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Wang X, Liu X, O'Donnell MJ, McQueen M, Sniderman A, Pare G, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Xavier D, Zhang H, Liu L, Pais P, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Judge C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Nilanont Y, Yusuf S. Tobacco use and risk of acute stroke in 32 countries in the INTERSTROKE study: a case-control study. EClinicalMedicine 2024; 70:102515. [PMID: 38516107 PMCID: PMC10955659 DOI: 10.1016/j.eclinm.2024.102515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background Smoking is a major risk factor for the global burden of stroke. We have previously reported a global population attributable risk (PAR) of stroke of 12.4% associated with current smoking. In this study we aimed to explore the association of current tobacco use with different types of tobacco exposure and environmental tobacco smoke (ETS) exposure on the risk of stroke and stroke subtypes, and by regions and country income levels. Methods The INTERSTROKE study is a case-control study of acute first stroke and was undertaken with 13,462 stroke cases and 13,488 controls recruited between January 11, 2007 and August 8, 2015 in 32 countries worldwide. Association of risk of tobacco use and ETS exposure were analysed with overall stroke, ischemic and intracerebral hemorrhage (ICH), and with TOAST etiological stroke subtypes (large vessel, small vessel, cardioembolism, and undetermined). Findings Current smoking was associated with an increased risk of all stroke (odds ratio [OR] 1.64, 95% CI 1.46-1.84), and had a stronger association with ischemic stroke (OR 1.85, 95% CI 1.61-2.11) than ICH (OR 1.19 95% CI 1.00-1.41). The OR and PAR of stroke among current smokers varied significantly between regions and income levels with high income countries (HIC) having the highest odds (OR 3.02 95% CI 2.24-4.10) and PAR (18.6%, 15.1-22.8%). Among etiological subtypes of ischemic stroke, the strongest association of current smoking was seen for large vessel stroke (OR 2.16, 95% CI 1.63-2.87) and undetermined cause (OR 1.97, 95% CI 1.55-2.50). Both filtered (OR 1.73, 95% CI 1.50-1.99) and non-filtered (OR 2.59, 95% CI 1.79-3.77) cigarettes were associated with stroke risk. ETS exposure increased the risk of stroke in a dose-dependent manner, exposure for more than 10 h per week increased risk for all stroke (OR 1.95, 95% CI 1.69-2.27), ischemic stroke (OR 1.89, 95% CI 1.59-2.24) and ICH (OR 2.00, 95% CI 1.60-2.50). Interpretation There are significant variations in the magnitude of risk and PAR of stroke according to the types of tobacco used, active and ETS exposure, and countries with different income levels. Specific strategies to discourage tobacco use by any form and to build a smoke free environment should be implemented to ease the global burden of stroke. Funding The Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland, and through unrestricted grants from several pharmaceutical companies with major contributions from Astra Zeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MERCK, Sharp and Dohme, Swedish Heart and Lung Foundation, UK Chest, and UK Heart and Stroke.
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Affiliation(s)
- Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
| | - Xin Liu
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
| | - Martin J. O'Donnell
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
- NUI Galway, Galway, Ireland
| | - Matthew McQueen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Guillaume Pare
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Graeme J. Hankey
- St John's Medical College and Research Institute, Bangalore, India
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Siu Lim Chin
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | | | - Denis Xavier
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | - Hongye Zhang
- Beijing Hypertension League Institute, Beijing, China
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, China
| | - Prem Pais
- St John's Medical College and Research Institute, Bangalore, India
| | - Patricio Lopez-Jaramillo
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | | | - Peter Langhorne
- Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
| | - Annika Rosengren
- Sahlgrenska Academy and University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Antonio L. Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | | | - Alvaro Avezum
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Charles Mondo
- Uganda Heart Institute, Mulago Hospital, Kampala, Uganda
| | | | | | | | | | - Nana Pogosova
- National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Romana Iqbal
- Department of Medicine, Aga Khan University Hospitals in Karachi, Pakistan
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica, Rosario, Argentina
| | - Khalid Yusoff
- UCSI University, Cheras, Kuala Lumpur 56000, Malaysia
| | - Afzalhussein Yusufali
- Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, United Arab Emirates
| | - Aytekin Oguz
- Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
| | | | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Okechukwu S. Ogah
- Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
| | - A. Ogunniyi
- Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
| | | | | | | | | | | | - Yongchai Nilanont
- Neurology Division, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - INTERSTROKE Investigators
- Beijing Hypertension League Institute, Beijing, China
- National Genetic Resources Research Center, National Research Institute for Family Planning, Beijing, China
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
- NUI Galway, Galway, Ireland
- McGill University Health Centre, Montreal, QC, Canada
- St John's Medical College and Research Institute, Bangalore, India
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
- Eduardo Mondlane University, Maputo, Mozambique
- Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
- Sahlgrenska Academy and University Hospital, University of Gothenburg, Gothenburg, Sweden
- College of Medicine, University of Philippines, Manila, Philippines
- Al Shaab Teaching Hospital, Khartoum, Sudan
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
- Uganda Heart Institute, Mulago Hospital, Kampala, Uganda
- Department of Neurology, University Hospital, Essen, Germany
- Institute of Psychiatry and Neurology, Warsaw, Poland
- National Research Center for Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- Department of Medicine, Aga Khan University Hospitals in Karachi, Pakistan
- Estudios Clinicos Latinoamerica, Rosario, Argentina
- UCSI University, Cheras, Kuala Lumpur 56000, Malaysia
- Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, United Arab Emirates
- Istanbul Medeniyet Üniversitesi, Istanbul, Turkey
- Department of Cardiology, Hospital Luis Vernaza, Guayaquil, Ecuador
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
- Department of Medicine, University College Hospital, Ibadan PMB 5116, Nigeria
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Universidad Peruana Cayetano Heredia, Lima, Peru
- University of Split, Croatia
- Rush Alzheimer Disease Research Center in Chicago, Chicago, IL, USA
- University of Limpopo, Pretoria, South Africa
- Neurology Division, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Elsayed A, Ghaith M, Yosri A, Li Z, El-Dakhakhni W. Genetic programming expressions for effluent quality prediction: Towards AI-driven monitoring and management of wastewater treatment plants. J Environ Manage 2024; 356:120510. [PMID: 38490009 DOI: 10.1016/j.jenvman.2024.120510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
Continuous effluent quality prediction in wastewater treatment processes is crucial to proactively reduce the risks to the environment and human health. However, wastewater treatment is an extremely complex process controlled by several uncertain, interdependent, and sometimes poorly characterized physico-chemical-biological process parameters. In addition, there are substantial spatiotemporal variations, uncertainties, and high non-linear interactions among the water quality parameters and process variables involved in the treatment process. Such complexities hinder efficient monitoring, operation, and management of wastewater treatment plants under normal and abnormal conditions. Typical mathematical and statistical tools most often fail to capture such complex interrelationships, and therefore data-driven techniques offer an attractive solution to effectively quantify the performance of wastewater treatment plants. Although several previous studies focused on applying regression-based data-driven models (e.g., artificial neural network) to predict some wastewater treatment effluent parameters, most of these studies employed a limited number of input variables to predict only one or two parameters characterizing the effluent quality (e.g., chemical oxygen demand (COD) and/or suspended solids (SS)). Harnessing the power of Artificial Intelligence (AI), the current study proposes multi-gene genetic programming (MGGP)-based models, using a dataset obtained from an operational wastewater treatment plant, deploying membrane aerated biofilm reactor, to predict the filtrated COD, ammonia (NH4), and SS concentrations along with the carbon-to-nitrogen ratio (C/N) within the effluent. Input features included a set of process variables characterizing the influent quality (e.g., filtered COD, NH4, and SS concentrations), water physics and chemistry parameters (e.g., temperature and pH), and operation conditions (e.g., applied air pressure). The developed MGGP-based models accurately reproduced the observations of the four output variables with correlation coefficient values that ranged between 0.98 and 0.99 during training and between 0.96 and 0.99 during testing, reflecting the power of the developed models in predicting the quality of the effluent from the treatment system. Interpretability analyses were subsequently deployed to confirm the intuitive understanding of input-output interrelations and to identify the governing parameters of the treatment process. The developed MGGP-based models can facilitate the AI-driven monitoring and management of wastewater treatment plants through devising optimal rapid operation and control schemes and assisting the plants' operators in maintaining proper performance of the plants under various normal and disruptive operational conditions.
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Affiliation(s)
- Ahmed Elsayed
- Department of Civil Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L7, Canada; Department of Irrigation and Hydraulic Engineering, Faculty of Engineering, Cairo University, 1 Gamaa Street, Giza 12613, Egypt.
| | - Maysara Ghaith
- Department of Civil Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L7, Canada; Department of Irrigation and Hydraulic Engineering, Faculty of Engineering, Cairo University, 1 Gamaa Street, Giza 12613, Egypt
| | - Ahmed Yosri
- Department of Civil Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L7, Canada; Department of Irrigation and Hydraulic Engineering, Faculty of Engineering, Cairo University, 1 Gamaa Street, Giza 12613, Egypt
| | - Zhong Li
- Department of Civil Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L7, Canada
| | - Wael El-Dakhakhni
- Department of Civil Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L7, Canada; School of Computational Science and Engineering, McMaster University, 1280 Main Street West, Hamilton, ON L8S4K1, Canada
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Fereig RM, Mazeed AM, El Tawab AAA, El-Diasty M, Elsayed A, Shaapan RM, Abdelbaset AE, Frey CF, Alawfi BS, Altwaim SA, Alharbi AS, Wareth G. Exposure to Brucella Species, Coxiella burnetii, and Trichinella Species in Recently Imported Camels from Sudan to Egypt: Possible Threats to Animal and Human Health. Pathogens 2024; 13:179. [PMID: 38392917 PMCID: PMC10892970 DOI: 10.3390/pathogens13020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Brucellosis and coxiellosis/Q fever are bacterial infections caused by Brucella species and Coxiella burnetii, respectively; camels are highly susceptible to both pathogens. Trichinellosis is a parasitic infection caused by various Trichinella nematode species. Reportedly, camels are susceptible to experimental infection with Trichinella spp., but information on this potential host species is scarce. All three infections are of zoonotic nature and thus of great public health concern. The current study aimed to determine antibodies against the three pathogens in recently imported camels (n = 491) from Sudan at the two main ports for the entrance of camels into southern Egypt using commercial indirect ELISAs. Samples were collected in two sampling periods. The seropositivity rates of Brucella spp., C. burnetii, and Trichinella spp. were 3.5%, 4.3%, and 2.4%, respectively. Mixed seropositivity was found in 1% for Brucella spp. and C. burnetii. Marked differences were found between the two study sites and the two sampling periods for Brucella. A higher rate of seropositivity was recorded in the Red Sea/older samples that were collected between 2015 and 2016 (4.3%, 17/391; odds ratio = 9.4; p < 0.030) than in those collected in Aswan/recent samples that were collected between 2018 and 2021 (0/100). Concerning C. burnetii, samples collected during November and December 2015 had a significantly higher positivity rate than the other samples (13%, 13/100; OD = 4.8; p < 0.016). The same effect was observed for antibodies to Trichinella spp., with samples collected during November and December 2015 showing a higher positivity rate than the other samples (7%, 7/100; OD = 10.9; p < 0.001). This study provides valuable information on the seroprevalence of Brucella spp. and additional novel information on C. burnetii and Trichinella spp. in recently imported camels kept in quarantine before delivery to other Egyptian regions. This knowledge can be utilized to reduce health hazards and financial burdens attributable to brucellosis, Q fever, and trichinellosis in animals and humans in Egypt.
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Affiliation(s)
- Ragab M. Fereig
- Division of Internal Medicine, Department of Animal Medicine, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| | - Amira M. Mazeed
- Department of Infectious Diseases, Faculty of Veterinary Medicine, Arish University, Arish 45516, Egypt;
| | - Ashraf A. Abd El Tawab
- Department of Bacteriology, Immunology, and Mycology, Faculty of Veterinary Medicine, Benha University, Toukh 13736, Egypt;
| | - Mohamed El-Diasty
- Agricultural Research Center (ARC), Animal Health Research Institute-Mansoura Provincial Laboratory, (AHRI-Mansoura), Giza 12618, Egypt;
| | - Ahmed Elsayed
- Agricultural Research Center (ARC), Animal Health Research Institute-Al Shalateen Provincial Laboratory (AHRI-Al Shalateen), Giza 12618, Egypt;
| | - Raafat M. Shaapan
- Department of Zoonoses, National Research Centre, 33 El-Tahrir Street, Dokki 12622, Egypt;
| | - Abdelbaset E. Abdelbaset
- Laboratory of Parasitology, Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, Sapporo 060-0808, Japan;
- Clinical Laboratory Diagnosis, Department of Animal Medicine, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt
| | - Caroline F. Frey
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse-Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland;
| | - Bader S. Alawfi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia;
| | - Sarah A. Altwaim
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia (A.S.A.)
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Azzah S. Alharbi
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia (A.S.A.)
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Gamal Wareth
- Institute of Bacterial Infections and Zoonoses, Fredrich-Loeffler-Institut (FLI), 07743 Jena, Germany
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07747 Jena, Germany
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Adam MS, Jmor S, Elsayed A, Naz N. Coexistence of nephrogenic systemic fibrosis and calciphylaxis in a gadolinium-naïve, chronic haemodialysis patient. BMJ Case Rep 2024; 17:e258482. [PMID: 38350702 PMCID: PMC10868240 DOI: 10.1136/bcr-2023-258482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
We present a case of a man in his 40s who was on haemodialysis for over 20 years presenting with rapidly progressive decline in mobility, associated with fixed flexion deformities of joints and peau d'orange appearance of skin together with areas of ulceration that was concerning for calciphylaxis. Skin biopsies were consistent with both nephrogenic systemic fibrosis and calciphylaxis. He has never had exposure to gadolinium-based contrast agent. His treatment included daily dialysis sessions, which were challenging due to vascular access issues and three times weekly sodium thiosulfate. He rapidly declined in hospital and died within 2 weeks of presentation while being treated for a hospital-acquired pneumonia.
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Affiliation(s)
- Mariyam Shiruzima Adam
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Shilan Jmor
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Ahmed Elsayed
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Noshaba Naz
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
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Reda R, Ahmed Y, Magdy I, Nabil H, Khamis M, Lila MA, Refaey A, Eldabaa N, Elmagd MA, Ragab AE, Elsayed A. Wall panel structure design optimization of a hexagonal satellite. Heliyon 2024; 10:e24159. [PMID: 38293483 PMCID: PMC10824784 DOI: 10.1016/j.heliyon.2024.e24159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Considering that it satisfies high strength and stiffness at a low weight, the grid structure is the ideal option for meeting the requirements for developing the wall panel structure for the satellite. The most attractive grid structures for the satellite wall panel industry are isogrid and honeycomb structures. The first part of this work involves studying the mechanical and dynamic performance of five designs for the satellite wall panel made of 7075-T0 Al-alloy. These designs include two isogrid structures with different rib widths, two honeycomb structures with different cell wall thicknesses, and a solid structure for comparison. The performance of these designs was evaluated through compression, bending, and vibration testing using both finite element analysis (FEA) with the Ansys workbench and experimental testing. The FEA results are consistent with the experimental ones. The results show that the isogrid structure with a lower rib thickness of 2 mm is the best candidate for manufacturing the satellite wall panel, as this design reveals the best mechanical and dynamic performance. The second part of this work involves studying the influence of the length of the sides of the best isogrid structure in the range of 12 mm-24 mm on its mechanical and dynamic performance to achieve the lowest possible mass while maintaining the structure's integrity. Then, a modified design of skinned wall panels was introduced and dynamically tested using FEA. Finally, a CAD model of a hexagonal satellite prototype using the best-attained design of the wall panel, i.e., the isogrid structure with a 2 mm rib width and 24 mm-long sides, was built and dynamically tested to ensure its safe design against vibration. Then, the satellite prototype was manufactured, assembled, and successfully assessed.
