Papers by Mahmoud A Abdelwahab
Clinical Obstetrics & Gynecology
American Journal of Obstetrics & Gynecology MFM, 2022
OBJECTIVE Pregnancies complicated by opioid use disorder (OUD) are at an increased risk for prete... more OBJECTIVE Pregnancies complicated by opioid use disorder (OUD) are at an increased risk for preterm birth (PTB), defined as delivery <37 weeks gestation. Limited literature is available on prevalence and risk factors for PTB in pregnancies complicated by OUD maintained on buprenorphine Therefore, we sought to determine rate of PTB and risk factors for PTB in this population. STUDY DESIGN We performed a retrospective cohort study of pregnant individuals with singleton gestation receiving buprenorphine for OUD, who delivered at a tertiary academic medical center between 7/1/2013 and 6/30/2018. Individuals who had at least three visits in our co-located clinic were included in analysis. Patients were divided into 2 groups, those delivered <37 weeks gestation were included in preterm group, while patient delivered ≥ 37 weeks were included in term group. We defined "supplements to buprenorphine" to include any illicit drugs found on antepartum urine toxicology. Variables evaluated as potential risk factors for PTB included medical and infectious comorbidities as well as illicit polysubstance use. RESULTS The overall PTB rate in this cohort was 22.7% (115/507). There was a non-significant trend towards decrease in overall PTB and provider-initiated PTB rate over study period. No differences found in spontaneous PTB or PTB< 34 weeks. There were no differences in use of tobacco, alcohol, number of prenatal visits or gestational age when prenatal care started between those who delivered preterm compared to term. Individuals with PTB in the index pregnancy were more likely to have history of PTB compared to those with term delivery (73% vs 16%; P<.01). No medical or infectious comorbidity nor any specific supplement increased risk of PTB. Among individuals using 0, 1, 2, or 3 or more illicit supplements in addition to confirmed buprenorphine for OUD, the PTB rate was 27.4% (reference), 18.0% (P=0.09), 18.1% (P=0.44), and 15.8% (P=0.77), respectively. CONCLUSION The PTB rate among individuals using buprenorphine for OUD (22.7%) is higher than national average but lower than the reported PTB rate in individuals using methadone for MOUD.. No medical or infectious comorbidity or use of additional illicit substances increased the risk of PTB.
Journal of Case Reports and Images in Obstetrics and Gynecology, 2021
Introduction: The incidence of cardiac disease in pregnancy continues to increase, particularly p... more Introduction: The incidence of cardiac disease in pregnancy continues to increase, particularly pregnancy with complex congenital heart diseases. Fontan circulation is a unique circulation surgically created for individuals with single ventricle physiology, effects of which on developing placenta and fetus are not completely understood. Chronic placental hypoxia in Fontan circulation might explain increased incidence of chorioangioma in those patients. Case Report: We present the case of a 28-year-old female with congenital pulmonary atresia and an extracardiac Fontan circulation with fenestrations and chronic right to left shunting, with baseline oxygen saturation of 87–91%. She had three successful pregnancies. Placentomegaly has been noted in all her pregnancies, with recurrent chorioangioma noted in her first and last pregnancy. Conclusion: Fontan circulation with chronic hypoxia may be associated with increased risk of giant chorioangioma with potential for adverse perinatal ou...
Egyptian Journal of Biochemistry and Molecular Biology, 2009
... Our H-frequency findings in the control group are similar to those for a healthy Hispanic adu... more ... Our H-frequency findings in the control group are similar to those for a healthy Hispanic adult population (32%) (Corella, 2002), and for Brazilian elderly population 34.8% (Carolina, et al., 2007) but higher than for English (25%) (Mattu et al., 2002), North American (27%) (Chen ...
