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Biomedical subjects

E Mansour

Publications and source records attributed to E Mansour.

18 recordsLinked to original sources
PubMed2005

Morbidity and mortality of low-birth-weight infants in Egypt.

Low birth weight is one of the major determinants of neonatal survival and postneonatal morbidity. This study assessed the morbidity and mortality of low-birth-weight (LBW) infants during the first 3 months. Data were collected for 6701 live births. All singleton liveborn LBW infants as well as a comparison group of normal-birth-weight (NBW) infants were followed up for 3 months. Data were collected on weight, morbidity and mortality using a structured questionnaire. Admission to neonatal intensive care unit and mortality were more frequent in LBW (31.6%, 2.0%) than NBW infants (2.0%, 0.2%). They also had increased risk of neonatal jaundice at 1 month, an increased risk of growth retardation and a much higher risk of mortality.

Birth Weight↗
PubMed2004

Anaemia among schoolchildren in Qena Governorate, Upper Egypt.

A study was carried out during January/February 2001 in Deshna and Armant Districts of Qena Governorate, Upper Egypt, to establish the prevalence of anaemia among schoolchildren aged 6 to 11 years and define appropriate control interventions in the area. Haemoglobin levels were measured directly in schools using a portable spectrophotometer. The mean (SD) level of haemoglobin in 1844 schoolchildren in 37 schools was 12.79 (1.15) g/dL. Only 12% of children were below the WHO cut-off for anaemia for this age group (< 11.5 g/dL) and no cases of severe anaemia (< 7.0 g/dL) were detected. The low prevalence of mild to moderate anaemia indicates that mass iron supplementation is not justifiable, but routine monitoring of haemoglobin levels should be part of the public health activities in the schools.

Anemia↗
PubMed2000

Adjuvant active specific immunotherapy for stage II and III colon cancer with an autologous tumor cell vaccine: Eastern Cooperative Oncology Group Study E5283.

PURPOSE: A randomized phase III clinical trial of adjuvant active specific immunotherapy (ASI) with an autologous tumor cell-bacillus Calmette-Guérin (BCG) vaccine was conducted to determine whether surgical resection plus ASI was more beneficial than resection alone in stage II and III colon cancer patients. PATIENTS AND METHODS: Patients (n = 412) with colon cancer (297 with stage II disease, 115 with stage III disease) were randomly allocated to an observation arm or to a treatment arm in which they received three weekly intradermal vaccine injections of 10(7) irradiated autologous tumor cells beginning approximately 4 weeks after surgery. The first two weekly injections also contained 10(7) BCG organisms. Patients were observed for determination of time to recurrence and disease-free and overall survival. RESULTS: This was a negative study in that after a 7.6-year median follow-up period, there were no statistically significant differences in clinical outcomes between the treatment arms. However, there were disease-free survival (P =.078) and overall survival (P =.12) trends in favor of ASI when treatment compliance was evaluated, ie, patients who received the intended treatment had a delayed cutaneous hypersensitivity (DCH) response to the third vaccination (induration >/=5 mm). Also, the magnitude of the DCH response correlated with improved prognosis. The 5-year survival proportion was 84.6% for those with indurations greater than 10 mm, compared with 45.0% for those with indurations less than 5 mm. CONCLUSIONS: When all randomized patients were evaluated, no significant clinical benefit was seen with ASI in surgically resected colon cancer patients with stage II or III colon cancer. However, there was an indication that treatment compliance with effective immunization results in disease-free and overall survival benefits.

Adjuvants, Immunologic↗
PubMed1998

Prostate-specific antigen (PSA), PSA density and age-adjusted PSA reference values in screening for prostate cancer--a study of a randomly selected population of 2,400 men.

