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Amin S, Hasanin A, Mansour R, Mostafa M, Zakaria D, Arafa AS, Yassin A, Ziada H. Oral midodrine for prophylaxis against post-spinal anesthesia hypotension during hip arthroplasty in elderly population: a randomized controlled trial. BMC Anesthesiol 2024; 24:64. [PMID: 38355397 PMCID: PMC10865567 DOI: 10.1186/s12871-024-02442-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND We aimed to evaluate the efficacy of midodrine as a prophylaxis against post-spinal hypotension in elderly patients undergoing hip arthroplasty. METHODS This randomized controlled trial included elderly patients undergoing hip arthroplasty under spinal anesthesia. Ninety minutes before the procedure, patients were randomized to receive either 5-mg midodrine or placebo (metoclopramide). After spinal anesthesia, mean arterial pressure (MAP) and heart rate were monitored every 2 min for 20 min then every 5 min until the end of the procedure. Post-spinal hypotension (MAP < 80% baseline) was treated with 10 mg ephedrine. The primary outcome was intraoperative ephedrine consumption. Secondary outcomes were the incidence of post-spinal hypotension, bradycardia, and hypertension (MAP increased by > 20% of the baseline reading). RESULTS We analyzed 29 patients in the midodrine group and 27 in the control group. The intraoperative ephedrine consumption was lower in the midodrine group than in the control group (median [quartiles]: 10 [0, 30] mg versus 30 [20, 43] mg, respectively, P-value: 0.002); and the incidence of intraoperative hypotension was lower in the midodrine group than that in the control group. The incidence of hypertension and bradycardia were comparable between the two groups. CONCLUSION The use of 5 mg oral midodrine decreased the vasopressor requirements and incidence of hypotension after spinal anesthesia for hip surgery in elderly patients. CLINICAL TRIAL REGISTRATION This study was registered on September 22, 2022 at clinicaltrials.gov registry, NCT05548985, URL: https://classic. CLINICALTRIALS gov/ct2/show/NCT05548985 .
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Affiliation(s)
- Sarah Amin
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Hasanin
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Rehab Mansour
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Mostafa
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dina Zakaria
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amany S Arafa
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Akram Yassin
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hisham Ziada
- Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
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Gambichler T, Würfel L, Abu Rached N, Mansour R, Bechara FG, Scheel CH. Systemic immune-inflammation biomarkers in psoriasis patients under interleukin 17A-inhibitor treatment. J Eur Acad Dermatol Venereol 2023. [PMID: 36682043 DOI: 10.1111/jdv.18895] [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: 11/12/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
Affiliation(s)
- T Gambichler
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - L Würfel
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - F G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - C H Scheel
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
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Romano F, Wendelspiess M, Mansour R, Abplanalp-Marti O, Starvaggi C, Holzner F, Steiner I, Keitel K. Safety of nurse-directed triage intranasal fentanyl protocol for acute pain management in a European pediatric emergency department: A retrospective observational analysis. Front Pediatr 2023; 11:1070685. [PMID: 36861074 PMCID: PMC9969078 DOI: 10.3389/fped.2023.1070685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Nurse-directed pain protocols for intranasal fentanyl administration are not widely implemented in European (EU) pediatric emergency departments (PED). Barriers include perceived safety concerns for intranasal (IN) fentanyl. The aim of this study is to describe our experience with a nurse-directed triage IN fentanyl protocol with a focus on safety in a tertiary EU PED. METHODS We conducted a retrospective analysis of patient records of children aged 0-16 years who received nurse-directed IN fentanyl between January 2019 and December 2021 at the PED of the University Children's Hospital of Bern, Switzerland. Extracted data points included demographics, presenting complaint, pain score, IN fentanyl dosage, concomitant pain medication use, and adverse events. RESULTS A total of 314 patients were identified with ages ranging from 9 months to 15 years. The main indication for nurse-directed fentanyl administration was musculoskeletal pain due to trauma (n = 284, 90%). Mild adverse events (vertigo) were reported in two patients (0.6%), without a correlation to concomitant pain medication or protocol violation. The only reported severe adverse event of syncope and hypoxia in a 14-year-old adolescent occurred in a setting where the institutional nurse-directed protocol was violated. CONCLUSION In accordance with previous studies outside of Europe, our data support the case that when appropriately used, nurse-directed IN fentanyl is a safe potent opioid analgesic for pediatric acute pain management. We strongly encourage the introduction of nurse-directed triage fentanyl protocols Europe-wide in order to provide effective and adequate acute pain management in children.
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Affiliation(s)
- F Romano
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - M Wendelspiess
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - R Mansour
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - O Abplanalp-Marti
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - C Starvaggi
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - F Holzner
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - I Steiner
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - K Keitel
- Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Susok L, Said S, Reinert D, Mansour R, Scheel CH, Becker JC, Gambichler T. The pan-immune-inflammation value and systemic immune-inflammation index in advanced melanoma patients under immunotherapy. J Cancer Res Clin Oncol 2022; 148:3103-3108. [PMID: 35006344 PMCID: PMC9508007 DOI: 10.1007/s00432-021-03878-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) in patients with cutaneous melanoma (CM) under immune checkpoint inhibitor (ICI) therapy. METHODS PIV and SII were calculated before the start of ICI therapy and at time of progression/death in patients with metastatic CM (stage III/IV). Sex-age-matched CM patients in stage I/II and healthy subjects (HC) served as controls. RESULTS The median PIV of stage III/IV patients was significantly (P = 0.0011) higher than in stage I/II patients and HC. SII was significantly (P = 0.00044) lower in HC than in CM patients. At baseline, PIV and SII did significantly correlate with lactate dehydrogenase (P = 0.045/0.017). However, ROC curve statistics revealed that SII and PIV were not significantly associated with clinical parameters, including best response to ICI treatment (P = 0.87/0.64), progression-free survival (P = 0.73/0.91), and melanoma-specific survival (P = 0.13/0.17). Moreover, there were no significant changes of PIV and SII from baseline to progression/death (P = 0.38/0.52). CONCLUSIONS Even though both immune-inflammation biomarkers showed some power to differentiate between CM stages and HC, respectively, PIV and SII seem not to be significant predictors for clinical outcome measures of CM patients under ICI therapy.
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Affiliation(s)
- L Susok
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - S Said
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - D Reinert
- Department of Radiology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | | | - J C Becker
- Translational Skin Cancer Research, DKTK Partner Site Essen/Düsseldorf, West German Cancer Center, Dermatology, University Duisburg-Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
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Verma IC, El-Beshlawy A, Tylki-Szymańska A, Martins A, Duan YL, Collin-Histed T, van der Linde MS, Mansour R, Dũng VC, Mistry PK. Transformative effect of a Humanitarian Program for individuals affected by rare diseases: building support systems and creating local expertise. Orphanet J Rare Dis 2022; 17:87. [PMID: 35369888 PMCID: PMC8977120 DOI: 10.1186/s13023-022-02192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractRare diseases affect > 400 million people globally with a disproportionate burden falling on children, resulting in high morbidity and mortality rates. Affected individuals in some under-resourced countries have limited access to expert care or treatments; moreover, they suffer long diagnostic journeys during which debilitating and life-threatening complications occur. Lysosomal storage disorders (LSD) are prototype rare diseases due, in the main, to inherited deficiencies of lysosomal enzymes/transporters that affect up to 1 in 5000 newborns. Recognizing the need to provide treatment access to people with LSDs everywhere, a collaborative partnership was pioneered and set up 30 years ago. Partnering with local authorities, non-government organizations across six continents, local as well as international experts, a robust, sustainable Humanitarian Program emerged that now represents the most enduring charitable access program for LSD treatment. Here we present the history, process, lasting beneficial effect of the program to develop healthcare systems and infrastructures, and the lessons learned from addressing major unmet needs for LSDs.