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Affiliation(s)
- Reham Reda
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Yasmeen Ahmed
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Islam Magdy
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Hossam Nabil
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Mennatullah Khamis
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Mohamed Abo Lila
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Ahmed Refaey
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Nada Eldabaa
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Manar Abo Elmagd
- Department of Mechanical Engineering, Faculty of Engineering, Suez University, P.O.Box: 43221, Suez, Egypt
| | - Adham E. Ragab
- Department of Industrial Engineering, College of Engineering, King Saud University, P.O. Box 800, Riyadh, 11421, Saudi Arabia
| | - Ahmed Elsayed
- Advanced Forming Research Centre, Strathclyde University, Renfrew, Glasgow, PA4 9LJ, Scotland
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Marzouk M, Elsayed A. Framework for assessing bridges construction impact on work zone traffic using BrIM. Sci Rep 2024; 14:83. [PMID: 38167437 PMCID: PMC10761946 DOI: 10.1038/s41598-023-50404-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
This research presents a framework for visualizing bridge construction impact on work zone traffic using Bridge Information Modelling (BrIM) and Google Maps API. The framework consists of four modules. The first module contains the construction data of the bridge by reporting the construction's daily progress. The second module is designated to model traffic data of the work zone using Google Maps API, traffic Survey counting, and Google Earth Images. The third module performs a traffic simulation for the work zone, and calculating the user cost of different stages. The fourth module visualizes the bridge's construction using Bridge Information Modelling (BrIM) and virtual reality in the Twinmotion engine to demonstrate the construction stages and the corresponding traffic states. An actual case study of El-Nahas Bridge in Cairo city-Egypt is presented to demonstrate the main features of the developed framework and its practical aspects. The case study results reveal that the impact of the construction stages varies on work zone traffic throughout the project period. The impact greatly influences the traffic status at the beginning of the project associated with high user costs. Then, the impact declines in later stages depending on the type of construction activities in each stage.
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Affiliation(s)
- Mohamed Marzouk
- Structural Engineering Department, Faculty of Engineering, Cairo University, Giza, 12613, Egypt.
| | - Ahmed Elsayed
- Integrated Engineering Design Management Program, Faculty of Engineering, Cairo University, Giza, Egypt
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Iqbal M, Hammour A, Elsayed A, Gad A. Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study. Med Hypothesis Discov Innov Ophthalmol 2023; 12:78-89. [PMID: 38357612 PMCID: PMC10862023 DOI: 10.51329/mehdiophthal1473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024]
Abstract
Background Keratoconus (KCN) is an ectatic disorder of the cornea characterized by stromal weakness and apical protrusion of the cornea, and is associated with a gradual and painless reduction in visual acuity. KCN in pediatric patients has certain important characteristics, such as a progressive and aggressive nature. We aimed to analyze the visual, refractive, and topographic outcomes of implanting a single 210° arc-length Keraring segment according to a novel, objective, Q value-based nomogram (Q-N) for the treatment of pediatric versus adult KCN. Methods This prospective, multicenter, non-randomized, open-label trial included 47 eyes of 47 patients who were allocated to one of two groups. The adult group included 33 eyes of patients ≥ 18 years of age, whereas the pediatric group included 14 eyes of patients aged 14 - 17 years. All patients underwent femtosecond laser-assisted implantation of a single 210° arc-length Keraring segment according to the Q-N and were followed up for 6 months. All eyes underwent visual acuity measurement, cycloplegic refraction, and corneal topography at baseline and 6 months after surgery. Results The study groups were comparable in terms of sex proportions and KCN grades (both P > 0.05). The adult group exhibited significant postoperative improvements in mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), and Kmax (all P < 0.001) with a mean change of -0.56 logarithm of the minimal angle of resolution (logMAR), - 0.40 logMAR, 3.07 diopters (D), 0.70 D, 3.42 D, and - 5.26 D, respectively. The pediatric group exhibited significant postoperative improvements in mean UDVA, CDVA, sphere, SE, and Kmax (all P < 0.05) with a mean change of - 0.62 logMAR, - 0.34 logMAR, 3.18 D, 3.67 D, and - 5.37 D, respectively. There were no significant differences between the groups in terms of the mean change in visual, refractive, and topographic variables (all P > 0.05). No postoperative complications were observed in either group. Conclusions Use of the objective Q-N was efficient in the treatment of pediatric KCN, with postoperative improvements in the mean visual, refractive, and topographic parameters, comparable to outcomes in adult keratoconus. Q-N achieved good corneal remodeling with subsequent improvements in visual, refractive, and topographic outcomes in both adult and pediatric patients with keratoconus. To verify our preliminary findings, we recommend further multicenter randomized clinical trials using the Q-N nomogram in a larger sample of pediatric patients with KCN as an adjunct treatment before or after CXL.
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Affiliation(s)
- Mohammed Iqbal
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Abdallah Hammour
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Elsayed
- Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Gad
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt
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Wefel JS, Deshmukh S, Brown PD, Grosshans DR, Sulman EP, Cerhan JH, Mehta MP, Khuntia D, Shi W, Mishra MV, Suh JH, Laack NN, Chen Y, Curtis AA, Laba JM, Elsayed A, Thakrar A, Pugh SL, Bruner DW. Impact of Apolipoprotein E Genotype on Neurocognitive Function in Patients With Brain Metastases: An Analysis of NRG Oncology's RTOG 0614. Int J Radiat Oncol Biol Phys 2023:S0360-3016(23)08238-X. [PMID: 38101486 DOI: 10.1016/j.ijrobp.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Whole-brain radiation therapy (WBRT) is a common treatment for brain metastases and is frequently associated with decline in neurocognitive functioning (NCF). The e4 allele of the apolipoprotein E (APOE) gene is associated with increased risk of Alzheimer disease and NCF decline associated with a variety of neurologic diseases and insults. APOE carrier status has not been evaluated as a risk factor for onset time or extent of NCF impairment in patients with brain metastases treated with WBRT. METHODS AND MATERIALS NRG/Radiation Therapy Oncology Group 0614 treated adult patients with brain metastases with 37.5 Gy of WBRT (+/- memantine), performed longitudinal NCF testing, and included an optional blood draw for APOE analysis. NCF test results were compared at baseline and over time with mixed-effects models. A cause-specific Cox model for time to NCF failure was performed to assess the effects of treatment arm and APOE carrier status. RESULTS APOE results were available for 45% of patients (n = 227/508). NCF did not differ by APOE e4 carrier status at baseline. Mixed-effects modeling showed that APOE e4 carriers had worse memory after WBRT compared with APOE e4 noncarriers (Hopkins Verbal Learning Test-Revised total recall [least square mean difference, 0.63; P = .0074], delayed recognition [least square mean difference, 0.75; P = .023]). However, APOE e4 carrier status was not associated with time to NCF failure (hazard ratio, 0.86; 95% CI, 0.60-1.23; P = .40). Memantine delayed the time to NCF failure, regardless of carrier status (hazard ratio, 0.72; 95% CI, 0.52-1.01; P = .054). CONCLUSIONS APOE e4 carriers with brain metastases exhibited greater decline in learning and memory, executive function, and the Clinical Trial Battery Composite score after treatment with WBRT (+/- memantine), without acceleration of onset of difference in time to NCF failure.
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Affiliation(s)
- Jeffrey S Wefel
- University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Snehal Deshmukh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
| | | | | | - Erik P Sulman
- Laura and Isaac Perlmutter Cancer Center, New York University Langone, New York, New York
| | | | - Minesh P Mehta
- Baptist Hospital of Miami and Florida International University, Miami, Florida
| | | | - Wenyin Shi
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Mark V Mishra
- University of Maryland Medical Systems, Baltimore, Maryland
| | - John H Suh
- Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Amarinthia Amy Curtis
- Spartanburg Medical Center, Accruals for Upstate Carolina NCORP-Gibbs Regional Cancer Center, Spartanburg, South Carolina
| | - Joanna M Laba
- London Regional Cancer Program, Accruals for University of Western Ontario, London, Ontario, Canada
| | - Ahmed Elsayed
- Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio
| | - Anu Thakrar
- John H. Stroger Jr Hospital of Cook County MBCCOP, Chicago, Illinois
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
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9
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Dean YE, Dahshan H, Motawea KR, Khalifa Z, Tanas Y, Rakha I, Hasan W, Kishk M, Mahmoud A, Elsayed A, Abdelkader O, Tokunaga A, Khalifa A, Helmy A, Elhalag RH, Farghaly RM, Abdelkader OKS, Shah J, Hakim D, Aiash H. Anthracyclines and the risk of arrhythmias: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35770. [PMID: 37986405 PMCID: PMC10659615 DOI: 10.1097/md.0000000000035770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND There have been controversial findings from recent studies regarding anthracyclines use and the subsequent risk of arrhythmias. This study aimed to evaluate the existing evidence of the risk of arrhythmias in patients treated with anthracyclines. METHODS PubMed, Scopus, and Web of Science databases were searched up to April 2022 using keywords such as "anthracycline" and "arrhythmia." Dichotomous data were presented as relative risk (RR) and confidence interval (CI), while continuous data were presented as mean difference (MD) and CI. Revman software version 5.4 was used for the analysis. RESULTS Thirteen studies were included with a total of 26891 subjects. Pooled analysis showed that anthracyclines therapy was significantly associated with a higher risk of arrhythmia (RR: 1.58; 95% CI: 1.41-1.76; P < .00001), ST segment and T wave abnormalities (RR: 1.73, 95% CI: 1.18-2.55, P = .005), conduction abnormalities and AV block (RR = 1.86, 95% CI = 1.06-3.25, P = .03), and tachycardia (RR: 1.736, 95% CI: 1.11-2.69, P = .02). Further analyses of the associations between anthracyclines and atrial flutter (RR = 1.30, 95% CI = 0.29-5.89, P = .74), atrial ectopic beats (RR: 1.27, 95% CI: 0.78-2.05, P = .34), and ventricular ectopic beats (RR: 0.93, 95% CI: 0.53-1.65, P = .81) showed no statistically significant results. Higher doses of anthracycline were associated with a higher risk of arrhythmias (RR: 1.49; 95% CI: 1.08-2.05; P = .02) compared to the lower doses (RR: 1.36; 95% CI: 1.00-1.85; P = .05). Newer generations of Anthracycline maintained the arrhythmogenic properties of previous generations, such as Doxorubicin. CONCLUSION Anthracyclines therapy was significantly associated with an increased risk of arrhythmias. Accordingly, Patients treated with anthracyclines should be screened for ECG abnormalities and these drugs should be avoided in patients susceptible to arrhythmia. The potential benefit of the administration of prophylactic anti-fibrotic and anti-arrhythmic drugs should also be explored.
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Affiliation(s)
- Yomna E. Dean
- Alexandria Medical Center (AMC), Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | - Hazem Dahshan
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Karam R. Motawea
- Alexandria Medical Center (AMC), Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | - Ziad Khalifa
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Yousef Tanas
- Alexandria Medical Center (AMC), Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | - Ibrahim Rakha
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Walaa Hasan
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Mohamed Kishk
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Alaa Mahmoud
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | - Ahmed Elsayed
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
| | | | | | - Ahmed Khalifa
- Beni Suef University, Faculty of Medicine, Beni Suef, Egypt
| | - Ahmed Helmy
- Kharkiv National Medical University, Kharkiv, Ukraine
| | - Rowan H. Elhalag
- Alexandria Medical Center (AMC), Alexandria University, Faculty of Medicine, Alexandria, Egypt
| | | | | | - Jaffer Shah
- Kateb University, Medical Research Center, Kabul, Afghanistan
- Weill Cornell Medicine, New York, NY, USA
| | - Diaa Hakim
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
- Harvard Medical School, Boston, US
| | - Hani Aiash
- Suez Canal University, Faculty of Medicine, Ismailia, Egypt
- SUNY Upstate Medical University, Syracuse, US
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10
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Dean YE, Elawady SS, Shi W, Salem AA, Chotwatanapong A, Ashraf H, Reddi T, Dundi POR, Habash WY, Habash MY, Ahmed S, Samir HM, Elsayed A, Arora A, Arora A, Elsayed A, Mady T, Tanas Y, Hazimeh Y, Alazmy M, Aiash H. Progression of diabetic nephropathy and vitamin D serum levels: A pooled analysis of 7722 patients. Endocrinol Diabetes Metab 2023; 6:e453. [PMID: 37743677 PMCID: PMC10638614 DOI: 10.1002/edm2.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND AND AIM Low serum Vitamin D levels have been associated with diabetic nephropathy (DN). Our study aimed to analyse the serum levels of vitamin D in patients suffering from DN and the subsequent changes in serum vitamin D levels as the disease progresses. METHODS PubMed, Embase, SCOPUS and Web of Science were searched using keywords such as '25 hydroxyvitamin D' and 'diabetic nephropathy'. We included observational studies that reported the association between the serum 25 hydroxy vitamin D levels and diabetic nephropathy without restriction to age, gender, and location. R Version 4.1.2 was used to perform the meta-analysis. The continuous outcomes were represented as mean difference (MD) and standard deviation (SD) and dichotomous outcomes as risk ratios (RR) with their 95% confidence interval (CI). RESULTS Twenty-three studies were included in our analysis with 7722 patients. Our analysis revealed that vitamin D was significantly lower in diabetic patients with nephropathy than those without nephropathy (MD: -4.32, 95% CI: 7.91-0.74, p-value = .0228). On comparing diabetic patients suffering from normoalbuminuria, microalbuminuria, or macroalbuminuria, we found a significant difference in serum vitamin D levels across different groups. Normoalbuminuria versus microalbuminuria showed a MD of -1.69 (95% CI: -2.28 to -1.10, p-value = .0002), while microalbuminuria versus macroalbuminuria showed a MD of (3.75, 95% CI: 1.43-6.06, p-value = .0058), proving that serum vitamin D levels keep declining as the disease progresses. Notwithstanding, we detected an insignificant association between Grade 4 and Grade 5 DN (MD: 2.29, 95% CI: -2.69-7.28, p-value = .1862). CONCLUSION Serum Vitamin D levels are lower among DN patients and keep declining as the disease progresses, suggesting its potential benefit as a prognostic marker. However, on reaching the macroalbuminuria stage (Grades 4 and 5), vitamin D is no longer a discriminating factor.
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Affiliation(s)
- Yomna E. Dean
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Sameh Samir Elawady
- Neuro‐endovascular Surgery DepartmentMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Wangpan Shi
- Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | | | | | - Haya Ashraf
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Tharun Reddi
- Arkansas College of Osteopathic MedicineFort SmithArkansasUSA
| | | | | | | | - Safaa Ahmed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Hana M. Samir
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | - Ahmed Elsayed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | | | | | - Tamer Mady
- International American University, College of MedicineVieux FortSaint Lucia
| | - Yousef Tanas
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Yusef Hazimeh
- Lebanese UniversityBeirutLebanon
- Zahraa Hospital, University Medical CenterBeirutLebanon
| | - Mohamed Alazmy
- Medical director, Dhaman Health Assurance CompanyKuwaitKuwait
| | - Hani Aiash
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
- SUNY Upstate Medical UniversitySyracuseNew YorkUSA
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11
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Elsayed A, Rixon S, Levison J, Binns A, Goel P. Application of classification machine learning algorithms for characterizing nutrient transport in a clay plain agricultural watershed. J Environ Manage 2023; 345:118924. [PMID: 37678017 DOI: 10.1016/j.jenvman.2023.118924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
Excess nutrients in surface water and groundwater can lead to water quality deterioration in available water resources. Thus, the classification of nutrient concentrations in water resources has gained significant attention during recent decades. Machine learning (ML) algorithms are considered an efficient tool to describe nutrient loss from agricultural land to surface water and groundwater. Previous studies have applied regression and classification ML algorithms to predict nutrient concentrations in surface water and/or groundwater, or to categorize an output variable using a limited number of input variables. However, there have been no studies that examined the application of different ML classification algorithms in agricultural settings to classify various output variables using a wide range of input variables. In this study, twenty-four ML classification algorithms were implemented on a dataset from three locations within the Upper Parkhill watershed, an agricultural watershed in southern Ontario, Canada. Nutrient concentrations in surface water were classified using geochemical and physical water parameters of surface water and groundwater (e.g., pH), climate and field conditions as the input variables. The performance of these algorithms was evaluated using four evaluation metrics (e.g., classification accuracy) to identify the optimal algorithm for classifying the output variables. Ensemble bagged trees was found to be the optimal ML algorithm for classifying nitrate concentration in surface water (accuracy of 90.9%), while the weighted KNN was the most appropriate algorithm for categorizing the total phosphorus concentration (accuracy of 87%). The ensemble subspace discriminant algorithm gave the highest overall classification accuracy for the concentration of soluble reactive phosphorus and total dissolved phosphorus in surface water with an accuracy of 79.2% and 77.9%, respectively. This study exemplifies that ML algorithms can be used to signify exceedance of recommended concentrations of nutrients in surface waters in agricultural watersheds. Results are useful for decision makers to develop nutrient management strategies.
