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  1. Article ; Online: The 6th ASPED-ISPAD Diabetes Academy. 11-12 October 2022, Sheikh Shakhbout Medical City Abu Dhabi - United Arab Emirates

    Elbarbary, Nancy / Deeb, Asma

    BMJ paediatrics open

    2023  Volume 7, Issue Suppl 1, Page(s) i

    Language English
    Publishing date 2023-07-13
    Publishing country England
    Document type Journal Article
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2023-ASPED
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  2. Article: Diabetes Mellitus Secondary to Acute Pancreatitis in a Child with Wolf-Hirschhorn Syndrome.

    Deeb, Asma

    Case reports in endocrinology

    2017  Volume 2017, Page(s) 3892467

    Abstract: Wolf-Hirschhorn Syndrome (WHS) is a rare genetic disease caused by deletion in the short arm of chromosome 4. It is characterized by typical fascial features and a varying degree of intellectual disabilities and multiple systemic involvement. ... ...

    Abstract Wolf-Hirschhorn Syndrome (WHS) is a rare genetic disease caused by deletion in the short arm of chromosome 4. It is characterized by typical fascial features and a varying degree of intellectual disabilities and multiple systemic involvement. Epidemiological studies confirmed the association of acute pancreatitis with the development of diabetes. However, this association has not been reported in WHS. We report an 18-year-old girl with WHS who presented acutely with nonketotic Hyperglycemic Hyperosmolar Status (HHS) in association with severe acute pancreatitis. Her presentation was preceded by febrile illness with preauricular abscess. She was treated with fluids and insulin infusion and remained on insulin 18 months after presentation. Her parents are cousins and the mother was diagnosed with type 2 diabetes. She had negative autoantibodies and no signs of insulin resistance and her monogenic diabetes genetic testing was negative. Microarray study using WHS probe confirmed deletion of 4p chromosome. Acute pancreatitis is uncommon in children and development of diabetes following pancreatitis has not been reported in WHS. HHS is considerably less frequent than diabetes ketoacidosis in children. We highlight the complex presentation with HHS and acute pancreatitis leading to diabetes that required long term of insulin treatment.
    Language English
    Publishing date 2017-10-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627633-1
    ISSN 2090-651X ; 2090-6501
    ISSN (online) 2090-651X
    ISSN 2090-6501
    DOI 10.1155/2017/3892467
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  3. Article ; Online: Challenges of Diabetes Management in Toddlers.

    Deeb, Asma

    Diabetes technology & therapeutics

    2017  Volume 19, Issue 7, Page(s) 383–390

    Abstract: Toddlers with type 1 diabetes have distinctive combination of challenges to their families and healthcare providers. A major factor is the difficulty in achieving metabolic control without risking hypoglycemia. The rising incidence of type 1 diabetes in ... ...

    Abstract Toddlers with type 1 diabetes have distinctive combination of challenges to their families and healthcare providers. A major factor is the difficulty in achieving metabolic control without risking hypoglycemia. The rising incidence of type 1 diabetes in toddlers increases the magnitude of the problem and creates a greater need for providing specialized service to cater for this age group's unique need. Type 1 has a specific disease nature in younger children and its clinical presentation mimics common childhood diseases. Symptoms and signs in the newly presented toddler with diabetes might be unspecific causing diagnosis to be missed or delayed. With the low cognitive ability and immature communication, toddlers might not be able to express their ill-feeling resulting from hypoglycemia or hyperglycemia. Hypoglycemia fear is common, which aggravates stress and reduces adherence to strict metabolic control. Nocturnal hypoglycemia is more common in toddlers and can be undiagnosed unless continuous glucose monitoring is used. Insulin administration and adjustment can be challenging due to pain, fear, refusal, and frequent intercurrent illness. Glucose monitoring is crucial. However, it can be distressing to the child and difficult to adhere to due to commitment or financial reasons. Insulin pump therapy is proven to be an effective and a safe method of treatment for toddlers, but it requires intensive training, resources, and long-term support. Provision of multidisciplinary team with special expertise in managing toddlers with diabetes is essential. Providing more physiological insulin regimes and customized technology is required to improve treatment compliance and diabetes control.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1452816-2
    ISSN 1557-8593 ; 1520-9156
    ISSN (online) 1557-8593
    ISSN 1520-9156
    DOI 10.1089/dia.2017.0130
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  4. Article ; Online: Letter to the Editor: Comments on "Sulfonylurea Treatment Before Genetic Testing in Neonatal Diabetes: Pros and Cons" by Carmody D, et al.