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Mansour R, El-Fayoumi HM, Fahmy A, Ibrahim IAAEH. Oleic acid acutely impairs glucose homeostasis in standard chow diet but not high-fructose, high-fat diet-fed mice by acting on free fatty acid receptor 1. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20710s] [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] [Indexed: 01/11/2023] Open
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Gambichler T, Stranzenbach R, Mansour R, Lee YP, Doerler M, Stücker M. Diffuse dermal angiomatosis of the breast in a young woman. Clin Exp Dermatol 2021; 47:415-416. [PMID: 34431548 DOI: 10.1111/ced.14904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- T Gambichler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Stranzenbach
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - R Mansour
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Y-P Lee
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Doerler
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
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El-Fayoumi S, Mansour R, Mahmoud A, Fahmy A, Ibrahim I. Pioglitazone Enhances β-Arrestin2 Signaling and Ameliorates Insulin Resistance in Classical Insulin Target Tissues. Pharmacology 2021; 106:409-417. [PMID: 34082428 DOI: 10.1159/000515936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/15/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Pioglitazone is a thiazolidinedione oral antidiabetic agent. This study aimed to investigate the effects of pioglitazone as insulin sensitizer on β-arrestin2 signaling in classical insulin target tissues. METHODS Experiments involved three groups of mice; the first one involved mice fed standard chow diet for 16 weeks; the second one involved mice fed high-fructose, high-fat diet (HFrHFD) for 16 weeks; and the third one involved mice fed HFrHFD for 16 weeks and received pioglitazone (30 mg/kg/day, orally) in the last four weeks of feeding HFrHFD. RESULTS The results showed significant improvement in the insulin sensitivity of pioglitazone-treated mice as manifested by significant reduction in the insulin resistance index. This improvement in insulin sensitivity was associated with significant increases in the β-arrestin2 levels in the adipose tissue, liver, and skeletal muscle. Moreover, pioglitazone significantly increased β-arrestin2 signaling in all the examined tissues as estimated from significant increases in phosphatidylinositol 4,5 bisphosphate and phosphorylation of Akt at serine 473 and significant decrease in diacylglycerol level. CONCLUSION To the best of our knowledge, our work reports a new mechanism of action for pioglitazone through which it can enhance the insulin sensitivity. Pioglitazone increases β-arrestin2 signaling in the adipose tissue, liver, and skeletal muscle of HFrHFD-fed mice.
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Affiliation(s)
- Shaimaa El-Fayoumi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt.,Department of Pharmacology, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Rehab Mansour
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt.,Central Administration, Zagazig University Hospitals, Zagazig, Egypt
| | - Amr Mahmoud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt.,Department of Pharmacology, Pharmacy Program, Oman College of Health Sciences, Muscat, Oman
| | - Ahmed Fahmy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Islam Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
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Mansour R, Thiagalingam A. Feasibility of m-Health Smoking Cessation Initiative in a Metropolitan Rapid Access Cardiology Clinic (RACC). Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.288] [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: 12/01/2022]
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Dalili D, Teh J, Bratby M, Reynolds J, Mansour R. Percutaneous Sclerotherapy of Spinal Aneurysmal Bone Cysts Causing Neurologic Compromise: Preliminary Experience with a Novel Technique. Semin Musculoskelet Radiol 2020. [DOI: 10.1055/s-0040-1722490] [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] [Indexed: 10/22/2022]
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Mansour R, Rioual S, Lescop B, Talbot P, Abboud M, Farah W, Tanné G. Development of a Resonant Microwave Sensor for Sediment Density Characterization. Sensors (Basel) 2020; 20:s20041058. [PMID: 32075308 PMCID: PMC7070468 DOI: 10.3390/s20041058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/16/2022]
Abstract
In this study, a sensor based on the development of a planar antenna immersed in sediments dedicated to water content monitoring in this type of material is proposed and experimentally validated. It is produced by a conventional Printed Circuit Board (PCB) manufacturing process on a double-sided metalized FR4 substrate. The sensitivity of the sensor is ensured by the variation of the real part of the complex dielectric permittivity of sediments with water content at around 1 GHz. As shown, in this frequency range, electrode polarization and Maxwell–Wagner polarization effects become negligible, leading to only a bulk water polarization sensitivity. The sensor operates in the reflection mode by monitoring the variation of the resonant frequency as a function of the sediment density through the S11 reflection measurements. An experimental sensitivity of 820 MHz.g−1.cm3 was achieved. Despite the simplification of data interpretation at the considered frequency, the influence of ionic species such as NaCl in sediments on the real part of the relative complex dielectric permittivity is highlighted. This demonstrates the importance of considering a second parameter such as the S11 level at low frequency or the electrical conductivity to extract the density from the frequency measurements.
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Affiliation(s)
- R. Mansour
- IFREMER, REM-GM-LAD, 29280 Plouzane, France;
- Univ Brest, Lab-STICC, CNRS, UMR 6285, F-29200 Brest, France; (B.L.); (P.T.); (G.T.)
- UEGP, Faculté des Sciences, Université Saint Joseph, BP 17-5208 Mar Mikhael, Beyrouth 1104 2020, Liban; (M.A.); (W.F.)
| | - S. Rioual
- Univ Brest, Lab-STICC, CNRS, UMR 6285, F-29200 Brest, France; (B.L.); (P.T.); (G.T.)
- Correspondence:
| | - B. Lescop
- Univ Brest, Lab-STICC, CNRS, UMR 6285, F-29200 Brest, France; (B.L.); (P.T.); (G.T.)
| | - P. Talbot
- Univ Brest, Lab-STICC, CNRS, UMR 6285, F-29200 Brest, France; (B.L.); (P.T.); (G.T.)
| | - M. Abboud
- UEGP, Faculté des Sciences, Université Saint Joseph, BP 17-5208 Mar Mikhael, Beyrouth 1104 2020, Liban; (M.A.); (W.F.)
| | - W. Farah
- UEGP, Faculté des Sciences, Université Saint Joseph, BP 17-5208 Mar Mikhael, Beyrouth 1104 2020, Liban; (M.A.); (W.F.)
| | - G. Tanné
- Univ Brest, Lab-STICC, CNRS, UMR 6285, F-29200 Brest, France; (B.L.); (P.T.); (G.T.)
