Biomedical subjects

C Yazbeck

Publications and source records attributed to C Yazbeck.

13 recordsLinked to original sources

PubMed2006

[Lead exposure in pregnant women and newborns: a screening update].

UNLABELLED: Human lead exposure has many sources. Relative importance of these sources varies widely according to geographic regions and human lifestyle. The impact of lead exposure on health has been well studied and public health interventions have been conducted. OBJECTIVE: The aim of this study was to evaluate current prevalence of lead burden in neonates, and seek for sources of maternal and fetal intoxication. POPULATION AND METHODS: A prospective multicentre study was conducted by the "Réseau périnatal 92" on a population of pregnant women attending 3 maternal wards in the north of 'Hauts-de-Seine' department in France. Between December 2003 and May 2004, a total of 1021 pregnant women were included. All patients signed an informed consent before participating in the study. Cord blood samples were collected at delivery for lead measurements. RESULTS: The mean cord blood lead concentration was 23.2 microg/l. Eighteen neonates over 1021 (1.8%) had lead levels above 100 microg/l. An environmental query was conducted by the social and public health office of the department (DDASS), and data were collected regarding the state of the housing and the lifestyle of the concerned family. Main sources of lead intoxication were 'tagine' food plates in 83.3% of cases, 'khôl' powder (used as eyeliner) in 88.9% of cases and substandard housings in 22.2% of cases. A specialized paediatric follow-up for the 18 neonates was performed. CONCLUSION: With the exception of substandard housing (old lead painting), other sources of lead intoxication were discovered: 'tagine' plates and 'khôl' powder. Almost all of these products came from Morocco. A public health intervention would be able to inform the population about these yet unknown sources of lead intoxication.

Female↗

PubMed2006

[Levonorgestrel-releasing intrauterine system in the treatment of dysfunctional uterine bleeding: A French multicenter study].

OBJECTIVE: To evaluate the levonorgestrel-releasing intra-uterine system as an alternative to surgical treatment in patients presenting with menorrhagia. PATIENTS AND METHODS: In the set of a prospective multicenter study, 49 patients with menorrhagia resistant to medical treatment and/or referred for hysterectomy or endometrial ablation were included. Medical visits were organized 3, 6, 12, 24 and 36 months after insertion of the levonorgestrel-releasing intra-uterine system. Visual score of menstrual bleeding and satisfaction index were noted on each visit. Transvaginal ultrasound, pap smear, endometrial biopsy, and clinical data were retrieved one month before and 12 months after inclusion for tolerance evaluation. RESULTS: Renouncement rate was 90.0% (95% CI = 80.7-96.6%). After a twelve months follow-up, 86.1% of patients were satisfied or very satisfied with their clinical state. We found a significant increase of hemoglobin rates from baseline (14,0 versus 12,9 g/dl; P < 10(-4)). Similar increases were also found in serum iron and ferritin. DISCUSSION AND CONCLUSION: This study confirms the efficacy of the levonorgestrel-releasing intra-uterine system in the control and reduction of menstrual blood loss in patients with dysfunctional uterine bleeding. The high rate of surgery cancellation is a proof of the potential role of the levonorgestrel-releasing intra-uterine system as an alternative treatment in these patients.

Adult↗

PubMed2006

[Ovarian endometriomas: Effect of laparoscopic cystectomy on ovarian response in IVF-ET cycles].

OBJECTIVE: To investigate the follicular response to controlled ovarian hyperstimulation (COH) in IVF-ET cycles after laparoscopic ovarian cystectomy for large endometriomas. PATIENTS AND METHODS: In the set of a retrospective controlled study, the medical records of 113 infertile women who underwent IVF-ET cycles after laparoscopic surgery were reviewed. The study group (A) consisted of 63 patients with severe pelvic endometriosis and endometrioma excision. The control group (B) consisted of 50 infertile patients with mild or minimal endometriosis. Interventions were laparoscopic ovarian cystectomy in the study group, and COH in both groups. RESULTS: Groups A and B were not different in terms of epidemiologic data. The total numbers of recruited follicles (9.1+/-3.3 vs 10.6+/-4.2; P = 0.001), mature follicles (> or =16 mm) (4.2+/-1.7 vs 4.8+/-2.2; P = 0.04), mature oocytes retrieved (5.8+/-3.8 vs 7.4+/-4.6; P = 0.02), and fertilization rate (48.9+/-34.9 vs 61.8+/-32.1%; P = 0.02) observed in group A were lower than those observed in group B, respectively. While the mean number of rFSH ampoules (75 IU) was increased in group A (38.1+/-20.4) compared to group B (29.3+/-16.4; P = 0.004), cumulative pregnancy rates were similar in both groups (27.5+/-8.8% vs 37.2+/-10.6%; P = 0.37). DISCUSSION AND CONCLUSIONS: Ovarian response was reduced during IVF-ET cycles in patients with history of severe endometriosis and laparoscopic excision of endometriomas compared to women with mild or minimal endometriosis without ovarian surgery.