    Deeb, Asma

    The Journal of clinical endocrinology and metabolism

    2016  Volume 101, Issue 3, Page(s) L36

    MeSH term(s) Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/drug therapy ; Female ; Genetic Testing/methods ; Humans ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/therapeutic use ; Male ; Sulfonylurea Compounds/adverse effects ; Sulfonylurea Compounds/therapeutic use
    Chemical Substances Hypoglycemic Agents ; Sulfonylurea Compounds
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/jc.2015-4249
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  5. Article: The Choice of Insulin Type and Regimen for Adolescents with Type 1 Diabetes during Ramadan Fasting: A Continuing Debate

    Hassan-Beck, Reem / Deeb, Asma

    Journal of Diabetes and Endocrine Practice

    2022  Volume 05, Issue 02, Page(s) 47–49

    Language English
    Publishing date 2022-04-01
    Publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2772-7653
    ISSN (online) 2772-7653
    DOI 10.1055/s-0042-1756469
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  6. Article: Characteristics of adolescents referred for bariatric surgery in Abu Dhabi, United Arab Emirates.

    Beck, Reem Hassan / Afrooz, Imrana / Suhail Masalawala, Muhammad / Watad, Rama / Al Shaban, Talat / Deeb, Asma

    Frontiers in pediatrics

    2024  Volume 12, Page(s) 1297251

    Abstract: About a third of children and adolescents are overweight or obese in the United Arab Emirates, and referrals for metabolic and bariatric surgery (MBS) are now common. Despite excellent evidence that MBS should be considered in adolescents with severe ... ...

    Abstract About a third of children and adolescents are overweight or obese in the United Arab Emirates, and referrals for metabolic and bariatric surgery (MBS) are now common. Despite excellent evidence that MBS should be considered in adolescents with severe obesity, it remains a management approach of last resort in many cases. Baseline, real-world data on adolescent patients living with obesity referred for surgery, their characteristics, and how these relate to current and future referral policy are important to ensure best practice. Here we examined the demographic, anthropometric, and clinical characteristics of adolescents referred for MBS over a three-year period to Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, UAE. Ninety-two adolescents living with obesity were recruited: 54.3% were female, the average age was 16.3 ± 2.4 years, and 88.0% of patients had a first-degree relative with a history of obesity and 62% a family history of bariatric surgery. The average BMI was 47.7 ± 10.5, and the average percentage of the 95th percentile BMI was 169.5 ± 38.8%. Complications of obesity (hypertension, type 2 diabetes and prediabetes, dyslipidemia, and liver function abnormalities) were common. Our analysis highlights that there exists a mismatch between the profiles of patients referred for MBS, local guidelines, and international best practice in decision-making for referral to MBS services. While many adolescents in the UAE seem to enjoy family support and experience in the surgical management of obesity, local guidelines need updating to reflect changes in the definitions of obesity, thresholds for referral, and to remove unnecessary developmental stage barriers to increase the window for personalized surgical management.
    Language English
    Publishing date 2024-03-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2024.1297251
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  7. Article: A novel homozygous mutation in the mannose phosphate isomerase gene causing congenital disorder of glycation and hyperinsulinemic hypoglycemia in an infant.

    Deeb, Asma / Al Amoodi, Abdulla

    Clinical case reports

    2018  Volume 6, Issue 3, Page(s) 479–483

    Abstract: We report a 4 years girl with congenital disorders of glycosylation (CDG) type Ib due to a novel homozygous mutation in MPI gene. She presented with diazoxide-responsive hyperinsulinemic hypoglycemia. CDG should be considered in unexplained hypoglycemia ... ...

