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Saad R, Duipmans J, Yerlett N, Plevey K, McCuaig C, Woolfe W, Steinau K, Phillips J, Azzopardi N, Thompson K, Ferreira da Rocha AC, Torres-Pradilla M, Ott H, Patton D, Moore Z, Murphy P, Mayre-Chilton K. Neonatal epidermolysis bullosa: a clinical practice guideline. Br J Dermatol 2024; 190:636-656. [PMID: 38175636 DOI: 10.1093/bjd/ljae006] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/05/2024]
Abstract
DEBRA International is undertaking a long-term initiative to develop clinical practice guidelines (CPGs) for epidermolysis bullosa (EB), to -improve the clinical care of people living with EB. Current neonatal care is based on evidence, clinical expertise and trial and error, with collaboration between the EB specialist team, parent or carer and patient, and is dependent on the neonate's individual presentation and type of EB. Early intervention based on research and clinical practice is needed to establish a foundation of knowledge to guide international practitioners to create and improve standards of care and to be able to work effectively with those newly diagnosed with EB. This CPG was created by an international panel with expertise working with persons with EB. The CPG focuses on neonatal care using a systematic review methodology covering four key areas: (i) diagnosis and parental psychosocial support; (ii) hospital management: medical monitoring, wound care and pain; (iii) feeding and nutrition; and (iv) discharge planning and EB education. These four areas highlight the importance of a multidisciplinary team approach, to provide a patient-specific holistic care model that incorporates the needs and wishes of the parents and carers. The Hospital Implementation Tool included promotes transfer of theory to clinical practice.
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Affiliation(s)
- Rebecca Saad
- Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - José Duipmans
- Center for Blistering Diseases, Department of Dermatology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Katie Plevey
- Great Ormond Street NHS Foundation Trust, London, UK
| | - Catherine McCuaig
- Sainte-Justine University Hospital Centre, and University of Montreal, Montreal, QC, Canada
| | - William Woolfe
- Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - K Steinau
- Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA
| | | | | | - Kerry Thompson
- Person living with epidermolysis bullosa
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | - Maurico Torres-Pradilla
- Dermatology Department, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
- Dermatology Department, Fundación Universitaria de Ciencias de la Salud, Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - Hagen Ott
- Division of Paediatric Dermatology and Centre for Rare Congenital Skin Diseases, Children's Hospital Auf der Bult, Hanover, Germany
| | - Declan Patton
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zena Moore
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Murphy
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Saad R, Ghaddar A, Zeenny RM. Pembrolizumab-induced myocarditis with complete atrioventricular block and concomitant myositis in a metastatic bladder cancer patient: a case report and review of the literature. J Med Case Rep 2024; 18:107. [PMID: 38383436 PMCID: PMC10882824 DOI: 10.1186/s13256-024-04397-3] [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] [Received: 01/09/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND The cardiovascular system is among the least systems affected by immune-related adverse events. We report a rare life-threatening case of pembrolizumab-induced myocarditis with complete atrioventricular block and concomitant myositis in a metastatic bladder cancer patient. CASE PRESENTATION An 82-year-old Caucasian female with invasive urothelial carcinoma, started on first-line pembrolizumab, was admitted four days after receiving her second dose for severe asthenia, diffuse muscle aches, neck pain, and lethargy. In the emergency department, she had several episodes of bradycardia reaching 40 beats per minute associated with general discomfort and fatigue. Electrocardiography showed a third-degree atrioventricular heart block, while the patient remained normotensive. Cardiac damage parameters were altered with elevated levels of creatine phosphokinase of 8930 U/L, suggestive of immune checkpoint inhibitor-induced myositis, and troponin T of 1.060 ng/mL. Transthoracic echocardiography showed a preserved ejection fraction. Pembrolizumab-induced myocarditis was suspected. Therefore, treatment was initiated with high-dose glucocorticoids for 5 days, followed by a long oral steroid taper. A pacemaker was also implanted. Treatment resulted in the resolution of heart block and a decrease in creatine phosphokinase to the normal range. CONCLUSION Life-threatening cardiac adverse events in the form of myocarditis may occur with pembrolizumab use, warranting vigilant cardiac monitoring. Troponin monitoring in high-risk patients, along with baseline echocardiography may help identify this complication promptly to prevent life-threatening consequences.
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Affiliation(s)
- R Saad
- Department of Pharmacy, American University of Beirut Medical Center, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - A Ghaddar
- Department of Pharmacy, American University of Beirut Medical Center, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon
| | - R M Zeenny
- Department of Pharmacy, American University of Beirut Medical Center, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020, Lebanon.
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
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Gorrie A, Saad R, Garside L, Bailie C, Wargon O. Gross motor development in children with epidermolysis bullosa. Child Care Health Dev 2024; 50:e13194. [PMID: 38108617 DOI: 10.1111/cch.13194] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/25/2023] [Accepted: 10/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Epidermolysis bullosa (EB) is a group of rare, congenital skin disorders, characterized by skin fragility and formation of blisters. The gross motor outcomes of children with EB are not known. OBJECTIVES The primary objective of the study was to measure the proportion of gross motor delay in children with EB. The secondary objectives were to measure the difference in gross motor outcomes between EB sub-types and change in gross motor outcomes over time. METHODS Children with EB, aged between one month and five and a half years of age, attending the Sydney Children's Hospital, Epidermolysis Bullosa Clinic, were eligible. Carers completed Ages and Stages Questionnaires, Third Edition, on behalf of their children. Questionnaires were scored, and outcomes were compared to age-expected norms. RESULTS There were 24 participants to complete a questionnaire. Eleven participants completed additional questionnaires over the 24 month study duration. The proportion of children with EB with gross motor delay was greater than age-expected norms (29.17% vs. 2.5%). The delay occurred in children with recessive dystrophic (80%) and epidermolysis bullosa simplex (33.33%) sub-types, but not dominant dystrophic (0%). No children with Junctional EB or Kindler EB joined this study. CONCLUSIONS This study demonstrates a difference in gross motor outcomes in children with EB. Children with recessive dystrophic and epidermolysis bullosa simplex should be prioritized for monitoring of, and intervention for, gross motor outcomes through multidisciplinary care. Further research investigating long-term outcomes for children with EB and the effectiveness of interventions would be beneficial.