The Egyptian Journal of Hospital Medicine
Background: Understanding the molecular basis of prostate cancer development is essential to impr... more Background: Understanding the molecular basis of prostate cancer development is essential to improve the therapeutic efficacy and to determine the clinical behavior of different cases. Genome protective mechanisms investigations is a mainstay of cancer research. Objective: To study the immunohistochemical expression of Claspin and TopBP1 in cases of prostate cancer to assess their relationship with clinicopathological and prognostic features of the disease. Patients and Methods: Claspin and TopBP1 expression was assessed immunohistochemically in eighty-four (84) prostate cancer patients and their prognostic significance was evaluated. Results: Positive Claspin expression and high TopBP1 score were strongly correlated with high pre-treatment level of PSA, groups of Gleason grade, higher Gleason score and advanced stage of tumor (P<0.001) for each. Positive Claspin expression was correlated with LN and distant metastasis (P<0.001). High TopBP1 score was strongly correlated with distant and LN metastasis (P=0.002, P=0.007 respectively). No association was found between both markers and age. A significant association was found between higher TopBP1 expression score & positive Claspin expression (P<0.001) and also shorter progression free survival. Upregulation of Claspin was associated with worse overall survival (p=0.045), but no association was detected among the expression of TopBP1 and overall survival (P=0.355). Conclusion: Claspin and TopBP1 expression have an important prognostic value in prostate cancer. Using them may help to identify high risk patients who will benefit the most from treatment. Besides, both markers can aid in the creation of improved methods that are useful against the therapy-resistant cancer.
Annals of burns and fire disasters, 2018
Burns are considered mostly a serious illness with devastating consequences and prolonged length ... more Burns are considered mostly a serious illness with devastating consequences and prolonged length of hospital stay. Moreover, burns are among the traumatic lesions with the highest costs for care due to their hospitalization time, treatment required and the need for rehabilitation therapy. This study aims to evaluate the factors affecting length of hospital stay and mortality rates in acute burn patients. The study was conducted on 82 patients who presented with acute burn and were admitted to the Plastic and Reconstructive Surgery Department Burn Unit, Tanta University Hospital, in the period from June 2016 to June 2017. A prospective study was carried out using the data of acutely burned patients, and a statistical analysis conducted with the data collected on different factors affecting burn patient length of hospital stay and mortality. The mean age of our patients was 16.5 years, mean LOS was 24.23 days and mortality rate was 9.8% of the total admitted cases, with half of the ca...
Acta pediátrica española, 2004
BioResources, 2021
Smart, environmentally friendly alternatives, i.e., frankincense and rice starch, are recommended... more Smart, environmentally friendly alternatives, i.e., frankincense and rice starch, are recommended for usage in modern paper conservation processes during the re-sizing process treatments. Different concentrations of frankincense and rice starch were applied to paper samples before and after ageing. Multiple analysis methods were performed to ensure the effectiveness of these materials. Promising results were found, but at varying degrees according to the type and concentration of the materials. Scanning electron microscopy illustrated that the frankincense particles were completely absorbed into the cell walls after ageing. Results indicated that there was no considerable change in pH before and after treatment or ageing; the best results for decreasing the acidity utilized a treatment with a mixture of frankincense and rice starch in a 2 to 1 ratio (F2S1). Fourier transform infrared spectroscopy illustrated an increased CH2 region and decreased OH stretching as a result of the bond...
Cancer biomarkers : section A of Disease markers, Jan 19, 2017
Epithelial-mesenchymal transition (EMT) is one of the main events in colorectal cancer (CRC) spre... more Epithelial-mesenchymal transition (EMT) is one of the main events in colorectal cancer (CRC) spread. Snail-1 is a zinc transcription factor that mediates EMT in tumor cells probably by down-regulation of E-cadherin and claudin-1. To detect the expression of epithelial markers (claudin-1 and E-cadherin) and mesenchymal markers (snail-1 and vimentin) in primary cancer colon. Also, to select stage II cancer patients of a high risk that can benefit from postoperative adjuvant chemotherapy. Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical analysis were performed to investigate snail-1, claudin-1, E-cadherin and vimentin expressions at mRNA and protein levels in fresh tissues of cancer colon and normal colonic mucosa. The correlations between the expression of these markers and clinicopathological parameters were performed. Normal colonic mucosa revealed complete membranous expression of claudin-1, preserved E-cadherin and negative snail-1 and vimentin expr...