Prostate cancer screening with DRE, TRUS, and PSA testing was offered to 2,400 randomly selected men 55-70 years old. Among 1,782 examined, 65 (3.6%) men with prostate cancer were diagnosed. The PSA results were correlated to the diagnosis, the men's age, and the prostate volume. Least square regression analysis was used to calculate the 95% upper confidence intervals for PSA in each year of age in men without prostate cancer. The PPV was calculated for: (i) PSA > 4 ng/ml, (ii) PSAD > 0.15, (iii) PSAD > 0.20 and (iv) age-adjusted PSA reference values. A significant correlation was found between PSA and prostate volume, between PSA and age, and between the prostate volume and age. The calculated annual growth of the prostate was 1.6% and the annual increase in PSA was 2.4%. The age-adjusted upper PSA reference values for the three age categories studied (55-59, 60-64 and 65-70 years) were 5.2, 5.8, and 6.7 ng/ml, respectively. The PPVs for PSA > 4 ng/ml, PSAD > 0.15, PSAD > 0.20, and the age-adjusted PSA reference values were 17%, 14%, 22%, and 27%, respectively. Age-adjusted PSA or PSAD may increase the PPV compared to PSA > 4 ng/ml. The detection rate is, however, inadequate. A PSA cut-off at 4 ng/ml could therefore be maintained in men 55-70 years old. The median PSA values and median prostate volumes calculated for men with benign findings may serve as a reference in future studies.

Age Factors↗
PubMed1997

Integrated disease control initiatives: polio eradication and neonatal tetanus elimination in Egypt.

Accelerated disease control initiatives, such as polio eradication by the year 2000, may substantially benefit public health programs in general. In Egypt, the control of other vaccine-preventable diseases, most noticeably neonatal tetanus (NT), has been facilitated by the polio eradication initiative. Linking NT reporting with the acute flaccid paralysis (AFP) surveillance system, which had been established for polio eradication, markedly improved the capacity to identify NT high-risk areas and target supplementary immunization activities appropriately. While the close integration of surveillance activities was to the benefit of both programs, mass immunization activities were not conducted simultaneously because of differences in the objectives, target populations, and operational aspects of oral polio vaccine and tetanus toxoid campaigns. In addition to substantial progress toward polio eradication in Egypt since 1988, there has been an 80% reduction in annual NT cases, in part due to the integration of appropriate aspects of these two disease control initiatives.

Adolescent↗
PubMed1997

The eradication of poliomyelitis in Egypt: critical factors affecting progress to date.

Poliomyelitis eradication activities in Egypt were reviewed to identify the critical factors for the progress seen by 1995 and to highlight problems that could be avoided in other countries in which poliomyelitis is endemic. National immunization and surveillance data demonstrate that the combination of high routine immunization coverage (>85%) with oral polio vaccine combined with two properly conducted rounds of national immunization days (NIDs) resulted in a 75% reduction in reported polio cases between 1992 and 1993. Available data suggest that earlier control strategies, such as single-round NIDs in 1990 and 1991, the administration of inactivated poliovirus vaccine (IPV) at 2 months of age in 1992-1993, and the use of "mop-up" campaigns while wild poliovirus was still widespread, did not contribute substantially to the recent decline in cases. Proper implementation of the World Health Organization's recommended strategies can eliminate wild poliovirus circulation in the large, densely populated tropical countries in which poliomyelitis remains endemic.

Egypt↗
PubMed1996

The role of surveillance in a 'high risk' approach to the elimination of neonatal tetanus in Egypt.

BACKGROUND: Despite an international resolution to eliminate neonatal tetanus (NT) as a public health problem by the year 1995, 490000 cases occurred worldwide in 1994. An analysis of the NT elimination programme in Egypt was conducted to determine the utility of a 'high risk' approach in controlling this disease. METHODS: Three of the indicators for identifying districts at high risk of NT were evaluated. NT rates, tetanus toxoid coverage (TT2+), and urban or rural status. The reduction in NT incidence from 1992 to 1994 was compared between those high risk districts (> or = 1 NT case/1000 live births in 1992) which did or did not conduct supplementary immunization (P = 0.035). RESULTS: In a multivariate analysis, the strongest indicator of the NT risk in a district was the presence of > or = 1 case/1000 live births in the previous year (Rate ratios [RR] = 3.34 in 1993 and 3.07 in 1994, P < 0.001). The TT2+ coverage was not a reliable indicator of NT risk. Urban areas had a significantly lower risk than rural areas (RR = 0.62) in 1993 and 0.49 in 1994, P < 0.001). The decline in NT rates was greatest in the 'high risk' districts that conducted supplementary immunization in both 1993 and 1994. CONCLUSIONS: Although tetanus toxoid immunization of pregnant women will protect newborns from NT, TT2+ coverage calculated by the administrative method may not reflect a population's risk of NT. Surveillance data, however, can be used to identify areas where the ongoing risk NT is high. Conducting supplementary immunization in areas that are identified as 'high risk' on the basis of previous NT rates can significantly reduce the number of cases in subsequent years.