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Affiliation(s)
- Andrew Gorrie
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Rebecca Saad
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Lydia Garside
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Claire Bailie
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Orli Wargon
- School of Clinical Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
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Ben-Joseph R, Saad R, Black J, Dabrowski E, Taylor B, Gallucci S, Somers V. CardioVascular Burden Of Narcolepsy Disease (CV-BOND): A Real-World Evidence Study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.419] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Parthasarathy S, Hyman D, Doherty J, Saad R, Zhang J, Morris S, Eldemir L, Fox B, Vang M, Schroeder J, Marshall N, Parks G. A Real-World Study Assessing the Relationship Between Positive Airway Pressure Treatment, Excessive Daytime Sleepiness, and Patient Satisfaction in Obstructive Sleep Apnoea. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.636] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Saad R, Somers V, Parks G, Pushkarna D, Fazeli M, Black J. Determinants of adherence/persistence to positive airway pressure therapy in patients with obstructive sleep apnoea. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.658] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Tsoukas A, Koutsogiannaki E, Giannakopoulou I, Gioti O, Iliopoulos D, Saad R, Chalkitis V, Peteinaki A, Karapedi E, Papaioannou N. Automated right ventricular strain by speckle tracking echocardiography in patients with systemic scleroderma. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2631] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients with scleroderma the morphological remodeling and alteration of right ventricular (RV) function begins even before the setting of pulmonary artery hypertension (PAH). These alterations are associated with worse outcomes and high mortality.
Purpose
Early detection of RV dysfunction is possible using advanced imaging techniques and can lead to specific therapeutic measures before installation of PAH. Purpose of this study is to evaluate new indices, based on speckle tracking technology, for identification of subclinical RV systolic failure.
Methods
Twenty-five (25) scleroderma patients without any signs or symptoms of PAH and twenty-five (25) healthy subjects were included in the present study. Two-dimensional echocardiography (2DE) and two-dimensional speckle-tracking echocardiography (2DSTE) were performed. All the usual 2DE, Doppler and tissue Doppler imaging measurements were obtained for the evaluation of RV function. Moreover, TAPSE, maximum systolic myocardial velocity from TDI of lateral tricuspid valve annulus (SRV), auto RV global longitudinal strain (aRVGLS) and auto RV free wall longitudinal strain (aRVFWLS) by 2DSTE were measured. aRVGLS is a new index, with appropriate RV function echo logistics in new technology echo systems, independent from known manual measurements.
Results
In scleroderma patients significantly higher systolic pulmonary artery pressure was recorded, although it remained within normal limits in both groups. Scleroderma patients had significant decreased RV systolic function with significantly lower TAPSE and SRV. Both aRVGLS and aRVFWLS were also significantly lower in scleroderma patients compared to the control group. aRVGLS was the best predictor of early RV systolic impairment in patients with scleroderma.
Conclusions
Scleroderma is a severe systematic disease associated with high mortality rates. RV remodeling, dysfunction, and progressive pulmonary artery hypertension are among the most important internal organ manifestations of this disease. Early detection of RV dysfunction is possible by 2DSTE, and may be helpful to guide further therapy in these patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Tsoukas
- Asklepieion Voulas General Hospital , Athens , Greece
| | | | | | - O Gioti
- Asklepieion Voulas General Hospital , Athens , Greece
| | - D Iliopoulos
- Asklepieion Voulas General Hospital , Athens , Greece
| | - R Saad
- Asklepieion Voulas General Hospital , Athens , Greece
| | - V Chalkitis
- Asklepieion Voulas General Hospital , Athens , Greece
| | - A Peteinaki
- Asklepieion Voulas General Hospital , Athens , Greece
| | - E Karapedi
- Asklepieion Voulas General Hospital , Athens , Greece
| | - N Papaioannou
- Asklepieion Voulas General Hospital , Athens , Greece
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Urazaki MS, Dalarmi FR, Saad R, Lauretto ACB, Silva MIG, Martins SM, Castro MFL, Pedrão AF, Teixeira AKH. DOENÇA POR CRIOAGLUTININAS COM RESPOSTA INICIAL A CORTICOTERAPIA E IMUNOGLOBULINA: RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.025] [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: 11/06/2022] Open
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Lahens A, Saad R, Doreille A, Mesnard L, Rafat C, Paques M. Évaluation de la rétinographie au lit du malade par le néphrologue à l’admission des patients hospitalisés pour urgence hypertensive. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.373] [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: 11/15/2022]
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Greenblatt DT, Pillay E, Snelson K, Saad R, Torres Pradilla M, Widhiati S, Diem A, Knight C, Thompson K, Azzopardi N, Werkentoft M, Moore Z, Patton D, Mayre-Chilton KM, Murrell DF, Mellerio JE. Recommendations on pregnancy, childbirth and aftercare in epidermolysis bullosa: a consensus-based guideline. Br J Dermatol 2021; 186:620-632. [PMID: 34687549 PMCID: PMC9298908 DOI: 10.1111/bjd.20809] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Linked Comment:A.W. Lucky and E. Pope. Br J Dermatol 2022; 186:602–603. Plain language summary available online
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Affiliation(s)
- D T Greenblatt
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - E Pillay
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Snelson
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Saad
- Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - M Torres Pradilla
- Fundacion Universitaria de Ciencias de la Salud and Hospital de San Jose, Bogota, Colombia
| | - S Widhiati
- Pediatric Dermatology Division, Department of Dermatology and Venereology, Faculty of Medicine Universitas Sebelas Maret - Dr. Moewardi General Hospital, Surakarta, Indonesia
| | - A Diem
- EB House Austria, Outpatient Unit, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - C Knight
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Thompson
- Royal Adelaide Hospital, Port Road, Adelaide, SA, Australia
| | | | | | - Z Moore
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Patton
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K M Mayre-Chilton
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,DEBRA International, Vienna, Austria
| | - D F Murrell
- Department of Dermatology at St. George Hospital, University of New South Wales, Sydney, NSW, Australia
| | - J E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Zribi A, Bodin S, Bouhadiba S, Saad R, Romito N, Brignole-Baudouin F. Chronic myeloid leukemia presenting as progressively decreased visual acuity. J Fr Ophtalmol 2021; 44:e529-e531. [PMID: 34462147 DOI: 10.1016/j.jfo.2020.12.029] [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: 11/30/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- A Zribi
- IHU FOReSIGHT, Laboratoire, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 28, rue de Charenton, 75012 Paris, France
| | - S Bodin
- IHU FOReSIGHT, Services d'ophtalmologie 3, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - S Bouhadiba
- IHU FOReSIGHT, Laboratoire, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 28, rue de Charenton, 75012 Paris, France
| | - R Saad
- IHU FOReSIGHT, Services d'ophtalmologie 5, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - N Romito
- IHU FOReSIGHT, Services d'ophtalmologie 3, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - F Brignole-Baudouin
- IHU FOReSIGHT, Laboratoire, Centre Hospitalier national d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 28, rue de Charenton, 75012 Paris, France.