Female pelvic medicine & reconstructive surgery, Jan 9, 2017
This study aimed to characterize long-term urogynecologic issues of women with a history of bladd... more This study aimed to characterize long-term urogynecologic issues of women with a history of bladder exstrophy and pelvic organ prolapse (POP) and to assess the impact of POP repair on continence and sexual function. Patient demographics and surgical history related to exstrophy and POP were collected through chart review. Patient perceptions regarding sexual function, urinary continence, and quality of life were assessed through Web-based administration of validated questionnaires: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and POP-Urinary Incontinence Sexual Questionnaire. Maryland, United States. Review of a single-institution exstrophy-epispadias complex database resulted in 25 adult female patients with a history of POP treated at the authors' institution. Eleven patients participated and were included in the analysis. Urinary continence and sexual function. All participants underwent surgical repair for prolapse, with 7 (63.6%) ...
Journal of Pediatric Surgery, 2016
Surgical advancements have made cloacal exstrophy (CE) a survivable condition, though management ... more Surgical advancements have made cloacal exstrophy (CE) a survivable condition, though management remains complex. Urologic, orthopedic, colorectal and gynecologic interventions are not standardized, and the cost of this care is high. While the importance of a successful primary closure in terms of outcomes is known, the economic consequences of failure remain uncharacterized. A prospectively maintained institutional database of epispadias-exstrophy complex patients was reviewed for continent CE patients. Hospital charges for all inpatient admissions prior to achieving urinary continence were inflation-adjusted to year 2013 values using Consumer Price Index for medical care published by the United States Bureau of Labor Statistics. Records for which charge data were incomplete were completed by using single mean imputation, also inflation-adjusted. Descriptive data are presented as mean±standard deviation (SD). Of 102 CE patients, 35 had available hospital charge data: 15 who underwent successful primary closure at the authors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; institution and 20 who presented after previously failed primary closures at referring institutions. The mean±SD hospital charges for primary closure in the success group were $136,201±$48,920. These patients then underwent subsequent additional surgeries that accrued charges of $59,549±$25,189 in order to achieve continence. Overall, successful primary closures accumulated hospital charges of $200,366±$40,071. In comparison, patients referred after prior failure required significantly more hospital admissions and additional charges of $207,674±$65,820 were required to achieve continence (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Patients who failed primary closure are estimated to accumulate 70% more total health care charges compared to the group following successful primary closure. The cost of CE management until urinary continence is high, averaging more than $200,000 in inpatient hospital charges alone. Initial success is desirable from both an outcomes and economic perspective, as the cost of salvaging a failed primary closure at our institution is similar to the overall costs of a successful closure; this is in addition to the cost of any previous failed closures. Further studies will be required to determine the optimal timing of surgical management in terms of both patient outcomes and financial consequences.
Journal of pediatric urology, Jan 5, 2015
Recent articles document successful classic bladder exstrophy (CBE) closure without osteotomy. St... more Recent articles document successful classic bladder exstrophy (CBE) closure without osteotomy. Still, many patients require osteotomy if they have a large bladder template and pubic diastasis, or non-malleable pelvis. To understand the indications and outcomes of bladder closure with and without pelvic osteotomy in patients younger than 1 month of age. An institutional database of 1217 exstrophy-epispadias patients was reviewed for CBE patients closed at the authors' institution within the first month of life. Patient demographics, closure history, pubic diastasis distance, bladder capacity, and outcomes were recorded and compared using chi-square tests between osteotomy and non-osteotomy patients. Failure was defined as bladder dehiscence, prolapse, vesicocutaneous fistula, or bladder outlet obstruction requiring reoperation. Bladder capacity >100 mL was deemed sufficient for bladder neck reconstruction (BNR). One hundred CBE patients were included for analysis: 38 closed wi...