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Affiliation(s)
- Ahmed Elsayed
- School of Engineering, Morwick G360 Groundwater Research Institute, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada; Irrigation and Hydraulics Department, Faculty of Engineering, Cairo University, 1 Gamaa Street, Giza, 12613, Egypt.
| | - Sarah Rixon
- School of Engineering, Morwick G360 Groundwater Research Institute, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Jana Levison
- School of Engineering, Morwick G360 Groundwater Research Institute, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Andrew Binns
- School of Engineering, Morwick G360 Groundwater Research Institute, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Pradeep Goel
- Ministry of the Environment, Conservation and Parks (MECP), 125 Resources Road, Etobicoke, Ontario, M9P 3V6, Canada
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12
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Khafagy W, ElBassioune W, Rady M, Farouk E, Elhelw E, Saeed A, Mahmoud A, Abuelmatti H, Elsheikh A, Mahmoud M, Hussein M, Zaky A, Abdeltawab A, Ali S, Altoraky M, Hegazy M, Almorsy A, Alghazaly M, Rehan M, Elnady E, Khater S, Mahmoud A, Elsayed A, Deif H. A new promising approach to urodynamic stress urinary incontinence care can help menopausal women. Prz Menopauzalny 2023; 22:121-125. [PMID: 37829269 PMCID: PMC10566331 DOI: 10.5114/pm.2023.131058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/15/2022] [Indexed: 10/14/2023]
Abstract
Introduction The goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling. Material and methods This prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire - Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale). Results The single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups. Conclusions Single-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.
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Affiliation(s)
- Wael Khafagy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Walaa ElBassioune
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mahmoud Rady
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Elmetwally Farouk
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ehab Elhelw
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Saeed
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Mahmoud
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Hamada Abuelmatti
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Elsheikh
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed Mahmoud
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohammed Hussein
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Zaky
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Abdeltawab
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Soliman Ali
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Muhammad Altoraky
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mahmoud Hegazy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Almorsy
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Moatazza Alghazaly
- Department of Obstetrics and Gynaecology, Al-Azhar University, Al-Azhar, Egypt
| | - Mohamed Rehan
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Esam Elnady
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Saed Khater
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Alaa Mahmoud
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Ahmed Elsayed
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
| | - Hazem Deif
- Department of Urology, Al-Azhar University, Al-Azhar, Egypt
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13
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Bogari NM, Allam RM, Dannoun A, Athar M, Bouazzaoui A, Elkhateeb O, Porqueddu M, Amer SA, Elsayed A, Colombo GI. Role of single nucleotide polymorphism rs2383206 on coronary artery disease risk among Saudi Population: a case-control study. Eur Rev Med Pharmacol Sci 2023; 27:6671-6681. [PMID: 37522678 DOI: 10.26355/eurrev_202307_33137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE We aim to investigate the relationship between genetic variation and biological function on a genomic scale, focusing on identifying genes responsible for complex diseases using single nucleotide polymorphisms. Specifically, the study explores the association between the rs2383206 gene located on chromosome 9p21.3 and the development of coronary artery disease (CAD) in a specific Saudi population. PATIENTS AND METHODS This case-control study was conducted between September 2013 and May 2015 at King Abdullah Medical City (KAMC) and Al-Noor Specialist Hospital targeting the Saudi Population residing in the western region of Saudi Arabia. The study enrolled 315 cases with documented CAD and 205 controls with normal coronary arteries on coronary angiography. Genomic DNA was extracted from peripheral blood samples of both groups, and genotyping of rs2383206 was performed using the tetra-primer amplification-refractory mutation system-polymerase chain reaction (ARMS-PCR) method. RESULTS In this study, the prevalence of the GG genotype in rs2383206 was found to be higher in patients with CAD than in controls, with an odds ratio of 1.997 [95% confidence interval (CI): 1.176-3.394, p = 0.007]. Additionally, individuals with the GG genotype who had sedentary lifestyles, hyperlipidemia, and smoked were found to be at a higher risk for developing CAD (p = 0.003, 0.009, and 0.003, respectively). The G allele also increased the risk of CAD with an odds ratio of 1.413 (95% CI: 1.099-1.817; p = 0.004). CONCLUSIONS In conclusion, this study demonstrated a significant association between the rs2383206 variant located on chromosome 9p21 and the development of CAD. The findings of this study provide valuable insights into the genetic susceptibility to CAD and highlight the potential of this variant as a target for future functional studies.
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Affiliation(s)
- N M Bogari
- Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
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14
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Bakr L, Elsayed A, Saleh O, Abdalraouf M, Ng GA, Ibrahim M. Safety and efficacy of direct oral anticoagulants in bioprosthetic valves: A systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1099591. [PMID: 36923956 PMCID: PMC10008933 DOI: 10.3389/fcvm.2023.1099591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/03/2023] [Indexed: 03/03/2023] Open
Abstract
Background Direct oral anticoagulants are efficient alternatives to vitamin K antagonists. There is little evidence regarding their use in patients who underwent bioprosthetic valve replacement whether surgically or through a transcatheter approach and have another indication of anticoagulation. Trials have compared different members of the DOACs family to VKAs and showed that they were at least non-inferior to VKAs with regard to safety and efficacy. However, this is still controversial. Our meta-analysis aims at providing a clearer view of their future use in this subgroup of patients. Methods PubMed and Cochrane were searched for randomised clinical trials and observational studies. Bleeding, stroke, and all-cause mortality were the outcomes of interest. Results Ten papers with a total of 4,088 patients were included. Our meta-analysis revealed no significant differences between the incidence of bleeding between DOACs and warfarin (16% vs. 17%, OR = 0.94, 95% CI [0.56-1.57], p = 0.81, I 2 = 81%). No statistical difference was found in stroke between both groups (2.5% vs. 3.3%, OR = 0.75, 95% CI [0.41-1.38], p = 0.36, I 2 = 35%). All-cause mortality was not statistically significant between both groups (9.2% vs. 13.7%, OR = 0.85, 95% CI [0.68-1.07], p = 0.16, I 2 = 56%). Interestingly, subgroup analysis of randomised controlled trials and prospective studies favoured DOACs with lower risks of both bleeding and stroke. Conclusion Direct oral anticoagulants appear to be at least as safe and effective as VKAs in patients with bioprosthetic valves and another indication of anticoagulation. There could be potential benefit from the use of DOACs; however, further evidence is required. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021222146, identifier CRD42021222146.
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Affiliation(s)
- Lubna Bakr
- The Royal College of Surgeons of England, London, United Kingdom
| | - Ahmed Elsayed
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- NHS, Health Education England – North West (HEENW), Manchester, United Kingdom
| | - Omar Saleh
- Suez Canal University Hospital, Ismailia, Egypt
| | | | - Ghulam André Ng
- Glenfield Hospital, University Hospitals of Leicester NHS Trust (UHL), Leicester, United Kingdom
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research Leicester Biomedical Research Center, Leicester, United Kingdom
| | - Mokhtar Ibrahim
- Glenfield Hospital, University Hospitals of Leicester NHS Trust (UHL), Leicester, United Kingdom
- Department of Cardiology, Ain Shams University, Cairo, Egypt
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15
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Tabah A, Buetti N, Staiquly Q, Ruckly S, Akova M, Aslan AT, Leone M, Conway Morris A, Bassetti M, Arvaniti K, Lipman J, Ferrer R, Qiu H, Paiva JA, Povoa P, De Bus L, De Waele J, Zand F, Gurjar M, Alsisi A, Abidi K, Bracht H, Hayashi Y, Jeon K, Elhadi M, Barbier F, Timsit JF, Pollock H, Margetts B, Young M, Bhadange N, Tyler S, Ledtischke A, Finnis M, Ledtischke A, Finnis M, Dwivedi J, Saxena M, Biradar V, Soar N, Sarode V, Brewster D, Regli A, Weeda E, Ahmed S, Fourie C, Laupland K, Ramanan M, Walsham J, Meyer J, Litton E, Palermo AM, Yap T, Eroglu E, Attokaran AG, Jaramillo C, Nafees KMK, Rashid NAHA, Walid HAMI, Mon T, Moorthi PD, Sudhirchandra S, Sridharan DD, Haibo Q, Jianfeng X, Wei-Hua L, Zhen W, Qian C, Luo J, Chen X, Wang H, Zhao P, Zhao J, Wusi Q, Mingmin C, Xu L, Yin C, Wang R, Wang J, Yin Y, Zhang M, Ye J, Hu C, Zhou S, Huang M, Yan J, Wang Y, Qin B, Ye L, Weifeng X, Peije L, Geng N, Hayashi Y, Karumai T, Yamasaki M, Hashimoto S, Hosokawa K, Makino J, Matsuyoshi T, Kuriyama A, Shigemitsu H, Mishima Y, Nagashima M, Yoshida H, Fujitani S, Omori K, Rinka H, Saito H, Atobe K, Kato H, Takaki S, Hasan MS, Jamaluddin MFH, Pheng LS, Visvalingam S, Liew MT, Wong SLD, Fong KK, Rahman HBA, Noor ZM, Tong LK, Azman AH, Mazlan MZ, Ali S, Jeon K, Lee SM, Park S, Park SY, Lim SY, Goh QY, Ng SY, Lie SA, Kwa ALH, Goh KJ, Li AY, Ong CYM, Lim JY, Quah JL, Ng K, Ng LXL, Yeh YC, Chou NK, Cia CT, Hu TY, Kuo LK, Ku SC, Wongsurakiat P, Apichatbutr Y, Chiewroongroj S, Nadeem R, Houfi AE, Alsisi A, Elhadidy A, Barsoum M, Osman N, Mostafa T, Elbahnasawy M, Saber A, Aldhalia A, Elmandouh O, Elsayed A, Elbadawy MA, Awad AK, Hemead HM, Zand F, Ouhadian M, Borsi SH, Mehraban Z, Kashipazha D, Ahmadi F, Savaie M, Soltani F, Rashidi M, Baghbanian R, Javaherforoosh F, Amiri F, Kiani A, Zargar MA, Mahmoodpoor A, Aalinezhad F, Dabiri G, Sabetian G, Sarshad H, Masjedi M, Tajvidi R, Tabatabaei SMN, Ahmed AK, Singer P, Kagan I, Rigler M, Belman D, Levin P, Harara B, Diab A, Abilama F, Ibrahim R, Fares A, Buimsaedah A, Gamra M, Aqeelah A, AliAli AM, Homaidan AGS, Almiqlash B, Bilkhayr H, Bouhuwaish A, Taher AS, Abdulwahed E, Abousnina FA, Hdada AK, Jobran R, Hasan HB, Hasan RSB, Serghini I, Seddiki R, Boukatta B, Kanjaa N, Mouhssine D, Wajdi MA, Dendane T, Zeggwagh AA, Housni B, Younes O, Hachimi A, Ghannam A, Belkhadir Z, Amro S, Jayyab MA, Hssain AA, Elbuzidi A, Karic E, Lance M, Nissar S, Sallam H, Elrabi O, Almekhlafi GA, Awad M, Aljabbary A, Chaaban MK, Abu-Sayf N, Al-Jadaan M, Bakr L, Bouaziz M, Turki O, Sellami W, Centeno P, Morvillo LN, Acevedo JO, Lopez PM, Fernández R, Segura M, Aparicio DM, Alonzo MI, Nuccetelli Y, Montefiore P, Reyes LF, Reyes LF, Ñamendys-Silva SA, Romero-Gonzalez JP, Hermosillo M, Castillo RA, Leal JNP, Aguilar CG, Herrera MOG, Villafuerte MVE, Lomeli-Teran M, Dominguez-Cherit JG, Davalos-Alvarez A, Ñamendys-Silva SA, Sánchez-Hurtado L, Tejeda-Huezo B, Perez-Nieto OR, Tomas ED, De Bus L, De Waele J, Hollevoet I, Denys W, Bourgeois M, Vanderhaeghen SFM, Mesland JB, Henin P, Haentjens L, Biston P, Noel C, Layos N, Misset B, De Schryver N, Serck N, Wittebole X, De Waele E, Opdenacker G, Kovacevic P, Zlojutro B, Custovic A, Filipovic-Grcic I, Radonic R, Brajkovic AV, Persec J, Sakan S, Nikolic M, Lasic H, Leone M, Arbelot C, Timsit JF, Patrier J, Zappela N, Montravers P, Dulac T, Castanera J, Auchabie J, Le Meur A, Marchalot A, Beuzelin M, Massri A, Guesdon C, Escudier E, Mateu P, Rosman J, Leroy O, Alfandari S, Nica A, Souweine B, Coupez E, Duburcq T, Kipnis E, Bortolotti P, Le Souhaitier M, Mira JP, Garcon P, Duprey M, Thyrault M, Paulet R, Philippart F, Tran M, Bruel C, Weiss E, Janny S, Foucrier A, Perrigault PF, Djanikian F, Barbier F, Gainnier M, Bourenne J, Louis G, Smonig R, Argaud L, Baudry T, Dessap AM, Razazi K, Kalfon P, Badre G, Larcher R, Lefrant JY, Roger C, Sarton B, Silva S, Demeret S, Le Guennec L, Siami S, Aparicio C, Voiriot G, Fartoukh M, Dahyot-Fizelier C, Imzi N, Klouche K, Bracht H, Hoheisen S, Bloos F, Thomas-Rueddel D, Petros S, Pasieka B, Dubler S, Schmidt K, Gottschalk A, Wempe C, Lepper P, Metz C, Viderman D, Ymbetzhanov Y, Mugazov M, Bazhykayeva Y, Kaligozhin Z, Babashev B, Merenkov Y, Temirov T, Arvaniti K, Smyrniotis D, Psallida V, Fildisis G, Soulountsi V, Kaimakamis E, Iasonidou C, Papoti S, Renta F, Vasileiou M, Romanou V, Koutsoukou V, Matei MK, Moldovan L, Karaiskos I, Paskalis H, Marmanidou K, Papanikolaou M, Kampolis C, Oikonomou M, Kogkopoulos E, Nikolaou C, Sakkalis A, Chatzis M, Georgopoulou M, Efthymiou A, Chantziara V, Sakagianni A, Athanasa Z, Papageorgiou E, Ali F, Dimopoulos G, Almiroudi MP, Malliotakis P, Marouli D, Theodorou V, Retselas I, Kouroulas V, Papathanakos G, Montrucchio G, Sales G, De Pascale G, Montini LM, Carelli S, Vargas J, Di Gravio V, Giacobbe DR, Gratarola A, Porcile E, Mirabella M, Daroui I, Lodi G, Zuccaro F, Schlevenin MG, Pelosi P, Battaglini D, Cortegiani A, Ippolito M, Bellina D, Di Guardo A, Pelagalli L, Covotta M, Rocco M, Fiorelli S, Cotoia A, Rizzo AC, Mikstacki A, Tamowicz B, Komorowska IK, Szczesniak A, Bojko J, Kotkowska A, Walczak-Wieteska P, Wasowska D, Nowakowski T, Broda H, Peichota M, Pietraszek-Grzywaczewska I, Martin-Loeches I, Bisanti A, Cartoze N, Pereira T, Guimarães N, Alves M, Marques AJP, Pinto AR, Krystopchuk A, Teresa A, de Figueiredo AMP, Botelho I, Duarte T, Costa V, Cunha RP, Molinos E, da Costa T, Ledo S, Queiró J, Pascoalinho D, Nunes C, Moura JP, Pereira É, Mendes AC, Valeanu L, Bubenek-Turconi S, Grintescu IM, Cobilinschi C, Filipescu DC, Predoi CE, Tomescu D, Popescu M, Marcu A, Grigoras I, Lungu O, Gritsan A, Anderzhanova A, Meleshkina Y, Magomedov M, Zubareva N, Tribulev M, Gaigolnik D, Eremenko A, Vistovskaya N, Chukina M, Belskiy V, Furman M, Rocca RF, Martinez M, Casares V, Vera P, Flores M, Amerigo JA, Arnillas MPG, Bermudez RM, Armestar F, Catalan B, Roig R, Raguer L, Quesada MD, Santos ED, Gomà G, Ubeda A, Salgado DM, Espina LF, Prieto EG, Asensio DM, Rodriguez DM, Maseda E, De La Rica AS, Ayestaran JI, Novo M, Blasco-Navalpotro MA, Gallego AO, Sjövall F, Spahic D, Svensson CJ, Haney M, Edin A, Åkerlund J, De Geer L, Prazak J, Jakob S, Pagani J, Abed-Maillard S, Akova M, Aslan AT, Timuroglu A, Kocagoz S, Kusoglu H, Mehtap S, Ceyhun S, Altintas ND, Talan L, Kayaaslan B, Kalem AK, Kurt I, Telli M, Ozturk B, Erol Ç, Demiray EKD, Çolak S, Akbas T, Gundogan K, Sari A, Agalar C, Çolak O, Baykam NN, Akdogan OO, Yilmaz M, Tunay B, Cakmak R, Saltoglu N, Karaali R, Koksal I, Aksoy F, Eroglu A, Saracoglu KT, Bilir Y, Guzeldag S, Ersoz G, Evik G, Sungurtekin H, Ozgen C, Erdoğan C, Gürbüz Y, Altin N, Bayindir Y, Ersoy Y, Goksu S, Akyol A, Batirel A, Aktas SC, Morris AC, Routledge M, Morris AC, Ercole A, Antcliffe D, Rojo R, Tizard K, Faulkner M, Cowton A, Kent M, Raj A, Zormpa A, Tinaslanidis G, Khade R, Torlinski T, Mulhi R, Goyal S, Bajaj M, Soltan M, Yonan A, Dolan R, Johnson A, Macfie C, Lennard J, Templeton M, Arias SS, Franke U, Hugill K, Angell H, Parcell BJ, Cobb K, Cole S, Smith T, Graham C, Cerman J, Keegan A, Ritzema J, Sanderson A, Roshdy A, Szakmany T, Baumer T, Longbottom R, Hall D, Tatham K, Loftus S, Husain A, Black E, Jhanji S, Baikady RR, Mcguigan P, Mckee R, Kannan S, Antrolikar S, Marsden N, Torre VD, Banach D, Zaki A, Jackson M, Chikungwa M, Attwood B, Patel J, Tilley RE, Humphreys MSK, Renaud PJ, Sokhan A, Burma Y, Sligl W, Baig N, McCoshen L, Kutsogiannis DJ, Sligl W, Thompson P, Hewer T, Rabbani R, Huq SMR, Hasan R, Islam MM, Gurjar M, Baronia A, Kothari N, Sharma A, Karmakar S, Sharma P, Nimbolkar J, Samdani P, Vaidyanathan R, Rubina NA, Jain N, Pahuja M, Singh R, Shekhar S, Muzaffar SN, Ozair A, Siddiqui SS, Bose P, Datta A, Rathod D, Patel M, Renuka MK, Baby SK, Dsilva C, Chandran J, Ghosh P, Mukherjee S, Sheshala K, Misra KC, Yakubu SY, Ugwu EM, Olatosi JO, Desalu I, Asiyanbi G, Oladimeji M, Idowu O, Adeola F, Mc Cree M, Karar AAA, Saidahmed E, Hamid HKS. Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study. Intensive Care Med 2023; 49:178-190. [PMID: 36764959 PMCID: PMC9916499 DOI: 10.1007/s00134-022-06944-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/23/2022] [Indexed: 02/12/2023]
