1
|
Al Shukri M, Said M, Nair A, Mathew M, Gowri V. Is there a difference in the clinical profile and outcome of women using levonorgestrel IUD for abnormal uterine bleeding and those using it for contraception?: A comparative cross-sectional study. Turk J Obstet Gynecol 2024; 21:7-14. [PMID: 38440962 PMCID: PMC10920973 DOI: 10.4274/tjod.galenos.2024.51460] [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: 11/18/2023] [Accepted: 01/07/2024] [Indexed: 03/06/2024] Open
Abstract
Objective The most common indications for Levonorgestrel intrauterine device (LNG-IUD) are contraception and management of abnormal uterine bleeding (AUB). This study was conducted with the aim of exploring the differences in the clinical profile and outcome of women using LNG-IUD for contraception and AUB. Materials and Methods This was a retrospective comparative cross-sectional study of women who underwent LNG-IUD (52 mg) between 2012 and 2017. Their electronic health records were reviewed until the last documented follow-up or until December 2021. Results A total of 235 women had LNG-IUD with an age range of 21 to 62 years and a mean of (37.98 years±6.76). Of these women, 153/235 (65.1%) had it for contraception and 82/235 (34.89%) had it for AUB. The follow-up was 1-94 months with (mean ± SEM) follow-up for the AUB group of (21.48±2.31) months and for contraception group was (20.74±1.76) months (p-value of 0.80). There was a significant difference between the two groups in the age and body mass index (BMI), where women who had LNG-IUD for AUB were older (mean of 42.54±6.49 years, p-value <0.001) and had higher BMI (31.88±7.52 kg/m2, p-value =0.011). All LNG-IUDs that were indicated for contraception were inserted in an outpatient setting. However, 68.3% in the AUB, the insertion was in the operating theater in conjunction with hysteroscopy. After combining both expulsion and removal of LNG-IUD during the follow-up period, there was no significant difference between the 2 groups in the overall retention rate during the follow-up (p-value =0.998). Conclusion this study shows that women using LNG-IUD for the management of AUB are older and have a higher BMI compared with those using it for contraception. AUB women experienced more expulsion compared with the contraception group, but there was no difference between the 2 groups in the overall survival/retention of LNG-IUD.
Collapse
Affiliation(s)
- Maryam Al Shukri
- Department of Obstetrics and Gynecology; Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Maryam Said
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Asha Nair
- Department of Obstetrics and Gynecology; Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Mariam Mathew
- Department of Obstetrics and Gynecology; Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Vaidyanatahn Gowri
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
2
|
Said M, Gümüs M, Rodemerk J, Chihi M, Rauschenbach L, Dinger TF, Darkwah Oppong M, Dammann P, Wrede KH, Sure U, Jabbarli R. The value of ventricular measurements in the prediction of shunt dependency after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 2023; 165:1545-1555. [PMID: 37127799 DOI: 10.1007/s00701-023-05595-6] [Citation(s) in RCA: 1] [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: 02/02/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Chronic hydrocephalus requiring shunt placement is a common complication of aneurysmal subarachnoid hemorrhage (SAH). Different risk factors and prediction scores for post-SAH shunt dependency have been evaluated so far. We analyzed the value of ventricle measurements for prediction of the need for shunt placement in SAH patients. METHODS Eligible SAH cases treated between 01/2003 and 06/2016 were included. Initial computed tomography scans were reviewed to measure ventricle indices (bifrontal, bicaudate, Evans', ventricular, Huckman's, and third ventricle ratio). Previously introduced CHESS and SDASH scores for shunt dependency were calculated. Receiver operating characteristic analyses were performed for diagnostic accuracy of the ventricle indices and to identify the clinically relevant cut-offs. RESULTS Shunt placement followed in 221 (36.5%) of 606 patients. In univariate analyses, all ventricular indices were associated with shunting (all: p<0.0001). The area under the curve (AUC) ranged between 0.622 and 0.662. In multivariate analyses, only Huckman's index was associated with shunt dependency (cut-off at ≥6.0cm, p<0.0001) independent of the CHESS score as baseline prediction model. A combined score (0-10 points) containing the CHESS score components (0-8 points) and Huckman's index (+2 points) showed better diagnostic accuracy (AUC=0.751) than the CHESS (AUC=0.713) and SDASH (AUC=0.693) scores and the highest overall model quality (0.71 vs. 0.65 and 0.67), respectively. CONCLUSIONS Ventricle measurements are feasible for early prediction of shunt placement after SAH. The combined prediction model containing the CHESS score and Huckman's index showed remarkable diagnostic accuracy regarding identification of SAH individuals requiring shunt placement. External validation of the presented combined CHESS-Huckman score is mandatory.
Collapse
Affiliation(s)
- Maryam Said
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany.
- Department of Neurosurgery and Spine Surgery, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany.
| | - Meltem Gümüs
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Jan Rodemerk
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Laurèl Rauschenbach
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Thiemo F Dinger
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Karsten H Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| |
Collapse
|
3
|
Said M, Gümüs M, Rodemerk J, Chihi M, Rauschenbach L, Dinger TF, Darkwah Oppong M, Ahmadipour Y, Dammann P, Wrede KH, Sure U, Jabbarli R. Morphometric Study of the Initial Ventricular Indices to Predict the Complications and Outcome of Aneurysmal Subarachnoid Hemorrhage. J Clin Med 2023; 12:jcm12072585. [PMID: 37048667 PMCID: PMC10095006 DOI: 10.3390/jcm12072585] [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] [Received: 11/30/2022] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Objective: Acute hydrocephalus is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Several ventricular indices have been introduced to enable measurements of ventricular morphology. Previously, researchers have showed their diagnostic value for various neurological disorders. In this study, we evaluated the association between ventricular indices and the clinical course, occurrence of complications and outcome of SAH. Methods: A total of 745 SAH patients with available early admission computed tomography scans were included in the analyses. Six ventricular indices (bifrontal, bicaudate, ventricular and third ventricle ratios and Evans’ and Huckman’s indices) were measured. Primary endpoints included the occurrence of cerebral infarctions, in-hospital mortality and a poor outcome at 6 months. Secondary endpoints included different adverse events in the course of SAH. Clinically relevant cut-offs for the indices were determined using receiver operating curves. Univariate analyses were performed. Multivariate analyses were conducted on significant findings in a stepwise backward regression model. Results: The higher the values of the ventricular indices were and the older the patient was, the higher the WFNS and Fisher’s scores were, and the lower the SEBES score was at admission. Patients with larger ventricles showed a shorter duration of intracranial pressure increase > 20 mmHg and required decompressive craniectomy less frequently. Ventricular indices were independently associated with the parameters of inflammatory response after SAH (C-reactive protein in serum and interleukin-6 in cerebrospinal fluid and fever). Finally, there were independent correlations between larger ventricles and all the primary endpoints. Conclusions: The lower risk of intracranial pressure increase and absence of an association with vasospasm or systemic infections during SAH, and the poorer outcome in individuals with larger ventricles might be related to a more pronounced neuroinflammatory response after aneurysmal bleeding. These observations might be helpful in the development of specific medical and surgical treatment strategies for SAH patients depending on the initial ventricle measurements.