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Guo S, Mansour R, Henderson Slater D. Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series. Can Prosthet Orthot J 2019; 2:33061. [PMID: 37614805 PMCID: PMC10443475 DOI: 10.33137/cpoj.v2i1.33061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/21/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Residual limb neuromas are a significant cause of post-amputation pain. There is little knowledge concerning ultrasound-guided (US) radiofrequency ablation (RFA) as treatment. OBJECTIVE To investigate US-guided RFA for neuroma associated pain in individuals with limb amputation. METHODOLOGY The notes of nine consecutive patients were retrospectively reviewed. Information obtained included neuroma size and nerve, RFA duration/temperature, pain scores, analgesic requirements and ease/comfort of prosthetic use. Eight patients had lower-limb amputations and one had a trans-radial amputation. All except one, underwent diagnostic US-guided steroid injection to confirm the neuroma as the source of pain, prior to RFA. RESULTS Six patients reported significant reduction in pain scores (defined as at least 50% reduction) and an improvement in comfort/ease of wearing their prosthetic limb, with no adverse effects. Three of these six patients also reported a reduction in analgesic requirements. Of the three remaining patients - one had a large sciatic nerve neuroma that was eventually surgically excised, another had confounding pain from an adjacent bony spur, whilst the third patient did not receive a routine diagnostic steroid injection prior to RFA. CONCLUSIONS Our findings suggest that US-guided RFA is safe and effective for small to medium-sized residual limb neuroma associated pain in individuals with limb amputation. It can reduce pain and analgesic requirements, improve comfort/ease of wearing the prosthesis and potentially avoid surgical excision. We recommend patients should undergo a diagnostic steroid injection prior to RFA to confirm that the neuroma is the source of pain.
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Affiliation(s)
- S. Guo
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, UK
| | - R. Mansour
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UK
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Abu Tahoun L, Khatib Y, Farfora H, Ghoul S, Abdallah A, Abdarrahman R, Jarrah RAL, Mansour R, Al Tamimi Z, Ammar K, Mutlak S. Mobile Mammography in Lower-Middle–Income Country, Jordan Experience. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.21900] [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] [Indexed: 11/20/2022] Open
Abstract
Background: Breast cancer is the most common malignancy among adults in Jordan accounting for 39.4% of all newly diagnosed cancers. Jordan is a lower-middle–income country that lacks national screening program. King Hussein Cancer Foundation/Center (KHCF/KHCC) and Jordan Breast Cancer Program had put significant efforts over past years to increase awareness about breast cancer and improve mammography services. They have introduced two mobile mammography units aiming at reaching women in their local communities, in underserved and underprivileged regions. Aim: Describe the experience of making mammography accessible and free of charge to women in rural and remote areas with limited access to mammography services. Methods: Local health educators were trained to recruit women aged 40 years and above to get free screening mammogram in mobile mammography unit. Data collected from five rural areas in Jordan from 2012 until 2017. Total number is 13570 women. Recall was performed at the fixed mammography unit at KHCC and was free of charge until the diagnosis of cancer affirmed or deferred. Results: The highest percentage of women 55.2% (N: 7733) aged 41-50 years. Women aged less than 40 years were recruited due to their breast-related symptoms. It was ethically difficult to refrain imaging symptomatic women in van in remote areas. However, in areas closer to KHCC symptomatic women with no medical insurance were directly referred to KHCC with voucher for free mammogram and workup. Total number of women referred for screening was 13058 (96.2%) and those referred as diagnostic was 512 (3.8%); their mean age was 48.8 and 45 years respectively. Overall recall rate was 29.3% (N: 3822) among screening cases. Cancer detection rate was 0.85% (N: 112) among screened women and 6.8% (N: 35) among diagnostic cases. Number of women who failed to adhere to follow-up procedures was N=1191 (8.8%). It was noticed that family history of cancer correlated with better adherence to complete follow-up procedures. Conclusion: Mobile mammography unit enabled access to screening mammography in rural areas and also encouraged symptomatic women to seek medical advice early. Ensuring financial coverage may have been an additional motivational factor. Follow-up studies may be conducted to compare tumor size differences between screening and diagnostic cases, prognosis and quality of life.
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Mansour R, Grissa Lebdi K, Rezgui S. Assessment of the performance of some new insecticides for the control of the vine mealybug Planococcus ficus in a Tunisian vineyard. ACTA ACUST UNITED AC 2017. [DOI: 10.12681/eh.11591] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mealybugs (Hemiptera: Pseudococcidae) cause major economic losses in many Tunisian grapegrowing areas. In an attempt to improve management strategies for the Vine Mealybug (VM) Planococcus ficus (Signoret), three insecticides, imidacloprid, Prev-Am® and spirotetramat, were evaluated for their effect on this insect on vine, with reference to methidathion. The systemic insecticide spirotetramat (Movento® 150 OD) provided the greatest control performance of the VM populations, compared to the contact insecticide methidathion, the systemic insecticide imidacloprid applied through furrow irrigated system, and to Prev-Am®, a new contact biopesticide. Three weeks after treatment, VM eggs and adult females were missing from spirotetramat-treated vines. Additionally, spirotetramat supplied a long-residual activity against VM populations and prevented further spread of these insects on vine leaves. Therefore, this new systemic insecticide could be incorporated in an Integrated Pest Management program for VM control in Tunisian vineyards. Despite its short-residual activity, Prev-Am® was shown to be more effective than both methidathion and imidacloprid, mainly on VM eggs and L3 nymphs, and resulted in the highest level of VM L1-L2 nymph decrease on vine trunks. Hence, this biopesticide might prove useful for VM management in vineyards.