Journal of Urology, 2015
We will provide journalists and editors with full-text copies of the articles in question prior t... more We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date. Questions regarding embargo should be directed to
Pediatric endocrinology reviews : PER, 2012
Changes in the coagulation cascade have been implicated in the pathogenesis of the vascular diabe... more Changes in the coagulation cascade have been implicated in the pathogenesis of the vascular diabetic complications. to assess D-dimer level (as a marker of coagulation cascade/fibrinolysis activation) in type 1 and type 2 diabetics and its correlation with microvascular complications and serum total cholesterol (TC) level. Ninety patients were included divided into two groups. Group 1; comprised 50 type 1 diabetics with a mean age of 13.56 years. Their disease duration ranged between 0.4-16 years. Group 2; comprised 40 type 2 diabetics with a mean age of 13.5 years. Their disease duration ranged between 0.4-8 years. Patients were compared to 60 healthy age and sex matched subjects served as controls. Laboratory investigations included; fasting blood glucose, glycosylated hemoglobin, quantitative urinary albumin creatinine ratio (ACR), serum TC and measurement of plasma D-dimer levels. Type 2 diabetics had significantly higher weight and body mass index (BMI) Standard deviation score...
European Journal of Haematology, 2012
Objective: Although BIRC6/Apollon seems to play a critical role as an antiapoptotic regulator, i... more Objective: Although BIRC6/Apollon seems to play a critical role as an antiapoptotic regulator, its clinical relevance in acute leukemia remains largely elusive. Therefore, we aimed to investigate BIRC6 gene expression in childhood acute leukemia in relation to clinicopathological characteristics at presentation, therapeutic response, and prognosis.Methods: BIRC6 expression level was assessed in 75 children with acute leukemia; 30 patients with acute myeloblastic leukemia (AML) and 45 patients with acute lymphoblastic leukemia (ALL) using real‐time quantitative reverse transcriptase‐polymerase chain reaction.Results: The median level of BIRC6 expression did not differ significantly between AML and ALL patients. BIRC6 expression level was higher in patients with AML and ALL with extramedullary involvement, white blood cell (WBC) count ≥10 × 109/L, and unfavorable cytogenetics at diagnosis. BIRC6 gene expression was higher in patients with unfavorable response to therapy at day 14, ...
Kidney Research and Clinical Practice, 2016
Background: Interleukin-10 (IL-10) is an important immunoregulatory cytokine. There are few studi... more Background: Interleukin-10 (IL-10) is an important immunoregulatory cytokine. There are few studies evaluating the association between IL-10 and lupus nephritis (LN). The aim of this study was to evaluate the association of IL-10 gene promoter-592 A/C with LN susceptibility. Methods: The study was conducted on 84 patients with systemic lupus erythematosus (SLE). Patients were divided into LN group (Group I, 48 patients) and non-LN group (Group II, 36 patients). The-592 A/C polymorphisms in IL-10 promoter gene were determined by polymerase chain reaction and restriction fragment length polymorphism in both groups. IL-10 was determined by enzyme-linked immunosorbent assay. Frequencies of the genotypes were compared between LN and non-LN patients and among LN patients with different pathologic classes. Results: There was a significant increase in serum level of IL-10 (P ¼ 0.001) in Group I compared with Group II and significant positive correlation between serum IL-10 and SLE disease activity index (r ¼ 0.466, P ¼ 0.001) in Group I. There were no significant differences in the distribution of the IL-10 gene promoter-592 A/C genotypes or the allele frequencies between Groups I and II. There was no significant difference between AC/CC and AA genotypes with SLE disease activity index, proteinuria, hematuria, anti-double-stranded DNA, and IL-10 in Group I. There was no significant difference in the distribution of AC and CC genotypes among different pathologic LN classes. Conclusion: IL-10 suggested to play a role in pathogenesis and development of LN. However, the promoter-592 A/C of IL-10 gene suggested to be not associated with serum IL-10 levels or LN susceptibility. In addition, it appears that promoter-592 A/C of IL-10 gene not associated with LN activity or the pathologic classes of LN.
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Papers by Mahmoud A Abdelwahab