Egypt↗
PubMed1995

Evaluation of house-to-house versus fixed-site oral poliovirus vaccine delivery strategies in a mass immunization campaign in Egypt.

Among poliomyelitis eradication activities recommended by WHO are national immunization days. Most campaigns have delivered oral poliovirus vaccine (OPV) from fixed sites, reaching 80-90% of target populations. Although house-to-house vaccination provides nearly universal coverage, countries have been reluctant to use this approach because it is considered more costly and logistically difficult. To quantify the cost-effectiveness of both these strategies, we compared the vaccine coverage and vaccination costs per child for house-to-house and fixed-site delivery (38% and 13% higher, respectively), the costs per child vaccinated were similar. This was due primarily to the high coverage levels achieved in house-to-house delivery (100% versus 86%) and the reduced vaccine wastage. Vaccinating children at highest risk of infection was only 25-50% as expensive on a per child basis using house-to-house delivery, since such children were less likely to visit fixed sites. These findings may not be generalizable to other countries where labour costs are higher and the population density lower; however, house-to-house delivery may prove to be the most cost-effective eradication strategy by ensuring universal access to immunization.

Child Health Services↗
PubMed1994

Heparin prevents antigen-induced airway hyperresponsiveness: interference with IP3-mediated mast cell degranulation?

We hypothesized that heparin, because of its antiallergic and/or anti-inflammatory properties, modifies airway hyperresponsiveness (AHR). We studied the effects of inhaled heparin on AHR induced by specific antigen or by platelet-activating factor (PAF), a proinflammatory mediator. Specific lung resistance (sRL) was measured in 17 allergic sheep before, immediately after, and serially for up to 2 h after airway challenge with either specific antigen or PAF. Airway responsiveness was expressed as the cumulative provocative dose of carbachol that increased sRL to 4 cmH2O/s [PD4, in breath units (BU; 1 BU = 1 breath of 1% carbachol solution)]. PD4 was determined on a baseline day and on various experimental days 2 h after airway challenge with antigen or PAF, without or after pretreatment with inhaled heparin (1,000 U/kg). Pretreatment with inhaled heparin prevented antigen-induced bronchoconstriction and postantigen AHR. PD4 was 26 +/- 2.6 (SE), 12 +/- 1.7, and 22 +/- 2.8 BU on baseline, antigen control, and postheparin days, respectively. Heparin given immediately after the antigen challenge failed to modify the magnitude and/or duration of antigen-induced bronchoconstrictor response or postantigen AHR. Heparin also failed to prevent PAF-induced changes in sRL and AHR. In vitro heparin inhibited anti-immunoglobin E- and 1,4,5-inositol triphosphate-mediated degranulation of rat peritoneal mast cells without attenuating the effects of the Ca2+ ionophore A-23187. These data suggest that in "acute responders" heparin prevents antigen-induced bronchoconstriction and AHR, possibly by inhibiting 1,4,5-inositol triphosphate-dependent mast cell mediator release and not by its anti-inflammatory action.

Animals↗
PubMed1993

Integration of hepatitis B immunization in the Expanded Program on Immunization of the Child Survival Project.

The Expanded Program on Immunization (EPI) is a component of the Child Survival Project (CSP) whose objectives are to reduce the incidence rates of six childhood diseases (Measles, Diphtheria, Pertussis, Tetanus, Tuberculosis, Poliomyelitis) and to reduce the number of infant deaths from those diseases by increasing effective vaccination coverage. In 1991, the CSP/EPI developed a national plan to introduce national immunization of infants against hepatitis B in an attempt to control the magnitude and seriousness of the damage which viral hepatitis causes in terms of morbidity, mortality and serious sequelae as hepatitis B is an endemic disease in Egypt causing an important public health problem which requires urgent control. This presentation will discuss the integrated effort undertaken to plan and implement the program, the different challenges it faces, control studies being performed as well as the proposed objectives of the hepatitis B vaccination program.