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Dyer S, Chambers GM, de Mouzon J, Nygren KG, Zegers-Hochschild F, Mansour R, Ishihara O, Banker M, Adamson GD. International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010. Hum Reprod 2016; 31:1588-609. [PMID: 27207175 DOI: 10.1093/humrep/dew082] [Citation(s) in RCA: 286] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What were utilization, outcomes and practices in assisted reproductive technology (ART) globally in 2008, 2009 and 2010? SUMMARY ANSWER Global utilization and effectiveness remained relatively constant despite marked variations among countries, while the rate of single and frozen embryo transfers (FETs) increased with a concomitant slight reduction in multiple birth rates. WHAT IS KNOWN ALREADY ART is widely practised in all regions of the world. Monitoring utilization, an approximation of availability and access, as well as effectiveness and safety is an important component of universal access to reproductive health. STUDY DESIGN, SIZE, DURATION This is a retrospective, cross-sectional survey on utilization, effectiveness and safety of ART procedures performed globally from 2008 to 2010. PARTICIPANTS, SETTING, METHODS Between 58 and 61 countries submitted data from a total of nearly 2500 ART clinics each year. Aggregate country data were processed and analyzed based on forms and methods developed by the International Committee for Monitoring Assisted Reproductive Technologies (ICMART). Results are presented at country, regional and global level. MAIN RESULTS AND THE ROLE OF CHANCE For the years 2008, 2009 and 2010, >4 461 309 ART cycles were initiated, resulting in an estimated 1 144 858 babies born. The number of aspirations increased by 6.4% between 2008 and 2010, while FET cycles increased by 27.6%. Globally, ART utilization remained relatively constant at 436 cycles/million in 2008 and 474 cycles/million population in 2010, but with a wide country range of 8-4775 cycles/million population. ICSI remained constant at around 66% of non-donor aspiration cycles. The IVF/ICSI combined delivery rate (DR) per fresh aspiration was 19.8% in 2008; 19.7% in 2009 and 20.0% in 2010, with corresponding DRs for FET of 18.8, 19.7 and 20.7%. In fresh non-donor cycles, single embryo transfer increased from 25.7% in 2008 to 30.0% in 2010, while the average number of embryos transferred fell from 2.1 to 1.9, again with wide regional variation. The rates of twin deliveries following fresh non-donor transfers were, in 2008, 2009 and 2010, 21.8, 20.5 and 20.4%, respectively, with a corresponding triplet rate of 1.3, 1.0 and 1.1%. Fresh IVF and ICSI carried a perinatal mortality rate per 1000 births of 22.8 (2008), 19.2 (2009) and 21.0 (2010), compared with 15.1, 12.8 and 14.6/1000 births following FET in the same periods of observation. The proportion of women aged 40 years or older undergoing non-donor ART increased from 20.8 to 23.2% from 2008 to 2010. LIMITATIONS, REASON FOR CAUTION The data presented are reliant on the quality and completeness of data submitted by individual countries. This report covers approximately two-thirds of the world ART activity. WIDER IMPLICATIONS OF FINDINGS The ICMART World Reports provide the most comprehensive global statistical census and review of ART utilization, effectiveness, safety and quality. While ART treatment continues to increase globally, the wide disparities in access to treatment and embryo transfer practices warrant attention by clinicians and policy makers. STUDY FUNDING/COMPETING INTERESTS The authors declare no conflict of interest and no specific support from any organizations in relation to this manuscript. ICMART acknowledges financial support from the following organizations: American Society for Reproductive Medicine; European Society for Human Reproduction and Embryology; Fertility Society of Australia; Japan Society for Reproductive Medicine; Japan Society of Fertilization and Implantation; Red Latinoamericana de Reproduccion Asistida; Society for Assisted Reproductive Technology; Government of Canada (Research grant), Ferring Pharmaceuticals (Grant unrelated to World Reports). TRIAL REGISTRATION not applicable.
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Affiliation(s)
- S Dyer
- Department of Obstetrics & Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - G M Chambers
- National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, Australia
| | - J de Mouzon
- Institut National de la Santé et de la Recherche Médicale Service de Gynécologie Obstétrique II et de Médecine de la Reproduction, Groupe Hospitalier Cochin-Saint Vincet de Paul, Paris, France
| | - K G Nygren
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - F Zegers-Hochschild
- Clinica las Condes and Program of Ethics and Public Policies in Human Reproduction, University Diego Portales, Santiago, Chile
| | - R Mansour
- Egyptian IVF-ET Center, Cairo, Egypt
| | - O Ishihara
- Department of Obstetrics and Gynaecology, Saitama Medical University, Moroyama, Japan
| | - M Banker
- Nova IVI Fertility, Chennai, India
| | - G D Adamson
- Palo Alto Medical Foundation Fertility Physicians of North California, San Jose, CA, USA
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Matharu GS, Mansour R, Dada O, Ostlere S, Pandit HG, Murray DW. Which imaging modality is most effective for identifying pseudotumours in metal-on-metal hip resurfacings requiring revision: ultrasound or MARS-MRI or both? Bone Joint J 2016; 98-B:40-8. [PMID: 26733514 PMCID: PMC4714034 DOI: 10.1302/0301-620x.98b1.36746] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims The aims of this study were to compare the
diagnostic test characteristics of ultrasound
alone, metal artefact reduction sequence MRI
(MARS-MRI) alone, and ultrasound combined with
MARS-MRI for identifying intra-operative
pseudotumours in metal-on-metal hip resurfacing
(MoMHR) patients undergoing revision surgery. Methods This retrospective diagnostic accuracy study
involved 39 patients (40 MoMHRs). The time between
imaging modalities was a mean of 14.6 days (0 to
90), with imaging performed at a mean of 5.3
months (0.06 to 12) before revision. The
prevalence of intra-operative pseudotumours was
82.5% (n = 33). Results Agreement with the intra-operative findings was
82.5% (n = 33) for ultrasound alone, 87.5%
(n = 35) for MARS-MRI alone, and 92.5%
(n = 37) for ultrasound and MARS-MRI combined. The
diagnostic characteristics for ultrasound alone
and MARS-MRI alone reached similar sensitivities
(90.9% vs 93.9%) and positive
predictive values (PPVs; 88.2% vs
91.2%), but higher specificities (57.1%
vs 42.9%) and negative predictive
values (NPVs; 66.7% vs 50.0%)
were achieved with MARS-MRI. Ultrasound and
MARS-MRI combined produced 100% sensitivity and
100% NPV, whilst maintaining both specificity
(57.1%) and PPV (91.7%). For the identification of a pseudotumour, which
was confirmed at revision surgery, agreement was
substantial for ultrasound and MARS-MRI combined
(κ = 0.69), moderate for MARS-MRI alone
(κ = 0.54), and fair for ultrasound
alone (κ = 0.36). Discussion These findings suggest that ultrasound and/or
MARS-MRI have a role when assessing patients with
a MoMHR, with the choice dependent on local
financial constraints and the availability of
ultrasound expertise. However in patients with a
MoMHR who require revision, combined imaging was
most effective. Take home message: Combined imaging with
ultrasound and MARS-MRI always identified
intra-operative pseudotumours if present.
Furthermore, if neither imaging modality showed a
pseudotumour, one was not found
intra-operatively. Cite this article: Bone Joint
J 2016;98-B:40–8.
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Affiliation(s)
- G S Matharu
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
| | - R Mansour
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
| | - O Dada
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
| | - S Ostlere
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
| | - H G Pandit
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
| | - D W Murray
- NDORMS and Nuffield Orthopaedic Centre, Oxford, UK
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Schönhofer S, Mansour R, Ghotbi R. Initial results of the management of aortoiliac aneurysms with GORE® Excluder® Iliac Branched Endoprosthesis. J Cardiovasc Surg (Torino) 2015; 56:883-888. [PMID: 26509393] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM We prospectively observed the outcomes of all patients (N.=15) with an aortoiliac and a common iliac artery aneurysm who were electively treated with the GORE® Excluder® Iliac Branched Endoprosthesis (IBE) with regard to clinical, anatomical and radiological results. METHODS We evaluated operative mortality, aneurysm rupture rate and aneurysm related mortality as well as conversion to open surgery, incidence of endoleak, rate of aneurysm migration, aneurysm enlargement, graft patency, reintervention rate and the clinical outcome. Postoperative follow-up included a computed tomography angiography (CTA) before discharge, clinical evaluation and Duplex ultrasound or CTA 3 weeks after the intervention and Duplex ultrasound every 3 months afterwards. RESULTS Mean patient age was 79 years (range 61-83 years); f/m: 1/2; mean follow-up was 9 months; 80% of the patients presented 2 or more major comorbidities and 1/3 were considered to be not eligible for open repair. Mean hospitalization time was 5 days. Technical success rate was 93.3% (intent-to-treat basis). Mortality within 30 days was 0%; there were no ruptures; type II endoleak directly after the procedure occurred in 20%, dropping to 13.3% after 3 months. We defined the initial technical success in absence of type I endoleaks. The initial technical success rate was 100%. No IBE occlusion or type Ia, Ib or III endoleak was observed during the postoperative follow-up (mean follow-up: 9 months). All of the internal iliac side branches remained patent. Reintervention rate, buttock claudication rate and pelvic complication rate were 0%. CONCLUSION The GORE® IBE provides a new and safe alternative for the management of complete endovascular repair of an extensive aortoiliac or common iliac aneurysm while maintaining pelvic blood flow in iliac branched devices. Due to the lower complexity if compared to previous endovascular or hybrid methods, it should be performed in every anatomically suitable case.
