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Motawea KR, Rabea RK, Elhalag RH, Goodloe J, Awad DM, Kaur M, Awad AK, Swed S, Varney J. Cosmetic operative care abroad leads to a multidrug-resistant Mycobacterium abscessus infection in a patient: a case report. J Med Case Rep 2022; 16:448. [PMID: 36447286 PMCID: PMC9710160 DOI: 10.1186/s13256-022-03678-z] [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: 01/06/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The Mycobacterium abscessus complex is a nontuberculous mycobacteria species that is pervasive in soil and water. Various medical equipment malfunctions, infected surfaces, and patient transmission are potential causes of Mycobacterium abscessus infection in the hospital environment. These cases have an annual prevalence that ranges from 1.4 to 6.6 per 100,000 infections, mainly increasing. CASE PRESENTATION We present the case of a 23-year-old American female patient who presented to the emergency room with significant abdominal pain between low pelvic sutures and the umbilicus. She reported abdominal pain, pruritus, and boils on her back preventing her from standing upright. The symptoms occurred in the liposuction area after cosmetic surgery in the Dominican Republic. The clinical, radiological, and cultural findings helped diagnose Mycobacterium abscessus infection. We conducted a mini literature review on the published reports of Mycobacterium abscessus. CONCLUSION Mycobacterium abscessus infection may occur due to surgical procedures abroad. Measures are required to combat Mycobacterium abscessus and reduce its prevalence in hospital settings.
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Affiliation(s)
- Karam R. Motawea
- grid.7155.60000 0001 2260 6941Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Randa K. Rabea
- grid.7269.a0000 0004 0621 1570Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rowan H. Elhalag
- grid.7155.60000 0001 2260 6941Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Jason Goodloe
- grid.464520.10000 0004 0614 2595School of Medicine, American University of the Caribbean, Philipsburg, Sint Maarten
| | - Dina M. Awad
- grid.7155.60000 0001 2260 6941Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Manmeet Kaur
- grid.464520.10000 0004 0614 2595School of Medicine, American University of the Caribbean, Philipsburg, Sint Maarten
| | - Ahmed K. Awad
- grid.7269.a0000 0004 0621 1570Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sarya Swed
- grid.42269.3b0000 0001 1203 7853Faculty of Medicine, Aleppo University, Aleppo, Syria
| | - Joseph Varney
- grid.464520.10000 0004 0614 2595School of Medicine, American University of the Caribbean, Philipsburg, Sint Maarten
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Ghozy S, El-Qushayri AE, Varney J, Kacimi SEO, Bahbah EI, Morra ME, Shah J, Kallmes KM, Abbas AS, Elfil M, Alghamdi BS, Ashraf G, Alhabbab R, Dmytriw AA. The prognostic value of neutrophil-to-lymphocyte ratio in patients with traumatic brain injury: A systematic review. Front Neurol 2022; 13:1021877. [PMID: 36353130 PMCID: PMC9638118 DOI: 10.3389/fneur.2022.1021877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/17/2022] [Accepted: 09/30/2022] [Indexed: 11/26/2022] Open
Abstract
Traumatic brain injury (TBI) places a heavy load on healthcare systems worldwide. Despite significant advancements in care, the TBI-related mortality is 30–50% and in most cases involves adolescents or young adults. Previous literature has suggested that neutrophil-to-lymphocyte ratio (NLR) may serve as a sensitive biomarker in predicting clinical outcomes following TBI. With conclusive evidence in this regard lacking, this study aimed to systematically review all original studies reporting the effectiveness of NLR as a predictor of TBI outcomes. A systematic search of eight databases was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement (PRISMA) recommendations. The risk of bias was assessed using the Quality in Prognostic Studies (QUIPS) tool. Eight studies were ultimately included in the study. In most of the studies interrogated, severity outcomes were successfully predicted by NLR in both univariate and multivariate prediction models, in different follow-up durations up to 6 months. A high NLR at 24 and 48 h after TBI in pediatric patients was associated with worse clinical outcomes. On pooling the NLR values within studies assessing its association with the outcome severity (favorable or not), patients with favorable outcomes had 37% lower NLR values than those with unfavorable ones (RoM= 0.63; 95% CI = 0.44–0.88; p = 0.007). However, there were considerable heterogeneity in effect estimates (I2 = 99%; p < 0.001). Moreover, NLR was a useful indicator of mortality at both 6-month and 1-year intervals. In conjunction with clinical and radiographic parameters, NLR might be a useful, inexpensive marker in predicting clinical outcomes in patients with TBI. However, the considerable heterogeneity in current literature keeps it under investigation with further studies are warranted to confirm the reliability of NLR in predicting TBI outcomes.
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Affiliation(s)
- Sherief Ghozy
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, United States
- Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC Program), Oxford University, Oxford, United Kingdom
- *Correspondence: Sherief Ghozy
| | | | - Joseph Varney
- School of Medicine, American University of the Caribbean, Philipsburg, Sint Maarten
| | | | | | | | - Jaffer Shah
- Drexel University College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Kevin M. Kallmes
- Nested Knowledge, Saint Paul, MN, United States
- Superior Medical Experts, Saint Paul, MN, United States
| | | | - Mohamed Elfil
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Badrah S. Alghamdi
- Neuroscience Unit, Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Pre-Clinical Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghulam Ashraf
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Ghulam Ashraf
| | - Rowa Alhabbab
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adam A. Dmytriw
- Neurointerventional Program, Departments of Medical Imaging and Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada
- Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Motawea KR, El-Sakka AA, Kandil OA, Ahmed N, Abdelnaem M, Zaki B, Elhalag RH, Varney J, Swed S, Nashwan AJ, Sawaf B, Seijari M, Farwati A, Battikh N, Rakab A. Relation Between Familial Mediterranean Fever and QT Markers (QTc, QTd, and QTcd): A Systematic Review and Meta-Analysis. Cureus 2022; 14:e30585. [DOI: 10.7759/cureus.30585] [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] [Accepted: 10/22/2022] [Indexed: 11/05/2022] Open
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Ha NX, Le-Van T, Nam NH, Raut A, Varney J, Huy NT. A problem of self-isolation in Japan: The relationship between self-isolation and COVID-19 community case. Health Promot Perspect 2022; 12:192-199. [PMID: 36276422 PMCID: PMC9508386 DOI: 10.34172/hpp.2022.24] [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] [Received: 02/04/2022] [Accepted: 04/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The Japanese government advised mild or asymptomatic coronavirus disease-2019 (COVID-19) cases to self-isolate at home, while more severe individuals were treated at health posts. Poor compliance with self-isolation could be a potential reason for the new outbreak. Our study aimed to find out the correlation between the rising new cases of COVID-19 and home-based patients in Japan. Methods: A secondary data analysis study was conducted with the data from COVID-19- involved databases collected from Johns Hopkins University, Japanese Ministry of Health, Labour and Welfare, and Community Mobility Reports of Google. New community cases, stringency index, number of tests, and active cases were analyzed. Using a linear regression model, an independent variable was utilized for a given date to predict the future number of community cases. Results: Research results show that outpatient cases, the stringency, and Google Mobility Trend were all significantly associated with the number of COVID-19 community cases from the sixth day to the ninth day. The model predicting community cases on the eighth day (R2=0.8906) was the most appropriate showing outpatients, residential index, grocery and pharmacy index, retail and recreation index, and workplaces index were positively related (β1=24.2, 95% CI: 20.3– 26.3, P<0.0001; β2=277.7, 95% CI: 171.8–408.2, P<0.0001; β3=112.4, 95% CI: 79.8–158.3, P<0.0001; β4=73.1, 95% CI: 53- 04.4, P<0.0001; β5=57.2, 95% CI: 25.2–96.8, P=0.001, respectively). In contrast, inpatients, park index, and adjusted stringency index were negatively related to the number of community cases (β6=-2.8, 95% CI: -3.9 – -1.6, P<0.0001; β7=-33, 95% CI: -43.6 – -27, P<0.0001; β8=-14.4, 95% CI: -20.1– -12, P<0.0001, respectively). Conclusion: Outpatient cases and indexes of Community Mobility Reports were associated with COVID-19 community cases.