Collapse
|
4
|
Gümüs M, Said M, Chihi M, Dinger TF, Rodemerk J, Frank B, Darkwah Oppong M, Dammann P, Wrede KH, Forsting M, Sure U, Jabbarli R. Circadian rhythm and aneurysmal subarachnoid hemorrhage: Is there an alarm clock for the rupture timing? Eur J Neurol 2023. [PMID: 36975760 DOI: 10.1111/ene.15804] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE AND BACKGROUND Data on the temporal distribution of the bleeding time of intracranial aneurysms is limited to few small studies. With this study, we aimed to analyze time patterns of the occurrence of aneurysmal subarachnoid hemorrhage (SAH), particularly focusing on the impact of patients' socio-demographic and clinical characteristics on the ictus timing. METHODS This study is based on the institutional SAH cohort with 782 consecutive cases treated between January 2003 and June 2016. Data was collected on the ictus time, patients' socio-demographic and clinical characteristics, as well as the initial severity and outcome. Univariate and multivariate analyses were performed on the bleeding timeline. RESULTS There were two peaks in the circadian rhythm of SAH, one in the morning (7 to 9 a.m.) and the other in the evening (7 to 9 p.m.). The strongest alterations in the bleeding time patterns were observed for weekdays, patients' age, sex, and ethnicity. Individuals with chronic alcohol and painkiller consumption showed a higher bleeding peak between 1 and 3 p.m. Finally, the bleeding time showed no impact on the severity, clinically relevant complications and the outcome of SAH patients. CONCLUSIONS This study is one of the very few detailed analyses of the impact of specific socio-demographic, ethnic, behavioral and clinical characteristics on the rupture timing of aneurysms. Our results point to the possible relevance of the circadian rhythm for the rupture event, and therefore might be useful in the elaboration of preventive measures against aneurysm rupture.
Collapse
Affiliation(s)
- Meltem Gümüs
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Maryam Said
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Thiemo F Dinger
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Rodemerk
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Benedikt Frank
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Karsten H Wrede
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Forsting
- Institute for Diagnostic and Interventional Radiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
5
|
Said M, Odensass S, Gümüs M, Rodemerk J, Chihi M, Rauschenbach L, Dinger TF, Darkwah Oppong M, Dammann P, Wrede KH, Sure U, Jabbarli R. Comparing radiographic scores for prediction of complications and outcome of aneurysmal subarachnoid hemorrhage: Which performs best? Eur J Neurol 2023; 30:659-670. [PMID: 36371646 DOI: 10.1111/ene.15634] [Citation(s) in RCA: 1] [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: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE Aneurysmal subarachnoid hemorrhage (aSAH) is characterized by high morbidity and mortality proceeding from the initial severity and following complications of aSAH. Various scores have been developed to predict these risks. We aimed to analyze the clinical value of different radiographic scores for prognostication of aSAH outcome. METHODS Initial computed tomography scans (≤48 h after ictus) of 745 aSAH cases treated between January 2003 and June 2016 were reviewed with regard to Subarachnoid Hemorrhage Early Brain Edema Score (SEBES), and Claassen, Barrow Neurological Institute (BNI), Hijdra, original Graeb and Fisher scale scores. The primary endpoints were development of delayed cerebral ischemia (DCI), in-hospital mortality and unfavorable outcome (modified Rankin Scale score >3) at 6 months after subarachnoid hemorrhage. Secondary endpoints included the different complications that can occur during aSAH. Clinically relevant cutoffs were defined using receiver-operating characteristic curves. The radiographic scores with the highest values for area under the curve (AUC) were included in the final multivariate analysis. RESULTS The Hijdra sum score had the most accurate predictive value and independent associations with all primary endpoints: DCI (AUC 0.678, adjusted odds ratio [aOR] 2.83; p < 0.0001); in-hospital mortality (AUC 0.704, aOR 2.83; p < 0.0001) and unfavorable outcome (AUC 0.726, aOR 2.91; p < 0.0001). Multivariate analyses confirmed the independent predictive value of the radiographic scales for risk of decompressive craniectomy (SEBES and Fisher score), cerebral vasospasm (SEBES, BNI score and Fisher score) and shunt dependency (Hijdra ventricle score and Fisher score) after aSAH. CONCLUSIONS Initial radiographic severity of aSAH was independently associated with occurrence of different complications during aSAH and the final outcome. The Hijdra sum score showed the highest diagnostic accuracy and robust predictive value for early detection of risk of DCI, in-hospital mortality and unfavorable outcome after aSAH.
Collapse
Affiliation(s)
- Maryam Said
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Svenja Odensass
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Meltem Gümüs
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Jan Rodemerk
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Laurèl Rauschenbach
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Thiemo Florin Dinger
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Karsten Henning Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
- Center for Translational Neuro- & Behavioral Sciences (C-TNBS), University Duisburg Essen, Essen, Germany
| |
Collapse
|
6
|
Dinger TF, Peschke J, Chihi M, Gümüs M, Said M, Santos AN, Rodemerk J, Michel A, Darkwah Oppong M, Li Y, Deuschl C, Wrede KH, Dammann PR, Frank B, Kleinschnitz C, Forsting M, Sure U, Jabbarli R. Small intracranial aneurysms of the anterior circulation: A negligible risk? Eur J Neurol 2023; 30:389-398. [PMID: 36333955 DOI: 10.1111/ene.15625] [Citation(s) in RCA: 1] [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: 09/05/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE According to the International Study of Unruptured Intracranial Aneurysms, small (<7 mm) unruptured intracranial aneurysms (IAs) of the anterior circulation (aC) carry a neglectable 5-year rupture risk. In contrast, some studies report frequencies of >20% of all ruptured IAs being small IAs of the aC. This contradiction was addressed in this study by analyzing the rates and risk factors for rupture of small IAs within the aC. METHODS Of the institutional observational cohort, 1676 small IAs of the aC were included. Different demographic, clinical, laboratory, and radiographic characteristics were collected. A rupture risk score was established using all independent prognostic factors. The score performance was checked using receiver operating characteristic curve analysis. RESULTS Of all registered small IAs of the aC, 20.1% were ruptured. The developed small IAs of the aC (SIAAC) score (range = -4 to +13 points) contained five major risk factors: IA location and size, arterial hypertension, alcohol abuse, and chronic renal failure. In addition, three putative protective factors were also included in the score: hypothyroidism, dyslipidemia, and peripheral arterial disease. Increasing rates of ruptured IA with increasing SIAAC scores were observed, from 0% (≤-1 points) through >50% (≥8 points) and up to 100% in patients scoring ≥12 points. The SIAAC score achieved excellent discrimination (area under the curveSIAAC = 0.803) and performed better than the PHASES (Population,Hypertension, Age, Size of the aneurysm, Earlier SAH from another aneurysm, Site of aneurysm) score. CONCLUSIONS Small IAs of the aC carry a considerable rupture risk. After external validation, the proposed rupture risk score might provide a basis for better decision-making regarding the treatment of small unruptured IAs of the aC.
Collapse
Affiliation(s)
- Thiemo Florin Dinger
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jonas Peschke
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Meltem Gümüs
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Maryam Said
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Alejandro Nicolas Santos
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jan Rodemerk
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Michel
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Yan Li
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Cornelius Deuschl
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karsten Henning Wrede
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Philipp René Dammann
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Benedikt Frank
- Department of Neurology and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Forsting
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, and Center for Translational Neuroscience and Behavioral Science, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
7
|
Said M, Dinger TF, Gümüs M, Rauschenbach L, Chihi M, Rodemerk J, Lenz V, Oppong MD, Uerschels AK, Dammann P, Wrede KH, Sure U, Jabbarli R. Impact of Anemia Severity on the Outcome of an Aneurysmal Subarachnoid Hemorrhage. J Clin Med 2022; 11:jcm11216258. [PMID: 36362486 PMCID: PMC9657573 DOI: 10.3390/jcm11216258] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: Previous reports indicate a negative impact of anemia on the outcome of an aneurysmal subarachnoid hemorrhage (SAH). We aimed to identify the outcome-relevant severity of post-SAH anemia. Methods: SAH cases treated at our institution between 01/2005 and 06/2016 were included (n = 640). The onset, duration, and severity (nadir hemoglobin (nHB) level) of anemia during the initial hospital stay were recorded. Study endpoints were new cerebral infarctions, a poor outcome six months post-SAH (modified Rankin scale > 3), and in-hospital mortality. To assess independent associations with the study endpoints, different multivariable regression models were performed, adjusted for relevant patient and baseline SAH characteristics as well as anemia-associated clinical events during the SAH. Results: The rates of anemia were 83.3%, 67.7%, 40.0%, 15.9%, and 4.5% for an nHB < 11 g/dL, < 10 g/dL, < 9 g/dL, < 8 g/dL, and < 7 g/dL, respectively. The higher the anemia severity, the later was the onset (post-SAH days 2, 4, 5.4, 7.6 and 8, p < 0.0001) and the shorter the duration (8 days, 6 days, 4 days, 3 days, and 2 days, p < 0.0001) of anemia. In the final multivariable analysis, only an nHB < 9 g/dL was independently associated with all study endpoints: adjusted odds ratio 1.7/3.22/2.44 for cerebral infarctions/in-hospital mortality/poor outcome. The timing (post-SAH day 3.9 vs. 6, p = 0.001) and duration (3 vs. 5 days, p = 0.041) of anemia with an nHB < 9 g/dL showed inverse associations with the risk of in-hospital mortality, but not with other study endpoints. Conclusions: Anemia is very common in SAH patients affecting four of five individuals during their hospital stay. An nHB decline to < 9 g/dL was strongly associated with all study endpoints, independent of baseline characteristics and SAH-related clinical events. Our data encourage further prospective evaluations of the value of different transfusion strategies in the functional outcomes of SAH patients.
