glucose-6-phosphate dehydrogenase deficiency anemia. Gaz Egypt Paediatr Assoc 1977; 26:73-81. [PMID: 612474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Twenty cases of thalassemia major and 20 children with glucose-6-phosphate dehydrogenase deficiency were studied for the protein content of their red cell membrane as well as for its fractions, compared to 20 normal controls. The results showed that the total membrane proteins per red cell and the various fraction percentages in both conditions were not significantly different from normal controls. Also the acrylamide gel electrophoretic studies of the red cell membrane proteins gave band patterns identical with those of normal controls. These results are discussed.
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