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Affiliation(s)
- Nam Xuan Ha
- Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
| | - Truong Le-Van
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- Traditional Medicine Hospital of Ministry of Public Security, Hanoi, Vietnam
| | - Nguyen Hai Nam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Global Clinical Scholars Research Training Program, Harvard Medical School, Boston, Massachusetts, USA
| | - Akshay Raut
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- St. George’s Hospital, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai 400001, India
| | - Joseph Varney
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- American University of the Caribbean, School of Medicine, Sint Maarten, Sint Maarten
| | - Nguyen Tien Huy
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- School of Tropical Diseases and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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5
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Shah J, Shah A, Tokhi AF, Shedrow J, Hernandez N, Varney J, Qaderi P, Masoumi SJ, Qaderi S. Afghan Health Related Concerns Following the US Withdrawal: Results of a Survey Given via Social Media. Front Public Health 2022; 10:905481. [PMID: 35910864 PMCID: PMC9332619 DOI: 10.3389/fpubh.2022.905481] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background The United States Armed Forces completed their withdrawal from Afghanistan on August 30th, 2021, ending 20 years of war in Afghanistan. This rapid timeline from announcement to withdrawal and subsequent power transfer had profound consequences on the Afghan people, particularly in the domains of health and healthcare. Methods On 15 September 2021, we posted an anonymous online cross-sectional survey on social media (Twitter, Facebook, and WhatsApp groups) to collect data about respondents from Afghanistan. Questions focused on COVID-19 symptoms, concerns, and individual care with a focus on changes related to the United States (US) withdrawal from Afghanistan. The form was composed of 17 questions which included multiple choice, single choice, and numeric options. All questions were optional including demographic data. Results Our survey yielded 1,074 responses from the Farsi version and 572 responses from the Pashto version for a total of 1,646 responses. 1,286 (80%) of respondents were in Afghanistan at the time of survey submission. Concerning the US withdrawal from Afghanistan, 26% (412) respondents were extremely concerned and 12% (181) were moderately concerned. A majority of respondents report concerns regarding mental health due to the US withdrawal. 27% (418) report extreme concern, 12% (186) report moderate concern, and 15% (229) report a little concern. There is a significant difference in the proportions of concern (for US withdrawal generally, as well as physical and mental health) across gender. 49% of Female respondents report extreme concern regarding the US withdrawal compared to 22% of Male respondents (P < 0.001). With respect to physical health concerns 36% of Females report extreme concern compared to 16% of Males (P < 0.001). Finally on the mental health concerns, 54% of Females report extreme concern compared to 22% of Males (P < 0.001). Conclusion The results from this survey are susceptible to the possibility of internal validity and/or external validity. However, we are accepting of those possibilities considering this survey wasn't designed to be bulletproof, but rather serve as a voice for those who can't be heard and to inform the public of the hardships occurring across the globe due to a steadfast retraction of the US footprint from their soil. Our findings indicate salient changes and public health concerns among Afghans following the US withdrawal from the region. These concerns varied across gender and ethnic groups. Our findings may serve as the first step in addressing the health concerns of Afghans following two decades of US military presence. The results should be understood through the limitations associated with a survey study design. Future research and policy aimed at tackling short and long-term health and social concerns in Afghanistan should consider the role of US withdrawal.
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Affiliation(s)
- Jaffer Shah
- Medical Research Center, Kateb University, Kabul, Afghanistan
- Afghanistan National Charity Organization for Special Diseases, Kabul, Afghanistan
| | - Asghar Shah
- Division of Biology and Medicine, Brown University, Providence, RI, United States
| | - Ahmad Fahim Tokhi
- Department of Stem Cell and Regenerative Medicine, Eskiseir Osmangazi University, Eskiseir, Turkey
| | - Jordan Shedrow
- American University of the Caribbean Medial School, Cupe Coy, Sint Maarten
| | - Nicolas Hernandez
- American University of the Caribbean Medial School, Cupe Coy, Sint Maarten
| | - Joseph Varney
- American University of the Caribbean Medial School, Cupe Coy, Sint Maarten
| | - Pashton Qaderi
- Psychology and Educational Science Department, Balkh University, Balkh, Afghanistan
| | - Seyed Javad Masoumi
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Shohra Qaderi
- Afghanistan National Charity Organization for Special Diseases, Kabul, Afghanistan
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Shohra Qaderi
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Motawea KR, Varney J, Gamal M, Abbas KS, Monib FA, Albuni MK, Battikh E, Sawaf B, Khairy LT, Bakkour A, Muwaili AHH, Abdelmajid FAA, Ahmed EMS, Muwaili DHH, Ahmed SMA, Swed S. Meta-analysis of the relation between irritable bowel syndrome and antibodies against endogenous gonadotropin-releasing hormone and its receptor. Proc (Bayl Univ Med Cent) 2022; 36:61-65. [PMID: 36578611 PMCID: PMC9762813 DOI: 10.1080/08998280.2022.2093588] [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: 12/31/2022] Open
Abstract
This meta-analysis assessed the association between gonadotropin hormone-releasing hormone (GnRH) antibodies and irritable bowel syndrome (IBS). We defined a search strategy and implemented it with PubMed, Ovid, Scopus, and Web of Science databases for English language publications. The data were evaluated for acceptability, and randomized controlled studies as well as case-control, cross-sectional, and cohort studies reporting the prevalence of GnRH antibodies in IBS patients were included. The total number of patients in the included studies was 1095: 270 patients in the IBS group and 825 patients in the control group. By comparing the IBS group and the control group, we found a statistically significant association between IBS and the increased prevalence of GnRH IgM antibodies (risk ratio = 2.29, 95% confidence interval = 1.58 to 3.31, P < 0.0001). We also found a statistically significant association between IBS and increased prevalence of GnRH receptor IgM antibodies compared with controls (risk ratio = 3.80, 95% confidence interval = 1.72 to 8.38, P = 0.001). The meta-analysis revealed a statistically significant association between IBS and increased prevalence of GnRH IgM and GnRH receptor IgM antibodies.