Collapse
Affiliation(s)
- Maryam Said
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
- Correspondence: ; Tel.: +49-201-723-1201; Fax: +49-201-723-5909
| | - Thiemo Florin Dinger
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Meltem Gümüs
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Laurèl Rauschenbach
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Jan Rodemerk
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Veronika Lenz
- Institute of Transfusion Medicine, University Hospital of Essen, 45147 Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Anne-Kathrin Uerschels
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Karsten Henning Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Duisburg Essen, 47147 Duisburg, Germany
| |
Collapse
|
8
|
Jabbarli R, Darkwah Oppong M, Chihi M, Dinger TF, Said M, Rodemerk J, Dammann P, Schmidt B, Deuschl C, Guberina N, Wrede KH, Sure U. Regular medication as a risk factor for intracranial aneurysms: A comparative case–control study. Eur Stroke J 2022; 8:251-258. [PMID: 37021158 PMCID: PMC10069188 DOI: 10.1177/23969873221129080] [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] [Received: 07/28/2022] [Accepted: 09/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Previous medical history strongly contributes to the genesis of intracranial aneurysms (IA). A possible impact of regular medication on the occurrence of abdominal aortic aneurysms has been reported. Aim: To evaluate the value of regular medication on the risk of development and rupture of IA. Methods: Data on medication use and related comorbidities were obtained from the institutional IA registry. A 1:1 age- and sex-matched patient sample was collected from the population-based Heinz Nixdorf Recall Study with individuals from the same area. Results: In the analysis comparing IA cohort ( n = 1960) with the matched normal population ( n = 1960), the use of statins (adjusted odds ratio, 1.34 [95% confidence interval 1.02–1.78]), antidiabetics (1.46 [1.08–1.99]), and calcium channel blockers (1.49 [1.11–2.00]) was independently associated with higher risk of IA, whereas uricostatics (0.23 [0.14–0.38]), aspirin (0.23 [0.13–0.43]), beta-blockers (0.51 [0.40–0.66]), and angiotensin-converting enzyme inhibitors (0.38 [0.27–0.53]) were related to lower risk of IA. In the multivariable analysis within the IA cohort ( n = 2446), SAH patients showed higher drug exposure with thiazide diuretics (2.11 [1.59–2.80]), but lower prevalence of remaining antihypertensive medication—beta-blockers (0.38 [0.30–0.48]), calcium channel blockers (0.63 [0.48–0.83]), angiotensin-converting enzyme inhibitors (0.56 [0.44–0.72]), and angiotensin-1 receptor blockers (0.33 [0.24–0.45]). Patients with ruptured IA were less likely to be treated with statins (0.62 [0.47–0.81]), thyroid hormones (0.62 [0.48–0.79]), and aspirin (0.55 [0.41–0.75]). Conclusions: Regular medication might impact the risks related to the development and rupture of IA. Further clinical trials are required to clarify the effect of regular medication on IA genesis.
Collapse
Affiliation(s)
- Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Thiemo Florin Dinger
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Maryam Said
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Jan Rodemerk
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Cornelius Deuschl
- Institute for Diagnostic and Interventional Radiology, Department of Neuroradiology, University Hospital Essen, Essen, Germany
| | - Nika Guberina
- Department of Radiotherapy, University Hospital Essen, Essen, Germany
| | - Karsten H. Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
| |
Collapse
|
9
|
Dinger TF, Darkwah Oppong M, Park C, Said M, Chihi M, Rauschenbach L, Gembruch O, Deuschl C, Wrede KH, Lenz V, Kleinschnitz C, Forsting M, Sure U, Jabbarli R. Development of multiple intracranial aneurysms: beyond the common risk factors. J Neurosurg 2022; 137:1056-1063. [PMID: 35120308 DOI: 10.3171/2021.11.jns212325] [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: 10/03/2021] [Accepted: 11/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of multiple intracranial aneurysms (MIAs) has increased over the last decades. Because MIAs have been identified as an independent risk factor for formation, growth, and rupture of intracranial aneurysms (IAs), a more profound understanding of the underlying pathophysiology of MIAs is needed. Therefore, the authors' extensive institutional aneurysm database was analyzed to elucidate differences between patients with a single IA (SIA) and those with MIAs. METHODS A total of 2446 patients seen with or for IAs at the University Hospital of Essen, Essen, Germany, from January 2003 to June 2016 were included in this retrospective cohort study and were separated into MIA and SIA subgroups. Patient data were screened for sociodemographic and radiographic parameters, preexisting medical conditions, and results of blood examinations. These parameters were analyzed for their correlations with MIAs and absolute number of IAs. RESULTS MIAs were identified in 853 (34.9%) patients. In multivariable analysis, MIAs were independently associated with female sex (p = 0.001), arterial hypertension (p = 0.023), tobacco abuse (p = 0.009), AB blood group (p = 0.010), and increased admission values for C-reactive protein (p = 0.006), mean corpuscular volume (p = 0.009), and total serum protein (p = 0.034), but not with diagnostic modality (3D vs 2D digital subtraction angiography, p = 0.912). Absolute number of IAs was independently associated with female sex (p < 0.001), arterial hypertension (p = 0.014), familial predisposition to IA (p = 0.015), tobacco consumption (p = 0.025), increased mean corpuscular volume (p = 0.002), and high platelet count (p = 0.007). CONCLUSIONS In this sizable consecutive series of patients with IAs, the authors confirmed the impact of common IA risk factors on the genesis of MIAs. In addition, specific hemorheological and hemocytological features may also contribute to the development of MIAs.
Collapse
Affiliation(s)
- Thiemo F Dinger
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Chikadibia Park
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Maryam Said
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Mehdi Chihi
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Laurèl Rauschenbach
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Oliver Gembruch
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Cornelius Deuschl
- 2Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Karsten H Wrede
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Veronika Lenz
- 3Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; and
| | - Christoph Kleinschnitz
- 4Department of Neurology and Center for Translational Neuroscience and Behavioral Science (C-TNBS), University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Michael Forsting
- 2Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Sure
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- 1Department of Neurosurgery and Spine Surgery, University Hospital, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
10
|
Said M, Wahrenberg A, Warnqvist A, Jernberg T, Witt N, Svensson P. Association between family history and severity of coronary artery disease in a nationwide sample of patients with a first time myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1276] [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
Having an early family history of coronary artery disease (CAD) is strongly associated with incident cardio-vascular disease. In younger patients with acute coronary syndrome, an association between family history and the severity of CAD, determined by the number of affected coronary arteries diagnosed through coronary angiography, has been reported. However, it is unknown if these findings apply to unselected patients with a first-time myocardial infarction (MI) and whether an early family history of other atherosclerotic cardiovascular diseases (ASCVD) affect CAD severity. Therefore, our objective was to investigate the association between a family history of ASCVD and the extent of CAD determined by coronary angiography findings in a large nationwide sample of patients with a first-time MI.