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Affiliation(s)
- S Schönhofer
- Department of Vascular and Endovascular Surgery, Helios Hospital Munich‑West, Teaching Hospital of Ludwig Maximilian University, Munich, Germany -
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Sharaf N, Mansour R, Elsayed N, Mahran L. P078: Neuroprotective effect of thymoquinone against lipopolysaccharide-induced Alzheimer's disease in an animal model. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70253-0] [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: 10/24/2022]
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Le Pape P, Hache G, Lanet F, Mansour R, Blanc D, Combralier-Amirat V. CP-091 Involvement of Hospital Pharmacists in health education for prisoners: assessment of a workshop on treatment compliance. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.89] [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] Open
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Ferraretti A, Goossens V, Bhattacharya S, Castilla JA, de Mouzon J, Korsak V, Andersen AN, Kupka M, Adamson D, Zegers-Hochschild F, Ishihara O, Sullivan E, Mansour R, Nygren KG, Banker M, de Mouzon J, Dyer S, Dyer SJ. Session 23: European and Global ART Monitoring (presentation of the EIM and ICMART data reports). Hum Reprod 2013. [DOI: 10.1093/humrep/det151] [Citation(s) in RCA: 2] [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: 11/12/2022] Open
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Sullivan EA, Zegers-Hochschild F, Mansour R, Ishihara O, de Mouzon J, Nygren KG, Adamson GD. International Committee for Monitoring Assisted Reproductive Technologies (ICMART) world report: assisted reproductive technology 2004. Hum Reprod 2013; 28:1375-90. [PMID: 23442757 DOI: 10.1093/humrep/det036] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Have changes in assisted reproductive technology (ART) practice and outcomes occurred globally between 2003 and 2004? SUMMARY ANSWER Globally, ART practice has changed with an increasing prevalence of the use of ICSI rather than conventional IVF. In 2004, a small but increasing number of countries are incorporating single embryo transfer. There remain unacceptably high rates of three or more embryo transfers in select countries resulting in multiple births and adverse perinatal outcomes. WHAT IS KNOWN ALREADY World data on the availability, effectiveness and safety of ART have been published since 1989. The number of embryos transferred is a major determinant of the iatrogenic increase in multiple pregnancies and is highly correlated with the likelihood of multiple birth and excess perinatal morbidity and mortality. STUDY DESIGN, SIZE, DURATION Cross-sectional survey of countries and regions undertaking surveillance of ART procedures started in 2004 and their corresponding outcomes. PARTICIPANTS/MATERIALS, SETTING, METHODS Of total, 2184 clinics from 52 reporting countries and regions. Number of ART clinics, types of cycles and procedures, pregnancy, delivery and multiple birth rates and perinatal outcomes. MAIN RESULTS AND THE ROLE OF CHANCE A total of 954 743 initiated cycles resulted in an estimated 237 809 babies born. This was a 2.3% increase in the number of reported cycles from 2003. The availability of ART varied by country and ranged from 14 to 3844 treatment cycles per million population. Over one-third (37.2%) of ART clinics performed <100 cycles per year with only 19.9% performing ≥ 500 cycles per year. Of all cycles, 60.6% were ICSI. Frozen embryo transfers (FETs) represented 31% of the initiated cycles. The overall delivery rate per fresh aspiration for IVF and ICSI was 20.2% compared with 16.6% per FET. The average number of embryos transferred was 2.35. Single (16.3%) and double embryo transfers accounted for 73.2% of cycles. The overall proportion of deliveries with twins and triplets from IVF and ICSI was 25.1 and 1.8%, respectively, but varied widely by country and region. The proportion of premature deliveries per fresh aspiration for IVF and ICSI was 33.7% compared with 26.3% per FET. The perinatal death rate was 25.8 per 1000 births for fresh aspiration for IVF and ICSI compared with 14.2 per 1000 births per FET. LIMITATIONS, REASONS FOR CAUTION Data are incomplete with seven countries not providing data to the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) in 2004 that had in 2003. The validity of data reflects current data collection practice. In 2004, 79.3% of the clinics in participating countries reported to their national or regional registries and to ICMART. In addition, the number of ART cycles per million population is a measure which is affected by a country's government policy, regulation, funding and the number of service providers. WIDER IMPLICATIONS OF THE FINDINGS ART practice, effectiveness and outcomes vary markedly internationally. Notably, the increasing proportion of cycles that are FET, the change in practice to single embryo transfer and the cessation of the transfer of three or more embryos in some countries has resulted in improved perinatal outcomes with minimal impact on pregnancy rates. STUDY FUNDING/COMPETING INTEREST(S) ICMART receives financial support from ASRM, ESHRE, FSA, Japan Society for Reproductive Medicine, REDLARA, MEFS and SART.
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Affiliation(s)
- E A Sullivan
- National Perinatal Statistics and Epidemiology Unit, School of Women's and Children's Health, University of New South Wales, Randwick Hospitals Campus, McNevin Dickson Building Room Level 2, Randwick, NSW 2031, Australia.