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Affiliation(s)
| | - Joseph Varney
- American University of the Caribbean School of Medicine, Sint Maarten
| | | | | | | | | | - Elias Battikh
- Department of Internal Medicine, Damascus University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | | | - Agyad Bakkour
- Faculty of Medicine, Albaath University, Homs, Syria
| | | | | | | | | | | | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria,Corresponding author: Sarya Swed, MBBCh, Faculty of Medicine, Aleppo University, Syria (e-mail: )
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7
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Motawea KR, Kandil OA, Varney J, Aboelenein M, Ibrahim N, Shaheen A, Khairy LT, Bakkour A, Muwaili AHH, Muwaili DHH, Abdelmajid FAA, Ahmad EMS, Albuni MK, Battikh E, Sawaf B, Swed S, Ahmed SMA, Awad DM, Shah J, Aiash H. Association of familial Mediterranean fever and epicardial adipose tissue: A systematic review and meta‐analysis. Health Sci Rep 2022; 5:e693. [PMID: 35734339 PMCID: PMC9193962 DOI: 10.1002/hsr2.693] [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] [Received: 02/14/2022] [Revised: 04/15/2022] [Accepted: 05/12/2022] [Indexed: 12/03/2022] Open
Abstract
Background and Aim Some studies reported a positive link between familial Mediterranean fever (FMF) and epicardial adipose tissue. Our meta‐analysis aimed to evaluate whether there is a significant association between FMF and increased epicardial adipose tissue thickness. Methods We searched the following databases: PUBMED, WOS, OVID, SCOPUS, and EMBASE. Inclusion criteria were any original articles that reported epicardial adipose tissue in FMF patients with no age restriction, excluding reviews, case reports, editorials, animal studies, and non‐English studies. Thirty eligible studies were screened full text but only five studies were suitable. We used RevMan software (5.4) for the meta‐analysis. Results The total number of patients included in the meta‐analysis in the FMF patients group is 256 (mean age = 24.3), and the total number in the control group is 188 (mean age = 24.98). The pooled analysis between FMF patients and controls was [mean difference = 0.82 (95% CI = 0.25–1.39), p‐value = 0.005]. We observed heterogeneity that was not solved by random effects (p > 0.00001). We performed leave one out test by removing the Kozan et al. study, and the heterogeneity was solved (p = 0.07), and the results were (MD = 0.98, 95% CI = 0.52–1.43, p‐value < 0.0001). Conclusion FMF patients are at increased risk of developing epicardial adipose tissue compared to controls. More multicenter studies with higher sample sizes are needed to support our results.
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Affiliation(s)
| | | | - Joseph Varney
- School of Medicine American University of the Caribbean Cupecoy Sint Maarten
| | | | - Nancy Ibrahim
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Ahmed Shaheen
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Lina T. Khairy
- Faculty of Medicine The National Ribat University Al‐Ribat Sudan
| | | | - Ali H. H. Muwaili
- Faculty of Medicine Ivano‐Frankivsk National Medical University Ivano‐Frankivsk Ukraine
| | - Dhuha H. H. Muwaili
- Faculty of Medicine Ivano‐Frankivsk National Medical University Ivano‐Frankivsk Ukraine
| | | | - Eman M. S. Ahmad
- Departments of Obstetrics and Gynecology Nile Valley University Atbra Sudan
| | - Mhd K. Albuni
- Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Elias Battikh
- Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Bisher Sawaf
- Department of Internal Medicine Hamad Medical Corporation Doha Qatar
| | - Sarya Swed
- Faculty of Medicine Aleppo University Aleppo Syria
| | | | - Dina M. Awad
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Jaffer Shah
- Medical Research Center Kateb University Kabul Afghanistan
| | - Hani Aiash
- Cardiovascular perfusion Department Upstate Medical University Syracuse New York USA
- Family Medicine Department Suez Canal University Ismailia Governorate Egypt
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8
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Ghozy S, Reda A, Varney J, Elhawary AS, Shah J, Murry K, Sobeeh MG, Nayak SS, Azzam AY, Brinjikji W, Kadirvel R, Kallmes DF. Neuroprotection in Acute Ischemic Stroke: A Battle Against the Biology of Nature. Front Neurol 2022; 13:870141. [PMID: 35711268 PMCID: PMC9195142 DOI: 10.3389/fneur.2022.870141] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 02/06/2022] [Accepted: 04/21/2022] [Indexed: 12/22/2022] Open
Abstract
Stroke is the second most common cause of global death following coronary artery disease. Time is crucial in managing stroke to reduce the rapidly progressing insult of the ischemic penumbra and the serious neurologic deficits that might follow it. Strokes are mainly either hemorrhagic or ischemic, with ischemic being the most common of all types of strokes. Thrombolytic therapy with recombinant tissue plasminogen activator and endovascular thrombectomy are the main types of management of acute ischemic stroke (AIS). In addition, there is a vital need for neuroprotection in the setting of AIS. Neuroprotective agents are important to investigate as they may reduce mortality, lessen disability, and improve quality of life after AIS. In our review, we will discuss the main types of management and the different modalities of neuroprotection, their mechanisms of action, and evidence of their effectiveness after ischemic stroke.