Adult↗

PubMed2006

3-D scapular kinematics during arm elevation: effect of motion velocity.

BACKGROUND: No three-dimensional (3-D) data exist on the influence of motion velocity on scapular kinematics. The effect of arm elevation velocity has been studied only in a two-dimensional setting. METHODS: Thirty healthy subjects performed dominant (right) arm elevation in two planes, sagittal and frontal, and at slow and fast self-selected arm speed. Scapular orientation and humeral elevation were measured at 30 Hz recording frequency with use of a 6-degree-of-freedom electromagnetic system (Polhemus Fastraka). Motion was computed according to the International Society of Biomechanics standards. Scapular orientation was also determined with the arm held in different static positions. FINDINGS: We obtained a full 3-D kinematic description of scapula achieving a reliable, complex 3-D motion during humeral elevation and lowering. The maximal sagittal arm elevation showed a characteristic "M"-shape pattern of protraction/retraction curve. Scapular rotations did not differ significantly between slow and fast movements. Moreover, protraction/retraction and tilt angular values did not differ significantly between static and dynamic tasks. However, scapular lateral rotation values differed between static and dynamic measurements during sagittal and frontal arm elevation. Lateral scapular rotation appears to be less in static than in dynamic measurement, particularly in the sagittal plane. INTERPRETATION: Interpolation of statically recorded positions of the bones cannot reflect the kinematics of the scapula.

Adult↗

PubMed2005

Multi-detector row CT scanning in Paleoanthropology at various tube current settings and scanning mode.

The purpose of this study was to determine the optimal tube current setting and scanning mode for hominid fossil skull scanning, using multi-detector row computed tomography (CT). Four fossil skulls (La Ferrassie 1, Abri Pataud 1, CroMagnon 2 and Cro-Magnon 3) were examined by using the CT scanner LightSpeed 16 (General Electric Medical Systems) with varying dose per section (160, 250, and 300 mAs) and scanning mode (helical and conventional). Image quality of two-dimensional (2D) multiplanar reconstructions, three-dimensional (3D) reconstructions and native images was assessed by four reviewers using a four-point grading scale. An ANOVA (analysis of variance) model was used to compare the mean score for each sequence and the overall mean score according to the levels of the scanning parameters. Compared with helical CT (mean score=12.03), the conventional technique showed sustained poor image quality (mean score=4.17). With the helical mode, we observed a better image quality at 300 mAs than at 160 in the 3D sequences (P=0.03). Whereas in native images, a reduction in the effective tube current induced no degradation in image quality (P=0.05). Our study suggests a standardized protocol for fossil scanning with a 16 x 0.625 detector configuration, a 10 mm beam collimation, a 0.562:1 acquisition mode, a 0.625/0.4 mm slice thickness/reconstruction interval, a pitch of 5.62, 120 kV and 300 mAs especially when a 3D study is required.

Adult↗

PubMed2005

[Diagnostic hysteroscopy and risk of peritoneal dissemination of tumor cells].

Questions have been raised about the safety of diagnostic hysteroscopy preceding surgical treatment of endometrial carcinoma. Several studies showed that the risk of a positive cytology among patients presenting endometrial adenocarcinoma was increased after diagnostic hysteroscopy, suggesting a peritoneal dissemination of tumor cells due to the exploration. We studied this hypothesis on the basis of a systematic review of the scientific data. Five studies fulfilling inclusion criteria have been selected and have been introduced into a fixed model of meta-analysis. On a total of 756 studied patients, 79 presented a positive peritoneal cytology. The diagnostic hysteroscopy did not increase significantly the risk of abdominal dissemination of tumor cells, the peritoneal cytology being positive among 38 patients in the group having undergone this intervention vs 41 patients in the control group (OR = 1,64; 95% CI: 0,96-2,80). In conclusion, no formal evidence is currently available concerning the role of diagnostic hysteroscopy on the frequency of peritoneal dissemination of tumor cells, or on the vital prognosis of the patients presenting with endometrial carcinoma. From the data available, there is not any reason to avoid diagnostic hysteroscopy in the initial workup of endometrial cancer.

Adenocarcinoma↗

PubMed2004

[Sexual function following hysterectomy].

OBJECTIVE: This paper examines the evidence about the impact of hysterectomy on one aspect of quality of life, sexuality. PATIENTS AND METHODS: A systematic review of the French and English language literature was conducted using the search terms "sexuality", "hysterectomy", "libido", and "orgasm". RESULTS: Twenty-one studies were found, ten prospective and 11 retrospective. Outcome measures were mostly postoperative libido and orgasm. Most studies did not consider important confounding factors. The majority of authors found either no change or an enhancement of sexuality in women who had an hysterectomy. DISCUSSION AND CONCLUSION: The majority of research evaluating the effect of hysterectomy on sexuality was poorly designed. The available evidence shows that hysterectomy did not adversely affect sexuality. A number of confounding factors should be taken into account in future studies. The role of the gynecologist in the preparation to this kind of operations is very important.