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Ferraretti A, Goossens V, Bhattacharya S, Castilla JA, De Mouzon J, Korsak V, Kupka M, Nygren KG, Nyboe Andersen A, David Adamson G, Zegers-Hochschild F, Ishihara O, Sullivan E, Mansour R, Nygren KG, Banker M, Dyer S, de Mouzon J, Ishihara O, Zegers-Hochschild F, De Mouzon J, Mansour R, Nygren KG, Banker M, Dyer S, Adamson GD. SESSION 26: EUROPEAN AND GLOBAL ART MONITORING. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.26] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Khalid SN, Qureshi IZ, Nagulapally S, Mittal S, Malhotra N, Noh O, Mansour R, Seror G, Aboulghar M, Moghazy MONA, Al-Inany H, Singh M, Singh R, Wiweko B, Shafira N, Bennett LR, Chaudhury K, Subramani E, Pasricha P, Chakravarty BN. SESSION 04: DEVELOPING COUNTRIES AND INFERTILITY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mansour R, Tawab N, Kamal O, El-faissal Y, Serour A, Aboulghar M. Intrauterine injection of human chorionic gonadotrophin before embryo transfer significantly improves the implantation and pregnancy rates in IVF/ICSI. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.136] [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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Mansour R, Nada A, El-Khayat W, Abdel-Hak A, Inany H. A simple and relatively painless technique for hysterosalpingography, using a thin catheter and closing the cervix with the vaginal speculum: a pilot study. Postgrad Med J 2011; 87:468-71. [DOI: 10.1136/pgmj.2010.106658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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de Mouzon J, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, Kupka M, Nygren KG, Nyboe Andersen A, Zegers - Hochschild F, Adamson D, Gosta Nygren K, De Mouzon J, Sullivan E, Ishihara O, Mansour R. INVITED SESSION, SESSION 55: EUROPEAN AND GLOBAL ART MONITORING, Wednesday 6 July 2011 08:30 - 09:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tryfonidis M, Jackson W, Mansour R, Cooke PH, Teh J, Ostlere S, Sharp RJ. Acquired adult flat foot due to isolated plantar calcaneonavicular (spring) ligament insufficiency with a normal tibialis posterior tendon. Foot Ankle Surg 2010; 14:89-95. [PMID: 19083621 DOI: 10.1016/j.fas.2007.11.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [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] [Received: 05/17/2007] [Revised: 10/28/2007] [Accepted: 11/25/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND We present nine cases of acquired flat foot deformity (AFFD) in adults caused by isolated spring ligament insufficiency. METHODS We present the clinical sign that allows differentiation of this diagnosis from posterior tibialis tendon (PTT) dysfunction namely the ability to single leg tiptoe, but with persistent forefoot abduction and heel valgus. In addition we illustrate the unique radiological features which allow confirmation of the diagnosis. Only a solitary previous case report has documented this alternative aetiology of AFFD; in that case, diagnosis was made intra-operatively. RESULTS Six patients have been managed with orthoses. Three patients underwent surgery; one patient who presented early had isolated repair of the spring ligament complex. The remaining two required a calcaneal osteotomy and flexor digitorum longus transfer as for a PTT reconstruction. CONCLUSION We propose that early diagnosis (with ultrasound confirmation) and management of this condition would offer a better prognosis and allow less interventional surgery.
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Affiliation(s)
- M Tryfonidis
- Department of Foot & Ankle Surgery, Nuffield Orthopaedic Centre NHS Trust, Windmill Road, Headington, Oxford OX3 7LD, UK.
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Sheth B, Liu J, Olagbaju O, Varghese L, Mansour R, Reddoch S, Pearson D, Loveland K. Identifying social and non-social change in natural scenes: children vs.adults, and children with and without autism. J Vis 2010. [DOI: 10.1167/10.7.1299] [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] Open
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de Mouzon J, Lancaster P, Nygren KG, Sullivan E, Zegers-Hochschild F, Mansour R, Ishihara O, Adamson D. World Collaborative Report on Assisted Reproductive Technology, 2002. Hum Reprod 2010. [DOI: 10.1093/humrep/dep454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, Vanderpoel S. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril 2009; 92:1520-4. [PMID: 19828144 DOI: 10.1016/j.fertnstert.2009.09.009] [Citation(s) in RCA: 836] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 09/09/2009] [Accepted: 09/09/2009] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Many definitions used in medically assisted reproduction (MAR) vary in different settings, making it difficult to standardize and compare procedures in different countries and regions. With the expansion of infertility interventions worldwide, including lower resource settings, the importance and value of a common nomenclature is critical. The objective is to develop an internationally accepted and continually updated set of definitions, which would be utilized to standardize and harmonize international data collection, and to assist in monitoring the availability, efficacy, and safety of assisted reproductive technology (ART) being practiced worldwide. METHOD Seventy-two clinicians, basic scientists, epidemiologists and social scientists gathered together at the World Health Organization headquarters in Geneva, Switzerland, in December 2008. Several months before, three working groups were established as responsible for terminology in three specific areas: clinical conditions and procedures, laboratory procedures, and outcome measures. Each group reviewed the existing International Committee for Monitoring Assisted Reproductive Technology glossary, made recommendations for revisions and introduced new terms to be considered for glossary expansion. RESULT(S) A consensus was reached on 87 terms, expanding the original glossary by 34 terms, which included definitions for numerous clinical and laboratory procedures. Special emphasis was placed in describing outcome measures, such as cumulative delivery rates and other markers of safety and efficacy in ART. CONCLUSION(S) Standardized terminology should assist in analysis of worldwide trends in MAR interventions and in the comparison of ART outcomes across countries and regions. This glossary will contribute to a more standardized communication among professionals responsible for ART practice, as well as those responsible for national, regional, and international registries.
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Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, van der Poel S. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 2009; 24:2683-7. [PMID: 19801627 DOI: 10.1093/humrep/dep343] [Citation(s) in RCA: 582] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Many definitions used in medically assisted reproduction (MAR) vary in different settings, making it difficult to standardize and compare procedures in different countries and regions. With the expansion of infertility interventions worldwide, including lower resource settings, the importance and value of a common nomenclature is critical. The objective is to develop an internationally accepted and continually updated set of definitions, which would be utilized to standardize and harmonize international data collection, and to assist in monitoring the availability, efficacy, and safety of assisted reproductive technology (ART) being practiced worldwide. METHOD Seventy-two clinicians, basic scientists, epidemiologists and social scientists gathered together at the WHO headquarters in Geneva, Switzerland in December, 2008. Several months in advance, three working groups were established which were responsible for terminology in three specific areas: clinical conditions and procedures, laboratory procedures and outcome measures. Each group reviewed the existing ICMART glossary, made recommendations for revisions and introduced new terms to be considered for glossary expansion. RESULTS A consensus was reached on 87 terms, expanding the original glossary by 34 terms, which included definitions for numerous clinical and laboratory procedures. Special emphasis was placed in describing outcome measures such as cumulative delivery rates and other markers of safety and efficacy in ART. CONCLUSIONS Standardized terminology should assist in analysis of worldwide trends in MAR interventions and in the comparison of ART outcomes across countries and regions. This glossary will contribute to a more standardized communication among professionals responsible for ART practice, as well as those responsible for national, regional and international registries.
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Abstract
e19101 Background: Carboplatin is a commonly used drug in stage III/IV non-small cell lung cancer (NSCLC). Its dose in typically calculated with the Calvert equation that uses the glomerular filtration rate (GFR) from various predictive formulae such as MDRD, Cockroft-Gault, Jeliffe and Wright as well as the targeted area under the curve (AUC) for carboplatin. Myelosuppression is a common toxicity of carboplatin and this study aimed to assess the relationship between dosing and toxicity as well as if there would be any significant difference in dosing based on calculation of GFR from the above formulae in our patient population. Methods: Data from patients with Stage III and IV NSCLC seen between 1/1/99 to 12/31/2007 were analyzed. Patients who received concurrent radiation, who died before the first cycle was completed, as well as patients with missing lab values were excluded. Only the first cycle of the carboplatin based regime was used for analysis with nadir platelets, hemoglobin and wbc's used as endpoints. SPSS software was used for statistical analysis including Pearson correlation, ANCOVA, independent t-tests as well as multivariate linear regression models. Results: Of the 216 patients initially abstracted for analysis only 132 patients were analyzable. Demographically 71 were Caucasian and rest were African-American while 92 were male. The carboplatin dose calculated from all four formulae were highly correlated (p < 0.0001). The drop in the three cell counts were correlated to each other (p< 0.05), particularly the drop in platelet count with other two cell counts. The correlation between the drop in wbc and drop in hemoglobin approached significance (p=0.075). The nadir wbc was significantly associated with BSA (p=0.004), wbc level at baseline (p< 0.000) and approached significance for carboplatin dose (p=0.059) by ANCOVA analysis, while significance was not reached for nadir platelets or nadir hemoglobin. Conclusions: The different predictive equations resulted in similar doses of carboplatin that were statistically significant. BSA correlated significantly with myelosuppression while carboplatin dose only approached significance. No significant financial relationships to disclose.