Material and methods
This study included a consecutive sample of 22,686 one-year survivors of first-ever MI aged, 18 to 76 years, identified in the national register SWEDEHEART. Attending the standardized 1-year revisit after MI, from 2006 through 2013. First-degree relatives, defined as parents and full siblings, were identified in the Swedish Multi-Generation Register and data on historical hospitalisations and deaths were extracted. The exposure was defined as having a first-degree relative with records of early ASCVD, defined as a register-verified hospitalisation due to myocardial infarction, any angina with coronary revascularization, stroke or cardiovascular death before the age of 55 in male or 65 years in female relatives. The primary outcome was severity of CAD categorized to four groups: zero-, single-, two- or three-vessel disease as registered in SWEDE-HEART. Left main stem disease was included in the three-vessel category. The distribution of the CAD severity categories was compared between those with and without an early family history of ASCVD using multinomial logistic regression, adjusted for age and sex and using single-vessel disease as the reference group.
Results
We included 22 686 participants (median age 63 [IQR 57–68] years; 27% women), of which 1450 had a family history of early ASCVD. A total of 2134 patients did not have any significant obstructive findings at the first coronary angiography, 10 951 patients had single-vessel disease, 5516 patients had two-vessel disease and 3970 patients had three-vessel or main stem disease. Both two-vessel disease (RRR 1.31, 95% CI 1.14–1.50) and three vessel and/or left main stem disease (RRR 1.29, 95% CI 1.1–1.51) were more common in patients with early family history of ASCVD when adjusting for age and sex, whereas no significant angiographic disease was less common (RRR 0.76, 95% 0.61–0.95).
Conclusion
Patients with a first-time MI and a family history of early ASCVD have an approximately 30% higher risk of advanced coronary artery disease, with more than two affected coronary vessels or left main stem disease.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Swedish Heart and Lung Association (Riksförbundet HjärtLung) Graph 1
Collapse
Affiliation(s)
- M Said
- South General Hospital, Stockholm, Sweden
| | | | | | - T Jernberg
- Karolinska Institutet, Stockholm, Sweden
| | - N Witt
- South General Hospital, Stockholm, Sweden
| | - P Svensson
- Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
11
|
Mitton B, Paruk F, Gous A, Chausse J, Milne M, Becker P, Said M. Investigating the need for therapeutic drug monitoring of imipenem in critically ill patients: Are we getting it right? S Afr Med J 2021; 111:903-909. [PMID: 34949257] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The drug levels and clearances of imipenem in critically ill patients are not comprehensively described in current literature, yet it is vital that adequate levels be achieved for therapeutic success. OBJECTIVES To determine the proportion of critically ill patients treated with imipenem/cilastatin with sub-therapeutic imipenem plasma levels, and to compare the clinical outcomes of those patients with therapeutic levels with those who had sub-therapeutic levels. METHODS Trough imipenem plasma levels of 68 critically ill patients from a surgical intensive care unit were measured using a validated high-performance liquid chromatography method. Imipenem trough levels were compared with the minimum inhibitory concentration (MIC) of the causative bacterial agents, based on a target value of 100% time above MIC (¦T >MIC). RESULTS The proportion of participants with sub-therapeutic imipenem levels was 22% (95% confidence interval (CI) 13% - 34%). The 14- and 28-day mortality rates in the sub-therapeutic group were 33% and 40%, respectively, compared with 19% (p=0.293) and 26% (p=0.346), respectively, in the therapeutic group. Sub-therapeutic imipenem plasma levels are associated with adjusted hazard ratio of 1.47 (95% CI 0.55 - 3.91). CONCLUSIONS The lower proportion of critically ill patients with sub-therapeutic imipenem plasma levels in this study compared with previous studies may be attributed to the practice of higher dosages and the administration method of extended infusions of imipenem/cilastatin in our setting. The results demonstrate a trend of higher mortality in patients with sub-therapeutic imipenem levels, although the results were not statistically significant at this sample size.
Collapse
Affiliation(s)
- B Mitton
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, South Africa; Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa.
| | | | | | | | | | | | | |
Collapse
|
12
|
Said M, Gümüs M, Herten A, Dinger TF, Chihi M, Darkwah Oppong M, Deuschl C, Wrede KH, Kleinschnitz C, Sure U, Jabbarli R. Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) as a radiographic marker of clinically relevant intracranial hypertension and unfavorable outcome after subarachnoid hemorrhage. Eur J Neurol 2021; 28:4051-4059. [PMID: 34293828 DOI: 10.1111/ene.15033] [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: 06/12/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE The severity of early brain edema (EBE) after aneurysm rupture was reported to be strongly associated with the risk of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Using the recently developed Subarachnoid Hemorrhage Early Brain Edema Score (SEBES), we analyzed the predictors of EBE and its impact on complications related to intracranial pressure (ICP) increase after SAH and on poor outcome. METHODS All consecutive SAH cases treated between January 2003 and June 2016 with assessable SEBES were included (n = 745). Data on demographic characteristics, medical history, initial severity of SAH, need for conservative ICP treatment and decompressive craniectomy, occurrence of cerebral infarctions and unfavorable outcome at 6 months (modified Rankin scale score > 2) were collected. Univariable and multivariable analyses were performed. RESULTS Younger age (<55 years; adjusted odds ratio [aOR] 3.16, 95% confidence interval [CI] 2.28-4.38), female sex (aOR 1.64, 95% CI 1.16-2.31), poor initial clinical condition (World Federation of Neurosurgical Societies score 4-5; aOR 1.74, 95% CI 1.23-2.46), presence of intracerebral hemorrhage (aOR 1.63, 95% CI 1.12-2.36), hypothyroidism (aOR 0.60, 95% CI 0.37-0.98) and renal comorbidity (aOR 0.29, 95% CI 0.11-0.78) were independently associated with SEBES (scores 3-4). There was an independent association between SEBES 3-4 and the need for conservative ICP treatment (aOR 2.43, 95% CI 1.73-3.42), decompressive craniectomy (aOR 2.68, 95% CI 1.84-3.89), development of cerebral infarcts (aOR 2.24, 95% CI 1.53-3.29) and unfavorable outcome (aOR 1.48, 95% CI 1.0-2.17). CONCLUSIONS SEBES is a reliable predictor of ICP-related complications and poor outcome of SAH. Our findings highlight the need for further research of the impact of patients' demographic characteristics and comorbidities on the severity of EBE after SAH.
Collapse
Affiliation(s)
- Maryam Said
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Meltem Gümüs
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Annika Herten
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Thiemo Florin Dinger
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Mehdi Chihi
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Cornelius Deuschl
- Department of Diagnostic and Interventional Radiology, University Hospital of Essen, Essen, Germany
| | - Karsten H Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology and Center for Translational and Behavioral Neurosciences (C-TNBS), University Hospital of Essen, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital of Essen, Essen, Germany
| |
Collapse
|
13
|
Sethi N, Klugman D, Said M, Hom L, Bowers S, Berger JT, Wernovsky G, Donofrio MT. Standardized delivery room management for neonates with a prenatal diagnosis of congenital heart disease: A model for improving interdisciplinary delivery room care. J Neonatal Perinatal Med 2021; 14:317-329. [PMID: 33361613 DOI: 10.3233/npm-200626] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Precise characterization of cardiac anatomy and physiology through fetal echocardiography can predict early postnatal clinical course. Some neonates with prenatally defined critical congenital heart disease have anticipated precipitous compromise during perinatal transition for which specialized, diagnosis-specific delivery room care can be arranged to expeditiously stabilize cardiopulmonary hemodynamics. In this article, we describe our institutional approach to the delivery room care of neonates with prenatally diagnosed congenital heart disease, emphasizing our diagnosis-specific care pathways for newborns with critical disease.