Abstract
PURPOSE In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. METHODS We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. RESULTS 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. CONCLUSIONS HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Brisbane, Australia. .,Queensland Critical Care Research Network (QCCRN), Brisbane, QLD, Australia. .,Queensland University of Technology, Brisbane, QLD, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Niccolò Buetti
- Infection Control Program and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France
| | | | - Stéphane Ruckly
- Université de Paris, INSERM, IAME UMR 1137, 75018, Paris, France.,ICUREsearch, Biometry, 38600, Fontaine, France
| | - Murat Akova
- Department of Infectious Diseases, Hacettepe University School of Medicine, Ankara, Turkey
| | - Abdullah Tarik Aslan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Marc Leone
- Department of Anesthesiology and Intensive Care Unit, Hospital Nord, Aix Marseille University, Assistance Publique Hôpitaux Universitaires de Marseille, Marseille, France
| | - Andrew Conway Morris
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.,Division of Immunology, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, Cb2 1QP, UK.,JVF Intensive Care Unit, Addenbrooke's Hospital, Cambridge, Hills Road, Cambridge, CB2 0QQ, UK
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Kostoula Arvaniti
- Intensive Care Unit, Papageorgiou University Affiliated Hospital, Thessaloníki, Greece
| | - Jeffrey Lipman
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Nimes University Hospital, University of Montpellier, Nimes, France.,Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Ricard Ferrer
- Intensive Care Department, SODIR-VHIR Research Group, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Haibo Qiu
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Nanjing Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - José-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar Universitário Sao Joao, Porto, Portugal.,Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal.,Infection and Sepsis ID Group, Porto, Portugal
| | - Pedro Povoa
- NOVA Medical School, New University of Lisbon, Lisbon, Portugal.,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark.,Polyvalent Intensive Care Unit, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal
| | - Liesbet De Bus
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Jan De Waele
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Farid Zand
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohan Gurjar
- Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
| | - Adel Alsisi
- ICU Department, Prime Hospital, Dubai, United Arab Emirates.,Critical Care Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khalid Abidi
- Medical ICU, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hendrik Bracht
- Central Interdisciplinary Emergency Medicine, University Hospital Ulm, Ulm, Germany
| | - Yoshiro Hayashi
- Department of Intensive Care Medicine, Kameda General Hospital, Kamogawa, Japan
| | - Kyeongman Jeon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - François Barbier
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Régional d'Orléans, 14, avenue de L'Hôpital, 45100, Orléans, France
| | - Jean-François Timsit
- Université Paris-Cité, INSERM, IAME UMR 1137, 75018, Paris, France.,Medical and Infectious Diseases Intensive Care Unit, AP-HP, Bichat-Claude Bernard University Hospital, 46 Omdurman maternity hospitalrue Henri Huchard, 75877, Paris Cedex, France
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Ismaiel A, Abunahleh A, Elsayed A, Leucuţa D, Popa S, Ismaiel M, Dumitrascu D. ADIPONECTIN LEVELS IN GRAVES' DISEASE - SYSTEMATIC REVIEW AND META-ANALYSIS. Acta Endocrinol (Buchar) 2023; 19:87-98. [PMID: 37601709 PMCID: PMC10439329 DOI: 10.4183/aeb.2023.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Context Graves' disease is the most prevalent cause of hyperthyroidism worldwide. Adiponectin, the most abundant adipokine, plays a significant role in a cluster of prevalent diseases connected to metabolic disorders. Objective Although the association between adiponectin and Graves' disease has been studied, the existing data is inconsistent. Therefore, we conducted this systematic review and meta-analysis to evaluate the relationship between adiponectin levels and Graves' disease. Methods We performed a systematic electronic search on PubMed, EMBASE, Scopus and Cochrane Library using predefined keywords. We used the NHLBI quality assessment tools to assess the included studies. Results There were 11 studies involving 781 subjects included in our qualitative synthesis, while 6 studies were included in our quantitative synthesis. We observed significantly increased adiponectin levels in Graves' disease patients compared to controls (MD 2.983 [95% CI 0.138-5.828]) and hypothyroidism patients (MD 3.389 [95% CI 1.332-5.446]). Nevertheless, no significant MD was observed when comparing Graves' disease patients with and without Graves' ophthalmopathy (MD -27.124 [95% CI -88.893 - 34.645]). Conclusions Adiponectin levels were significantly higher in patients with Graves' disease compared to controls and hypothyroidism patients. However, patients with and without Graves' ophthalmopathy did not present a significant mean difference in adiponectin levels.
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Affiliation(s)
- A. Ismaiel
- “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Department of Internal Medicine, Cluj-Napoca, Ireland
| | - A.L. Abunahleh
- “Iuliu Hațieganu” University of Medicine and Pharmacy, Faculty of Medicine, Cluj-Napoca, Ireland
| | - A. Elsayed
- County Emergency Hospital Ilfov, Department of Internal Medicine, Bucharest, Ireland
| | - D.C. Leucuţa
- “Iuliu Hațieganu” University of Medicine and Pharmacy, Department of Medical Informatics and Biostatistics, Cluj-Napoca, Ireland
| | - S.L. Popa
- “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Department of Internal Medicine, Cluj-Napoca, Ireland
| | - M. Ismaiel
- “St Michael's” Hospital, Department of Surgery, Dublin, Ireland
| | - D.L. Dumitrascu
- “Iuliu Hațieganu” University of Medicine and Pharmacy, 2 Department of Internal Medicine, Cluj-Napoca, Ireland
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17
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Elsayed A, Allan D, Davies PSE, Dalgleish S. Total knee replacement in a transtibial amputee. BMJ Case Rep 2022; 15:15/12/e252080. [PMID: 36593597 PMCID: PMC9723825 DOI: 10.1136/bcr-2022-252080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We present the case of a man in his 60s with a transtibial amputation (TTA) undergoing total knee replacement (TKR) for symptomatic osteoarthritis (OA). It is unusual to develop OA in the ipsilateral knee to TTA; and while it is postulated that this is because patients preferentially load their unaffected limb to protect the TTA-sided knee, there is also the ability to offload specific knee compartments through prosthetic adjustment. When planning TKR in such patients, it is important to consider several technical challenges in order to prevent a poor outcome. The literature is sparse with evidence to guide decision-making, and this case report and literature review aims to summarise our preoperative planning and intraoperative technique, which ultimately resulted in a good outcome.
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Affiliation(s)
- Ahmed Elsayed
- University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Douglas Allan
- Trauma and Orthopaedic Surgery, Ninewells Hospital and Medical School, Dundee, UK
| | | | - Stephen Dalgleish
- Trauma and Orthopaedic Surgery, Ninewells Hospital and Medical School, Dundee, UK
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18
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Elsayed A, Mahmoud N, Abdel-Mageed M, Abd El-Rahim M. Impact of earthworm species and growth habitats on the quality of vermicompost. Archives of Agriculture Sciences Journal 2022; 0:288-304. [DOI: 10.21608/aasj.2023.179910.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Fereig RM, Abdelbaky HH, El-Alfy ES, El-Diasty M, Elsayed A, Mahmoud HYAH, Ali AO, Ahmed A, Mossaad E, Alsayeqh AF, Frey CF. Seroprevalence of Toxoplasma gondii and Neospora caninum in camels recently imported to Egypt from Sudan and a global systematic review. Front Cell Infect Microbiol 2022; 12:1042279. [PMID: 36452298 PMCID: PMC9702086 DOI: 10.3389/fcimb.2022.1042279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/31/2022] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Toxoplasma gondii and Neospora caninum are closely related intracellular protozoan parasites of medical and veterinary concern by causing abortions and systemic illness. Limited or ambiguous data on the prevalence of T. gondii and N. caninum in camels triggered us to conduct this study. METHODS Camels (n = 460) recently imported from Sudan and destined mainly for human consumption, were tested for specific antibodies against these protozoans using commercially available ELISAs. From the two only quarantine stations for camels from Sudan, 368 camels were sampled between November 2015 and March 2016 in Shalateen, Red Sea governorate, and 92 samples were collected between September 2018 and March 2021 from Abu Simbel, Aswan governorate. RESULTS & DISCUSSION Overall, seropositive rates in camels were 25.7%, 3.9% and 0.8% for T. gondii, N. caninum and mixed infection, respectively. However, marked differences were found between the two study sites and/or the two sampling periods: For T. gondii, a higher rate of infection was recorded in the Red Sea samples (31.5%, 116/368; odds ratio 20.7, 5.0-85.6; P<0.0001) than in those collected in Aswan (2.2%, 2/92). The opposite was found for N. caninum with a lower rate of infection in the Red Sea samples (0.82%, 3/368; odds ratio 23.7, 6.7-83.9; P<0.0001) than in the samples from Aswan (16.3%, 15/92). Additionally, our systematic review revealed that the overall published seroprevalence of T. gondii and N. caninum was 28.6% and 14.3% in camels worldwide, respectively. To the best of our knowledge, this study provides the first record of seroprevalence of both T. gondii and N. caninum in recently imported camels kept under quarantine conditions before delivery to other Egyptian cities and regions. In addition, our review provides inclusive data on the prevalence of T. gondii and N. caninum in camel globally. This knowledge provides basic data for the implementation of strategies and control measures against neosporosis and toxoplasmosis.
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Affiliation(s)
- Ragab M. Fereig
- Division of Internal Medicine, Department of Animal Medicine, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Hanan H. Abdelbaky
- Doctor of Veterinary Sciences, Veterinary Clinic, Eterinary Directorate, Qena, Egypt
| | - El-Sayed El-Alfy
- Department of Parasitology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed El-Diasty
- Agricultural Research Center (ARC), Animal Health Research Institute-Mansoura Provincial Lab, (AHRI-Mansoura), Cairo, Egypt
| | - Ahmed Elsayed
- Agricultural Research Center (ARC), Animal Health Research Institute-Al Shalateen Provincial Lab (AHRI-Al Shalateen), Giza, Cairo, Egypt
| | - Hassan Y. A. H. Mahmoud
- Division of Infectious Diseases, Department of Animal Medicine, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Alsagher O. Ali
- Division of Infectious Diseases, Department of Animal Medicine, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Abdulrahman Ahmed
- Division of Infectious Diseases, Department of Animal Medicine, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt
| | - Ehab Mossaad
- Department of Pathology, Parasitology and Microbiology, College of Veterinary Medicine, Sudan University of Science and Technology, Khartoum, Sudan
| | - Abdullah F. Alsayeqh
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Caroline F. Frey
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse-Faculty, University of Bern, Bern, Switzerland
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Salama M, Abdo A, Mousa A, Shaheen A, Elsayed A, Soliman A. Morus Alba Leaf Extract-Based Biogenic Production of Silver Nanoparticles: Characterization, Antibacterial, and Antiviral Evaluation. Egypt J Chem 2022. [DOI: 10.21608/ejchem.2022.153506.6682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Alattar RA, Abdalla S, Abdallah T, Kazman R, Qadmour A, Ibrahim T, Alhariri B, Shaar SH, Bajwa A, Alimam A, Qazi R, Ben Abid F, Daghfal J, Eldeeb A, Shukri K, Elsayed A, Rustom F, Alsamawi M, Abdelmajid A, Basulto MAP, Cobian AAR, Abukhattab M, Alkhal A, Almaslamani MA, Omrani AS. Favipiravir for the treatment of coronavirus disease 2019 pneumonia; a propensity score-matched cohort study. J Infect Public Health 2022; 15:1061-1064. [PMID: 36087547 PMCID: PMC9420008 DOI: 10.1016/j.jiph.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/21/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022] Open
Abstract
We retrospectively investigated the clinical outcomes of favipiravir in patients with COVID-19 pneumonia. Patients who between 23 May 2020 and 18 July 2020 received ≥ 24 h of favipiravir were assigned to the favipiravir group, while those who did not formed the non-favipiravir group. The primary outcome was 28-day clinical improvement, defined as two-category improvement from baseline on an 8-point ordinal scale. Propensity scores (PS) for favipiravir therapy were used for 1:1 matching. The unmatched cohort included 1493 patients, of which 51.7% were in the favipiravir group, and 48.3% were not receiving supplemental oxygen at baseline. Significant baseline differences between the two unmatched groups existed, but not between the PS-matched groups (N = 774). After PS-matching, there were no significant differences between the two groups in the proportion with 28-day clinical improvement (93.3% versus 92.8%, P 0.780), or 28-day all-cause mortality (2.1% versus 3.1%, P 0.360). Favipiravir was associated with more viral clearance by day 28 (79.8% versus 64.1%, P < 0.001). Adverse events were common in both groups, but the 93.9% were Grades 1-3. Favipiravir therapy for COVID-19 pneumonia is well tolerated but is not associated with an increased likelihood of clinical improvement or reduced all-cause mortality by 28 days.
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Affiliation(s)
| | | | - Tasneem Abdallah
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rashid Kazman
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Aseelah Qadmour
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Tawheeda Ibrahim
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Bassem Alhariri
- Division of Internal Medicine, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Shahd H Shaar
- Communicable Disease Center, Hamad Medical Corporation
| | - Abeer Bajwa
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abeir Alimam
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Rabia Qazi
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Fatma Ben Abid
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Ali Eldeeb
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
| | - Kinda Shukri
- Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Elsayed
- Communicable Disease Center, Hamad Medical Corporation
| | - Fatima Rustom
- Communicable Disease Center, Hamad Medical Corporation
| | - Musaed Alsamawi
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Alaaeldin Abdelmajid
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Mohamed Abukhattab
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdullatif Alkhal
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Muna A Almaslamani
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ali S Omrani
- Communicable Disease Center, Hamad Medical Corporation; Division of Infectious Diseases, Department of Medicine, Hamad Medical Corporation, Doha, Qatar; Faculty of Medicine, Qatar University.