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Affiliation(s)
- Sherief Ghozy
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, United States.,Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC Program), Oxford University, Oxford, United Kingdom
| | - Abdullah Reda
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Joseph Varney
- School of Medicine, American University of the Caribbean, Philipsburg, Sint Maarten
| | | | - Jaffer Shah
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | | | - Mohamed Gomaa Sobeeh
- Faculty of Physical Therapy, Sinai University, Cairo, Egypt.,Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Sandeep S Nayak
- Department of Internal Medicine, NYC Health + Hospitals/Metropolitan, New York, NY, United States
| | - Ahmed Y Azzam
- Faculty of Medicine, October 6 University, Giza, Egypt
| | - Waleed Brinjikji
- Department of Neurosurgery, Mayo Clinic Rochester, Rochester, MN, United States
| | | | - David F Kallmes
- Department of Neuroradiology, Mayo Clinic, Rochester, MN, United States
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Varney J, Motawea KR, Mostafa MR, AbdelQadir YH, Aboelenein M, Kandil OA, Ibrahim N, Hashim HT, Murry K, Jackson G, Shah J, Boury M, Awad AK, Patel P, Awad DM, Rozan SS, Talat NE. Efficacy of heads-up CPR compared to supine CPR positions: Systematic review and meta-analysis. Health Sci Rep 2022; 5:e644. [PMID: 35620549 PMCID: PMC9128396 DOI: 10.1002/hsr2.644] [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: 12/22/2021] [Revised: 03/03/2022] [Accepted: 04/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aim Cardiopulmonary resuscitation (CPR) in full-coded patients requires effective chest compressions with minimal interruptions to maintain adequate perfusion to the brain and other vital organs. Many novel approaches have been proposed to attain better organ perfusion compared to traditional CPR techniques. The purpose of this review is to investigate the safety and efficacy of heads-up CPR versus supine CPR. Methods We searched PubMed Central, SCOPUS, Web of Science, and Cochrane databases from 1990 to February 2021. After the full-text screening of 40 eligible studies, only seven studies were eligible for our meta-analysis. We used the RevMan software (5.4) to perform the meta-analysis. Results In survival outcome, the pooled analysis between heads-up and supine CPR was (risk ratio = 0.98, 95% confidence interval [CI] = 0.17-5.68, p = 0.98). The pooled analyses between heads-up CPR and supine CPR in cerebral flow, cerebral perfusion pressure and coronary perfusion pressure outcomes, were (mean difference [MD] = 0.10, 95% CI = 0.03-0.17, p = 0.003), (MD = 12.28, 95% CI = 5.92-18.64], p = 0.0002), and (MD = 8.43, 95% CI = 2.71-14.14, p = 0.004), respectively. After doing a subgroup analysis, cerebral perfusion was found to increase during heads-up CPR compared with supine CPR at 6 min CPR duration and 18 to 20 min CPR duration as well. Conclusion Our study suggests that heads-up CPR is associated with better cerebral and coronary perfusion compared to the conventional supine technique in pigs' models. However, more research is warranted to investigate the safety and efficacy of the heads-up technique on human beings and to determine the best angle for optimization of the technique results.
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Affiliation(s)
- Joseph Varney
- School of Medicine American University of the Caribbean Philipsburg Sint Maarten (Dutch Part)
| | | | | | | | | | | | - Nancy Ibrahim
- Faculty of Medicine Alexandria University Alexandria Egypt
| | | | | | - Garrett Jackson
- School of Medicine American University of the Caribbean Philipsburg Sint Maarten (Dutch Part)
| | - Jaffer Shah
- Kateb University Medical Research Center Kateb University Kabul Afghanistan.,New York State Department of Health New York USA
| | - Maty Boury
- School of Medicine American University of the Caribbean Philipsburg Sint Maarten (Dutch Part)
| | - Ahmed K Awad
- Faculty of Medicine Ain-Shams University Cairo Egypt
| | - Priya Patel
- School of Medicine American University of the Caribbean Philipsburg Sint Maarten (Dutch Part)
| | - Dina M Awad
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Samah S Rozan
- Faculty of Medicine Alexandria University Alexandria Egypt
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10
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Varney J, Motawea KR, Kandil OA, Hashim HT, Murry K, Shah J, Shaheen A, Akwari J, Awad AK, Rivera A, Mostafa MR, Swed S, Awad DM. Prehospital administration of broad‐spectrum antibiotics for sepsis patients: A systematic review and meta‐analysis. Health Sci Rep 2022; 5:e582. [PMID: 35387313 PMCID: PMC8973268 DOI: 10.1002/hsr2.582] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/11/2022] [Accepted: 03/09/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Aims Some studies have suggested that earlier initiation of antibiotics has shown positive outcomes in sepsis patients. We aimed to do a systematic review and meta‐analysis to evaluate the effect of prehospital administration of antibiotics on 28 days mortality and length of stay in hospital and intensive care unit for sepsis patients. Methods We formulated a search strategy and used it on search databases PubMed, Scopus, Web of Science, and Embase. We then screened the records for eligibility and included controlled studies, either clinical trials or cohort studies reporting prehospital antibiotic administration for sepsis patients. We excluded duplicates, books, conferences' abstracts, case reports, editorials, letters, author responses, not English studies, and studies with nonavailable full text. Animal and lab studies were also excluded. Results The total number of studies identified is 1811, 19 were eligible for systematic review and 4 for meta‐analysis (three cohort and one clinical trial). The total number of sepsis patients in the four included studies in the 28 days mortality outcome was 3523 (1779 took prehospital antibiotics and 1744 did not take prehospital antibiotics). Of 1779 who took the antibiotics, 190 died, and of 1744 who did not take antibiotics, 292 died (95% confidence interval 0.68–0.97, p = 0.02). Conclusion This meta‐analysis reveals that receiving prehospital antibiotics can significantly lower mortality in sepsis patients compared to patients who do not receive prehospital antibiotics. However, more clinical trials and multicenter prospective studies with high sample sizes are needed to get strong evidence supporting our findings.