Collapse
Affiliation(s)
- N Sethi
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - D Klugman
- Division of Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - M Said
- Division of Neonatology, Children's National Hospital, Washington, DC, USA
| | - L Hom
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - S Bowers
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - J T Berger
- Division of Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - G Wernovsky
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
- Division of Cardiac Critical Care, Children's National Hospital, Washington, DC, USA
| | - M T Donofrio
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| |
Collapse
|
14
|
Cherni A, Zeiri N, Yahyaoui N, Said M. Consequences of dielectric mismatch on linear and third order nonlinear optical properties for CdS/ZnSe core/shell QD-matrix. Chem Phys 2020. [DOI: 10.1016/j.chemphys.2020.110947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
15
|
Amal B, Farhat W, Mabrouk MB, Said M, Mizouni A, Ali AB, Sboui H, Belaid I, Imene C, Faten E, Ammar N, Makram H, Leila B, Slim B. P-306 Survival and recurrence of patients operated on for stomach cancer and its determinants. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.388] [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: 10/23/2022] Open
|
16
|
Zeiri N, Naifar A, Abdi-Ben Nasrallah S, Said M. Impact of dielectric environment on the linear and nonlinear optical properties for CdS/ZnS cylindrical core/shell quantum dots. Chem Phys Lett 2020. [DOI: 10.1016/j.cplett.2020.137215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
17
|
Abstract
IntroductionAgranulocytosis is a potentially life-threatening haematological side effect induced by typical and atypical neuroleptic. When agranulocytosis is associated with a specific anti-psychotic, the medication should be discontinued. This severe side effect is troublesome.Case reportWe report the case of a 60-year-old man, treated with amisulpride for schizophrenia, who developed an agranulocytosis. This patient had been treated with first and second generation anti-psychotic drugs during his life and had already been exposed to many neuroleptics without any signs of toxicity. However, after three days of the introduction of amisulpride he presented a rapid onset agranulocytosis (leukocytes 1.2 G/L and neutrophils 0.4 G/L). After discontinuation of amisulpride, blood count returned to normal. The favorable evolution after discontinuation of treatment: the normality of biological and cytological examinations is in favor of a causal relationship between this severe neutropenia al introduction of amisulpride.ConclusionThis case report highlights the risk of amisulpride in inducing agranulocytosis, a risk underestimated in regard of the clozapine risk to induce agranulocytosis or neutropenia. For this reason, it seems reasonable to recommend performing a blood count before introduction and during the treatment by anti-psychotics.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
18
|
Said M, adam A, Ibrahim S, Gawish R, Lewis N. SUN-237 HCV INFECTION IS PROTECTIVE AGAINST OXIDATIVE STRESS IN ESRD PATIENTS ON MAINTENANCE HEMODIALYSIS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.772] [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: 10/24/2022] Open
|
19
|
Barhoumi M, Lazaar K, Bouzidi S, Said M. A DFT study of Janus structure of S and Se in HfSSe layered as a promising candidate for electronic devices. J Mol Graph Model 2019; 96:107511. [PMID: 31881469 DOI: 10.1016/j.jmgm.2019.107511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/03/2019] [Revised: 11/26/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
The transition-metal dichalcogenides are presently being intensively researched because of their unique optoelectronic properties. Further, the success of TMDs in all areas of science without exception has opened the street to find other two-dimensional materials. Based on density functional theory, we study the vibrational and electronic properties of the mixed-phase of S and Se in HfSSe system, i.e, HfSSe monolayer and HfSSe/HfSSe bilayer. In this framework, our systems are full dynamically stable, which shown by their phonon dispersion. Also, we found that the HfSSe (heterolayer) monolayer is an indirect semiconductor (0.63 eV with BLYP), while the HfSSe (alternating) monolayer is a direct semiconductor (0.753 eV with BLYP). Our AA, AB, AA', and AB' of HfSSe/HfSSe (heterolayer) bilayer are indirect band gaps in a range 0.361-0.830 eV, which are promising candidates for electronic devices as field-effect transistors, photodetectors, and other optoelectronics. Nevertheless, HfSSe/HfSSe (alternating) bilayer is a direct bandgap semiconductor with a value of 0.671 eV, when vdW is used.
Collapse
Affiliation(s)
- M Barhoumi
- Laboratoire de la Matière Condensée et des Nanosciences (LMCN), Université de Monastir, Département de Physique, Faculté des Sciences de Monastir, Avenue de l'Environnement, 5019, Monastir, Tunisia.
| | - K Lazaar
- Laboratoire de la Matière Condensée et des Nanosciences (LMCN), Université de Monastir, Département de Physique, Faculté des Sciences de Monastir, Avenue de l'Environnement, 5019, Monastir, Tunisia
| | - S Bouzidi
- Laboratoire de la Matière Condensée et des Nanosciences (LMCN), Université de Monastir, Département de Physique, Faculté des Sciences de Monastir, Avenue de l'Environnement, 5019, Monastir, Tunisia
| | - M Said
- Laboratoire de la Matière Condensée et des Nanosciences (LMCN), Université de Monastir, Département de Physique, Faculté des Sciences de Monastir, Avenue de l'Environnement, 5019, Monastir, Tunisia
| |
Collapse
|
20
|
Barhoumi M, Lazaar K, Said M. DFT study of electronic and optical properties of silicene functionalized with chemical groups. J Mol Graph Model 2019; 91:72-79. [PMID: 31195339 DOI: 10.1016/j.jmgm.2019.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/03/2019] [Accepted: 06/02/2019] [Indexed: 11/26/2022]
|
21
|
Carta MG, Said M, Piras M, Moro MF. [An evolutionist approach of mood disorders from a transcultural perspective]. Encephale 2019; 45:530-532. [PMID: 30879780 DOI: 10.1016/j.encep.2018.12.002] [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: 03/27/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The objective of this paper is to verify if traits and symptoms defined as pathological and maladjusted in certain contexts may produce adaptive effects in other contexts, especially if they occur in sub-threshold forms. METHODS A historical examination of how the symptoms of depression have changed in front of great social changes and an analysis of Sardinian migrants' thymic profiles toward several metropolises. RESULTS AND CONCLUSIONS Mood disorders have been increasing since the "English malady" in the 17th century, and we suppose that some forms of mood disorders might have an adaptive advantage. Otherwise, the increase of such an epidemic would have been self-limited. From a sociobiological point of view, it is highly probable that the environment of a rapidly evolving society can select people who are explorers and able to support accelerated biorhythms and that the condition of social change stimulates psychological and psychopathologic changes. It is also possible that hyperthymic persons modulate and create the new environment. If this model can explain the epidemic of mood disorders, its verification should guide future research.
Collapse
Affiliation(s)
- M G Carta
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italie
| | - M Said
- Razi Hospital, Faculty of medicine of Tunis, Tunis, Tunisia.
| | - M Piras
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari, Cagliari, Italie
| | - M F Moro
- Mailman School of Public Health Columbia University, New York, United States
| |
Collapse
|
22
|
Lema AA, Maigoro MA, Said M, Marwana AM, Nuraddeen W. Prevalence of bovine trypanasomosis in Katsina Central Abattoir, Katsina State. ACTA ACUST UNITED AC 2018. [DOI: 10.4314/njpar.v39i2.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
23
|
Barhoumi M, Lazaar K, Said M. DFT study of optoelectronic and magnetic properties of a novel type perovskites. Chem Phys 2018. [DOI: 10.1016/j.chemphys.2018.07.010] [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: 10/28/2022]
|
24
|
Smelt HJM, Pouwels S, Said M, Smulders JF. Neuropathy by folic acid supplementation in a patient with anaemia and an untreated cobalamin deficiency: a case report. Clin Obes 2018; 8:300-304. [PMID: 29852529 DOI: 10.1111/cob.12254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/06/2018] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 11/27/2022]
Abstract
The rising rates of bariatric surgery (BS) are accompanied by neurological complications related to nutrient deficiencies. One of the risk factors for neurological complications in BS patients is poor vitamin and mineral supplementation. Prevention, diagnosis and treatment of these disorders are necessary parts of lifelong care after BS. Particularly important for optimal functioning of the nervous system are vitamin B1 , B6 , B12 (cobalamin), E, copper and possibly vitamin B11 (folic acid). In this case report, we narrate about a patient with anaemia and multiple vitamin and mineral deficiencies after Roux-en-Y gastric bypass (RYGB) with an alimentary limb of 150 cm and a biliopancreatic limb of 100 cm. RYGB is associated with an increased risk of vitamin deficiencies, especially a vitamin B12 deficiency. The patient in this case report developed psychiatric-neurological symptoms due to folic acid supplementation in an untreated cobalamin deficiency. Second, we tried to elucidate the vitamin physiology to understand specific mechanisms after BS.