Child↗
PubMed1992

Attenuation of platelet-activating factor-induced airway responses with methylprednisolone succinate in sheep.

Intratracheal instillation of platelet-activating factor (PAF) in sheep produces bronchoconstriction and airway hyperresponsiveness (AHR) by a two-stage process that involves the initial stimulation of PAF receptors followed by the secondary generation of proinflammatory mediators. Because the biological effects of PAF may be mediated by these proinflammatory metabolites, it is possible that a steroidal anti-inflammatory agent would modify the airway responses of PAF. We measured specific lung resistance (sRL) in sheep (n = 11) before, immediately after, and serially for up to 2 h after intratracheal instillation of PAF (30 micrograms/kg). Airway responsiveness was measured 2 h post-PAF when sRL had returned to baseline and was expressed as the cumulative provocating dose of carbachol that increased sRL to 4 l.cmH2O.l-1.s (PD4). PD4 was determined on a control day and on different experiment days without or after treatment with intravenous methylprednisolone (MPS; 1 mg/kg) administered 3 h before (n = 6), 20 min before PAF (n = 7), or 20 min after PAF challenge (n = 7). PAF increased sRL by 222 +/- 44% (SE) above baseline and decreased PD4 of carbachol by 44 +/- 5% (P less than 0.05). Pretreatment (both 3 h and 20 min) with MPS attenuated the PAF-induced increases in sRL, whereas its administration 20 min post-PAF had no effect. Irrespective of the effects on sRL, MPS administration inhibited the PAF-induced AHR.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1992

Mechanisms of metabisulfite-induced bronchoconstriction: evidence for bradykinin B2-receptor stimulation.

Sodium metabisulfite (MBS) is a food preservative that can trigger bronchoconstriction in asthmatic subjects. Previous studies designed to identify the mechanisms involved in this response have yielded conflicting results. We noted certain similarities between the pharmacology of MBS-induced airway responses and those elicited by bradykinin (BK), another provocating agent in asthmatic subjects. Therefore we used allergic sheep to determine whether MBS-induced bronchoconstriction 1) had a pharmacology similar to that previously seen with BK in this model, including protection by a BK B2-receptor antagonist, NPC-567, and 2) was associated with increased concentrations of immunoreactive kinins in bronchoalveolar lavage. We measured specific lung resistance before and immediately after inhaled buffer and increasing concentrations of MBS (30 breaths of 25, 50, and 100 mg/ml) and calculated the concentration producing 100% increase in specific lung resistance over baseline (PC100). In seven sheep, geometric mean control PC100 was 33.1 mg/ml. Pretreatment with either the anticholinergic agent ipratropium bromide (180 micrograms; PC100 87.1 mg/ml) or the antiasthma drug nedocromil sodium (1 mg/kg aerosol; PC100 97.7 mg/ml) blocked the MBS-induced bronchoconstriction (P less than 0.05), whereas the histamine H1-receptor antagonist chlorpheniramine (2 mg/kg iv) was ineffective. Furthermore the MBS-induced bronchoconstriction was not affected by the neutral endopeptidase inhibitor thiorphan (40 breaths of a 1 mg/ml solution) or the angiotensin-converting enzyme inhibitor enalaprilat (2.5 mg aerosol). In six sheep the MBS-induced bronchoconstriction was completely blocked by NPC-567 (20 breaths, 5 mg/ml aerosol): after treatment with NPC-567 mean PC100 was 100 mg/ml compared with 57.5 mg/ml in the control trial (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Lipid mediators contribute to oxygen-radical-induced airway responses in sheep.