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Affiliation(s)
- Joseph Varney
- School of Medicine American University of the Caribbean Cupecoy Sint Maarten
| | | | | | - Hashim T. Hashim
- College of Medicine University of Baghdad Nassiryah Dhi Qar Iraq
| | | | - Jaffer Shah
- Medical Research Center Kateb Univeristy Kabul Afghanistan
- New York State Department of Health New York USA
| | - Ahmed Shaheen
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Joy Akwari
- School of Medicine American University of the Caribbean Cupecoy Sint Maarten
| | - Ahmed K. Awad
- Faculty of Medicine Ain‐Shams University Cairo Egypt
| | - Amanda Rivera
- School of Medicine American University of the Caribbean Cupecoy Sint Maarten
| | | | - Sarya Swed
- Faculty of Medicine Aleppo university Aleppo Syria
| | - Dina M. Awad
- Faculty of Medicine Alexandria University Alexandria Egypt
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11
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Awad AK, Elbadawy MA, Boury M, Rivera A, Motawea K, Shah J, Parnia S, Varney J. Simple headache revealed a rare lymphoma: Waldenstrom macroglobulinemia with unique markers: a case report and review of the literature. J Egypt Natl Canc Inst 2022; 34:10. [PMID: 35253074 DOI: 10.1186/s43046-022-00107-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/28/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Waldenstrom macroglobulinemia (WM) is a rare lymphoma with an incidence rate of 3 per million people per year, with approximately 1000 to 1500 new cases diagnosed each year in the USA. It is primarily seen in Caucasian males with a median age of 70 years old. Patients are most often asymptomatic, but WM can manifest itself with constitutional symptoms such as lethargy, bleeding, organomegaly, and neurological or fundoscopic abnormalities. WM is characterized by immunoglobulin M (IgM) monoclonal gammopathy, lymphocytic infiltration of bone marrow, and normocytic anemia due to bone marrow replacement. CASE PRESENTATION Our patient is a Hispanic 67-year-old female that presents with one month of intermittent band-like bilateral headache accompanied by dizziness, light-headedness, nausea, and blurred vision. A thorough diagnostic workup was performed, including serum protein electrophoresis (SPEP) with serum immunofixation (SIFE) showing an M spike and IgM kappa. Bone marrow biopsy was significant for lymphoplasmacytic infiltration with nodular B cells (CD19+, CD20+, CD22+). Computerized Tomography (CT) imaging showed splenomegaly in the patient. Treatment was provided for hyperviscosity syndrome with plasmapheresis twice. The patient reported improvement of her symptoms and was then scheduled for chemotherapy. Throughout 7 months, our patient received multiple cycles of bortezomib, dexamethasone, and rituximab. While her symptoms improved her psychiatric status got progressively worse. CONCLUSION It is important not to neglect symptoms such as a headache, which may seem small, but could serve as a clue in the diagnosis of Waldenstrom's macroglobulinemia.
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Affiliation(s)
- Ahmed K Awad
- Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | | | - Maty Boury
- American University of the Caribbean, School of Medicine, Philipsburg, St. Maarten, SXM
| | - Amanda Rivera
- American University of the Caribbean, School of Medicine, Philipsburg, St. Maarten, SXM
| | - Karam Motawea
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Jaffer Shah
- Drexel University College of Medicine, Philadelphia, USA
| | - Shanli Parnia
- Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Joseph Varney
- American University of the Caribbean, School of Medicine, Philipsburg, St. Maarten, SXM
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12
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Ghozy S, Zayan AH, El‐Qushayri AE, Parker KE, Varney J, Kallmes KM, Morsy S, Abbas AS, Diestro JDB, Dmytriw AA, Shah J, Hassan AE, Islam SMS. Physical activity level and stroke risk in
US
population: A matched case–control study of 102,578 individuals. Ann Clin Transl Neurol 2022; 9:264-275. [PMID: 35094505 PMCID: PMC8935290 DOI: 10.1002/acn3.51511] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Received: 09/13/2021] [Revised: 01/02/2022] [Accepted: 01/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Stroke has been linked to a lack of physical activity; however, the extent of the association between inactive lifestyles and stroke risk has yet to be characterized across large populations. Purpose This study aimed to explore the association between activity‐related behaviors and stroke incidence. Methods Data from 1999 to 2018 waves of the concurrent cross‐sectional National Health and Nutrition Examination Survey (NHANES) were extracted. We analyzed participants characteristics and outcomes for all participants with data on whether they had a stroke or not and assessed how different forms of physical activity affect the incidence of disease. Results Of the 102,578 individuals included, 3851 had a history of stroke. A range of activity‐related behaviors was protective against stroke, including engaging in moderate‐intensity work over the last 30 days (OR = 0.8, 95% CI = 0.7–0.9; P = 0.001) and vigorous‐intensity work activities over the last 30 days (OR = 0.6, 95% CI = 0.5–0.8; P < 0.001), and muscle‐strengthening exercises (OR = 0.6, 95% CI = 0.5–0.8; P < 0.001). Conversely, more than 4 h of daily TV, video, or computer use was positively associated with the likelihood of stroke (OR = 11.7, 95% CI = 2.1–219.2; P = 0.022). Conclusion Different types, frequencies, and intensities of physical activity were associated with reduced stroke incidence, implying that there is an option for everyone. Daily or every other day activities are more critical in reducing stroke than reducing sedentary behavior duration.
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Affiliation(s)
- Sherief Ghozy
- Department of Neuroradiology Mayo Clinic Rochester Minnesota USA
- Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC program) Oxford University Oxford UK
| | | | | | - Kate Elizabeth Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Melbourne Vic. Australia
| | - Joseph Varney
- School of Medicine American University of the Caribbean Cupecoy Sint Maarten
| | - Kevin M. Kallmes
- Nested Knowledge St. Paul Minnesota USA
- Superior Medical Experts St. Paul Minnesota USA
| | - Sara Morsy
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine Tanta University Tanta Egypt
- School of Chemistry and Biosciences, Faculty of Life Sciences University of Bradford Bradford UK
| | | | - Jose Danilo B. Diestro
- Radiology Department, Central Hospital of University of Montreal University of Montreal Montreal QC Canada
| | - Adam A. Dmytriw
- Neuroendovascular Program Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USA
| | - Jaffer Shah
- Medical Research Center Kateb University Kabul Afghanistan
| | - Ameer E. Hassan
- Department of Neurology University of Texas Rio Grande Valley Harlingen Texas USA
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Melbourne Vic. Australia
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13
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Hashim HT, Ramadhan MA, Ahmad S, Shah J, Varney J, Motawea KR, Kandil OA. The role of the electrocardiogram in the recognition of cardiac transplant rejection: A systematic review and meta‐analysis. Clin Cardiol 2022; 45:258-264. [PMID: 35066923 PMCID: PMC8922543 DOI: 10.1002/clc.23783] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background In cardiac transplant recipients, the electrocardiogram (ECG) is a noninvasive measure of early allograft rejection. The ECG can predict an acute cellular rejection, thus shortening the time to recognition of rejection. Earlier diagnosis has the potential to reduce the number and severity of rejection episodes. Methodology A systematic literature review was conducted to identify and select the original research reports on using electrocardiography in diagnosing cardiac transplant rejection in accordance with the PRISMA guidelines. Studies included reported sensitivity and specificity of ECG readings in heart transplant recipients during the first post‐transplant year. Data were analyzed with Review manager version 5.4. p‐value was used in testing the significant difference. Results After the removal of duplicates, 98 articles were eligible for screening. After the full‐text screening, a total of 17 papers were included in the review based on the above criteria. A meta‐analysis of five studies was done. Conclusion In heart transplant recipients, a noninvasive measure of early allograft rejection has the potential to reduce the number and severity of rejection episodes by reducing the time and cost of surveillance of rejection and shortening the time to recognition of rejection.