Collapse
Affiliation(s)
- H J M Smelt
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
| | - S Pouwels
- Department of Surgery, Sint Franciscus Gasthuis & Vlietland, Schiedam, The Netherlands
| | - M Said
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
| | - J F Smulders
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| |
Collapse
|
25
|
Said M, Dangor Y, van Hougenhouck-Tulleken W, Mbelle N, Strydom KA, Ismail F. First outbreak of Ralstonia mannitolilytica bacteraemia in patients undergoing haemodialysis at a tertiary hospital in Pretoria, South Africa. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
26
|
Attia D, El Saeed K, Elakel W, El Baz T, Omar A, Yosry A, Elsayed MH, Said M, El Raziky M, Anees M, Doss W, El Shazly Y, Wedemeyer H, Esmat G. The adverse effects of interferon-free regimens in 149 816 chronic hepatitis C treated Egyptian patients. Aliment Pharmacol Ther 2018; 47:1296-1305. [PMID: 29504152 DOI: 10.1111/apt.14538] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Received: 10/01/2017] [Revised: 10/30/2017] [Accepted: 01/07/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Interferon-free regimens are associated with high sustained virological response; however, associated adverse effects have yet to be fully reported. AIM To evaluate the adverse effects associated with the different direct-acting antiviral drug (DAA) regimens in Egyptian patients. METHODS This multicenter retrospective study included all adverse effects during and after treatment with DAA regimens of 149 816 chronic hepatitis C treated Egyptian patients. Patients received sofosbuvir (SOF)/ribavirin (RBV) (n = 21 835), SOF/simeprevir (n = 24 215) SOF/daclatasvir (DCV) (n = 58 477), SOF/DCV/RBV (n = 45 188) and paritaprevir/ombitasvir/ritonavir/RBV (n = 101). The duration of treatment varied between 12 and 24 weeks. All changes in the treatment regimens, discontinuation, mortality, and serious side effects were reported. RESULTS Adverse effects developed in 2475 (1.7%) (mean age [54 ± 9], male gender [53%]) patients. Serious side effects developed in 68% of these patients, and SOF/RBV was the most common causing regimen (73%, P < 0.001). Anaemia and hyperbilirubinemia were the most common side effects (731/149816, 0.5% and 463/149816, 0.3%, respectively) and SOF/RBV (588/21835, 3% and 353/21835, 1.6%, respectively) showed the highest incidence in the treated patients. Hepatocellular carcinoma and mortality were reported in 0.02% and 0.06% of all treated patients, respectively. Patients with liver cirrhosis showed higher incidence of serious side effects (Log rank P = 0.045) and mortality (Log rank P = 0.025) than patients without liver cirrhosis. Male gender (P = 0.012), lower haemoglobin (P < 0.001), platelets (P < 0.001) and albumin (P = 0.001), higher bilirubin (P = 0.002) and cirrhosis (P < 0.001) were factors associated with serious side effects development. CONCLUSION Adverse effects associated with DAAs are few, anaemia being the most common. SOF/RBV regimen showed the highest rate of side effects while SOF/DCV showed the least.
Collapse
Affiliation(s)
- D Attia
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Beni-suef University, Beni-suef, Egypt
| | - K El Saeed
- Department of Tropical Medicine, Ain Shams University, Cairo, Egypt
| | - W Elakel
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - T El Baz
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Omar
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Yosry
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M H Elsayed
- National Committee of Viral Hepatitis MOH, Ain Shams University, Cairo, Egypt
| | - M Said
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M El Raziky
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Anees
- Department of Tropical Medicine, Tanta University, Tanta, Egypt
| | - W Doss
- National Committee of Viral Hepatitis MOH, Cairo University, Cairo, Egypt
| | - Y El Shazly
- National Committee of Viral Hepatitis MOH, Ain Shams University, Cairo, Egypt
| | - H Wedemeyer
- Department of Hepatology, Gastroenterology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - G Esmat
- National Committee of Viral Hepatitis MOH, Cairo University, Cairo, Egypt
| |
Collapse
|
27
|
Berg R, Taraldsen S, Said M, Sørbye I, Vangen S. 4.11-P8The effectiveness of surgical interventions for women with FGM/C: a systematic review. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.173] [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: 11/13/2022] Open
Affiliation(s)
- R Berg
- Norwegian Institute of Public Health, Norway
| | - S Taraldsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Norway
| | - M Said
- Oslo University Hospital Ullevål, Norway
| | - I Sørbye
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Norway
| | - S Vangen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Norway
| |
Collapse
|
28
|
Said M, Moreno I, Roudsari B. 3:18 PM Abstract No. 63 The role of IR, GI, and surgery in gastrostomy tube placement for Medicare beneficiaries. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.074] [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: 11/26/2022] Open
|
29
|
Said M, Roudsari B, Pillai R, Vu C. Abstract No. 600 Lower extremity endovascular revascularization for Medicare beneficiaries. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.645] [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: 10/17/2022] Open
|
30
|
Pouwels S, Huisman S, Smelt HJM, Said M, Smulders JF. Lipoedema in patients after bariatric surgery: report of two cases and review of literature. Clin Obes 2018; 8:147-150. [PMID: 29372593 DOI: 10.1111/cob.12239] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 10/12/2017] [Revised: 11/14/2017] [Accepted: 11/29/2017] [Indexed: 11/26/2022]
Abstract
Lipoedema is a disorder of adipose tissue that is characterized by abnormal subcutaneous fat deposition, leading to swelling and enlargement of the lower limbs as well as the trunk. This entity is often misdiagnosed as lymphoedema or obesity and, therefore, may be overlooked and missed in patients scheduled for bariatric surgery. Patients with lipoedema who undergo bariatric surgery may have to continue to have extensive lower extremity and trunk adiposity despite adequate weight loss. In this report, we present two patients who had extensive trunk and lower extremity adiposity, one of them before and the other after the bariatric surgery.
Collapse
Affiliation(s)
- S Pouwels
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands
| | - S Huisman
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands
| | - H J M Smelt
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
| | - M Said
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
| | - J F Smulders
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
- Obesity Center, Catharina Hospital, Eindhoven, The Netherlands
| |
Collapse
|
31
|
Leach M, Bett B, Said M, Bukachi S, Sang R, Anderson N, Machila N, Kuleszo J, Schaten K, Dzingirai V, Mangwanya L, Ntiamoa-Baidu Y, Lawson E, Amponsah-Mensah K, Moses LM, Wilkinson A, Grant DS, Koninga J. Local disease-ecosystem-livelihood dynamics: reflections from comparative case studies in Africa. Philos Trans R Soc Lond B Biol Sci 2018; 372:rstb.2016.0163. [PMID: 28584171 PMCID: PMC5468688 DOI: 10.1098/rstb.2016.0163] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 01/20/2017] [Indexed: 12/16/2022] Open
Abstract
This article explores the implications for human health of local interactions between disease, ecosystems and livelihoods. Five interdisciplinary case studies addressed zoonotic diseases in African settings: Rift Valley fever (RVF) in Kenya, human African trypanosomiasis in Zambia and Zimbabwe, Lassa fever in Sierra Leone and henipaviruses in Ghana. Each explored how ecological changes and human–ecosystem interactions affect pathogen dynamics and hence the likelihood of zoonotic spillover and transmission, and how socially differentiated peoples’ interactions with ecosystems and animals affect their exposure to disease. Cross-case analysis highlights how these dynamics vary by ecosystem type, across a range from humid forest to semi-arid savannah; the significance of interacting temporal and spatial scales; and the importance of mosaic and patch dynamics. Ecosystem interactions and services central to different people's livelihoods and well-being include pastoralism and agro-pastoralism, commercial and subsistence crop farming, hunting, collecting food, fuelwood and medicines, and cultural practices. There are synergies, but also tensions and trade-offs, between ecosystem changes that benefit livelihoods and affect disease. Understanding these can inform ‘One Health’ approaches towards managing ecosystems in ways that reduce disease risks and burdens. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.
