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Biomedical subjects

R Sabbagh

Publications and source records attributed to R Sabbagh.

11 recordsLinked to original sources
PubMed1997

[Medical treatment of venous priapism apropos of 46 cases: puncture, pharmacologic detumescence or penile cooling?].

OBJECTIVE: To analyse the efficacy of three nonspecific medical approaches to the first-line treatment of priapism : a) intracavernous injection (ICI) of alpha-adrenergic agonists, b) cavernous puncture, c) penile cutaneous cooling. METHODS: 46 cases of venous priapism, due to various aetiologies, were initially treated by ICI of alpha-adrenergic agonists (23 cases), puncture (14 cases) or cooling (9 cases). These 3 methods were combined only in the case of failure and not uniformly, based on our experience. The results were analysed in terms of successful detumescence and preservation of erectile function. RESULTS: Detumescence was obtained and erectile function was preserved in almost 80% of cases, with conservative treatment alone. ICI (83%) and cooling (78%) were more effective as first-line treatment than puncture (57%). The delay to treatment was a more important parameter than the aetiology. Cooling was no longer effective after the 8th hour, puncture was no longer effective after the 9th hour and ICI was no longer effective after the 34th hour. Failures of conservative treatment and erectile sequelae were only observed in cases of priapism treated after the 24th hour. CONCLUSION: The 3 methods have a similar degree of efficacy, provided they are performed early. Their indication depends on : 1) the duration of priapism, 2) the presence or absence of cavernosal anoxia. Schematically (and in parallel with aetiological treatment when possible) : a) in the case of painless priapism < 12 hours, cooling can be tried first, b) in the case of failure or painless priapism > 12, but < 24 hours, ICI of alpha-adrenergic agonists associated with puncture is indicated (except in the case of contraindications to ICI), c) in the case of painful priapism or > 24 hours, puncture must be the first treatment. In the case of failure, cavernosal blood gases should be performed to evaluate cavernosal anoxia and to guide management.

Adrenergic alpha-Agonists↗
PubMed1997

An overview of thyroid carcinoma.

Approximately, 12,000 cases of thyroid carcinoma are diagnosed each year. This disease entity accounts for 1.5 percent of all malignancies and is clinically evident in four percent to seven percent of the United States population. This paper provides an overview of thyroid carcinoma, including types, incidence, predisposing factors, evaluation, and treatment.

Adult↗
PubMed1992

Colostomy plug devices: a possible new approach to the problem of incontinence.

The authors report their experience in the use of the Conseal (Coloplast S.p.A., Bologna, Italy) Colostomy Plug, a new device for the regulation of continence in patients with colostomies. The devices were tested on 57 patients divided into two groups: Group A (36 patients) fit with a two-piece Conseal system and Group B (21 patients) fit with a one-piece Conseal system. All patients had the same colostomy type, and all were trained for self-irrigation. The objectives of this randomized, prospective study were to determine compliance with the different systems, to identify the advantages, and to verify the possible different applications among the population of irrigated patients. The following results were obtained. Regarding compliance: Group A's results were excellent in 22.2 percent and good in 52.7 percent of patients. Group B had better compliance than Group A (excellent in 66.6 percent and good in 19 percent of patients). Regarding controlled evacuation, continence time, and silent gas emission: in Group A, the device permitted controlled evacuations (23.8 percent of patients practicing daily washouts) with silent and odorless gas emission (100 percent of cases). In Group B, the results concerning improvement in continence were good (33.3 percent of patients) and excellent concerning the emission of flatus. Regarding the potential use of both systems in different groups of self-irrigated patients: the study has revealed the Conseal Uni-system as being ideal for patients with a well-constructed stoma, slight gas distention, and a better psychologic adaptability to larger-sized systems. In all other cases, the alternative two-piece system is more suitable, owing to the better safety it offers.

Adult↗
PubMed1992

Characterization of Staphylococcus aureus isolates with decreased susceptibility to vancomycin and teicoplanin: isolation and purification of a constitutively produced protein associated with decreased susceptibility.