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12
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Akl A, Saad R, Elhosiny A, Bahabri N. POS-086 A Retrospective Study of Risk Factors For Antimicrobials-Associated Hyponatremia In Elderly. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.094] [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: 10/21/2022] Open
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Saad S, Saad R, Jouve L, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. Corneal crosslinking in keratoconus management. J Fr Ophtalmol 2020; 43:1078-1095. [DOI: 10.1016/j.jfo.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
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Kaur N, Mehr S, Katelaris C, Wainstein B, Altavilla B, Saad R, Valerio C, Codarini M, Burton P, Perram F, Baumgart K, Barnes EH, Campbell DE. Added Diagnostic Value of Peanut Component Testing: A Cross-Sectional Study in Australian Children. J Allergy Clin Immunol Pract 2020; 9:245-253.e4. [PMID: 32942048 DOI: 10.1016/j.jaip.2020.08.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Peanut components are widely used in clinical practice; however, their utility to predict challenge outcome in the Australian children, outside of infants, is not well studied. OBJECTIVE Can peanut component testing predict outcome of challenge in peanut-allergic children. METHODS All children attending peanut challenges, regardless of previous allergic reactions to peanut or sensitization (skin prick test or peanut IgE) alone, were recruited. Serum collected before the challenge was analyzed for peanut IgE and Ara h 1, 2, 3, 6, 8, and 9 (ImmunoCap). RESULTS Of the 222 children recruited, 89 (40%) were allergic on oral food challenge. Ara h 2 and 6 performed similarly to peanut IgE and skin prick test in predicting challenge outcome (area under the curve, 0.84-0.87). No baseline clinical characteristics, including past history, predicted challenge outcome. By logistic regression, degree of polysensitization to Ara h 1, 2, or 3 increased the odds of allergic reaction at oral food challenge at 0.35 and 1.0 kUA/L cutoff levels (P < .001 for both). All 11 children sensitized (>0.35 kUA/L) to Ara h 1, 2, and 3 reacted to peanut challenge. Degree of polysensitization at more than 1.0 kUA/L was associated with a lower cumulative eliciting dose (P = .016) and with severity of allergic reaction on challenge (P = .007). CONCLUSIONS In our cohort, sensitization to the combination of Ara h 1, 2, and 3 was highly predictive of peanut allergy. Overall, only Ara h 2 as individual component most correlated with severity of reaction at challenge and adrenaline use. Ara h 8 and 9 were not useful in predicting challenge outcome.
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Affiliation(s)
- Narinder Kaur
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia; Sydney Child Health Program, Sydney Children's Hospitals Network, Sydney, NSW, Australia
| | - Sam Mehr
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia
| | - Constance Katelaris
- Camden and Campbelltown Hospital, Sydney, NSW, Australia; School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Brynn Wainstein
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Betina Altavilla
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Rebecca Saad
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Carolina Valerio
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia
| | - Miriam Codarini
- Camden and Campbelltown Hospital, Sydney, NSW, Australia; School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Pamela Burton
- Camden and Campbelltown Hospital, Sydney, NSW, Australia
| | - Fiona Perram
- Camden and Campbelltown Hospital, Sydney, NSW, Australia
| | - Karl Baumgart
- Immunology, Douglass Hanly Moir Pathology, Sydney, NSW, Australia
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Sydney Medical School, Sydney University, Sydney, NSW, Australia
| | - Dianne E Campbell
- Department of Allergy and Immunology, The Children's Hospital at Westmead, SCHN, Sydney, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, 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P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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Saad S, Delbarre M, Saad R, Berguiga M, Benisty D, Marechal M, Adam T, Froussart F. Failure of systemic oral doxycycline in preventing ocular toxoplasmic retinochoroiditis in French military personnel. J ROY ARMY MED CORPS 2018; 164:122-123. [DOI: 10.1136/jramc-2017-000854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/26/2017] [Accepted: 11/28/2017] [Indexed: 11/03/2022]
Abstract
This paper describes two cases of toxoplasmic chorioretinitis presenting in two French soldiers who had been receiving oral doxycycline for malaria prophylaxis. This is despite the proven effectiveness of oral doxycycline in treating Toxoplasma gondii, the most common cause of this infection. The lack of effectiveness of oral doxycycline in these two cases most likely reflected that the ocular concentration of 100 mg daily doxycycline is too low to treat or prevent Toxoplasmic retinochoroiditis (TC). Clinicians should therefore be aware that soldiers taking prophylactic oral doxycycline are still at risk of developing ocular TC with potentially sight-threatening consequences if not treated adequately.
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Saad R, Lutz JC, Riehm S, Marcellin L, Gros CI, Bornert F. Conservative management of an atypical intra-sinusal ossifying fibroma associated to an aneurysmal bone cyst. J Stomatol Oral Maxillofac Surg 2017; 119:140-144. [PMID: 29074442 DOI: 10.1016/j.jormas.2017.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/04/2017] [Accepted: 10/10/2017] [Indexed: 11/25/2022]
Abstract
Ossifying fibroma (OF) is a benign fibro-osseous lesion mainly occurring in young adults and seems to originate from the periodontal ligament. Aneurysmal bone cyst (ABC) is a benign intraosseous lesion characterized by blood-filled spaces of various sizes. These two lesions can specifically affect the jaws and are commonly described in the literature. However, few cases describing an association of OF and ABC have been reported in the literature, especially in the maxillary sinus. We report the case of a 40-year-old male patient affected with an asymptomatic lesion with a dual component of OF and ABC laying in the maxillary sinus. Our aim is to discuss its clinical and morphological features as well as treatment results.