    Abstract We report a 4 years girl with congenital disorders of glycosylation (CDG) type Ib due to a novel homozygous mutation in MPI gene. She presented with diazoxide-responsive hyperinsulinemic hypoglycemia. CDG should be considered in unexplained hypoglycemia particularly in consanguineous families. Diagnosis enables monitoring/prevention of disease comorbidities and early effective treatment.
    Language English
    Publishing date 2018-01-25
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.1387
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  8. Article: Monitoring Haematocrit in Paediatric Patients Receiving Testosterone Therapy in Arab Countries.

    Alsaffar, Hussain / Habeb, Abdelhadi / Hamza, Rasha T / Deeb, Asma

    Cureus

    2021  Volume 13, Issue 8, Page(s) e17618

    Abstract: Objectives Testosterone is the main agent used to induce puberty in boys in Arab countries. It is recommended to monitor haematocrit before and during androgen replacement. However, data from single centre studies indicated that this recommendation is ... ...

    Abstract Objectives Testosterone is the main agent used to induce puberty in boys in Arab countries. It is recommended to monitor haematocrit before and during androgen replacement. However, data from single centre studies indicated that this recommendation is rarely practiced by paediatricians compared to adult physicians. The aim of this study is to evaluate the monitoring of haematocrit of patients on Testosterone therapy by paediatric endocrinologists practicing in Arab countries. Methods A cross-sectional study using an online survey that was sent to all members of the Arab Society for Paediatric Endocrinology and Diabetes (ASPED), who they practice in all Arab countries. The study was carried out between July and October 2019. Ethical approval was granted by ASPED council in May 2019 (MRE2019-02Q).  Results One hundred four physicians responded to the survey from 17 countries. 81/104 (77.8%) answered the question about Testosterone monitoring (42 paediatric endocrinologists, 11 general paediatrician consultants with interest in endocrine, 16 specialists, four fellows and eight residents). Of the 81 responders 18 clinicians (22.2%) thought of monitoring the haematocrit; 15 (18.5%) thought no laboratory monitoring is needed at all. Conclusion The survey indicated that most paediatric endocrinologists in Arab countries do not monitor haematocrit in patients on testosterone replacement and majority are not aware that secondary erythrocytosis can result from androgen therapy. Raising the awareness on monitoring haematocrit during androgen replacement therapy is needed especially when reaching the adult dose.
    Language English
    Publishing date 2021-08-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.17618
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  9. Article: Combined SPINK1 mutations induce early-onset severe chronic pancreatitis in a child with severe obesity.

    Abass, Maha Khalil / Al Shamsi, Aisha / Jan, Iftikhar / Masalawala, Mohammed Suhail Yasin / Deeb, Asma

    Endocrinology, diabetes & metabolism case reports

    2022  Volume 2022

    Abstract: Summary: The most frequent causes of pancreatitis classically have been known to be gallstones or alcohol. However, genetics can also play a key role in predisposing patients to both chronic and acute pancreatitis. The serine protease inhibitor Kazal ... ...