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Affiliation(s)
| | | | | | - Jaffer Shah
- Drexel University College of Medicine Philadelphia Pennsylvania USA
| | - Joseph Varney
- School of Medicine American University of the Caribbean St Maarten USA
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14
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Minh LHN, Abozaid AA, Ha NX, Le Quang L, Gad AG, Tiwari R, Nhat‐Le T, Quyen DK, AL‐Manaseer B, Kien ND, Vuong NL, Zayan AH, Nhi LHH, Surya Dila KA, Varney J, Tien Huy N. Clinical and laboratory factors associated with coronavirus disease 2019 (Covid-19): A systematic review and meta-analysis. Rev Med Virol 2021; 31:e2288. [PMID: 34472152 PMCID: PMC8646520 DOI: 10.1002/rmv.2288] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/08/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
SARS Coronavirus-2 is one of the most widespread viruses globally during the 21st century, whose severity and ability to cause severe pneumonia and death vary. We performed a comprehensive systematic review of all studies that met our standardised criteria and then extracted data on the age, symptoms, and different treatments of Covid-19 patients and the prognosis of this disease during follow-up. Cases in this study were divided according to severity and death status and meta-analysed separately using raw mean and single proportion methods. We included 171 complete studies including 62,909 confirmed cases of Covid-19, of which 148 studies were meta-analysed. Symptoms clearly emerged in an escalating manner from mild-moderate symptoms, pneumonia, severe-critical to the group of non-survivors. Hypertension (Pooled proportion (PP): 0.48 [95% Confident interval (CI): 0.35-0.61]), diabetes (PP: 0.23 [95% CI: 0.16-0.33]) and smoking (PP: 0.12 [95% CI: 0.03-0.38]) were highest regarding pre-infection comorbidities in the non-survivor group. While acute respiratory distress syndrome (PP: 0.49 [95% CI: 0.29-0.78]), (PP: 0.63 [95% CI: 0.34-0.97]) remained one of the most common complications in the severe and death group respectively. Bilateral ground-glass opacification (PP: 0.68 [95% CI: 0.59-0.75]) was the most visible radiological image. The mortality rates estimated (PP: 0.11 [95% CI: 0.06-0.19]), (PP: 0.03 [95% CI: 0.01-0.05]), and (PP: 0.01 [95% CI: 0-0.3]) in severe-critical, pneumonia and mild-moderate groups respectively. This study can serve as a high evidence guideline for different clinical presentations of Covid-19, graded from mild to severe, and for special forms like pneumonia and death groups.
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Affiliation(s)
- Le Huu Nhat Minh
- Cardiovascular Research DepartmentMethodist HospitalMerrillvilleIndianaUSA
- Online Research ClubNagasakiJapan
| | | | - Nam Xuan Ha
- Online Research ClubNagasakiJapan
- Hue University of Medicine and Pharmacy, Hue UniversityHue CityVietnam
| | - Loc Le Quang
- Online Research ClubNagasakiJapan
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | | | - Ranjit Tiwari
- Online Research ClubNagasakiJapan
- Department of Internal MedicineInstitute of MedicineTribhuvan UniversityKathmanduNepal
| | - Tran Nhat‐Le
- Online Research ClubNagasakiJapan
- Hue University of Medicine and Pharmacy, Hue UniversityHue CityVietnam
| | - Dinh Kim Quyen
- Online Research ClubNagasakiJapan
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Balqees AL‐Manaseer
- Online Research ClubNagasakiJapan
- School of MedicineUniversity of JordanAmmanJordan
| | - Nguyen Dang Kien
- Online Research ClubNagasakiJapan
- Department of Obstetrics and GynaecologyThai Binh University of Medicine and PharmacyThai BinhVietnam
| | - Nguyen Lam Vuong
- University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Ahmad Helmy Zayan
- Online Research ClubNagasakiJapan
- Department of OtolaryngologyMenoufia UniversityMenoufiaEgypt
| | - Le Huu Hanh Nhi
- Department of RadiologyVinmec Central Park International HospitalHo Chi Minh CityVietnam
| | - Kadek Agus Surya Dila
- Online Research ClubNagasakiJapan
- Department of Emergency MedicineGiri Emas HospitalSingaraja CityBuleleng, BaliIndonesia
| | - Joseph Varney
- Online Research ClubNagasakiJapan
- School of MedicineAmerican University of the CaribbeanSint MaartenNetherlands
| | - Nguyen Tien Huy
- Online Research ClubNagasakiJapan
- School of Tropical Medicine and Global HealthNagasaki UniversityNagasakiJapan
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15
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Tiwari R, Tam DNH, Shah J, Moriyama M, Varney J, Huy NT. Effects of sleep intervention on glucose control: A narrative review of clinical evidence. Prim Care Diabetes 2021; 15:635-641. [PMID: 33849816 DOI: 10.1016/j.pcd.2021.04.003] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/21/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Optimizing sleep has been recently gained exposure as a promising lifestyle consideration to aid in the control of diabetes. The evidence to support the impact of sleep quantity and quality on blood glucose control is largely acknowledged. This study aimed to review all published randomized controlled trials (RCTs) investigating the relationship between sleep and glucose control to synthesize an accurate overview. METHOD Literature from PubMed and Google Scholar was searched using the listed search terms to obtain RCTs on the role of sleep in glucose homeostasis. Seven RCTs were eligible and included in our review. References in these RCTs were screened for the presentation of the pathophysiology of metabolic disturbances relating to the sleep duration, and the relevant factors affecting blood glucose concentration. RESULTS Sleep deprivation and poor sleep quality are connected with blood glucose disturbance and reduction of insulin sensitivity. This leaves diabetic patients at an increased risk of glucose level fluctuations. However, the function of β-cells was likely to be conserved after 14-days of sleep deprivation. Sleep extension from 7 to 14 days improved blood glucose control and insulin sensitivity in both healthy and diabetes participants. Diabetes sleep education and personalized interventions that reduced stress and improved sleep quality contributed to glucose homeostasis in diabetic patients. Overall improving one's sleep hygiene was found to improve glucose control in diabetic patients. CONCLUSION Longer or short-term sleep deprivation may negatively affect glucose homeostasis, although the body temporarily compensates for the impaired function of β-cells when reduced sleep lasted up to 14 days. Thus, we recommend optimum sleep duration and optimistic sleep duration and sleep quality for decreasing risk and progression of diabetes.