Collapse
Affiliation(s)
- Melissa Leach
- Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | - Bernard Bett
- International Livestock Research Institute, Nairobi, Kenya
| | - M Said
- International Livestock Research Institute, Nairobi, Kenya
| | | | | | - Neil Anderson
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Noreen Machila
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Joanna Kuleszo
- Geography and Environment, University of Southampton, Southampton, UK
| | | | | | | | | | | | | | - Lina M Moses
- Department of Microbiology and Immunology, Tulane University, New Orleans, LA, USA
| | - Annie Wilkinson
- Institute for Development Studies, University of Sussex, Brighton BN1 9RE, UK
| | | | | |
Collapse
|
32
|
Abd El-Moneem A, Said M. Response of Some Peanut Genotypes to Phosphorus Fertilization Levels Under New Valley Conditions. AJAS 2018; 49:1-9. [DOI: 10.21608/ajas.2018.7763] [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: 09/01/2023]
|
33
|
Omar H, El Akel W, Elbaz T, El Kassas M, Elsaeed K, El Shazly H, Said M, Yousif M, Gomaa AA, Nasr A, AbdAllah M, Korany M, Ismail SA, Shaker MK, Doss W, Esmat G, Waked I, El Shazly Y. Generic daclatasvir plus sofosbuvir, with or without ribavirin, in treatment of chronic hepatitis C: real-world results from 18 378 patients in Egypt. Aliment Pharmacol Ther 2018; 47:421-431. [PMID: 29193226 DOI: 10.1111/apt.14428] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [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] [Received: 07/26/2017] [Revised: 08/22/2017] [Accepted: 10/30/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Treatment of chronic hepatitis C using combination of sofosbuvir (SOF) and daclatasvir (DCV) was used in several clinical trials and multicentre studies, which were somewhat limited to genotypes 1-3. The national program in Egypt is using SOF-DCV combination for large scale treatment. AIM To assess the efficacy and safety of combined SOF-DCV in treating patients with HCV-G4 in a real-world setting. METHODS Data and outcome of chronic HCV patients who were treated for 12 weeks with generic medications: DCV 60 mg plus SOF 400 mg ± ribavirin (RBV) within the national hepatitis C treatment program in Egypt are presented. Treatment-naïve patients without cirrhosis were treated without RBV, and those who had cirrhosis or were treatment-experienced (interferon experienced or SOF experienced) received RBV. Efficacy and safety were assessed, and baseline factors associated with sustained virological response at post-treatment week 12 (SVR12) were explored. RESULTS During the first 2 months of the programme, 18 378 patients with HCV-G4 started treatment with SOF-DCV with or without RBV. Overall, 95.1% achieved SVR12 (95.4% among patients treated without RBV and 94.7% for patients treated with RBV, P = .32). Treatment was prematurely discontinued in only 1.5% of patients. The most common events leading to discontinuation were patient withdrawal (n = 76) and pregnancy (n = 5). Five deaths occurred within this group. CONCLUSIONS Real-world experience of generic SOF-DCV in patients with chronic HCV-G4 proved to be safe and associated with a high SVR12 rate, in patients with different stages of fibrosis.
Collapse
Affiliation(s)
- H Omar
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - W El Akel
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - T Elbaz
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M El Kassas
- Faculty of Medicine, Helwan University, Cairo, Egypt
| | - K Elsaeed
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - H El Shazly
- National Liver Institute, Menoufiya University, Shebeen EL Kom, Egypt
| | - M Said
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Yousif
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - A A Gomaa
- Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - A Nasr
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - M Korany
- National Committee for Control of Viral Hepatitis, Cairo, Egypt
| | - S A Ismail
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - M K Shaker
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - W Doss
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - G Esmat
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - I Waked
- National Liver Institute, Menoufiya University, Shebeen EL Kom, Egypt
| | - Y El Shazly
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
34
|
|
35
|
Lezcano N, Mariángelo JIE, Vittone L, Wehrens XHT, Said M, Mundiña-Weilenmann C. Early effects of Epac depend on the fine-tuning of the sarcoplasmic reticulum Ca 2+ handling in cardiomyocytes. J Mol Cell Cardiol 2017; 114:1-9. [PMID: 29037982 DOI: 10.1016/j.yjmcc.2017.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/01/2017] [Revised: 09/19/2017] [Accepted: 10/09/2017] [Indexed: 12/30/2022]
Abstract
In cardiac muscle, signaling through cAMP governs many fundamental cellular functions, including contractility, relaxation and automatism. cAMP cascade leads to the activation of the classic protein kinase A but also to the stimulation of the recently discovered exchange protein directly activated by cAMP (Epac). The role of Epac in the regulation of intracellular Ca2+ homeostasis and contractility in cardiac myocytes is still matter of debate. In this study we showed that the selective Epac activator, 8-(4-chloro-phenylthio)-2'-O-methyladenosine-3', 5'-cyclic monophosphate (8-CPT), produced a positive inotropic effect when adult rat cardiac myocytes were stabilized at low [Ca2+]o (0.5mM), no changes at 1mM [Ca2+]o and a negative inotropic effect when [Ca2+]o was increased to 1.8mM. These effects were associated to parallel variations in sarcoplasmic reticulum (SR) Ca2+ content. At all [Ca2+]o studied, 8-CPT induced an increase in Ca2+ spark frequency and enhanced CaMKII autophosphorylation and the CaMKII-dependent phosphorylation of SR proteins: phospholamban (PLN, at Thr17 site) and ryanodine receptor (RyR2, at Ser2814 site). We used transgenic mice lacking PLN CaMKII phosphorylation site (PLN-DM) and knock-in mice with an inactivated CaMKII site S2814 on RyR2 (RyR2-S2814A) to investigate the involvement of these processes in the effects of Epac stimulation. In PLN-DM mice, 8-CPT failed to induce the positive inotropic effect at low [Ca2+]o and RyR2-S2814A mice showed no propensity to arrhythmic events when compared to wild type mice myocytes. We conclude that stimulation of Epac proteins could have either beneficial or deleterious effects depending on the steady-state Ca2+ levels at which the myocyte is functioning, favoring the prevailing mechanism of SR Ca2+ handling (uptake vs. leak) in the different situations.