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Affiliation(s)
- R Saad
- Dental faculty, university of Strasbourg, 8, rue Sainte-Elisabeth, 67000 Strasbourg, France; Oral Surgery and Oral Medicine unit, Dental Clinic, Hôpital Civil, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - J-C Lutz
- Faculty of Medicine, University of Strasbourg, 4, rue Kirschleger, 67000 Strasbourg, France; Stomatology, Maxillofacial and Plastic surgery Department, Hôpital Civil, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France; "Osteoarticular and Dental Regenerative Nanomedicine" laboratory, UMR 1109, Faculté de Médecine, FMTS, Inserm (French National Institute of Health and Medical Research), 67085 Strasbourg cedex, France
| | - S Riehm
- Medical imaging unit, hôpital de Hautepierre, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - L Marcellin
- Pathology Department, Hôpital de Hautepierre, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - C-I Gros
- Dental faculty, university of Strasbourg, 8, rue Sainte-Elisabeth, 67000 Strasbourg, France; "Osteoarticular and Dental Regenerative Nanomedicine" laboratory, UMR 1109, Faculté de Médecine, FMTS, Inserm (French National Institute of Health and Medical Research), 67085 Strasbourg cedex, France; Dentomaxillofacial radiology unit, Dental Clinic, Hôpital Civil, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - F Bornert
- Dental faculty, university of Strasbourg, 8, rue Sainte-Elisabeth, 67000 Strasbourg, France; Oral Surgery and Oral Medicine unit, Dental Clinic, Hôpital Civil, University Hospital of Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France; "Osteoarticular and Dental Regenerative Nanomedicine" laboratory, UMR 1109, Faculté de Médecine, FMTS, Inserm (French National Institute of Health and Medical Research), 67085 Strasbourg cedex, France.
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Crouchet E, Saad R, Affolter-Zbaraszczuk C, Ogier J, Baumert TF, Schuster C, Meyer F. Composite vector formulation for multiple siRNA delivery as a host targeting antiviral in a cell culture model of hepatitis C virus (HCV) infection. J Mater Chem B 2017; 5:858-865. [PMID: 32263854 PMCID: PMC7613424 DOI: 10.1039/c6tb01718e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease and cancer worldwide. RNA interference (RNAi)-based gene therapies have emerged recently as a promising tool to treat chronic viral infections. Indeed, small interfering RNAs (siRNAs) provide an opportunity to target host factors required for the viral life cycle. In this study, we evaluated a novel nanovector-based approach for siRNA delivery in a model of chronically infected hepatic cells. We designed original composite nanoparticles by coating the calcium phosphate core with siRNAs targeting HCV host-factors and pyridylthiourea-grafted polyethyleneimine (πPEI). Using combinations of different siRNAs, we observed an efficient and prolonged decrease of HCV replication. Moreover, we showed that the layer-by-layer technique of coating applied to our nanoparticles triggers a sequential release of siRNAs acting on different steps of the HCV life cycle. Together, our results demonstrate the efficacy of these nanoparticles for siRNA delivery and open new perspectives for antiviral therapies.
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Affiliation(s)
- E. Crouchet
- Inserm
- U1110
- Institut de Recherche sur les Maladies Virales et Hépatiques
- 67000 Strasbourg
- France
| | - R. Saad
- Inserm
- U1110
- Institut de Recherche sur les Maladies Virales et Hépatiques
- 67000 Strasbourg
- France
| | | | - J. Ogier
- Université de Strasbourg
- 67000 Strasbourg
- France
- Inserm
- U1121
| | - T. F. Baumert
- Inserm
- U1110
- Institut de Recherche sur les Maladies Virales et Hépatiques
- 67000 Strasbourg
- France
| | - C. Schuster
- Inserm
- U1110
- Institut de Recherche sur les Maladies Virales et Hépatiques
- 67000 Strasbourg
- France
| | - F. Meyer
- Université de Strasbourg
- 67000 Strasbourg
- France
- Inserm
- U1121
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Quental B, Saad R, Duarte L, Oliveira J, Frazilio A. Outbreak of bacterial phlebitis related to peripheral intravenous catheters at a general hospital in Brazil. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475110 DOI: 10.1186/2047-2994-4-s1-p215] [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: 11/11/2022] Open
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Saad R, Vidal P, Lessa S, Bastos V, Ito R, Genari C, Vasconcelos C, Queiroz M. Strategies for reducing surgical site infection in neurosurgery: experience from a Brazilian hospital. Antimicrob Resist Infect Control 2015. [PMCID: PMC4474849 DOI: 10.1186/2047-2994-4-s1-p79] [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: 11/10/2022] Open
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El-Sayed HF, Puvanachandra P, Hyder AA, Saad R, Eldawy S, Al-Gasseer N. Burden of road traffic injuries in Egypt: strengths and weaknesses of data sources. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590u.27] [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: 11/04/2022]
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Fahem N, Rouetbi N, Saad R, El Ghoul J, Mahou H, Bel Haj Mohamed S, Skhiri N, Joobeur S, Cheikh Mhamed S, El Kamel A. L’asthme en rémission : étude de 51 cas. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.211] [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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Elguedri S, Rouetbi N, Saad R, Bel Haj Mohamed S, El Ghoul J, Mahou H, Skhiri N, Joobeur S, Cheikh Mohamed S, Rouetbi N, El Kamel A. Influence du nombre des allergènes sur la sévérité de l’asthme. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.055] [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: 10/14/2022]
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Puvanachandra P, Hoe C, El-Sayed HF, Saad R, Al-Gasseer N, Bakr M, Hyder AA. Road traffic injuries and data systems in Egypt: addressing the challenges. Traffic Inj Prev 2012; 13 Suppl 1:44-56. [PMID: 22414128 DOI: 10.1080/15389588.2011.639417] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Road traffic injuries (RTIs) are a major cause of global mortality and morbidity, killing approximately 1.3 million people and injuring 20 to 50 million each year. The significance of this public health threat is most pronounced in low- and middle-income countries where 90 percent of the world's road traffic-related fatalities take place. Current estimates for Egypt show a road traffic fatality rate of 42 deaths per 100,000 population-one of the highest in the Eastern Mediterranean Region. RTIs are also responsible for 1.8 percent of all deaths and 2.4 percent of all disability-adjusted life years (DALYs) lost in the country. Despite this, studies surrounding this topic are scarce, and reliable data are limited. The overall goal of this article is to define the health impact of RTIs in Egypt and to identify the strengths and weaknesses of each data source for the purpose of improving the current RTI data systems. METHODS A 2-pronged approach was undertaken to assess the burden of RTIs in Egypt. First, a thorough literature review was performed using PubMed, Embase, ISIS Web of Knowledge, and Scopus databases. Articles pertaining to Egypt and road traffic injuries were selected for screening. With assistance from Egyptian colleagues, a comprehensive exploration of data sources pertaining to RTIs in Egypt was undertaken and secondary data from these sources were procured for analysis. RESULTS The literature review yielded a total of 20 studies, of which 6 were multi-country and 5 were hospital-based studies. None examined risk factors such as speeding, alcohol, or seat belt use. Secondary data sources were acquired from national hospital-based injury surveillance; a community-based health survey; pre-hospital injury surveillance; the Ministry of Transport; the General Authority for Roads, Bridges and Land Transport; death certificates; and the central agency for public motorization and statistics. Risk factor data are also limited from these sources. CONCLUSION The results of this article clearly highlight the significant burden that road traffic injuries pose on the health of the Egyptian population. The hospital-based injury surveillance system that has been established in the country and the use of International Classification of Diseases (ICD-10) coding brings the system very closely in line with international guidelines. There is, however, some considerable room for improvement, including the need to extend the coverage of the surveillance system, the inclusion of injury severity scores and disability indicators, and standardization of the sometimes rather disparate sources from various sectors in order to maximally capture the true burden of RTIs.