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22
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Elsayed A, Yu J, Lee T, Kim Y. Model study on real-time aeration based on nitrite for effective operation of single-stage anammox. Environ Res 2022; 212:113554. [PMID: 35644493 DOI: 10.1016/j.envres.2022.113554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/11/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
Anaerobic ammonia oxidation (Anammox) is an innovative technology for cost-efficient nitrogen removal without intensive aeration. However, effective control of the competition between nitrite oxidizing bacteria (XNOB) and Anammox bacteria (XANA) for nitrite is a key challenge for broad applications of single-stage Anammox processes in real wastewater treatment. Therefore, a real-time aeration scheme was proposed to determine dissolved oxygen (DO) based on nitrite concentration for effective control of XNOB growth while maintaining the XANA activity in a single-stage Anammox process. In this study, a non-steady state mathematical model was developed and calibrated using previously reported lab-scale Anammox results to investigate the efficiency of the proposed real-time aeration scheme in enhancing the Anammox process. Based on the calibrated model simulation results, DO of about 0.10 mg-O2/L was found to be ideal for maintaining effective nitrite creation by ammonia oxidizing bacteria (XAOB) while slowing down the growth of XNOB. If DO is too low (e.g., 0.01 mg-O2/L or lower), the overall rate of the ammonia removal is limited due to slow growth of XAOB. On the other hand, high DO (e.g., 1.0 mg-O2/L or higher) inhibits the growth of XANA, resulting in dominancy of XAOB and XNOB. According to the simulation results, nitrite concentration was found to be a rate-limiting parameter on effective nitrogen removal in single-stage Anammox processes. We also found that nitrite concentration can be used as a real-time switch for aeration in a single-stage Anammox process. A schematic aeration method based on real-time nitrite concentration was proposed and examined to control the competition between XANA and XNOB. In the model simulation, the XANA activity was successfully maintained because the schematic aeration prevented an outgrowth of XNOB, allowing energy-efficient nitrogen removal using single-stage Anammox processes.
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Affiliation(s)
- Ahmed Elsayed
- Department of Civil Engineering, McMaster University, Hamilton, Ontario, Canada; Irrigation and Hydraulics Department, Cairo University, Giza, Egypt
| | - Jaecheul Yu
- Department of Civil and Environmental Engineering, Pusan National University, Republic of Korea
| | - Taeho Lee
- Department of Civil and Environmental Engineering, Pusan National University, Republic of Korea
| | - Younggy Kim
- Department of Civil Engineering, McMaster University, Hamilton, Ontario, Canada.
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23
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Dawood RM, El-Meguid MA, Shousha HI, Elsayed A, Nabeel MM, Yosry A, Abdelaziz A, Salum GM. Seven gene signature explores the impact of DAAs on the appearance of hepatocellular carcinoma in HCV infected patients. Heliyon 2022; 8:e10119. [PMID: 36033258 PMCID: PMC9404272 DOI: 10.1016/j.heliyon.2022.e10119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/30/2022] [Accepted: 07/25/2022] [Indexed: 11/03/2022] Open
Abstract
HCV damages the hepatocytes ending with hepatocellular carcinoma (HCC). The direct-acting antivirals (DAAs) treatment has raised hopes for reducing the incidence of HCC. However, several scientific debate regarding the impact of DAAs on the occurrence of HCC in patients with cirrhosis. We aimed to study the Cirrhosis Risk Score (CRS), several clinical factors and tumor characteristics between patients who developed HCC either with or without DAAs treatment "DAA-exposed HCC patients" and "DAA-unexposed HCC patients". Methods CRS was assessed via genotyping by allelic discrimination assays in HCV patients who developed de novo HCC (with DAAs (DAA-exposed HCC patients, n = 50), and without DAAs treatment (DAA-unexposed HCC patients, n = 40)). APRI, FIB-4 scores, and tumor characteristics were assessed. Results Around 60% and 48% of DAA-exposed HCC patients and DAA-unexposed HCC patients; respectively had high CRS scores without significant difference. DAA-exposed HCC patients showed elevated Albumin, Hemoglobin and decreased ALT, AST compared with DAA-unexposed HCC patients (P = 0.002, 0.04, <0.001 and 0.006; respectively). FIB4 and APRI didn't reach the statistical difference between the studied groups. DAA-exposed HCC patients have higher overall survival (OS) than DAA-unexposed HCC patients (median: 30 & 15 months; respectively (p = 0.019)). Moreover, no significant differences were observed between the two groups in their focal lesion characteristics. Conclusion All studied patients are genetically predisposed to develop HCC. Moreover, DAAs significantly improved the OS and the biochemical parameters. No differences between the two groups were detected regarding their tumor characteristics. Accordingly, the appearance of HCC after treatment is attributed to the natural course of cirrhosis.
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Affiliation(s)
- Reham M Dawood
- Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
| | - Mai Abd El-Meguid
- Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
| | - Hend Ibrahim Shousha
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Ahmed Elsayed
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Mohamed Mahmoud Nabeel
- Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
| | - Ayman Yosry
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Ashraf Abdelaziz
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Ghada M Salum
- Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
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24
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Ramadan W, Elsayed A, Alim MA, Abdi E, Razek MKA. The Influence of Ballistic Exercises on Growth, Somatomedin Hormones for Soccer Players. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The sequence of exercise-induced hormonal changes demonstrates the quantification of training and competition loads and developing a sport-specific conditioning program.
AIM: The present study investigates the impact of ballistic exercises on biochemical variables and the muscular ability of soccer players.
METHODS: Participants were assigned randomly to two groups, including ten participants in each group, and underwent a pre- post-intervention test, including growth hormone, somatomedin hormone, triple jump, and wide jump.
RESULTS: The experimental group showed a significant increase in Growth by 43.56%, somatomedin by 6.99%, Triple jumps by 18.65%, and Wide jump by 15.68% compared to the control group.
CONCLUSION: In conclusion, ballistic exercises improved growth and somatomedin hormone, triple jump, and wide jump and thus enhancing biochemical variables and muscular ability.
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25
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Elkholy S, Sweed E, Elfakharany A, Elsayed A, ElBatsh M. P-1 Potential neuroprotective effects of losartan and donepezil on oxaliplatin-induced peripheral neuropathy in rats. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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26
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Elbaiomy M, Elsayed A. P-184 Prognostic value of mTOR expression and mismatch repair gene profile in advanced gastric and gastro-oesophageal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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27
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Elbaiomy M, Elsayed A, Akl T. P-182 Anti-EGFR antibodies may get benefit as first-line treatment in metastatic right-sided colon cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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28
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O’Donnell MJ, McQueen M, Sniderman A, Pare G, Wang X, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Xavier D, Lisheng L, Zhang H, Pais P, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Judge C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Nilanont Y, Yusuf S. Association of Lipids, Lipoproteins, and Apolipoproteins with Stroke Subtypes in an International Case Control Study (INTERSTROKE). J Stroke 2022; 24:224-235. [PMID: 35677977 PMCID: PMC9194539 DOI: 10.5853/jos.2021.02152] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Purpose The association of dyslipidemia with stroke has been inconsistent, which may be due to differing associations within etiological stroke subtypes. We sought to determine the association of lipoproteins and apolipoproteins within stroke subtypes.Methods Standardized incident case-control STROKE study in 32 countries. Cases were patients with acute hospitalized first stroke, and matched by age, sex and site to controls. Concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1), and apoB were measured. Non-HDL-C was calculated. We estimated multivariable odds ratio (OR) and population attributable risk percentage (PAR%). Outcome measures were all stroke, ischemic stroke (and subtypes), and intracerebral hemorrhage (ICH).Results Our analysis included 11,898 matched case-control pairs; 77.3% with ischemic stroke and 22.7% with ICH. Increasing apoB (OR, 1.10; 95% confidence interval [CI], 1.06 to 1.14 per standard deviation [SD]) and LDL-C (OR, 1.06; 95% CI, 1.02 to 1.10 per SD) were associated with an increase in risk of ischemic stroke, but a reduced risk of ICH. Increased apoB was significantly associated with large vessel stroke (PAR 13.4%; 95% CI, 5.6 to 28.4) and stroke of undetermined cause. Higher HDL-C (OR, 0.75; 95% CI, 0.72 to 0.78 per SD) and apoA1 (OR, 0.63; 95% CI, 0.61 to 0.66 per SD) were associated with ischemic stroke (and subtypes). While increasing HDL-C was associated with an increased risk of ICH (OR, 1.20; 95% CI, 1.14 to 1.27 per SD), apoA1 was associated with a reduced risk (OR, 0.80; 95% CI, 0.75 to 0.85 per SD). ApoB/A1 (OR, 1.38; 95% CI, 1.32 to 1.44 per SD) had a stronger magnitude of association than the ratio of LDL-C/HDL-C (OR, 1.26; 95% CI, 1.21 to 1.31 per SD) with ischemic stroke (<i>P</i><0.0001). Conclusions The pattern and magnitude of association of lipoproteins and apolipoproteins with stroke varies by etiological stroke subtype. While the directions of association for LDL, HDL, and apoB were opposing for ischemic stroke and ICH, apoA1 was associated with a reduction in both ischemic stroke and ICH. The ratio of apoB/A1 was the best lipid predictor of ischemic stroke risk.
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Affiliation(s)
- Martin J. O’Donnell
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
- Department of Medicine, HRB-Clinical Research Facility, NUI Galway, Galway, Ireland
- Correspondence: Martin J. O’Donnell Department of Medicine, HRB-Clinical Research Facility, NUI Galway, Newcastle Rd., Galway, Ireland Tel: +353-91-494-098 Fax: +353-905-297-3781 E-mail:
| | - Matthew McQueen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Allan Sniderman
- Division of Cardiology, McGill University Health Center, Montreal, QC, Canada
| | - Guillaume Pare
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Xingyu Wang
- National Center of Cardiovascular Disease, Beijing, China
| | - Graeme J. Hankey
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Siu Lim Chin
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Purnima Rao-Melacini
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - John Ferguson
- Department of Medicine, HRB-Clinical Research Facility, NUI Galway, Galway, Ireland
| | - Denis Xavier
- St John’s Medical College and Research Institute, Bangalore, India
| | - Liu Lisheng
- National Center of Cardiovascular Disease, Beijing, China
| | - Hongye Zhang
- Beijing Hypertension League Institute, Beijing, China
| | - Prem Pais
- St John’s Medical College and Research Institute, Bangalore, India
| | - Patricio Lopez-Jaramillo
- Fundacion Oftalmologica de Santander-Clinica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia
| | | | - Peter Langhorne
- Department of Geriatric Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy and University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Antonio L. Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | - Ahmed Elsayed
- Department of Surgery, Al Shaab Teaching Hospital, Khartoum, Sudan
| | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil
| | - Charles Mondo
- Department of Cardiology, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Conor Judge
- Department of Medicine, HRB-Clinical Research Facility, NUI Galway, Galway, Ireland
| | - Hans-Christoph Diener
- Institute for Medical Informatics, Department of Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | | | - Anna Czlonkowska
- Department of Neurology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Nana Pogosova
- National Research Center for Preventive Medicine, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Christian Weimar
- Institute for Medical Informatics, Department of Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Romana Iqbal
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Rafael Diaz
- Estudios Clínicos Latino America (ECLA), Instituto Cardiovascular de Rosario (ICR), Rosario, Argentina
| | - Khalid Yusoff
- University College Sedaya International (UCSI) University, Kuala Lumpur, Malaysia
| | - Afzalhussein Yusufali
- Department of Medicine, Hatta Hospital, Dubai Health Authority, Dubai Medical College, Dubai, United Arab Emirates
| | - Aytekin Oguz
- Department of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | | | - Fernando Lanas
- Faculty of Medicine, University of La Frontera, Temuco, Chile
| | - Okechukwu S. Ogah
- Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | | | | | | | | | | | - Yongchai Nilanont
- Neurology Division, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
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Elbeltagy A, Mohamed G, Akeel M, Abdelaziz K, Elbakry K, Elsayed A. Modulatory role of garlic ( Allium sativum) extract against cisplatin- induced nephrotoxicity in female albino rats and their offspring. F1000Res 2022; 11:504. [PMID: 37547786 PMCID: PMC10403747 DOI: 10.12688/f1000research.111293.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background: Cisplatin (CP) is one of the chemotherapeutic drugs widely utilized in the treatment of several malignancies. However, recently; its use has been limited because of its hazardous health drawbacks. Previous researches confirmed that CP has severe deleterious side effects on pregnant mothers and their fetuses. Garlic ( Allium sativum) extract has been claimed to exhibit potent antioxidative and free radical scavenging abilities. Aim: This work is mainly designed to evaluate the potential therapeutic role of garlic extract against CP-induced nephrotoxicity in pregnant rats and their offspring. Methods: 24 pregnant rats were used in the current study. They were randomly allocated into four groups (n=6): control, garlic, CP, and CP + garlic group. At the end of the weaning period, the mothers and the offsprings of all groups were sacrificed, the kidneys were immediately excised, and processed for histological and biochemical investigations. Also, blood samples were withdrawn and processed for estimation of the assigned biochemical parameters. Results: The renal histological sections from CP-treated mother rats displayed pronounced histopathological lesions however, their offspring showed mild renal histopathological lesions if compared with those of their mothers. The levels of renal tissue Superoxide dismutase, catalase, and glutathione peroxidase enzymes were significantly decreased. On the contrary, the levels of malondialdehyde, serum urea, and creatinine were significantly increased in CP-treated mother rats and their offspring as compared with control. The percentage value of caspase 3 activity was markedly elevated in the renal tissues of CP-treated mother rats and their offspring compared to the control group. Supplementation of garlic extract to the CP treated rats; the overall histological lesions, as well as biochemical parameters, were restored nearly to the control ones. It is concluded that garlic ( Allium sativum) extract has a powerful ameliorative role against CP-induced nephrotoxicity in pregnant rats and their offspring.
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Affiliation(s)
| | - Gamal Mohamed
- Department of Human Anatomy, , Faculty of Medicine, Jazan University, Jazan, KSA, Jazan, 45142, Saudi Arabia
| | - Mohammed Akeel
- Department of Human Anatomy, , Faculty of Medicine, Jazan University, Jazan, KSA, Jazan, 45142, Saudi Arabia
| | - Karoline Abdelaziz
- Zoology, Damanhour University Faculty of Science, Damanhour, 22511, Egypt
| | - Kadry Elbakry
- Zoology, Faculty of Science, Damietta, University, Damietta, Egypt, Damietta, 34611, Egypt
| | - Ahmed Elsayed
- Zoology, Damanhour University Faculty of Science, Damanhour, 22511, Egypt
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Elmekaty EZI, Alibrahim R, Hassanin R, Eltaib S, Elsayed A, Rustom F, Mohamed Ibrahim MI, Abu Khattab M, Al Soub H, Al Maslamani M, Al-Khal A. Darunavir-cobicistat versus lopinavir-ritonavir in the treatment of COVID-19 infection (DOLCI): A multicenter observational study. PLoS One 2022; 17:e0267884. [PMID: 35507606 PMCID: PMC9067693 DOI: 10.1371/journal.pone.0267884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background Coronavirus Disease 2019 (COVID-19) is an evolving pandemic that urged the need to investigate various antiviral therapies. This study was conducted to compare efficacy and safety outcomes of darunavir-cobicistat versus lopinavir-ritonavir in treating patients with COVID-19 pneumonia. Methods and findings This retrospective, multicenter, observational study was conducted on adult patients hospitalized in one of the COVID-19 facilities in Qatar. Patients were included if they received darunavir-cobicistat or lopinavir-ritonavir for at least three days as part of their COVID-19 treatments. Data were collected from patients’ electronic medical records. The primary outcome was a composite endpoint of time to clinical improvement and/or virological clearance. Descriptive and inferential statistics were used at alpha level of 0.05. A total of 400 patients was analyzed, of whom 100 received darunavir-cobicistat and 300 received lopinavir-ritonavir. Majority of patients were male (92.5%), with a mean (SD) time from symptoms onset to start of therapy of 7.57 days (4.89). Patients received lopinavir-ritonavir had significantly faster time to clinical improvement and/or virological clearance than patients received darunavir-cobicistat (4 days [IQR 3–7] vs. 6.5 days [IQR 4–12]; HR 1.345 [95%CI: 1.070–1.691], P = 0.011). Patients received lopinavir-ritonavir had significantly faster time to clinical improvement (5 days [IQR 3–8] vs. 8 days [IQR 4–13]; HR 1.520 (95%CI: 1.2–1.925), P = 0.000), and slower time to virological clearance than darunavir-cobicistat (25 days [IQR 15–33] vs. 21 days [IQR 12.8–30]; HR 0.772 (95%CI: 0.607–0.982), P = 0.035). No significant difference in the incidence or severity of adverse events between groups. The study was limited to its retrospective nature and the possibility of covariates, which was accounted for by multivariate analyses. Conclusion In patients with COVID-19 pneumonia, early treatment with lopinavir-ritonavir was associated with faster time to clinical improvement and/or virological clearance than darunavir-cobicistat. Future trials are warranted to confirm these findings. Trial registration ClinicalTrials.gov number, NCT04425382.