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Affiliation(s)
- Ranjit Tiwari
- Faculty of Medicine, Institute of Medicine, Tribhuvan University, Kathmandu, 44600, Nepal; Online Research Club (http://onlineresearchclub.org), Nagasaki, 852-8523, Japan.
| | - Dao Ngoc Hien Tam
- Online Research Club (http://onlineresearchclub.org), Nagasaki, 852-8523, Japan; Asia Shine Trading & Service CO., LTD, Ho Chi Minh City, Viet Nam.
| | - Jaffer Shah
- Drexel University College of Medicine, Philadelphia, PA, USA.
| | - Michiko Moriyama
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima 734-8553, Japan.
| | - Joseph Varney
- American University of the Caribbean, School of Medicine, St Maarten, SXM.
| | - Nguyen Tien Huy
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam; School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
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16
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Ibrahim Y, Raut A, Varney J, Sidhu A, Dong V, Tien Huy N. Lessons Learned from the Reemergent Coronavirus Disease 2019 (COVID-19) Cases in Areas of Long-reported No Community Transmission. Clin Infect Dis 2021; 73:142-143. [PMID: 32970787 PMCID: PMC7543313 DOI: 10.1093/cid/ciaa1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yasmine Ibrahim
- American University of the Caribbean School of Medicine, Cupe Coy, Sint Maarten
| | - Akshay Raut
- Rajarshee Chhatrapati Shahu Maharaj Government Medical College, Maharashtra, India
| | - Joseph Varney
- American University of the Caribbean School of Medicine, Cupe Coy, Sint Maarten
| | - Anmol Sidhu
- American University of the Caribbean School of Medicine, Cupe Coy, Sint Maarten
| | - Vinh Dong
- American University of the Caribbean School of Medicine, Cupe Coy, Sint Maarten
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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17
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Semlyen J, Curtis TJ, Varney J. Sexual orientation identity in relation to unhealthy body mass index: individual participant data meta-analysis of 93 429 individuals from 12 UK health surveys. J Public Health (Oxf) 2021; 42:98-106. [PMID: 30786282 PMCID: PMC8414914 DOI: 10.1093/pubmed/fdy224] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 04/16/2018] [Revised: 11/16/2018] [Accepted: 12/18/2018] [Indexed: 01/01/2023] Open
Abstract
Background Lesbian, gay and bisexual adults are more likely than heterosexual adults to experience
worse health outcomes. Despite increasing public health interest in the importance of
maintaining a healthy body weight, no study has considered sexual orientation identity
(SOI) and unhealthy BMI categories among adults in the UK population. Methods Individual participant data meta-analysis using pooled data from population health
surveys reporting on 93 429 adults with data on SOI, BMI and study covariates. Results Adjusting for covariates and allowing for between-study variation, women identifying as
lesbian (OR = 1.41, 95% CI: 1.16, 1.72) or bisexual (OR = 1.24, 95% CI: 1.03, 1.48) were
at increased risk of overweight/obesity compared to heterosexual women, but men
identifying as gay were at decreased risk (OR = 0.72, 95% CI: 0.61, 0.85) compared to
heterosexual men. Increased risk of being underweight was seen for women identifying as
‘other’ (OR = 1.95, 95% CI: 1.07, 3.56), and men identifying as gay (OR = 3.12, 95% CI:
1.83, 5.38), bisexual (OR = 2.30, 95% CI: 1.17, 4.52), ‘other’ (OR = 3.95, 95% CI: 1.85,
8.42). Conclusions The emerging picture of health disparities in this population, along with well
documented discrimination, indicate that sexual orientation should be considered as a
social determinant of health.
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Affiliation(s)
- J Semlyen
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
| | - T J Curtis
- Centre for Population Research in Sexual Health and HIV, Institute for Global Health, University College London, London, UK
| | - J Varney
- Public Health England, London, UK
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18
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Zahid SU, Taeeb AA, Shah J, Shah A, Qaderi S, Varney J, Aiash H, Mousavi SH. A parasagittal sinus meningioma in young female adult in Afghanistan. Interdisciplinary Neurosurgery 2021. [DOI: 10.1016/j.inat.2021.101121] [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: 10/22/2022] Open
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19
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Soltan MA, Crowley LE, Melville CR, Varney J, Cassidy S, Mahida R, Grudzinska FS, Parekh D, Dosanjh DP, Thickett DR. To What Extent do Social Determinants of Health Modulate Presentation, ITU Admission and Outcomes among Patients with SARS-COV-2 Infection? An Exploration of Household Overcrowding, Air Pollution, Housing Quality, Ethnicity, Comorbidities and Frailty. J Infect Dis Ther 2021; 9:1000002. [PMID: 37034137 PMCID: PMC7614405] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Background Internationally, researchers have called for evidence to support tackling health inequalities during the severe acute respiratory syndrome coronavirus 2 (COVID19) pandemic. Despite the 2020 Marmot review highlighting growing health gaps between wealthy and deprived areas, studies have not explored social determinants of health (ethnicity, frailty, comorbidities, household overcrowding, housing quality, air pollution) as modulators of presentation, intensive care unit (ITU) admissions and outcomes among COVID19 patients. There is an urgent need for studies examining social determinants of health including socioenvironmental risk factors in urban areas to inform the national and international landscape. Methods An in-depth retrospective cohort study of 408 hospitalized COVID19 patients admitted to the Queen Elizabeth Hospital, Birmingham was conducted. Quantitative data analyses including a two-step cluster analysis were applied to explore the role of social determinants of health as modulators of presentation, ITU admission and outcomes. Results Patients admitted from highest Living Environment deprivation indices were at increased risk of presenting with multi-lobar pneumonia and, in turn, ITU admission whilst patients admitted from highest Barriers to Housing and Services (BHS) deprivation Indies were at increased risk of ITU admission. Black, Asian and Minority Ethnic (BAME) patients were more likely, than Caucasians, to be admitted from regions of highest Living Environment and BHS deprivation, present with multi-lobar pneumonia and require ITU admission. Conclusion Household overcrowding deprivation and presentation with multi-lobar pneumonia are potential modulators of ITU admission. Air pollution and housing quality deprivation are potential modulators of presentation with multi-lobar pneumonia. BAME patients are demographically at increased risk of exposure to household overcrowding, air pollution and housing quality deprivation, are more likely to present with multi-lobar pneumonia and require ITU admission. Irrespective of deprivation, consideration of the Charlson Comorbidity Score and the Clinical Frailty Score supports clinicians in stratifying high risk patients.