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Affiliation(s)
- P Puvanachandra
- International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Saad R, Ghosn N. P2-539 Rabies: knowledge, attitude and practice survey in Baalbeck and Zgharta districts - Lebanon 2010. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.142976m.66] [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: 11/04/2022]
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Affiliation(s)
- K Bitar
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA Research Administration, VA Medical Center, Oklahoma City, OK, USA
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Saad R, Marsault S, Coloby P. Tumeurs corticosurrénaliennes à cellules oxyphiles : à propos d’un cas et revue de la littérature. Prog Urol 2011; 21:288-90. [DOI: 10.1016/j.purol.2010.04.005] [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] [Received: 11/23/2009] [Revised: 03/20/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
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Saracino G, Agura E, Berryman B, Fay J, Pineiro L, Vance E, Saad R. Lineage-Specific Chimerism Analysis is a Sensitive Predictor of Outcome After Allogeneic Myeloablative and Nonmyeloablative Stem Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.498] [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: 10/18/2022]
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Rao SSC, Camilleri M, Hasler WL, Maurer AH, Parkman HP, Saad R, Scott MS, Simren M, Soffer E, Szarka L. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil 2011; 23:8-23. [PMID: 21138500 DOI: 10.1111/j.1365-2982.2010.01612.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [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: 12/13/2022]
Abstract
BACKGROUND Disorders of gastrointestinal (GI) transit and motility are common, and cause either delayed or accelerated transit through the stomach, small intestine or colon, and affect one or more regions. Assessment of regional and/or whole gut transit times can provide direct measurements and diagnostic information to explain the cause of symptoms, and plan therapy. PURPOSE Recently, several newer diagnostic tools have become available. The American and European Neurogastroenterology and Motility Societies undertook this review to provide guidelines on the indications and optimal methods for the use of transit measurements in clinical practice. This was based on evidence of validation including performance characteristics, clinical significance, and strengths of various techniques. The tests include measurements of: gastric emptying with scintigraphy, wireless motility capsule, and (13)C breath tests; small bowel transit with breath tests, scintigraphy, and wireless motility capsule; and colonic transit with radioopaque markers, wireless motility capsule, and scintigraphy. Based on the evidence, consensus recommendations are provided for each technique and for the evaluations of regional and whole gut transit. In summary, tests of gastrointestinal transit are available and useful in the evaluation of patients with symptoms suggestive of gastrointestinal dysmotility, since they can provide objective diagnosis and a rational approach to patient management.
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Affiliation(s)
- S S C Rao
- Division of Gastroenterology/Hepatology, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1009, USA.
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Hafez M, Saad R, Jaffar HS, Gururaj G, Elhennawy H. National burden of injuries and violence: a household survey in Egypt. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.119] [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: 11/04/2022]
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Saad R, Jaffar HS, El Setouhy M, Hirshon JM. Evaluation of the National Injury Surveillance System in Egypt. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.203] [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: 11/03/2022]
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Aitelli C, Aitelli C, Saad R, Mackey D, Asmar L, Jones S, Jones S, Jones S, Pippen J, Pippen J, Pippen J. Analysis of Topoisomerase IIa and HER2 Status in 126 Patients from the US Oncology 9735 Trial of Adjuvant Chemotherapy with Docetaxel/Cyclophosphamide (TC) vs Doxorubicin/Cyclophosphamide (AC) in Early Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-2134] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER2/neu (HER2) positive breast cancers are associated with worse survival, resistance to cyclophosphamide/methotrexate/fluorouracil, and hypothesized to be sensitive to anthracyclines. It has been postulated that only a subset of HER2 positive breast cancers are sensitive to anthracyclines. Investigators have been working on how to identify this subset of patients, thus sparing patients from anthracyclines that have potential cardiac and bone marrow toxicities. Overexpression of the topoisomerase IIa gene (TOP2A) is the putative biomarker for sensitivity to anthracyclines. Testing tumors for overexpression of this gene may help identify patients who will not benefit from anthracylines. TOP2A is located in the same amplicon as the HER2 gene and can be assessed for overexpression by a FISH assay.Materials and Methods: Paraffin tissue blocks were obtained in 126 patients entered on US Oncology trial 9735 which recruited patients between 1997 and 2000. Data on HER2 status and outcome was previously reported (JCO 27:1177-1183, 2009). TOP2A status was then assessed by fluorescent in situ hybridization (FISH) using the LSI TOP2A Spectrum Orange Probe (Vysis). A total of 20 cells were counted and a gene ratio of greater than 2.0 was considered positive. Clinical data and outcome were available for statistical analysis.Results: We found that none of the 97 HER2 negative cases demonstrated overexpression of TOP2A by FISH analysis. TOP2A was overexpressed in 43% of the 29 HER2 positive cases. An analysis of outcome will be presented at the meeting, although the number of cases limits this observation.Discussion: Our study supports the observation that TOP2A is not overexpressed in HER2 negative disease and is only observed in a subset of cancers overexpressing HER2. Clinical correlation of outcome will be necessary to confirm whether or not TOP2A is a reliable biomarker of sensitivity to anthracyclines. The ongoing US Oncology trial of TC vs. TAC in HER2 negative breast cancer (USOR Trial 06-090) should provide that evidence.Supported in part by a grant from sanofi-aventis.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2134.