    Abstract Summary: The most frequent causes of pancreatitis classically have been known to be gallstones or alcohol. However, genetics can also play a key role in predisposing patients to both chronic and acute pancreatitis. The serine protease inhibitor Kazal type 1 (SPINK 1) gene is known to be strongly associated with pancreatitis. Patients with these underlying genetic mutations can have severe diseases with a high morbidity rate and frequent hospitalization. We report an Arab girl who presented with acute pancreatitis at the age of 7 years progressing to recurrent chronic pancreatitis over a few years. She had severe obesity from the age of 4 years and developed type 2 diabetes at the age of 12. She had a normal biliary system anatomy. Genetic analysis showed that she had combined heterozygous mutations in the SPINK1 gene (SPINK1, c.101A>G p.(Asn34Ser) and SPINK1, c.56-37T>C). Her parents were first-degree cousins, but neither had obesity. Mother was detected to have the same mutations. She had type 2 diabetes but never presented with pancreatitis. This case is the first to be reported from the Arab region with these combined mutations leading to recurrent chronic pancreatitis. It illustrates the importance of diagnosing the underlying genetic mutation in the absence of other known causes of pancreatitis. Considering the absence of pancreatitis history in the mother who did not have obesity but harboured the same mutations, we point out that severe obesity might be a triggering factor of pancreatitis in the presence of the mutations in SPINK1 gene in this child. While this is not an assumption from a single patient, we show that not all carriers of this mutation develop the disease even within the same family. Triggering factors like severe obesity might have a role in developing the disease.
    Learning points: Acute recurrent pancreatitis and chronic pancreatitis are uncommon in children but might be underdiagnosed. Biliary tract anomalies and dyslipidaemias are known causative factors for pancreatitis, but pancreatitis can be seen in children with intact biliary system. Genetic diagnosis should be sought in children with pancreatitis in the absence of known underlying predisposing factors. SPINK1 mutations can predispose to an early-onset severe recurrent pancreatitis and acute pancreatitis.
    Language English
    Publishing date 2022-09-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2785530-2
    ISSN 2052-0573
    ISSN 2052-0573
    DOI 10.1530/EDM-22-0273
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Could Alerting Physicians for Low Alkaline Phosphatase Levels Be Helpful in Early Diagnosis of Hypophosphatasia?

    Deeb, Asma / Elfatih, Abubaker

    Journal of clinical research in pediatric endocrinology

    2017  Volume 10, Issue 1, Page(s) 19–24

    Abstract: Objective: Hypophosphatasia (HPP) is an inborn error of metabolism with significant morbidity and mortality. Its presentation is nonspecific leading to delayed or missed diagnosis. Low alkaline phosphatase (ALP) is a diagnostic test. Unlike high ALP, ... ...

    Abstract Objective: Hypophosphatasia (HPP) is an inborn error of metabolism with significant morbidity and mortality. Its presentation is nonspecific leading to delayed or missed diagnosis. Low alkaline phosphatase (ALP) is a diagnostic test. Unlike high ALP, low level is commonly not flagged by laboratories as abnormal. A new treatment was shown to be effective in HPP. In this study we aimed to establish the frequency of low ALP levels requiring notification to physicians by the laboratory and also to describe the clinical manifestations of patients presenting with low ALP for a possible diagnosis of HPP.
    Methods: Patients under age 18 years with low ALP levels were identified from biochemistry records over a period of 6 months. Reference ranges were used as per the Associated Regional and University Pathologists Reference Laboratory (Utah, USA). Electronic results for patients with low levels were checked for flagging as abnormal/low ALP results. Charts of identified patients were reviewed. Presenting features were categorized under groups of disorders.
    Results: ALP levels were tested in 2890 patients. 702 had values less than 160 U/L. Of these patients, 226 (32%) had age/gender specific low ALP. None of the low ALP results was flagged as low. Twenty-one had more than one low reading and their charts were reviewed. Four patients in the neuromuscular and four in the miscellaneous group presented with features consistent with HPP despite these patients having no specific diagnoses.
    Conclusion: Laboratories do not alert physicians in cases with low ALP levels. A persistently low level in patients with unspecified diagnoses could be a key to diagnose HPP. Implementing lab-specific ranges and alerting for low levels could prompt physicians to investigate for undiagnosed HPP.
    MeSH term(s) Adolescent ; Alkaline Phosphatase/blood ; Child ; Child, Preschool ; Clinical Laboratory Services/standards ; Early Diagnosis ; Hematologic Tests/standards ; Humans ; Hypophosphatasia/blood ; Hypophosphatasia/diagnosis ; Infant
    Chemical Substances Alkaline Phosphatase (EC 3.1.3.1)
    Language English
    Publishing date 2017-08-02
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2641608-6
    ISSN 1308-5735 ; 1308-5727
    ISSN (online) 1308-5735
    ISSN 1308-5727
    DOI 10.4274/jcrpe.4426
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