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Affiliation(s)
| | - J. McLarty
- LSU Health Sciences Center, Shrevport, LA
| | - R. Mansour
- LSU Health Sciences Center, Shrevport, LA
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Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K. Incidental findings on MRI of the spine. Clin Radiol 2009; 64:353-61. [DOI: 10.1016/j.crad.2008.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 09/11/2008] [Accepted: 09/16/2008] [Indexed: 12/21/2022]
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Al-Inany H, Abousetta A, Mansour R, Seror G, Aboulghar M. P-72. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.07.417] [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: 10/24/2022]
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Hussain S, Singh M, Shi R, Mansour R, Mills G, Marion J. Megestrol acetate increases the incidence of deep venous thrombosis in patients with non small cell lung cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18510] [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: 11/20/2022] Open
Abstract
18510 Background: To evaluate the incidence of deep venous thrombosis (DVT) in patients with non small cell lung cancer who take megestrol acetate as an appetite stimulant. Methods: A retrospective study of patients with non small cell lung cancer (NSCLC) was performed to determine the incidence of deep venous thrombosis. We reviewed medical records of patients with NSCLC who were treated with and without megestrol acetate as an appetite stimulant during the course of their treatment or follow up. Cochran-Mantel-Hansel statistics was performed. Results: We reviewed the charts of 179 patients with NSCLC. 86 patients received megestrol acetate during the course of treatment or follow up whereas 93 did not. Within the treatment group, 28 patients were female and 58 were male. In the control group 43 patients were female and 50 were male. There was no significant difference in the ECOG performance status of those in the treatment group from those in the control group. The frequency of DVT was 3.4 times higher in the treatment group as compared to the control group adjusting for gender (p < 0.02). Similarly, the frequency of DVT was 2.8 times higher in the treatment group as compared to the control group adjusting for stage (P < 0.045). Conclusions: After adjusting for gender or stage, the incidence of DVT appears to be higher for patients with NSCLC who took megestrol acetate as compared to those who did not. Even though megestrol acetate was being used as an appetite stimulant, the observed differences were not due to differences in the performance status of the two groups. Further prospective study of the risks and benefits of megestrol acetate as an appetite stimulant in patients with advanced NSCLC and other malignancies is warranted. No significant financial relationships to disclose.
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Affiliation(s)
- S. Hussain
- Louisiana State University Health Science Center, Shreveport, LA
| | - M. Singh
- Louisiana State University Health Science Center, Shreveport, LA
| | - R. Shi
- Louisiana State University Health Science Center, Shreveport, LA
| | - R. Mansour
- Louisiana State University Health Science Center, Shreveport, LA
| | - G. Mills
- Louisiana State University Health Science Center, Shreveport, LA
| | - J. Marion
- Louisiana State University Health Science Center, Shreveport, LA
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Hussain S, Singh M, Shi R, Mansour R, Marion J. 95 INCIDENCE OF DEEP VENOUS THROMBOSIS IN PATIENTS WITH NON-SMALL CELL LUNG CANCER ON MEGESTROL ACETATE. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0008.94] [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: 11/18/2022]
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Shen S, Ramer R, Banciu M, Mansour R. Design and realisation of star-geometry dual-mode bandpass filter. Opt Express 2005; 13:9753-9757. [PMID: 19503182 DOI: 10.1364/opex.13.009753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A design of a planar dual-mode filter is proposed and developed for satellite and wireless communication systems. The novelty of the proposed structure consists of replacing simple diagonal design with a starlike one. This offers the ability of controlling the central frequency and the bandwidth. The filter was implemented on Rogers substrate with 10.8 dielectric constant. The proposed filter structure is 37% smaller in size in comparison with traditional dual mode filters.
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Mansour R, Nanni M, Muthukumar T, Butt SH, Cassar-Pullicino VN. Subperiosteal ganglion associated with Paget's disease of bone. Skeletal Radiol 2005; 34:419-23. [PMID: 15517248 DOI: 10.1007/s00256-004-0870-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Revised: 09/15/2004] [Accepted: 09/16/2004] [Indexed: 02/02/2023]
Abstract
Tumoral lesions related to Paget's disease may be classified as malignant, benign or pseudotumoral. While sarcomatous degeneration is the most feared complication, awareness of benign and pseudotumoral lesions is essential for assisting in accurate histological interpretation of the biopsy sample, which may avoid unnecessary repeat biopsies. We present the first case of a juxta-articular subperiosteal ganglion associated with Paget's disease, with classic imaging characteristics, especially on CT examination. The well-defined soft tissue mass at the medial aspect of the obturator rim, adjacent to a small fracture in pagetic quadrilateral plate, showed an ossified rim and internal gas lucencies, these being the hallmarks of a juxta-articular subperiosteal ganglion. On MRI, the lesion was of intermediate signal intensity on T1-weighted sequences, increased signal intensity on T2-weighted sequences, with rim enhancement after gadolinium contrast injection and preservation of fatty marrow signal of the underlying pagetic bone. Identification of the entity avoided an unnecessary biopsy or surgical intervention.
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Affiliation(s)
- R Mansour
- Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK
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Barakat Y, Mostafa NE, Ibrahim V, Mansour R. Relationships of surfactant head group weight fraction and some polarity terms by gas chromatography. Se Pu 2005; 23:341-6. [PMID: 16250439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Polarity, partition coefficient (K) , methanol carbon number of surfactant ((C(MeoH))S), and methanol carbon number of surfactant head group ((C(MeOH)) HG) are measured on six alkanolamides and five polyoxyethylenated long chain amines as stationary phases. From the measured methanol carbon numbers, polarity indices, (IP)S and (IP)HG, are calculated. The determined polarity terms are plotted against the head group weight fraction (f(HG)) of the investigated surfactants and several equations have been developed. The study reveals that the molecular structural gap between alkanolamides and polyoxyethylenated long chain amines diminished when HLB numbers of these surfactant classes are plotted against f(HG) values. Consequently, a general equation relating HLB and f(HG) is obtained.