"Derivative isolates" with 4- to 8-fold and 8- to 16-fold increases in MICs of vancomycin and teicoplanin, respectively, were selected from 2 susceptible clinical isolates of Staphylococcus aureus by serial incubation in low-level vancomycin. A protein of approximately 39 kDa was demonstrable in the cytoplasmic fraction and occasionally in the membrane fraction by SDS-PAGE of both derivatives. This protein was purified by DEAE chromatography, preparative SDS-PAGE, and electroelution. Derivative bacteria were larger on transmission electron microscopy, had thicker cell walls, and had changes in colony morphology on solid media. Further evidence for cell wall reorganization included loss of phage and capsular typing, decreased susceptibility to lysostaphin/lysozyme killing, and changes in condition for detection of optimal coagulase activity. The mechanism of decreased susceptibility to glycopeptide antibiotics among S. aureus derivative isolates is uncertain. The production of the approximately 39-kDa cytoplasmic protein and cell wall reorganization may mediate changed affinity of glycopeptide-peptidoglycan binding or impairment of glycopeptide access to its cell wall target.

Bacterial Proteins↗
PubMed1991

Uveal melanoma in teenagers and children. A report of 40 cases.

A review of 3706 consecutive patients with uveal melanoma revealed that 40 patients (1.1%) were age 20 years or younger at the time of diagnosis. The youngest patient was age 6 years but the majority of patients (78%) were between 15 and 20 years old. The tumor occurred in the iris in 5 cases (12%) and in the posterior uvea in 35 cases (88%). The mean largest tumor dimension and thickness was 10 mm and 5 mm, respectively. In all cases, the diagnosis of uveal melanoma was suspected before referral, and misdirected treatment was avoided. The tumor was initially treated by enucleation in 24 cases (60%), local resection in 7 (18%), plaque radiotherapy in 3 (8%), and observation in 6 (15%). Secondary treatment was required in 7 cases in the form of enucleation (4 cases), ablative laser (1 case), plaque radiotherapy (1 case), and exenteration (1 case). The mean follow-up period was 68 months (median, 48 months) from the time of treatment, and only one patient died of metastases (from a massive ciliochoroidal melanoma 33 months after treatment). The remainder of the group of young patients are alive and healthy. Cumulative survival rates show that 96% of young patients with uveal melanoma survive at the 5-year period.

Adolescent↗
PubMedDate not supplied

Current national trends in the posttreatment follow-up of patients with squamous cell carcinoma of the head and neck.

INTRODUCTION: Follow-up of individuals treated for a primary squamous carcinoma of the upper aerodigestive tract is critical because of the high risk of development of either recurrent disease or a new primary tumor. A mail survey of physicians actively practicing head and neck surgery was undertaken. MATERIALS AND METHODS: A multiple-choice survey was distributed to 400 members of the American Society for Head and Neck Surgery. Respondents indicated approach to post-treatment follow up. RESULTS: Surveys were returned from 290 members (73%). Routine monthly follow up is advocated by 73% of respondents during the first postoperative year. Patients are followed every 2 to 3 months in the second postoperative year by 90% of respondents. During postoperative years, 3 to 5 patients are seen every 4 to 6 months by 97% of respondents. All respondents see patients either semiannually or annually for the remainder of their lives. Sixty percent of respondents advocate annual screening chest radiographs, whereas 14% do not order routine chest radiographs. The overwhelming majority of respondents reserve barium swallow and computed tomographic (CT) scans for evaluation of symptomatic patients. Similarly, nuclear imaging is reserved for patients with specific symptoms or abnormal laboratory tests. Blood tests most frequently monitored include complete blood cell count (CBC) (43%), thyroid function test (22%), and liver function test (20%). Follow-up endoscopic evaluation under anesthesia is reserved for symptomatic patients by over 95% of respondents. CONCLUSION: These data demonstrate that head and neck surgeons rarely use supplemental studies other than chest radiograph during routine follow up. The authors speculate that routine chest radiograph may be valuable in screening for a second primary carcinoma. Techniques to screen for esophageal tumors remain contentious.

Audiometry↗