Female↗

PubMed2004

[Conservative treatment of endometrial cancer and atypical hyperplasia].

Endometrial carcinoma is the most frequent pelvic cancer encountered in women. The discovery of an endometrial carcinoma in a woman seeking pregnancy cannot be considered as exceptional. The medical alternative to the classic radical surgical treatment is studied in a review. Treatment with progestins might be considered and discussed with the couple in special indications. The oncologic risk to which this treatment exposes is limited. However, the application and the surveillance of this therapeutic protocol must obey strict rules, in order to recognize without delay any resistance to treatment. The spontaneous fertility of such patients seems weak, most probably because of their age, but assisted reproductive techniques (ART) could be considered in particular cases. Secondary hysterectomy is controversial, but a recent tendency is to widen this practice is becoming apparent.

Endometrial Hyperplasia↗

PubMed2004

[Update on medical treatment of female stress urinary incontinence].

A reasonable assumption is that incontinence would be relieved by increasing urethral resistance through stimulating alpha-adrenergic receptors in urethral smooth muscle. A review of available medical treatment of stress urinary incontinence is done. Alpha-receptor agonists are not in common use because of systemic side-effects. Estrogens do not seem to have beneficial effect on stress urinary incontinence. Currently, new molecules such as duloxetine, are uptake inhibitor of serotonin and noradrenaline could provide a noninvasive therapy for patients with urinary incontinence. Further studies to identify clinical applications are required.

Adrenergic Uptake Inhibitors↗

PubMed2003

[Preoperative endovaginal ultrasound in the assessment of myometrial invasion of endometrial adenocarcinoma].

OBJECTIVE: To determine, according to histological tumor grade, the reliability of preoperative endovaginal ultrasound in the detection of myometrial invasion in patients with stage I endometrial cancer. PATIENTS AND METHODS: Sixty-one patients with stage I endometrial carcinoma were evaluated with preoperative endovaginal ultrasound compared to postoperative results of pathologic examination, in a six-year retrospective study. RESULTS: Twenty-nine patients had a deep myometrial invasion (stage IC). The mean endometrial thickness was 9.5 mm in stage IA, 17.0 mm in stage IB and 20.0 mm in stage IC disease (P = 0.01). The sensitivity and the specificity of the ultrasound in the assessment of myometrial invasion in grade 1 tumors were 100% and 93.7%, respectively. They fell to 69.2% and 88.9% for high-grade tumors. The global accuracy of ultrasound was 82%. DISCUSSION AND CONCLUSIONS: The performance of preoperative ultrasound varies according to the literature. The association of morphological and morphometric criteria enables an increase in the sensitivity of the exam. In grade 1 tumors, the preoperative endovaginal ultrasound could help in identifying a group of patients at low risk of lymph node metastasis for which a pelvic lymphadenectomy would be avoidable.

Adenocarcinoma↗

PubMed1999

[Anatomoclinical correlations of endometriosis].

This is an epidemiological study of 1,498 patients who underwent laparoscopic surgery for different reasons. Between 1989 and 1996, 308 cases of endometriosis were identified among 1,498 patients who underwent laparoscopic surgery. One hundred and five patients were admitted for pelvic pain, 794 for infertility, 319 patients had both on admission, and 280 were admitted for non-gynecologic complaints. The incidence of endometriosis is related to the chief complaint on admission. This disease has different clinical manifestations, different locations and different stages. The mean age in our series is greater than that reported by the literature. The symptoms are related to the location of the lesions but not the stage of the disease. Unlike pelvic pain, infertility is correlated to the stages of the disease.

Adolescent↗

PubMedDate not supplied

Primary adenocarcinoma arising from endometriosis of the rectovaginal septum: a case report.

Adenocarcinomas developing in endometriotic lesions have been reported, most commonly in the ovary. The rectovaginal septum is a rare location of this neoplastic transformation. We report a case of primary adenocarcinoma arising from endometriosis of the rectovaginal septum in a 25-year-old woman presenting with lower abdominal pain and dyspareunia. Diagnostic and treatment modalities were discussed. Immunohistochemical studies of different keratin subtypes and CA125 expression of the tumor cells are of interest for the diagnosis. Preoperative radiation therapy promotes clinical symptoms relief, tumor volume reduction, and better radical surgical approach.

Adenocarcinoma↗

PubMedDate not supplied

[Radical surgical treatment of vulvar epidermoid cancer].

During an eighteen-year period, forty-nine patients with invasive epidermoid carcinoma of the vulva were treated by a radical vulvectomy at the Hôtel-Dieu de France hospital in Beirut. The age, the clinical presentation, and the lymph nodes involvement were close to what was published in the literature. The overall five-year survival rate was 72%. Those with stage I disease lesions had an excellent survival rate. A review of the literature would indicate that a conservative approach in the treatment of early invasive lesions can give satisfactory results, and that adjuvant radiotherapy is more beneficial than pelvic lymph nodes dissection when there is a high risk of pelvic involvement.

Age Distribution↗