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Affiliation(s)
- Y Barakat
- Egyptian Petroleum Research Institute, Cairo, Egypt
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Nanni M, Butt S, Mansour R, Muthukumar T, Cassar-Pullicino VN, Roberts A. Stress-induced Salter-Harris I growth plate injury of the proximal tibia: first report. Skeletal Radiol 2005; 34:405-10. [PMID: 15782342 DOI: 10.1007/s00256-004-0892-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2004] [Revised: 11/22/2004] [Accepted: 11/24/2004] [Indexed: 02/02/2023]
Abstract
We describe a case of chronic Salter-Harris I injury of the proximal tibial epiphysis. To our knowledge such an injury has not been described in the English language literature. The radiological appearance can mimic chronic infection. The possibility of chronic athletic stress-related change should be considered in such scenarios to avoid a misdiagnosis.
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Affiliation(s)
- M Nanni
- Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK
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Abstract
BACKGROUND For the last few decades urinary human chorionic gonadotrophin has been used to induce final follicular maturation and for triggering ovulation in assisted conception. Recombinant technology has allowed the production of two drugs that can be used for the same purpose: to mimic the endogenous luteinizing hormone (LH) surge. This would allow commercial production to be adjusted according to market requirements. In addition all urinary contaminants would also be removed. Hence, this would allow the safe subcutaneous administration of a compound with less batch-to-batch variation. However, prior to a change in practice, the effectiveness of the recombinant drugs should be known, compared to the currently used urinary human chorionic gonadotrophins. OBJECTIVES To assess the safety and efficacy of subcutaneous rhCG and high dose rLH compared with intramuscular uhCG for inducing final oocyte maturation and triggering ovulation. SEARCH STRATEGY We searched the Cochrane Menstrual Disorders and Subfertility Group trials register (27 August 2003), the Cochrane Central Register of Controlled Trials (CENTRAL on The Cochrane Library, issue 4, 2003), MEDLINE (1966 to Feb 2004) and EMBASE (1980 to Feb 2004). Searches were not limited by language. The bibliographies of included, excluded trials and abstracts of major meetings were searched for additional trials. Authors and pharmaceutical companies were contacted for missing and unpublished data. SELECTION CRITERIA Two reviewers independently scanned titles and abstracts, and selected those that appeared relevant for collection of the full paper. Only truly randomised controlled trials comparing rhCG or high dose r-LH with urinary hCG for triggering ovulation in assisted conception for treatment of infertility in normogonadotrophic women were included. DATA COLLECTION AND ANALYSIS Assessment of inclusion/exclusion, quality assessment and data extraction were performed independently by at least two reviewers. Discrepancies were discussed in the presence of a third reviewer and a consensus reached. Quality assessment included method of randomisation, allocation concealment, blinding of participants and assessors, reporting of a power calculation, intention to treat analysis, and handling of dropouts. Data extraction included characteristics of participants, the intervention and control procedures, and outcomes. MAIN RESULTS Seven RCTs were identified, four comparing rhCG and uhCG and three comparing rhLH and uhCG. There was no statistically significant difference between rhCG vs uhCG regarding the ongoing pregnancy/ live birth rate (OR 0.98, 95% CI 0.69 to 1.39), pregnancy rate, miscarriage or incidence of OHSS. There was no statistically significant difference between rhLH vs uhCG regarding the ongoing pregnancy/ live birth rate (OR 0.94, 95% CI 0.50 to 1.76), pregnancy rate, miscarriage or incidence of OHSS. The manufacturer of rhLH has decided not to further develop this product. rhCG was associated with a reduction in the incidence of local site reactions and other minor adverse effects (OR 0.47, 95% CI 0.32 to 0.70). AUTHORS' CONCLUSIONS There is no evidence of difference in clinical outcomes between urinary and recombinant gonadotrophins for induction of final follicular maturation. Additional factors should be considered when choosing gonadotrophin type, including safety, cost and drug availability.
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Affiliation(s)
- H G Al-Inany
- Department of Obstetrics & Gynecology, Faculty of Medicine, Cairo University, 8 Moustapha Hassanin St, Manial, Cairo, Egypt.
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Kayed H, Mansour R, Amer A, Abderazek A, Serour G, Aboulghar M. Chromosomal abnormalities of 1750 couples entering ICSI program. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.887] [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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Bellet R, Carducci M, Petrylak D, Kasimis B, Irwin D, Modiano M, Mansour R, Axelrod R, Doukas M. Phase II study of DHA-paclitaxel (TXP) as first line chemotherapy in patients with hormone refractory prostate cancer (HRPC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4657] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Bellet
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - M. Carducci
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - D. Petrylak
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - B. Kasimis
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - D. Irwin
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - M. Modiano
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - R. Mansour
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - R. Axelrod
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
| | - M. Doukas
- Luitpold Pharmaceuticals, Inc., Norristown, PA; Johns Hopkins University, Baltimore, MD; Columbia-Presbyterian Medical Center, New York, NY; East Orange VA Medical Center, East Orange, NJ; Alta Bates Comprehensive Cancer Center, Berkeley, CA; Arizona Oncology Associates, Tucson, AZ; Feist-Weiler Cancer Center, Shreveport, LA; Thomas Jefferson University Hospital, Philadelphia, PA; University of Kentucky and VA Medical Center, Lexington, KY
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Fahmy I, Kamal A, Shamloul R, Mansour R, Serour G, Aboulghar M. ICSI using testicular sperm in male hypogonadotrophic hypogonadism unresponsive to gonadotrophin therapy. Hum Reprod 2004; 19:1558-61. [PMID: 15142993 DOI: 10.1093/humrep/deh243] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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
BACKGROUND The aim of this study was to assess the use of testicular sperm for ICSI in azoospermic men with hypogonadotrophic hypogonadism unresponsive to gonadotrophin therapy. METHODS Fifteen patients with hypogonadotrophic hypogonadism who remained azoospermic after hormonal treatment underwent testicular sperm extraction (TESE) and ICSI. These men were recruited from the Egyptian IVF centre over a period of 4 years. All patients were given 75 IU hMG thrice weekly and 5000 IU hCG once or twice weekly for >/=6 months prior to attempting ICSI/TESE. RESULTS In 11 out of 15 patients (73%), sperm could be retrieved from testicular tissue and were used for ICSI. Two chemical pregnancies resulted but no clinical pregnancies. Nine patients continued gonadotrophin therapy for another 6 months. Sperm appeared in the ejaculate of three of them. The remaining six patients underwent another ICSI cycle, one using cryopreserved sperm and five underwent a second TESE. One chemical pregnancy and three clinical pregnancies were established. One ongoing, one singleton and one twin pregnancies resulted in the delivery of three healthy babies. In total, of 17 ICSI cycles performed using testicular sperm retrieval, the fertilization rate was 41.7% and the cumulative pregnancy rate was 20%. CONCLUSIONS The use of testicular sperm for ICSI is a treatment option that can be offered to azoospermic males with hypogonadotrophic hypogonadism either not responding or reluctant to continue hormonal treatment. However, prolonged hormonal treatment may improve TESE/ICSI results.
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Affiliation(s)
- I Fahmy
- The Egyptian IVF-ET Center, Maadi, Cairo 11431.
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Affiliation(s)
- M Kamel
- Al-Azhar University, Cairo, Egypt.
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Mansour R, Aboulghar M, Serour G, Fahmy I, Amin Y. The effectiveness of a low cost ovulation induction protocol in assisted reproduction. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02393-7] [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: 11/25/2022]
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