The purpose of this study was to determine if the bronchoconstriction and airway hyperresponsiveness (AHR) resulting from aerosolized xanthine (x; 0.1%)-xanthine oxidase (xo; 4.1 U) and the subsequent production of oxygen radicals is mediated by the secondary generation of lipid mediators. In seven conscious sheep, specific lung resistance (SRL) was measured before and after x-xo challenge; approximately 30 min later when SRL had returned to baseline, airway responsiveness to carbachol was determined from dose-response curves by calculating the cumulative provocating dose of carbachol in breath units (BU, defined as one breath of a 1% wt/vol carbachol solution) that increased SRL 400% over baseline (PD400). Inhaled x-xo caused in immediate increase in SRL of 162 +/- 36% (mean +/- SE; p less than 0.05) over baseline and decreased PD400 from a baseline value of 32.5 +/- 5.0 to 16.6 +/- 1.7 BU (p less than 0.05). Pretreatment with the H2O2 scavenger, catalase (CAT,; 38 mg aerosol), methylprednisolone succinate (MS; 1 mg/kg given intravenously), the cyclooxygenase inhibitor, indomethacin (IND; 2 mg/kg given intravenously), and the PAF antagonist, WEB-2086 (3 mg/kg given intravenously) all attenuated the x-xo-induced increase in SRL (p less than 0.05); the leukotriene D4 antagonist, MK-571 (5 mg by aerosol) had no effect. All agents inhibited the x-xo-induced decrease in PD400: mean BUs were 27 after CAT, 32 after WEB-2086, 34 after IND, 31 after MS, and 25 after MK-571 (all p less than 0.05 versus x-xo alone).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

PAF-induced airway responses in sheep: effects of a PAF antagonist and nedocromil sodium.

Platelet-activating factor (PAF) is a potent inflammatory mediator that can cause bronchoconstriction and airway hyperresponsiveness in selected human subjects and animals. The mechanism by which PAF induces these changes is not clearly understood. We therefore studied the effects of intratracheal instillation of PAF (30 micrograms/kg) on airway resistance and airway responsiveness in allergic sheep (n = 7) and attempted to modulate these effects with the specific PAF antagonist, WEB-2086, and the antiasthmatic agent, nedocromil sodium (NED). Specific lung resistance (SRL) was measured to assess bronchial responses to PAF, and airway responsiveness was determined by deriving a provocative dose of carbachol in breath units causing an increase in SRL to 4 L times centimeters of H2O per liters per second (PD4) from carbachol dose-response curves. PAF instillation increased mean +/- SD SRL to 228 +/- 134% above baseline. Two to 4 hours after PAF instillation, PD4 decreased by 55 +/- 9% from a baseline of 39 +/- 9 breath units (p less than 0.05). Airway responsiveness remained increased at 24 hours but returned to baseline by 48 hours. Pretreatment with WEB-2086 (3 mg/kg, intravenously) or NED (1 mg/kg, nebulized) blocked (p less than 0.05) PAF-induced bronchoconstriction and PAF-induced airway hyperresponsiveness. Instillation of lyso-PAF (30 micrograms/kg) did not cause bronchoconstriction or airway hyperresponsiveness. Thus, instilled PAF causes bronchoconstriction and airway hyperresponsiveness in allergic sheep by a receptor-mediated mechanism that likely involves the release of secondary mediators, the latter process being sensitive to NED.

Aerosols↗
PubMed1978

The effects of short-term venous congestion on forearm venous volume and reactive hyperemia blood flow in human subjects.

Congestive heart failure is associated with a reduction in limb venous volume at an effective venous pressure of 30 mm Hg (VV[30]). Further, an attenuated arteriolar dilation in response to a metabolic stimulus has been demonstrated. It was the purpose of this study to determine to what extent the chronic elevation in venous pressure seen in heart failure might explain these abnormalities of the limb circulation. Ten normal human volunteers were subjected to venous congestion of one arm for three hours at 70 mm Hg. A mercury-in-rubber strain gauge plethysmograph was used to measure forearm VV [30] and forearm blood flow at rest after release of five minutes of arterial occlusion (the reactive hyperemia response). Congestion reduced VV [30] 22%, resting forearm blood flow 49% and peak reactive hyperemia blood flow 25%. Thus, chronic venous congestion per se may significantly reduce limb venous volume as well as resting and reactive hyperemia blood flow.

Adult↗