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Affiliation(s)
- MA Soltan
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - LE Crowley
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - CR Melville
- Department of Medical Sciences, University of Manchester, Manchester, UK
| | - J Varney
- Department of Public Health, Birmingham City Council, Birmingham, UK
| | - S Cassidy
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - R Mahida
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - FS Grudzinska
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - D Parekh
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - DP Dosanjh
- University Hospitals Birmingham Foundation NHS trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - DR Thickett
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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20
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Varney J, Murry K, Humphrey N. Putting Our First Responders First: A Call for Health Insurance in Retirement for Palm Beach Gardens Fire Rescue. Int J Med Students 2020. [DOI: 10.5195/ijms.2020.710] [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: 11/20/2022] Open
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21
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Davey FR, Lawrence D, MacCallum J, Varney J, Hutchison R, Wurster-Hill D, Schiffer C, Sobol RE, Ciminelli N, Le Beau M. Morphologic characteristics of acute lymphoblastic leukemia (ALL) with abnormalities of chromosome 8, band q24. Am J Hematol 1992; 40:183-91. [PMID: 1609772 DOI: 10.1002/ajh.2830400306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The CALGB prospectively studied 140 adult acute lymphoblastic leukemia (ALL) patients for cytogenetic abnormalities. Seven (5%) patients with adequate cytogenetic preparations had t(8;14)(q24;q32) or t(8;22)(q24;q11). Patients were compared with non-8q24 patients for clinical and laboratory characteristics, response to therapy, and survival. The median age of patients with translocations involving 8q24 (71% males) was 40 years. Forty-three percent had lymphadenopathy, 29% splenomegaly, and 29% hepatomegaly. None exhibited central nervous system (CNS), skin, or gum involvement. These features did not differ significantly from non-8q24 ALLs. Patients with 8q24 translocations had higher hemoglobins (11.5 vs. 9.8 g/dl; P = 0.04) and lower percentage of blasts in the peripheral blood (8.5% vs. 69%; P = 0.007). Although all seven were finally categorized as ALL-L3, a marked variation in the proportion of typical L3 blasts was observed that initially resulted in the diagnoses of ALL-L2 in three cases and prolymphocytic leukemia in one. In five of five patients, the blasts typed as B cells (SIg+ and CD19+). Complete remission rates for patients with 8q24 translocations were 43%, whereas they were 68% for non-8q24 ALLS (P = 0.22). Furthermore, patients with 8q24 abnormalities exhibited significantly shorter survival (4.8 vs. 18.4 mo; P less than 0.001). We conclude that ALL with translocations of 8q24 in adults shows a mature B-cell immunophenotype (SIg+), poor prognosis and morphology ranging from classical ALL-L3 to ALL with a subpopulation of L3 cells. Thus, the diagnosis of ALL-L3 should be made when blastic cells possess a mature B-cell immunophenotype (SIg+) and an 8q24 translocation, even though the number of L3 cells is low.
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Affiliation(s)
- F R Davey
- Department of Pathology, SUNY Health Science Center, Syracuse 13210
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Noy M, Varney J, Aycliffe GA. Disinfection of plastic aprons. Nurs Times 1976; 72:39-40. [PMID: 958985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Ayliffe GA, Bridges K, Lilly HA, Lowbury EJ, Varney J, Wilkins MD. Comparison of two methods for assessing the removal of total organisms and pathogens from the skin. J Hyg (Lond) 1975; 75:259-74. [PMID: 1100713 PMCID: PMC2130301 DOI: 10.1017/s002217240004729x] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A standard hand-wash sampling technique was compared with a simple finger-streak sampling method in assessing the relative effectiveness of a number of alternative preparations used for disinfecting the surgeon's hands (alcoholic 0.5% chlorhexidine, alcoholic 0.1% tetrabrom-o-methyl phenol, a 4% chlorhexidine detergent solution, aqueous 0.5% chlorhexidine, 2% 'Irgasan' detergent solution and, as control, bar soap). There was a fairly good correlation between the results of assessment by the two methods after a single disinfection and after six disinfections, three on one day and three on the next. Significant differences were shown in 21 comparisons between treatments when the hand-wash sampling test was used, and 16 of these comparisons also showed a significant difference by the finger-streak test. Staphylococcus aureus was found in hand samplings from 5 out of 8 nurses in the Burns Unit of Birmingham Accident Hospital by the hand-wash sampling method and from 2 of the same 8 nurses by the finger-streak method; the numbers were small, and no Staph. aureus were isolated from the same hands after 1 min. wash in 70% ethyl alcohol. Similar sampling on 29 nurses in other wards showed Staph. aureus on 3 nurses (one in large numbers) by the hand-wash technique and on 1 nurse by the finger-streak test; in only 1 nurse whose hands showed Staph. aureus before disinfection was the organism found, by hand-wash sampling, after disinfection. Parallel sampling of nurses' hands after washing with soap and water and after disinfection with 95% ethanol showed larger numbers of Staph. aureus in a hospital for skin diseases than in a general hospital, and a lower incidence and somewhat lower density of Staph. aureus after ethanol treatment than after washing with soap and water; Gram-negative bacilli, on the other hand, were commoner on hands in the general than in the skin hospital, and present in much smaller numbers after disinfection with ethanol than after washing with soap and water. Antibiotic sensitivity tests showed the frequent recurrence on the hands of some nurses of multi-resistant Staph. aureus with resistance patterns similar to those found in infective lesions in some of the patients; different sensitivity patterns were usually found in staphylococci isolated from the nose. Even in wards where many patients were infected, carriage by nurses' hands of a particular strain of Staph. aureus did not seem to last for more than a few days.
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Ayliffe GA, Babb JR, Collins BJ, Davies J, Deverill C, Varney J. Disinfection of baths and bathwater. Nurs Times 1975; 71:22-3. [PMID: 808798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Martin A, Millard PH, Varney J. Practical problems in the organization of a drug trial in two hospital groups. Gerontol Clin (Basel) 1974; 16:100-4. [PMID: 4212257 DOI: 10.1159/000245491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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