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Affiliation(s)
| | - Rim Alibrahim
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Rania Hassanin
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Sitelbanat Eltaib
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Elsayed
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Fatima Rustom
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Hussam Al Soub
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Muna Al Maslamani
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
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Elsayed A, Shorbagi GE, Abdel-Rassoul M, Ghoneimy ME, Hamid MA, Fayad A, Rahman SA. The outcome of gracilis muscle flap wrapping around the neourethra-native urethral anastomosis after radial forearm free flap phalloplasty on the incidence of fistula formation. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Elsayed A, Kim Y. Estimation of kinetic constants in high-density polyethylene bead degradation using hydrolytic enzymes. Environ Pollut 2022; 298:118821. [PMID: 35016978 DOI: 10.1016/j.envpol.2022.118821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
Microplastic beads are an emerging contaminant that can cause serious environmental and public health problems. Potential bypass of microplastic beads from wastewater to sludge treatment systems is a key challenge in the conventional wastewater treatment process. Moreover, there are no systematic studies on microplastic bead degradation by hydrolytic enzymes that are rich in concentration within wastewater and sludge treatment processes (e.g., anaerobic digestion (AD)). In this study, lab-scale experiments were conducted to investigate the degradation of high-density polyethylene beads by hydrolytic enzymes (e.g., lipase) under various experimental conditions (e.g., temperature). In a 3-day batch experiment, protease was most effective in polyethylene bead degradation as 4.0% of the initial bead mass was removed at an enzyme concentration of 88 mg/L under thermophilic temperature (55 °C). It was also found that the increasing enzyme concentration and high temperature enhanced the polyethylene bead degradation. In a separate 7-day experiment with repeated doses of protease, 23.3% of the initial mass of beads was removed at thermophilic temperature, indicating that AD with a long retention time (e.g., 20 days) and heated temperature has a significant potential for polyethylene bead degradation. A mathematical model was developed and calibrated using the experimental results to estimate the kinetic constant of the high-density polyethylene bead reduction by an enzyme (k1,i) and enzyme self-decay constant (k2,ii). The calibrated k1,i ranged from 5.0 to 8.1× 10-4 L/mg/hr while k2,ii was 0.44-1.10 L/mg/hr. Using the calibrated model, degradation of polyethylene beads using a mixture of cellulase and protease was simulated, considering an interactive-decay reaction between the two enzymes. The calibrated model was used to simulate the polyethylene bead degradation in AD where 70-95% of the initial bead mass was removed at typical retention time under mesophilic digestion (37.5 °C). Based on the experimental and simulation results, it can be concluded that hydrolytic enzymes can be an efficient technology for large-scale high-density polyethylene bead removal applications.
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Affiliation(s)
- Ahmed Elsayed
- Department of Civil Engineering, McMaster University, 1280 Main St. W., JHE 301, Hamilton, Ontario, L8S 4L8, Canada; Department of Irrigation and Hydraulics, Faculty of Engineering, Cairo University, 1 Gamaa Street, Giza, 12613, Egypt
| | - Younggy Kim
- Department of Civil Engineering, McMaster University, 1280 Main St. W., JHE 301, Hamilton, Ontario, L8S 4L8, Canada.
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Elsayed A, Abomhya A, Avdiushko M, Kapur N, Awuah S, Barrett T, Goretsky T. NEW OXPHOS REGULATING COMPOUND – AUPHOS – INCREASES MITOCHONDRIAL COMPLEXES EXPRESSION IN MURINE AND HUMAN INTESTINAL EPITHELIAL CELLS. Inflamm Bowel Dis 2022. [DOI: 10.1093/ibd/izac015.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Abstract
INTRODUCTION
Mitochondrial dysfunction in intestinal epithelial cells (IEC) is a critical driver in the failure to heal chronic ulceration in IBD(1). OXPHOS is important for differentiation and cell polarity in repairing IEC(2,3). The development of new IBD drugs that improve mitochondria function would potentially accelerate mucosal repair and enhance overall clinical management of refractory patients. For this study, we tested the efficacy of a novel oral agent (AuPhos) that localized to mitochondria where it increases respiration (Wempe et al CCC, 2022) and mitochondrial energy production.
METHODS
Colonic IEC proteins from control and AuPhos-treated DSS mice were examined as described elsewhere (Wempe et al CCC, 2022). Both human biopsy and tissues from mice with reduced IEC mitochondria [VilCre/mTmG/TFAMfl/fl (IEC-TFAM-/-)](Abomhya et al CCC 2022) were incubated with AuPhos (0.2; 0.5; 1 μM for biopsies and 0.5 μM for mice) or vehicle for 3 hrs. at +4oC with rotation. N=4 mice/group.
RESULTS
In membranous IEC fractions of control mice, AuPhos increased protein expression of mitochondrial complexes (Mito-Cpx) (V – 50%, III – 52%, IV – 40%). DSS treatment decreased baseline expression dramatically (V – 62%, III – 56%, II - 69%; IV – 75%). AuPhos in DSS mice increased expression of complex V by 48%, III – 35%, II – 68%, IV – 55% {A,B}. Expression of transcriptional factors PGC1a and Nrf2, which regulate mitochondria biogenesis, were increased in nuclear IEC fractions of DSS mice by 50% and 43% respectively {C,D}. Mito-Cpx and TFAM levels increased in AuPhos-treated human biopsies in a dose dependent manner {E}. AuPhos normalized mitochondrial complex levels in tissue (3h) taken from mice with attenuated mitochondrial respiration (IEC-TFAM-/-).
CONCLUSION
AuPhos increases expression of mitochondrial complexes in human and in two different murine models. The results of biochemical signaling studies suggest increased mitochondrial respiration enhances PGC1a and Nrf2 levels which are upstream of TFAM, the major transcription factor for mitochondrial biogenesis. Our lab is currently investigating this novel compound as a means for improving mucosal metabolism and accelerating mucosal repair in IBD. (Wempe et al CCC, 2022)
1 Kugathasan, S. et al. Prediction of complicated disease course for children newly diagnosed with Crohn’s disease: a multicentre inception cohort study. Lancet389, 1710-1718, doi:10.1016/S0140-6736(1730317-3) (2017).
2 Rodriguez-Colman, M. J. et al. Interplay between metabolic identities in the intestinal crypt supports stem cell function. Nature543, 424-427, doi:10.1038/nature21673 (2017).
3 Schell, J. C. et al. Control of intestinal stem cell function and proliferation by mitochondrial pyruvate metabolism. Nat Cell Biol19, 1027-1036, doi:10.1038/ncb3593 (2017).
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Elmekaty EZI, Alibrahim R, Hassanin R, Eltaib S, Elsayed A, Rustom F, Mohamed Ibrahim MI, Abu Khattab M, Al Soub H, Al Maslamani M, Al-Khal A. Darunavir-Cobicistat versus Lopinavir-Ritonavir for COVID-19 Pneumonia: Qatar's Experience. Journal of Emergency Medicine, Trauma and Acute Care 2022. [DOI: 10.5339/jemtac.2022.qhc.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
| | - Rim Alibrahim
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Rania Hassanin
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Sitelbanat Eltaib
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Ahmed Elsayed
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Fatima Rustom
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | | | | | - Hussam Al Soub
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Muna Al Maslamani
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
| | - Abdullatif Al-Khal
- Communicable Diseases Center, Hamad Medical Corporation. Doha, Qatar * E-mail:
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Ramadan WA, Elsayed A. Influence of plyometric jump training on the physiological changes of male handball players. jhse 2022. [DOI: 10.14198/jhse.2023.182.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Ammar A, Elsayed A, Mohsin M, Shaaban H. P-EGS01 Cholecystectomy after gall stone pancreatitis. Br J Surg 2021. [DOI: 10.1093/bjs/znab430.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Background
According to the UK guidelines for the management of acute pancreatitis commissioned by the British Society of Gastroenterology,
All patients presenting with gallstone pancreatitis should be considered for cholecystectomy when they are well enough to undergo surgery. In cases of mild biliary pancreatitis, cholecystectomy should ideally be performed during the index admission or within 2 weeks of discharge as interval cholecystectomy is associated with a significant risk of readmission for recurrent biliary events.
In cases of severe gallstone pancreatitis, cholecystectomy may need to be delayed until collections have improved, unless the patient is well enough for surgery and the gallbladder is some distance from the collection
Methods
Methods
Inclusion Criteria
Exclusion Criteria
Results
80 patients were collected during the study period, 96 % of them were classified as mild pancreatitis
Cholecystectomy rate
Total percentage of cholecystectomies performed for mild gall stone pancreatitis during index admission or within 2 weeks from discharge : 37%
Percentage of early cholecystectomies for eligible patients (i.e.after ruling out unfit patients, patients declining treatment, previous cholecystectomy..etc) : 54%
Re-admission rate
Re-admission rate for early cholecystectomy patients : 7.4%
Re-admission rate for delayed cholecystectomy patients : 20.7%
Conclusions
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Affiliation(s)
- Ahmed Ammar
- The Mid Yorkshire Hospitals NHS trust, Wakefield, United Kingdom
| | - Ahmed Elsayed
- The Mid Yorkshire Hospitals NHS trust, Wakefield, United Kingdom
| | - Mohammad Mohsin
- The Mid Yorkshire Hospitals NHS trust, Wakefield, United Kingdom
| | - Hossam Shaaban
- The Mid Yorkshire Hospitals NHS trust, Wakefield, United Kingdom
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Alattar RA, Ahmed SA, Abdallah T, Kazman R, Qadmour AN, Ibrahim T, Alhariri B, Shaar SH, Bajwa A, Alimam A, Qazi R, Abid FB, Daghfal J, Eldeeb AM, Shukri K, Elsayed A, Rustom F, AlSamawi MS, Abdelmajid AA, Basulto M, Cobian A, Khattab MA, Almaslamani M, Khal AA, Omrani AS. 508. Title Favipiravir for the Treatment of Coronavirus Disease 2019; A Propensity Score Matched Cohort Study. Open Forum Infect Dis 2021. [PMCID: PMC8644787 DOI: 10.1093/ofid/ofab466.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background We investigated clinical outcomes of favipiravir in patients with COVID-19 pneumonia. Methods Patients who between 23 May 2020 and 18 July 2020 received ≥24 hours of favipiravir were assigned to the favipiravir group, while those who did not formed the non-favipiravir group. The primary outcome was 28-day clinical improvement, defined as two-category improvement from baseline on an 8-point ordinal scale. Propensity scores (PS) for favipiravir therapy were used for 1:1 matching. Cox regression was used to examine associations with the primary endpoint. Results The unmatched cohort included 1,493 patients, of which 51.7% were in the favipiravir group, and 48.3% were not receiving supplemental oxygen at baseline (table 1). Favipiravir was started within a median of 5 days from symptoms onset. Significant baseline differences between the two unmatched groups existed, but not between the PSmatched groups (N = 774) (table 1). After PS-matching, there were no significant differences between the two groups in the proportion with 28-day clinical improvement (93.3% versus 92.8%, P 0.780), or 28-day all-cause mortality (2.1% versus 3.1%, P 0.360) (Table 2). Favipiravir was associated with more viral clearance by day 28 (79.8% versus 64.1%, P < 0.001) (table 2). In the adjusted Cox proportional hazards model, favipiravir therapy was not associated 28-day clinical improvement (adjusted hazard ratio 0.978, 95% confidence interval 0.862 –1.109, P 0.726) (Table 3). ![]()
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Conclusion Favipiravir therapy for COVID-19 pneumonia is well tolerated but is not associated with an increased likelihood of clinical improvement or reduced all-cause mortality by 28 days. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | | | | | | | | | | | | | | | - Abeer Bajwa
- Hamad Medical corporation, Doha, Ad Dawhah, Qatar
| | - Abeir Alimam
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Rabia Qazi
- Hamad Medical corporation, Doha, Ad Dawhah, Qatar
| | | | | | - Ali M Eldeeb
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Kinda Shukri
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | | | | | | | | | | | | | | | | | | | - Ali S Omrani
- Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
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Elsayed A, Mauger C, Ferdian E, Gilbert K, Scadeng M, Pushparajah K, Young A. Flow vorticity relationships with right ventricular geometry in adult tetralogy of Fallot. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Repaired tetralogy of Fallot adults (rToF) undergo right ventricular (RV) remodeling, in part due to volume overload of residual pulmonary regurgitation volume (PRV). Time-resolved phase-contrast cardiac magnetic resonance imaging (4D Flow MRI) enables the qualitative and quantitative measurement of altered blood flow patterns, including vorticity. Cardiac atlases allow for complex three-dimensional heart shapes to be expressed as morphometric scores. Those scores show the extent of geometrical shift and can help explore uncharted relationships between vorticity and architecture.
Purpose
We aimed to quantify vorticity, incorporating deep learning to enhance 4D Flow data, and correlate this with global cardiac parameters and morphometric scores.
Methods
12 Adult rToF patients and 10 age-matched controls underwent 4D flow MRI and cine imaging. RV interventricular vorticity was calculated for outflow and inflow tracts. EDV, ESV and SV were computed from cines which were also used to build three-dimensional shape models.
The biventricular models were projected onto an atlas generated from 95 rToF patients, and twenty-one principal component analysis shape modes were correlated with cardiac metrics and vorticity to identify global shape variations. Association between biventricular shape and vorticity was further analysed using multivariate multiple regression models.
Results
Strong correlation was found between PRV and the right ventricular outflow tract (RVOT) vorticity. PRV and RVOT vorticity both correlated with the same 3 shape modes (r=−0.55, −0.50 and 0.6 (p<0.05) respectively for PR and r=0.63, −0.82 and 0.60 (p<0.05) respectively for vorticity) i.e., the RV dilates with an increase in basal bulging, apical bulging and tricuspid annulus tilting with more severe regurgitation, as well as a smaller LV, and a paradoxical movement of the septum (Figure 1). However, RV vorticity correlated with 2 modes that did not correlate with PRV, (r=−0.62, −0.69, p<0.05). With higher vorticity the RV was longer, increased tilting of the tricuspid annulus and an increased basal bulge around the tricuspid area. The multivariate analysis model demonstrated that higher vorticity was associated with displacement of the pulmonary valve and change in the RVOT length and direction. A septal displacement towards the left ventricle was observed and increased apical flatness of the RV (Figure 1). Qualitatively, vorticity in rToF group was more heterogeneous than controls (Figure 2).