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Affiliation(s)
| | | | - R. Saad
- 4Baylor University Medical Center, TX,
| | | | | | - S. Jones
- 1Baylor Sammons Cancer Center, TX,
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Ismiil N, Ghorab Z, Covens A, Nofech-Mozes S, Saad R, Dubé V, Khalifa M. Intraoperative margin assessment of the radical trachelectomy specimen. Gynecol Oncol 2009; 113:42-6. [DOI: 10.1016/j.ygyno.2008.12.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 12/10/2008] [Accepted: 12/11/2008] [Indexed: 11/28/2022]
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Nojkov B, Rubenstein JH, Adlis SA, Shaw MJ, Saad R, Rai J, Weinman B, Chey WD. The influence of co-morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2008; 27:473-82. [PMID: 18194508 DOI: 10.1111/j.1365-2036.2008.03596.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [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: 12/19/2022]
Abstract
BACKGROUND A subset of patients with gastro-oesophageal reflux disease (GERD) does not achieve complete symptom resolution with proton pump inhibitor (PPI) therapy. The factors which affect response to PPI therapy in GERD patients remain unclear. AIMS To determine the prevalence and impact of irritable bowel syndrome (IBS) and psychological distress (PD) on GERD symptoms and disease-specific quality of life (QoL) before and after PPI therapy and to assess the same outcomes before and after PPI therapy in non-erosive reflux disease (NERD) and erosive oesophagitis (EO) GERD patients. METHODS Patients undergoing oesophago-gastroduodenoscopy (OGD) for heartburn were recruited. Participants completed validated surveys: Digestive Health Symptom Index, Reflux Disease Questionnaire, Quality of Life in Reflux and Dyspepsia and Brief Symptom Inventory (BSI). IBS was defined as >3 Manning criteria and PD as BSI score >63. At OGD, patients were classified as NERD or EO. Patients were treated with rabeprazole 20 mg/day for 8 weeks before completing follow-up surveys. RESULTS Of 132 GERD patients enrolled, 101 completed the study. The prevalence rates of IBS and PD were 36% and 41%, respectively. IBS independently predicted worse QoL before and after PPI therapy. PD independently predicted worse GERD symptoms and QoL before and after PPI therapy. There were no differences in symptoms or QoL between NERD and EO patients before or after PPI therapy. CONCLUSIONS IBS and PD impacted GERD symptoms and QoL before and after PPI therapy. Symptoms and QoL before and after PPI therapy were similar in NERD and EO patients.
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Affiliation(s)
- B Nojkov
- Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, USA
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Rubenstein JH, Nojkov B, Korsnes S, Adlis SA, Shaw MJ, Weinman B, Inadomi JM, Saad R, Chey WD. Oesophageal hypersensitivity is associated with features of psychiatric disorders and the irritable bowel syndrome. Aliment Pharmacol Ther 2007; 26:443-52. [PMID: 17635379 DOI: 10.1111/j.1365-2036.2007.03393.x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Twenty per cent of patients with heartburn do not respond to proton pump inhibitors (PPIs). Many have normal oesophageal acid exposure. We hypothesized that such PPI non-responders have heightened oesophageal sensation, and that oesophageal hypersensitivity is associated with psychiatric features including somatization and anxiety. AIM To compare oesophageal sensation in subjects with heartburn categorized by response to PPI, and to correlate oesophageal sensation with psychiatric features. METHODS Twenty-one PPI responders, nine PPI non-responders and 20 healthy volunteers completed questionnaires of psychiatric disorders and gastrointestinal symptoms. Subjects underwent oesophageal sensory testing with acid perfusion and balloon distension. RESULTS Healthy volunteers displayed higher thresholds for sensation and discomfort from balloon distension than heartburn subjects (sensation P = 0.04, discomfort P = 0.14). Psychiatric disorders were associated with increased intensity of sensation (P = 0.02) and discomfort from acid (P = 0.01). Somatization was associated with increased discomfort from balloon distension (P = 0.006). Features of irritable bowel syndrome were associated with increased sensation and discomfort. CONCLUSIONS Heartburn subjects tend to have heightened oesophageal sensation, suggesting that oesophageal hypersensitivity may persist despite therapy with PPI. Oesophageal hypersensitivity is associated with features of psychiatric disease and with the irritable bowel syndrome, which might partly explain the aetiology of heartburn symptoms that are refractory to PPI.
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Affiliation(s)
- J H Rubenstein
- Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI 48109-0362, USA.
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Issaoui Z, Joobeur S, Skhiri N, Saadaoui S, Zaatir N, Saad R, Battikh M, Rouetbi N, El Kamel A. 66 L’asthme aux acariens : revue de 556 cas. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72442-7] [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: 01/18/2023]
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Rouetbi N, Maatallah A, Issaoui Z, Saad R, Mzoughi R, Abdoulay A, Ben Sayah M, Battikh M, El Kamel A. Intérêt de la colchicine dans le traitement des fibroses pulmonaires interstitielles diffuses (fid) idiopathiques : à propos de 28 cas. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72452-4] [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: 01/18/2023]
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Battikh M, Maatallah A, Mzoughi R, Saad R, Issaoui Z, Ben Sayah M, Rouetbi N, El Kamel A. Hypertension artérielle (HTA) et syndrome d’apnées du sommeil (SAS). Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72385-3] [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: 01/18/2023]
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Rouetbi N, Saad R, Maatallah A, Mzoughi R, Issaoui Z, Ben Sayeh M, Battikh M, Elkamel A. L’hypertension artérielle pulmonaire (HTAP) post hydatique : à propos d’une observation. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72188-x] [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: 01/18/2023]
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Ben Sayah M, Mzoughi R, Maatallah A, Issaoui Z, Saad R, Abdoulay A, Battikh M, Rouetbi N, El Kamel A. Le syndrome de MacLeod: à propos d’une nouvelle observation. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72241-0] [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: 01/18/2023]
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Saad R, Raab S, Liu Y, Pollice P, Silverman JF. Plasmacytoma of the larynx diagnosed by fine-needle aspiration cytology: a case report. Diagn Cytopathol 2001; 24:408-11. [PMID: 11391823 DOI: 10.1002/dc.1090] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/10/2022]
Abstract
Extramedullary plasmacytoma is a rare lesion. The use of fine-needle aspiration for diagnosis of plasmacytoma has been described in a few sporadic reports. To the best of our knowledge, none of these reports described the cytologic findings from plasmacytoma of the larynx. We report on a case of laryngeal plasmacytoma in a 79-yr-old man diagnosed by fine-needle aspiration cytology. The patient had a history of a plasmacytoma involving the sixth thoracic vertebra diagnosed in 1996, which progressed to multiple myeloma in 1997. He received treatment in the form of local radiation to the skeletal vertebrae and chemotherapy. Two years later, the patient presented with a large neck mass. Computed tomography (CT) was done at an outside facility, and the radiologic impression was of a large right glottic carcinoma with invasion into the right thyroid cartilage. Because of the history of multiple myeloma, a fine-needle aspiration (FNA) biopsy was performed of the laryngeal mass. Cytologic examination demonstrated atypical plasma cells arranged in a dissociative fashion, consistent with a plasmacytoma. Although there are previous surgical pathology reports of laryngeal plasmacytoma, to the best of our knowledge, this is the first report of plasmacytoma of the larynx diagnosed by FNA cytology.