Conclusions
Vorticity is a novel marker based on the influence of blood motion providing new insight into early diagnosis and prognosis of cardiac disease. This is the first study to examine the relationships between vorticity and regional RV shape changes in rToF. Mode associations with vorticity were different to associations with PRV. More longitudinal studies are required for standardization of change in vorticity with the disease process.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The New Zealand heart foundation Mode variations and morphometric modelVorticity visualization and analysis
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Affiliation(s)
- A Elsayed
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - C Mauger
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - E Ferdian
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - K Gilbert
- The University of Auckland, Auckland Bioengineering Institute, Auckland, New Zealand
| | - M Scadeng
- The University of Auckland, Department of Anatomy and Medical Imaging, Auckland, New Zealand
| | - K Pushparajah
- King's College London, Department of Biomedical Engineering, London, United Kingdom
| | - A Young
- King's College London, Department of Biomedical Engineering, London, United Kingdom
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Edwards JG, Barry M, Essam D, Elsayed M, Abdulkarim M, Elhossein BMA, Mohammed ZHA, Elnogomi A, Elfaki ASE, Elsayed A, Chang AY. Health system and patient-level factors serving as facilitators and barriers to rheumatic heart disease care in Sudan. Glob Health Res Policy 2021; 6:35. [PMID: 34598719 PMCID: PMC8486630 DOI: 10.1186/s41256-021-00222-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Rheumatic heart disease (RHD) remains a leading cause of morbidity and mortality in Sub-Saharan Africa despite widely available preventive therapies such as prophylactic benzathine penicillin G (BPG). In this study, we sought to characterize facilitators and barriers to optimal RHD treatment with BPG in Sudan. METHODS We conducted a mixed-methods study, collecting survey data from 397 patients who were enrolled in a national RHD registry between July and November 2017. The cross-sectional surveys included information on demographics, healthcare access, and patient perspectives on treatment barriers and facilitators. Factors associated with increased likelihood of RHD treatment adherence to prophylactic BPG were assessed by using adjusted logistic regression. These data were enhanced by focus group discussions with 20 participants, to further explore health system factors impacting RHD care. RESULTS Our quantitative analysis revealed that only 32% of the study cohort reported optimal prophylaxis adherence. Younger age, reduced primary RHD healthcare facility wait time, perception of adequate health facility staffing, increased treatment costs, and high patient knowledge about RHD were significantly associated with increased odds of treatment adherence. Qualitative data revealed significant barriers to RHD treatment arising from health services factors at the health system level, including lack of access due to inadequate healthcare staffing, lack of faith in local healthcare systems, poor ancillary services, and patient lack of understanding of disease. Facilitators of RHD treatment included strong interpersonal support. CONCLUSIONS Multiple patient and system-level barriers to RHD prophylaxis adherence were identified in Khartoum, Sudan. These included patient self-efficacy and participant perception of healthcare facility quality. Strengthening local health system infrastructure, while enhancing RHD patient education, may help to improve treatment adherence in this vulnerable population.
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Affiliation(s)
- Jeffrey G. Edwards
- Stanford University School of Medicine, Stanford, CA USA
- Present Address: Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Residency Program Coordinator, c/o Jeffrey Edwards, 801 Albany, St Boston, MA 02119-2598 USA
- Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Michele Barry
- Department of Medicine, Stanford University, Stanford, CA USA
- Center for Innovation in Global Health, Stanford University, Stanford, CA USA
| | - Dary Essam
- Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum, Sudan
| | - Mohammed Elsayed
- Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum, Sudan
| | | | | | - Zahia H. A. Mohammed
- Faculty of Medicine, Alzaeim Alazhari University, Khartoum, Sudan
- Department of Psychiatry, Alzaeim Alazhari University Khartoum, Khartoum, Sudan
| | | | - Amna S. E. Elfaki
- Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum, Sudan
| | - Ahmed Elsayed
- Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum, Sudan
| | - Andrew Y. Chang
- Department of Medicine, Stanford University, Stanford, CA USA
- Center for Innovation in Global Health, Stanford University, Stanford, CA USA
- Cardiovascular Institute, Stanford University, Stanford, CA USA
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El-Ganzoury IM, Zakaria ZM, Elsayed A, Elwarwary AE. Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis. QJM 2021; 114. [DOI: 10.1093/qjmed/hcab104.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Abstract
Background
Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).
Objectives
The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country.
Patients and Methods
The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019.
Results
About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis.
Conclusion
In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.
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Affiliation(s)
| | | | - Ahmed Elsayed
- Department of Orthopaedic Surgery, Faculty of Medicine – Ain Shams University
| | - Abd Ellah Elwarwary
- Department of Orthopaedic Surgery, Faculty of Medicine – Ain Shams University
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Elsheikh M, Elsayed A, Bennett N, Connor M. Corynebacterium Bovis: A Rare Case of Persistent Bacterial Keratitis and Corneal Perforation. Cureus 2021; 13:e16913. [PMID: 34513486 PMCID: PMC8412843 DOI: 10.7759/cureus.16913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/29/2022] Open
Abstract
We report a rare case of severe, non-contact lens-related Corynebacterium bovis corneal infection on a background of viral keratitis, resulting in corneal abscess formation with subsequent corneal perforation. An 89-year-old Caucasian lady presented with a significant epithelial defect and a dense stromal infiltrates on a background of herpes zoster keratitis, ultimately resulting in corneal perforation. Enrichment culture obtained from corneal scraping isolated the unusual organism Corynebacterium bovis. This was treated with a combination of culture-directed, targeted course of antibiotics and surgical interventions. To the best of our knowledge, this is the first reported case of profuse bacterial keratitis secondary to Corynebacterium bovis infiltration, on a background of viral keratitis, resulting in corneal abscess formation and subsequent perforation. This report highlights this rare bacterium’s characteristics including its pathogenicity in causing severe corneal disease, particularly in immunosuppressed environments such as in this case, apparent antibiotic sensitivities & resistance, and potential transmission route.
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Affiliation(s)
| | - Ahmed Elsayed
- Ophthalmology, NHS Dumfries & Galloway, Dumfries, GBR
| | | | - Martin Connor
- Microbiology, NHS Dumfries & Galloway, Dumfries, GBR
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Hafez AA, Hamdy Ashry A, Elsayed A, El Tayeb A, ElShenawy MBAS. Incidence of Iatrogenic Lumbar Spinal Instability after Laminectomy, Discectomy or Facetectomy. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: This thesis aim to report the incidence of iatrogenic spinal instability that occurs after laminectomy, discectomy or facetectomy in Lumbar spine surgery.
METHODS: This is a prospective study of 50 cases of degenerative lumbar spondylosis complaining of various symptoms of claudication, sciatica and back pain which were surgically managed by laminectomy according to the level of stenosis in the period between October 2018 and October 2020 in the neurosurgery department at Cairo university hospitals. Mesial facetectomy was added according to the degree of stenosis if needed. Some patients needed discectomy if sciatica was an eminent symptom.
RESULTS: Out of 50 patients included: 9 patients (18%) developed postoperative instability. The number of levels operated on and the degree of mesial facetectomy were found to be variables that may affect postoperative stability.
CONCLUSION: Iatrogenic instability may result from large laminectomy and extensive facetectomy for lumbar stenosis in patients who do not have obvious pre-existing instability.
Key words: Iatrogenic spinal instability - Laminectomy - conventional open discectomy - Mesial facetectomy.
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Satchidanand A, Higginbotham J, Bisantz A, Aldhaam N, Elsayed A, Carr I, Hussein AA, Guru K. "Put the what, where? Cut here?!" challenges to coordinating attention in robot-assisted surgery: a microanalytic pilot study. BMJ Open 2021; 11:e046132. [PMID: 34261681 PMCID: PMC8280894 DOI: 10.1136/bmjopen-2020-046132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION During robot-assisted surgery (RAS), changes to the operating room configuration pose challenges to communication by limiting team members' ability to see one another or use gesture. Referencing (the act of pointing out an object or area in order to coordinate action around it), may be susceptible to miscommunication due to these constraints. OBJECTIVES Explore the use of microanalysis to describe and evaluate communicative efficiency in RAS through examination of referencing in surgical tasks. METHODS All communications during ten robot-assisted pelvic surgeries (radical cystectomies and prostatectomies) were fully transcribed. Forty-six referencing events were identified within these and subjected to a process of microanalysis. Microanalysis employs detailed transcription of speech and gesture along with their relative timing/sequencing to describe and analyse interactions. A descriptive taxonomy for referencing strategies was developed with categories including references reliant exclusively on speech (anatomic terms/directional language and context dependent words (CD)); references reliant exclusively on gesture or available aspects of the environment (point/show, camera focus/movement in the visual field and functional movement); and references reliant on the integrated use of speech and gesture/environmental support (integrated communication (IC)). Frequency of utilisation and number/percent 'miscommunication', were collated within each category when miscommunication was defined as any reference met with incorrect or no identification of the target. RESULTS IC and CD were the most frequently used strategies (45% and 26%, respectively, p≤0.01). Miscommunication was encountered in 22% of references. The use of IC resulted in the fewest miscommunications, while CD was associated with the most miscommunications (42%). Microanalysis provided insight into the causes and nature of successful referencing and miscommunication. CONCLUSIONS In RAS, surgeons complete referencing tasks in a variety of ways. IC may provide an effective means of referencing, while other strategies may not be adequately supported by the environment.
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Affiliation(s)
- Antara Satchidanand
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
- Communication Disorders and Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Jeff Higginbotham
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
- Communication Disorders and Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Ann Bisantz
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
- Industrial and Systems Engineering, State University of New York at Buffalo, Buffalo, New York, USA
| | - Naif Aldhaam
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
| | - Ahmed Elsayed
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
| | - Iman Carr
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
| | - Ahmed A Hussein
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
| | - Khurshid Guru
- ATLAS Program, Roswell Park Comprehensive Cancer Center Department of Urology, Buffalo, New York, USA
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Smyth A, Judge C, Wang X, Pare G, Rangarajan S, Canavan M, Chin SL, Al-Hussain F, Yusufali AM, Elsayed A, Damasceno A, Avezum A, Czlonkowska A, Rosengren A, Dans AL, Oguz A, Mondo C, Weimar C, Ryglewicz D, Xavier D, Lanas F, Malaga G, Hankey GJ, Iversen HK, Zhang H, Yusoff K, Pogosova N, Lopez-Jamarillo P, Langhorne P, Diaz R, Oveisgharan S, Yusuf S, O'Donnell M. Renal Impairment and Risk of Acute Stroke: The INTERSTROKE Study. Neuroepidemiology 2021; 55:206-215. [PMID: 33951632 DOI: 10.1159/000515239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies reported an association of renal impairment with stroke, but there are uncertainties underpinning this association. AIMS We explored if the association is explained by shared risk factors or is independent and whether there are regional or stroke subtype variations. METHODS INTERSTROKE is a case-control study and the largest international study of risk factors for first acute stroke, completed in 27 countries. We included individuals with available serum creatinine values and calculated estimated glomerular filtration rate (eGFR). Renal impairment was defined as eGFR <60 mL/min/1.73 m2. Multivariable conditional logistic regression was used to determine the association of renal function with stroke. RESULTS Of 21,127 participants, 41.0% were female, the mean age was 62.3 ± 13.4 years, and the mean eGFR was 79.9 ± 23.5 mL/min/1.73 m2. The prevalence of renal impairment was higher in cases (22.9% vs. 17.7%, p < 0.001) and differed by region (p < 0.001). After adjustment, lower eGFR was associated with increased odds of stroke. Renal impairment was associated with increased odds of all stroke (OR 1.35; 95% CI: 1.24-1.47), with higher odds for intracerebral hemorrhage (OR 1.60; 95% CI: 1.35-1.89) than ischemic stroke (OR 1.29; 95% CI: 1.17-1.42) (pinteraction 0.12). The largest magnitudes of association were seen in younger participants and those living in Africa, South Asia, or South America (pinteraction < 0.001 for all stroke). Renal impairment was also associated with poorer clinical outcome (RRR 2.97; 95% CI: 2.50-3.54 for death within 1 month). CONCLUSION Renal impairment is an important risk factor for stroke, particularly in younger patients, and is associated with more severe stroke and worse outcomes.
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Affiliation(s)
- Andrew Smyth
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.,HRB Clinical Research Facility Galway, School of Medicine, NUI Galway, Galway, Ireland.,Department of Nephrology, Galway University Hospitals, Galway, Ireland
| | - Conor Judge
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.,HRB Clinical Research Facility Galway, School of Medicine, NUI Galway, Galway, Ireland.,Department of Nephrology, Galway University Hospitals, Galway, Ireland
| | - Xingu Wang
- Beijing Hypertension League Institute, Beijing, China
| | - Guillaume Pare
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Michelle Canavan
- HRB Clinical Research Facility Galway, School of Medicine, NUI Galway, Galway, Ireland
| | - Siu Lim Chin
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | | | | | | | | | | | - Annika Rosengren
- Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Antonio L Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | - Aytekin Oguz
- Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Charles Mondo
- Uganda Heart Institute, Mulago Hospital, Kampala, Uganda
| | | | | | - Denis Xavier
- St John's Medical College and Research Institute, Bangalore, India
| | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Graeme J Hankey
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Washington, Australia
| | - Helle K Iversen
- Stroke Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hongye Zhang
- Beijing Hypertension League Institute, Beijing, China
| | - Khalid Yusoff
- Universiti Teknologi MARA, Selayang, Selangor, Malaysia, UCSI University, Cheras, Kuala Lumpur, Malaysia
| | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russian Federation
| | - Patricio Lopez-Jamarillo
- Instituto de Investigaciones FOSCAL, Escuela de Medicina, Universidad de Santander, Bucaramanga, Colombia
| | - Peter Langhorne
- Academic Section of Geriatric Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, United Kingdom
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica, Rosario, Argentina
| | - Shahram Oveisgharan
- Rush Alzheimer Disease Research Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Martin O'Donnell
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.,HRB Clinical Research Facility Galway, School of Medicine, NUI Galway, Galway, Ireland
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Judge C, O’Donnell MJ, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Smyth A, Xavier D, Lisheng L, Zhang H, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Yusuf S. Urinary Sodium and Potassium, and Risk of Ischemic and Hemorrhagic Stroke (INTERSTROKE): A Case-Control Study. Am J Hypertens 2021; 34:414-425. [PMID: 33197265 PMCID: PMC8057138 DOI: 10.1093/ajh/hpaa176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/27/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although low sodium intake (<2 g/day) and high potassium intake (>3.5 g/day) are proposed as public health interventions to reduce stroke risk, there is uncertainty about the benefit and feasibility of this combined recommendation on prevention of stroke. METHODS We obtained random urine samples from 9,275 cases of acute first stroke and 9,726 matched controls from 27 countries and estimated the 24-hour sodium and potassium excretion, a surrogate for intake, using the Tanaka formula. Using multivariable conditional logistic regression, we determined the associations of estimated 24-hour urinary sodium and potassium excretion with stroke and its subtypes. RESULTS Compared with an estimated urinary sodium excretion of 2.8-3.5 g/day (reference), higher (>4.26 g/day) (odds ratio [OR] 1.81; 95% confidence interval [CI], 1.65-2.00) and lower (<2.8 g/day) sodium excretion (OR 1.39; 95% CI, 1.26-1.53) were significantly associated with increased risk of stroke. The stroke risk associated with the highest quartile of sodium intake (sodium excretion >4.26 g/day) was significantly greater (P < 0.001) for intracerebral hemorrhage (ICH) (OR 2.38; 95% CI, 1.93-2.92) than for ischemic stroke (OR 1.67; 95% CI, 1.50-1.87). Urinary potassium was inversely and linearly associated with risk of stroke, and stronger for ischemic stroke than ICH (P = 0.026). In an analysis of combined sodium and potassium excretion, the combination of high potassium intake (>1.58 g/day) and moderate sodium intake (2.8-3.5 g/day) was associated with the lowest risk of stroke. CONCLUSIONS The association of sodium intake and stroke is J-shaped, with high sodium intake a stronger risk factor for ICH than ischemic stroke. Our data suggest that moderate sodium intake-rather than low sodium intake-combined with high potassium intake may be associated with the lowest risk of stroke and expected to be a more feasible combined dietary target.
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Affiliation(s)
- Conor Judge
- Department of Medicine, NUI Galway, Galway, Ireland
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
- Wellcome Trust Health Research Board Irish Clinical Academic Training (ICAT), Dublin, Ireland
| | - Martin J O’Donnell
- Department of Medicine, NUI Galway, Galway, Ireland
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Graeme J Hankey
- School of Medicine and Pharmacology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sumathy Rangarajan
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Siu Lim Chin
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Purnima Rao-Melacini
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | | | - Andrew Smyth
- Department of Medicine, NUI Galway, Galway, Ireland
| | - Denis Xavier
- Department of Medicine, St John’s Medical College and Research Institute, Bangalore, India
| | - Liu Lisheng
- Department of Medicine, National Center of Cardiovascular Disease, Beijing, China
| | - Hongye Zhang
- Department of Medicine, Beijing Hypertension League Institute, Beijing, China
| | - Patricio Lopez-Jaramillo
- Department of Medicine, Instituto de Investigaciones MASIRA, Universidad de Santander, Bucaramanga, Colombia
| | | | - Peter Langhorne
- Department of Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, Scotland, UK
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Antonio L Dans
- College of Medicine, University of Philippines, Manila, Philippines
| | - Ahmed Elsayed
- Department of Surgery, Al Shaab Teaching Hospital, Khartoum, Sudan
| | - Alvaro Avezum
- Department of Medicine, International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Charles Mondo
- Department of Medicine, Kiruddu National Referral Hospital, Kampala, Uganda
| | | | - Anna Czlonkowska
- Department of Medicine, Military Institute of Aviation Medicine, Warsaw, Poland
| | - Nana Pogosova
- Department of Medicine, National Medical Research Center of Cardiology, Moscow, Russia
| | | | - Rafael Diaz
- Department of Medicine, Estudios Clínicos Latino America (ECLA), Instituto Cardiovascular de Rosario (ICR), Rosario, Argentina
| | - Khalid Yusoff
- Department of Medicine, Universiti Teknologi MARA, Selayang, Selangor and UCSI University, Kuala Lumpur, Malaysia
| | - Afzalhussein Yusufali
- Department of Medicine, Hatta Hospital, Dubai Health Authority/Dubai Medical College, Dubai, UAE
| | - Aytekin Oguz
- Department of Internal Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Xingyu Wang
- Department of Medicine, Beijing Hypertension League Institute, Beijing, China
| | - Fernando Lanas
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Okechukwu S Ogah
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Helle K Iversen
- Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - German Malaga
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Shahram Oveisgharan
- Department of Medicine, Rush Alzheimer Disease Research Center in Chicago, Chicago, Illinois, USA
| | - Fawaz Al Hussain
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Salim Yusuf
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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Dawood RM, Salum GM, El-Meguid MA, Elsayed A, Yosry A, Abdelaziz A, Shousha HI, Nabeel MM, El Awady MK. Development of a gene signature for predicting cirrhosis risk score of chronic liver disease associated with HCV infection in Egyptians. Microb Pathog 2021; 153:104805. [PMID: 33609649 DOI: 10.1016/j.micpath.2021.104805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Complex diseases such as fibrosis are likely polygenic. Lately, cirrhosis risk score (CRS) clearly discriminated Chronic HCV patients with high-risk versus those with low-risk for cirrhosis better than clinical factors. METHODS Herein, the CRS was assessed via genotyping by allelic discrimination assays in 243 HCV Egyptian patients categorized into 164 patients didn't develop HCC (93 mild, 71 advanced fibrosis); and 79 patients developed HCC. APRI and FIB-4 scores were calculated, compared with CRS and correlated with degree of fibrosis progression. RESULTS Median of the three CRS, APRI and FIB-4 scores were significantly elevated in late fibrotic and HCC patients (p < 0.001); however CRS displayed proper discrimination (mild fibrosis (0.59; 0.4-0.75), advanced fibrosis (0.75; 0.7-0.86) and HCC (0.73; 0.57-0.77); (p < 0.001)). The ROC analysis of CRS score displayed modest accuracy to discriminate between mild and advanced fibrotic patient; AUC was 0.73; p < 0.0001), while AUC was only 0.57 (p = 0.05) for the discrimination between HCC and no HCC. Moreover, the combination of CRS, APRI and FIB4 lessened the power of correlation (AUC, 0.63 (p < 0.0001)) in fibrosis prognosis. In HCC prognosis, the combination of CRS, APRI and FIB4 in HCC patients showed modest accuracy with AUC, 0.59 (p = 0.0001). CONCLUSION The diagnostic accuracy of FIB-4 for predicting liver fibrosis was nearly identical to that of CRS, however the strength of CRS score stemmed from that it is built on 7 SNPs host genetic factor. Our study validates non invasive algorithms for fibrosis prognosis purposes which may aid in decision making for therapeutic intervention.
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Affiliation(s)
- Reham M Dawood
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt.
| | - Ghada M Salum
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
| | - Mai Abd El-Meguid
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
| | - Ahmed Elsayed
- Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Ayman Yosry
- Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Ashraf Abdelaziz
- Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Hend Ibrahim Shousha
- Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Mohamed Mahmoud Nabeel
- Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Egypt
| | - Mostafa K El Awady
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt
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Luo S, Nguyen KT, Nguyen BTT, Feng S, Shi Y, Elsayed A, Zhang Y, Zhou X, Wen B, Chierchia G, Talbot H, Bourouina T, Jiang X, Liu AQ. Deep learning-enabled imaging flow cytometry for high-speed Cryptosporidium and Giardia detection. Cytometry A 2021; 99:1123-1133. [PMID: 33550703 DOI: 10.1002/cyto.a.24321] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022]
Abstract
Imaging flow cytometry has become a popular technology for bioparticle image analysis because of its capability of capturing thousands of images per second. Nevertheless, the vast number of images generated by imaging flow cytometry imposes great challenges for data analysis especially when the species have similar morphologies. In this work, we report a deep learning-enabled high-throughput system for predicting Cryptosporidium and Giardia in drinking water. This system combines imaging flow cytometry and an efficient artificial neural network called MCellNet, which achieves a classification accuracy >99.6%. The system can detect Cryptosporidium and Giardia with a sensitivity of 97.37% and a specificity of 99.95%. The high-speed analysis reaches 346 frames per second, outperforming the state-of-the-art deep learning algorithm MobileNetV2 in speed (251 frames per second) with a comparable classification accuracy. The reported system empowers rapid, accurate, and high throughput bioparticle detection in clinical diagnostics, environmental monitoring and other potential biosensing applications.
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Affiliation(s)
- Shaobo Luo
- ESIEE, Universite Paris-Est, Noisy-le-Grand Cedex, France.,Nanyang Environment and Water Research Institute, Nanyang Technological University, Singapore, Singapore
| | - Kim Truc Nguyen
- Nanyang Environment and Water Research Institute, Nanyang Technological University, Singapore, Singapore.,School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Binh T T Nguyen
- School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Shilun Feng
- Nanyang Environment and Water Research Institute, Nanyang Technological University, Singapore, Singapore.,School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Yuzhi Shi
- School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Ahmed Elsayed
- ESIEE, Universite Paris-Est, Noisy-le-Grand Cedex, France
| | - Yi Zhang
- School of Mechanical & Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Xiaohong Zhou
- Research Centre of Environmental and Health Sensing Technology, School of Environment, Tsinghua University, Beijing, China
| | - Bihan Wen
- School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | | | - Hugues Talbot
- CentraleSupelec, Universite Paris-Saclay, Saint-Aubin, France
| | | | - Xudong Jiang
- School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Ai Qun Liu
- Nanyang Environment and Water Research Institute, Nanyang Technological University, Singapore, Singapore.,School of Electrical & Electronic Engineering, Nanyang Technological University, Singapore, Singapore
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O' Donnell M, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Xavier D, Lisheng L, Zhang H, Pais P, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Smyth A, Judge C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, AlHussain F, Daliwonga M, Nilanont Y, Yusuf S. Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level. Heart 2020; 107:heartjnl-2019-316515. [PMID: 33318082 DOI: 10.1136/heartjnl-2019-316515] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/27/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Hypertension is the most important modifiable risk factor for stroke globally. We hypothesised that country-income level variations in knowledge, detection and treatment of hypertension may contribute to variations in the association of blood pressure with stroke. METHODS We undertook a standardised case-control study in 32 countries (INTERSTROKE). Cases were patients with acute first stroke (n=13 462) who were matched by age, sex and site to controls (n=13 483). We evaluated the associations of knowledge, awareness and treatment of hypertension with risk of stroke and its subtypes and whether this varied by gross national income (GNI) of country. We estimated OR and population attributable risk (PAR) associated with treated and untreated hypertension. RESULTS Hypertension was associated with a graded increase in OR by reducing GNI, ranging from OR 1.92 (99% CI 1.48 to 2.49) to OR 3.27 (2.72 to 3.93) for highest to lowest country-level GNI (p-heterogeneity<0.0001). Untreated hypertension was associated with a higher OR for stroke (OR 5.25; 4.53 to 6.10) than treated hypertension (OR 2.60; 2.32 to 2.91) and younger age of first stroke (61.4 vs 65.4 years; p<0.01). Untreated hypertension was associated with a greater risk of intracerebral haemorrhage (OR 6.95; 5.61 to 8.60) than ischaemic stroke (OR 4.76; 3.99 to 5.68). The PAR associated with untreated hypertension was higher in lower-income regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime non-measurement of blood pressure was associated with stroke (OR 1.80; 1.32 to 2.46). CONCLUSIONS Deficits in knowledge, detection and treatment of hypertension contribute to higher risk of stroke, younger age of onset and larger proportion of intracerebral haemorrhage in lower-income countries.
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Affiliation(s)
- Martin O' Donnell
- HRB-Clinical Research Facility, National University of Ireland Galway, Galway, Ireland
| | - Graeme J Hankey
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Sumathy Rangarajan
- Dept of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Siu Lim Chin
- Dept of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Purnima Rao-Melacini
- Dept of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - John Ferguson
- National University of Ireland Galway, Galway, Ireland
| | - Denis Xavier
- St John's Research Insitiute, Bangalore, Karnataka, India
| | - Liu Lisheng
- National Center for Cardiovascular Diseases China, Xicheng District, Beijing, China
- Beijing Hypertension League Institute, Beijing, China
| | - Hongye Zhang
- Beijing Hypertension League Institute, Beijing, China
| | - Prem Pais
- St John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | | | | | - Peter Langhorne
- Academic Section of Geriatric Medicine, Glasgow Royal Infirmary, University of Glasgow, Glasgow, UK
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital, Goteborg, Sweden
| | - Antonio L Dans
- University of the Philippines Manila College of Medicine, Manila, Metro Manila, Philippines
| | | | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | | | - Andrew Smyth
- National University of Ireland Galway, Galway, Ireland
| | - Conor Judge
- Medicine, National University of Ireland Galway, Galway, Galway, Ireland
| | - Hans-Christoph Diener
- Department of Neurology, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
| | | | | | - Nana Pogosova
- National Medical Research Center of Cardiology, Moscow, Russia, Moskva, Russian Federation
| | - Christian Weimar
- Neurology, Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
- BDH-clinic Elzach, Elzach, Germany
| | - Romana Iqbal
- Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
| | - Rafael Diaz
- Estudios Clínicos Latino America (ECLA), Instituto Cardiovascular de Rosario (ICR), Rosario, Argentina
| | - Khalid Yusoff
- Universiti Teknologi MARA, Selayang, Selangor and UCSI University, Kuala Lumpur, Malaysia
| | | | - Aytekin Oguz
- Department of Internal Medicine, Istanbul Medeniyet University, Istanbul, Istanbul, Turkey
| | - Xingyu Wang
- Laboratory of Human Genetics, Beijing Hypertension League Institute, Beijing, China
| | - Ernesto Penaherrera
- Department of Cardiology, Luis Vernaza General Hospital, Guayaquil, Guayas, Ecuador
| | - Fernando Lanas
- Internal Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Adensola Ogunniyi
- Neurology Unit, Department of Medicine, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Helle K Iversen
- Department of Neurology, University of Copenhagen, Rigshospitalet, Denmark
| | - German Malaga
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Zvonko Rumboldt
- Department of Medicine, University of Split, Split, Splitsko-dalmatinska, Croatia
| | | | | | - Magazi Daliwonga
- Department of Medicine, University of Limpopo, Sovenga, Limpopo, South Africa
| | - Yongchai Nilanont
- Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Salim Yusuf
- Dept of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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Kamal EE, Ali MEM, Mohamed MZ, Soliman M, El-Mahdy RI, Elsayed A, Badran AY. Relation of pharmacopenile duplex ultrasonography parameters and glycated hemoglobin (HbA1c) in diabetic patients with erectile dysfunction. Rev Int Androl 2020; 20:31-40. [PMID: 33334711 DOI: 10.1016/j.androl.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/22/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) is one of the main threats in diabetic patients. This research aimed to assess the relationship between glycated hemoglobin (HbA1c) level and pharmacopenile duplex ultrasonography (PPDU) indices in diabetic patients with ED. MATERIALS AND METHODS A total of 130 males with ED were recruited (100 had diabetes mellitus (DM) and 30 did not as control). The International Index of Erectile Function (IIEF) was used to evaluate patients for ED. Measurement of HbA1c, lipid profile and assessment of erectile function using PPDU were performed. All participants were assessed to take the medical history. RESULTS The mean age±SD was 53.8±8.9 and 53.6±2.8 years for patients and controls, respectively. Patients had variable grades of ED: mild in 20%, mild to moderate in 32.3%, moderate in 35.3%, and severe in 12.3%. A significant association was found between the existence of DM and a deprived response to intracorporeal injection (ICI), rising end-diastolic velocity (EDV), and reducing resistance index (RI) values. Comparing all diabetic groups according to HbA1c with controls, a significant relationship was found in; severity of IIEF-5 score, poor response to ICI, decreased peak systolic velocity (PSV) at 10min, increased EDV at 10, 20min and decreased RI at 10, 20min. A significant relationship was found between smoking, dyslipidaemia, and decreased PSV at 10, 20min and decreased increment ratio. However, a non-significant relationship was observed between age, type of DM and PPDU parameters. CONCLUSION Poor glycaemic control of DM is associated with an increase in EDV and decrease in RI, and PSV of PPDU.
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Affiliation(s)
- Emad Eldien Kamal
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Mohammed Essam M Ali
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | | | - Mona Soliman
- Department of Internal medicine and endocrinology, Faculty of Medicine, Assiut University, Egypt
| | - Reham I El-Mahdy
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt.
| | - Ahmed Elsayed
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Aya Y Badran
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
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50
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Elfeky SA, Elsayed A, Moawad M, Ahmed WA. Hydroxyapatite nanocomposite as a potential agent in osteosarcoma PDT. Photodiagnosis Photodyn Ther 2020; 32:102056. [PMID: 33068821 DOI: 10.1016/j.pdpdt.2020.102056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/26/2020] [Accepted: 10/02/2020] [Indexed: 01/09/2023]
Abstract
Using Nanoplatforms as a hauler for photosensitizers is a bespoke paradigm to improve its bioavailability and to boost the PDT efficacy. Herein, the photodynamic cytotoxicity of methylene blue (MB) loaded on hydroxyapatite nanoparticles (HA-NPs) was tested against human osteosarcoma-derived cells (Saos-2 cell line). HA-NPs and HA-NPs loaded with MB (HA-NPs-MB) were prepared by a chemical precipitation method and characterized by TEM, Zeta potential, FTIR, and XRD. TEM images revealed that HA-NPs have a rod shape with a diameter of 14-17 nm and length around 46-64 nm. FTIR and Zeta potential confirmed the adsorption of cationic MB on HA-NPs. XRD pattern was identical to the standard XRD pattern of HA-NPs. Incubation of Saos-2 cells (24 h) with HA-NPs-MB then irradiation of cells (5 min) with a diode laser (808 nm), causes a higher decrement of cell viability (determined by MTT assay) than that caused by free MB. The LC50 was 57.53 µg/mL and 86.99 µg/mL for HA-NPs-MB and free MB, respectively. Thus, the nanoformulation of MB greatly reduced the dose of MB required for effective PDT. This study also investigated the mode of cell death after incubation of cells with free MB or HA-NPs-MB composite then exposure to laser radiation. The results revealed that the majority of cells died by apoptosis while a minor fraction of cells died by necrosis, especially in the case of HA-NPs-MB. Levels of caspase-3 and death receptor-4 (DR-4) were more elevated in the case of HA-NPs-MB than free MB. The effect of the prepared nanocomposite and free MB on Raw murine macrophage (RAW 264.7) viability was also examined using the MTT assay. The results indicated that HA-NPs-MB in the presence of laser has a great cytotoxic effect on macrophage cells compared to other treatments. This may present an advantage through decreasing macrophage that promotes tumor growth. In conclusion, HA-NPs-MB nanocomposite surmounts free MB and HA-NPs in destroying macrophage cells and Saos-2 cells through apoptosis in the presence of laser irradiation. This study introduces a thorough and new insight on osteosarcoma (cancer cell line Saos-2) PDT using HA-NPs-MB exploiting the biosafety of HA-NPs.
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Affiliation(s)
- Souad A Elfeky
- National Institute of Laser Enhanced Sciences, Cairo University, Giza, 12613, Egypt.
| | - Ahmed Elsayed
- National Institute of Laser Enhanced Sciences, Cairo University, Giza, 12613, Egypt
| | - Mahmoud Moawad
- Department of Surgical Pathology, National Cancer Institute, Cairo University, Egypt
| | - Wafaa A Ahmed
- Department of Cancer Biology, National Cancer Institute, Cairo University, Egypt
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