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Affiliation(s)
- R Saad
- Department of Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15222, USA
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Abstract
CONTEXT Oncocytomas are generally small and present slow growth. Finding of the tumor usually occurs incidentally. Their incidence is higher among male patients. Oncocytomas in mucous bronchial glands are extremely rare. CASE REPORT A 35-year-old male who presented bronchial oncocytoma. The tumor was found after bronchoscopy that investigated an atelectasis of the upper left lobe. Histological examination with optical microscopy revealed a mature neoplasm formed by ovoid cells with thin, granular, eosinophilic cytoplasm and small nuclei similar to oncocytes. Electron microscopy showed mitochondrial hyperplasia. A three-year follow-up after thoracotomy followed by lobectomy and removal of the bronchial tumor was uneventful.
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Affiliation(s)
- R T de Aquino
- Department of Medicine, Faculty of Medicine, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
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Abstract
AIMS: The aim of this study was to assess the risk and progress of portal vein thrombosis (PVT) after splenectomy. METHODS: A prospective study was conducted in which two groups of patients were compared; each group comprised 50 patients (27 men, 23 women). Patients in the splenectomy group were of mean age 46.3 years. A second group of patients (mean age 48.5 years) had upper abdominal surgery other than splenectomy. All patients were examined before and 2 weeks after operation by duplex Doppler ultrasonography (DDUS) of the portal system. Those who developed PVT were followed up by DDUS at 6 and 12 months. RESULTS: PVT developed in 10 per cent of patients who underwent splenectomy. The portal vein was completely occluded by thrombus in 4 per cent and partially occluded in 6 per cent of patients. Symptoms and signs attributable to PVT (abdominal pain, diarrhoea, nausea, vomiting and mild fever) were found in 80 per cent of those who developed this complication. Follow-up of such patients revealed complete recanalization of portal vein in 40 per cent and partial recanalization in 60 per cent after treatment with antibiotics and long-term anticoagulation therapy. No patient who underwent upper abdominal surgery (other than splenectomy) developed PVT afterwards. CONCLUSIONS: Splenectomy (compared with other upper abdominal surgery) is followed by PVT in 10 per cent of patients but can be treated successfully.
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Affiliation(s)
- AM Hassn
- Pilgrim Hospital, Boston, UK and Ain-Shams University Hospital, Egypt
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Abstract
The drinking behavior responses to centrally administered N G-nitro-L-arginine methyl ester (L-NAME; 10, 20 or 40 microg/microl), an inhibitor of nitric oxide synthase, were studied in satiated rats, with cannulae stereotaxically implanted into the lateral ventricle (LV) and subfornical organ (SFO). Water intake increased in all animals after angiotensin II (ANG II) injection into the LV, with values of 14.2 +/- 1.4 ml/h. After injection of L-NAME at doses of 10, 20 or 40 microg/microl into the SFO before injection of ANG II (12 ng/microl) into the LV, water intake decreased progressively and reached basal levels after treatment with 0.15 M NaCl and with the highest dose of L-NAME (i.e., 40 microg). The water intake obtained after 40 microg/microl L-NAME was 0.8 +/- 0.01 ml/h. Also, the injection of L-NAME, 10, 20 or 40 microg/microl, into the LV progressively reduced the water intake induced by hypertonic saline, with values of 5.3 +/- 0.8, 3.2 +/- 0.8 and 0.7 +/- 0.01 ml/h, respectively. These results indicate that nitric oxide is involved in the regulation of drinking behavior induced by centrally administered ANG II and cellular dehydration and that the nitric oxide of the SFO plays an important role in this regulation.
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Affiliation(s)
- W A Saad
- Departamento de Fisiologia, Faculdade de Odontologia, Universidade Estadual Paulista, Araraquara, SP, Brasil.
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Saad R, Bellec V, Dugay J, Blanchi A, Foulet A, Renou P. [Association of celiac disease and esophageal small cell carcinoma]. Presse Med 1999; 28:277-8. [PMID: 10073168] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Coeliac disease is known to favor the development of neoplasia. Coeliac disease associated with small-cell carcinoma of the esophagus has not been reported to date. CASE REPORT A 51-year-old man with coeliac disease known for several years was hospitalized for epigastric pain. Work-up led to the diagnosis of small-cell carcinoma of the lower esophagus. The patient was treated with 6 cycles of chemotherapy using an etoposide-ciplatinum protocol associated with 60 Gy radiotherapy starting at the third cycle. The patient has remained in complete remission 2 years after diagnosis. DISCUSSION Small-cell carcinoma of the esophagus is an exceptional finding in a patient with coeliac disease. Chemotherapy associated with radiotherapy has been successful in our patient.
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Affiliation(s)
- R Saad
- Centre Hospitalier du Mans, Le Mans
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Antunes VR, Camargo GM, Saad R, Saad WA, Luiz AC, Camargo LA. Role of angiotensin II and vasopressin receptors within the supraoptic nucleus in water and sodium intake induced by the injection of angiotensin II into the medial septal area. Braz J Med Biol Res 1998; 31:1597-600. [PMID: 9951557 DOI: 10.1590/s0100-879x1998001200013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 11/21/2022] Open
Abstract
In this study we investigated the effects of the injection into the supraoptic nucleus (SON) of non-peptide AT1- and AT2-angiotensin II (ANG II) receptor antagonists, DuP753 and PD123319, as well as of the arginine-vasopressin (AVP) receptor antagonist d(CH2)5-Tyr(Me)-AVP, on water and 3% NaCl intake induced by the injection of ANG II into the medial septal area (MSA). The effects on water or 3% NaCl intake were assessed in 30-h water-deprived or in 20-h water-deprived furosemide-treated adult male rats, respectively. The drugs were injected in 0.5 microliter over 30-60 s. Controls were injected with a similar volume of 0.15 M NaCl. Antagonists were injected at doses of 20, 80 and 180 nmol. Water and sodium intake was measured over a 2-h period. Previous administration of the AT1 receptor antagonist DuP753 into the SON decreased water (65%, N = 10, P < 0.01) and sodium intake (81%, N = 8, P < 0.01) induced by the injection of ANG II (10 nmol) into the MSA. Neither of these responses was significantly changed by injection of the AT2-receptor antagonist PD123319 into the SON. On the other hand, while there was a decrease in water intake (45%, N = 9, P < 0.01), ANG II-induced sodium intake was significantly increased (70%, N = 8, P < 0.01) following injection of the V1-type vasopressin antagonist d(CH2)5-Tyr(Me)-AVP into the SON. These results suggest that both AT1 and V1 receptors within the SON may be involved in water and sodium intake induced by the activation of ANG II receptors within the MSA. Furthermore, they do not support the involvement of MSA AT2 receptors in the mediation of these responses.
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Affiliation(s)
- V R Antunes
- Departamento de Fisiologia e Patologia, Faculdade de Odontologia, Universidade Estadual Paulista, Araraquara, SP, Brasil
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Saad WA, Camargo LA, Silveira JE, Saad R, Camargo GM. Imidazoline receptors of the paraventricular nucleus on the pressor response induced by stimulation of the subfornical organ. J Physiol Paris 1998; 92:25-30. [PMID: 9638593 DOI: 10.1016/s0928-4257(98)80019-3] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the present experiments we investigated a possible involvement of imidazoline receptors of the paraventricular nucleus (PVN) of the hypothalamus on the pressor effects of the angiotensin II (ANG II) injected into the subfornical organ (SFO), in male Holtzman rats (250-300 g) with a cannula implanted into the third ventricle (3rdV), PVN and SFO. At first we tested the participation of alpha 2 and imidazoline agonist and antagonist compounds on the pressor effect of ANG II injected into the 3rdV. Based on the results we may conclude that clonidine associated with rilmenidine was able to block the hypertensive response to ANG II. The ANG II (20 pmol) injected into SFO induced a robust increase in blood pressure (37 +/- 2 mmHg). Isotonic saline (0.15 M) NaCl did not produce any change in blood pressure (5 +/- 2 mmHg). The injection of rilmenidine (30 micrograms/kg/1 microL), an imidazoline agonist agent injected into PVN before ANG II injection into SFO, blocked the pressor effect of ANG II (5 +/- 2 mmHg). Also, the injection of idazoxan (60 micrograms/kg/microL) before rilmenidine blocked the inhibitory effect of rilmenidine on blood pressure (39 +/- 4 mmHg). The injection of clonidine (20 nmol/microL) prior to ANG II into the 3rdV produced a decreased in arterial blood pressure (37 +/- 2 mmHg) to (15 +/- 4 mmHg). The injection of yohimbine (80 nmol/microL) prior to clonidine blocked the effect of clonidine on the effect of ANG II (27 +/- 2 mmHg). The injection of rilmenidine prior to ANG II also induced a decrease in arterial blood pressure (10 +/- 3 mmHg). The injection of idazoxan prior to rilmenidine also blocked the inhibitory effect of rilmenidine (24 +/- 3 mmHg). In summary, the present study demonstrated that rilmenidine decreases the hypertensive effect of ANG II, with more potency than clonidine, even when injected into 3rdV or PVN. This study established that the PVN interacts with SFO by imidazoline receptors in order to control the arterial blood pressure.
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Affiliation(s)
- W A Saad
- Department of Physiology, School of Dentistry, Paulista State University, UNESP, Brazil
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Saad R, Gritsch HA, Shapiro R, Jordan M, Vivas C, Scantlebury V, Demetris AJ, Randhawa PS. Clinical significance of renal allograft biopsies with "borderline changes," as defined in the Banff Schema. Transplantation 1997; 64:992-5. [PMID: 9381547 DOI: 10.1097/00007890-199710150-00010] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [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: 02/05/2023]
Abstract
BACKGROUND The Banff Schema suggests the term "borderline changes" for biopsies showing changes insufficient for a diagnosis of mild acute rejection. The appropriate clinical management for patients showing such changes on biopsy is controversial. METHODS We reviewed the clinical course and response to antirejection therapy of 24 patients with borderline changes, and compared our findings with those obtained from 14 patients with mild acute rejection. Patients were classified as showing complete response, partial response, or no response to antirejection treatment, depending on whether the posttreatment fall in serum creatinine was >70%, 30-70%, or <30% of the pretreatment rise, respectively. Renal allograft biopsies were systematically evaluated in accordance with the Banff schema. RESULTS Complete response to antirejection therapy was seen in 15/24 (63%), partial response in 3/24 (13%), and nonresponse in 6/24 (25%) patients with borderline change. Compared with patients showing complete response, nonresponse was associated with higher scores of acute tubular necrosis and chronic allograft nephropathy (P<0.05). By comparison, 12/14 (86%) cases of mild acute rejection showed complete response to antirejection therapy (P=0.25 vs. patients with borderline change), and lack of response was associated with a higher score for chronic allograft nephropathy. CONCLUSION When biopsies are done in the context of renal allograft dysfunction, borderline changes frequently require increased immunosuppression. These findings should not be extrapolated to protocol biopsies performed in the setting of stable graft function.
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Affiliation(s)
- R Saad
- Department of Pathology, University of Pittsburgh, School of Medicine, Pennsylvania 15213, USA
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