Collapse
Affiliation(s)
- N Lezcano
- Centro de Investigaciones Cardiovasculares, CCT-CONICET La Plata, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina
| | - J I E Mariángelo
- Centro de Investigaciones Cardiovasculares, CCT-CONICET La Plata, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina
| | - L Vittone
- Centro de Investigaciones Cardiovasculares, CCT-CONICET La Plata, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina
| | - X H T Wehrens
- Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, United States
| | - M Said
- Centro de Investigaciones Cardiovasculares, CCT-CONICET La Plata, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina
| | - C Mundiña-Weilenmann
- Centro de Investigaciones Cardiovasculares, CCT-CONICET La Plata, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina.
| |
Collapse
|
36
|
Ayadi T, Debbichi L, Said M, Lebègue S. An ab initio study of the electronic structure of indium and gallium chalcogenide bilayers. J Chem Phys 2017; 147:114701. [DOI: 10.1063/1.4997233] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Vale S, Grinter K, Smith J, Aiken J, Voukelatos S, Said M. P53: ADDRESSING FOOD ALLERGY IN FOOD SERVICE: THE NATIONAL ALLERGY STRATEGY FOOD SERVICE PROJECT. Intern Med J 2017. [DOI: 10.1111/imj.53_13578] [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: 11/29/2022]
Affiliation(s)
- S Vale
- National Allergy Strategy; Sydney Australia
- Australian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
| | | | - J Smith
- Australian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
| | - J Aiken
- Allergy & Anaphylaxis Australia; Sydney Australia
| | - S Voukelatos
- Allergy & Anaphylaxis Australia; Sydney Australia
| | - M Said
- National Allergy Strategy; Sydney Australia
- Allergy & Anaphylaxis Australia; Sydney Australia
| |
Collapse
|
38
|
Vale S, Smith J, Said M, Joshi P, Allen K, Loh R. P54: PREVENTING THE DEVELOPMENT OF FOOD ALLERGY: IMPLEMENTING NEW ASCIA GUIDELINES FOR INFANT FEEDING. Intern Med J 2017. [DOI: 10.1111/imj.54_13578] [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: 11/30/2022]
Affiliation(s)
- S Vale
- National Allergy Strategy; Sydney Australia
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
| | - J Smith
- National Allergy Strategy; Sydney Australia
| | - M Said
- National Allergy Strategy; Sydney Australia
- Allergy & Anaphylaxis Australia; Sydney Australia
| | - P Joshi
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
- Allergy & Anaphylaxis Australia; Sydney Australia
- The Childrens Hospital at Westmead; Sydney Australia
| | - K Allen
- National Allergy Strategy; Sydney Australia
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
- Centre for Food & Allergy Research (CFAR), Victoria; Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - R Loh
- National Allergy Strategy; Sydney Australia
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
- Centre for Food & Allergy Research (CFAR), Victoria; Australia
- Princess Margaret Hospital; Perth Australia
| |
Collapse
|
39
|
Vale S, Loh R, Smith J, Aiken J, Salter S, Said M. P52: 250 K: A YOUTH ALLERGY AWARENESS PROJECT BY THE NATIONAL ALLERGY STRATEGY. Intern Med J 2017. [DOI: 10.1111/imj.52_13578] [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: 11/30/2022]
Affiliation(s)
- S Vale
- National Allergy Strategy; Sydney Australia
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
| | - R Loh
- National Allergy Strategy; Sydney Australia
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
- Princess Margaret Hospital; Perth Australia
| | - J Smith
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney; Australia
| | - J Aiken
- Allergy & Anaphylaxis Australia; Sydney Australia
| | - S Salter
- University of Western Australia; Perth Australia
| | - M Said
- National Allergy Strategy; Sydney Australia
- Allergy & Anaphylaxis Australia; Sydney Australia
| |
Collapse
|
40
|
Charsley H, Clifford R, Said M, Vale S, Salter S. P5: ADRENALINE AUTOINJECTOR CARRIAGE AND STORAGE IN THE AUSTRALIAN ANAPHYLAXIS POPULATION. Intern Med J 2017. [DOI: 10.1111/imj.5_13578] [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: 11/28/2022]
Affiliation(s)
- H Charsley
- The University of Western Australia; Perth Australia
| | - R Clifford
- The University of Western Australia; Perth Australia
| | - M Said
- Allergy & Anaphylaxis Australia (A&AA), New South Wales; Australia
| | - S Vale
- Australasian Society of Clinical Immunology and Allergy (ASCIA), New South Wales; Australia
| | - S Salter
- The University of Western Australia; Perth Australia
| |
Collapse
|
41
|
Maatallah H, Ammar HB, Aissa A, Nefzi R, Said M, Hechmi ZE. Antipsychotic polypharmacy among schizophrenia outpatients. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1601] [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: 11/27/2022] Open
Abstract
IntroductionSince their introduction by Delay and Deniker in the 1950s, neuroleptic drugs have significantly modified the evolutionary prognosis of schizophrenia. Their combination has also become a widespread practice.ObjectivesThe aim of this study was to analyze the associations of neuroleptic drugs by describing the characteristics of types and doses, understanding the reasons for these associations and studying the relationship existing in such situation regarding adherence to treatment, tolerance and the number of hospitalizations.MethodsOur study was retrospective, descriptive and analytical. It has been conducted from March, 1st to May, 30th 2015 and involved 70 stabilized patients diagnosed with schizophrenia according to DSM 5. Clinical characteristics were collected from patients and their medical records. Evaluations were conducted using PANSS, MARS and GAS.ResultsOverall, 70 male patients were recruited. The mean age was 40 years old: 30% received classical monotherapy while 70% were treated only by an atypical antipsychotic. Among patients receiving two drugs, 85% received classical bitherapy while 9% were under both classical and atypical drugs. Only 6% received atypical bitherapy. Chlorpromazine equivalent doses in case of monotherapy was 325.92 mg/day, while it reached 1148.65 mg/day in case of drugs association. Administration of a combined therapy had poor tolerance rate and all patients suffered from adverse effects. Adherence to treatment was better while receiving monotherapy (88% versus 45%) and the number of hospitalizations was lower with an average of 3 against 10.ConclusionOur study revealed several shortcomings in our current management of patients with schizophrenia and addressed the implication of socioeconomic status on therapeutic outcomes.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
42
|
Elsharkawy A, Fouad R, El Akel W, El Raziky M, Hassany M, Shiha G, Said M, Motawea I, El Demerdash T, Seif S, Gaballah A, El Shazly Y, Makhlouf MAM, Waked I, Abdelaziz AO, Yosry A, El Serafy M, Thursz M, Doss W, Esmat G. Sofosbuvir-based treatment regimens: real life results of 14 409 chronic HCV genotype 4 patients in Egypt. Aliment Pharmacol Ther 2017; 45:681-687. [PMID: 28070899 DOI: 10.1111/apt.13923] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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] [Received: 06/18/2016] [Revised: 07/31/2016] [Accepted: 12/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic hepatitis C virus infection is one of the most important health problems in Egypt. The Ministry of Health's National Treatment Programme introduced sofosbuvir-based therapy in October 2014. AIM To assess the clinical effectiveness and predictors of response to SOF-based treatment regimens, either dual therapy, with SOF/ribavirin (RBV) for 6 months or triple therapy with SOF/peg-IFN-alfa-2a/RBV for 3 months, in a cohort of patients treated in National Treatment Programme affiliated centres in Egypt. METHODS Between October 2014 and end of 2014, patients who were eligible for treatment were classified according to their eligibility for interferon therapy: Group 1 (interferon eligible) were treated with triple therapy for 12 weeks and Group 2 (interferon ineligible) were treated with dual therapy for 24 weeks. Difficult to treat patients included those with F3-F4 on Metavir score, Fib-4 >3.25, albumin ≤3.5, total Bilirubin >1.2 mg/dL, INR >1.2 and platelet count <150 000 mm3 . RESULTS Twelve weeks post-treatment data were available on 14 409 patients; 8742 in group 1 and 5667 in group 2. In group 1, the sustained virological response at week 12 (SVR12) was 94% and in group 2 the SVR12 was 78.7%. Multivariate logistic regression analysis in which treatment failure is the dependent variable was done. Male gender, being a difficult to treat patient and previous interferon therapy were significant predictors of nonresponse in both treatment groups. CONCLUSION Results of sofosbuvir-based therapies in Egypt achieved similar rates of SVR12 as seen in phase III efficacy studies.
Collapse
Affiliation(s)
- A Elsharkawy
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - R Fouad
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - W El Akel
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M El Raziky
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Hassany
- Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt
| | - G Shiha
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansora, Egypt
| | - M Said
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - I Motawea
- Internal Medicine Department, Faculty of Medicine, Menia University, Minia, Egypt
| | - T El Demerdash
- Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - S Seif
- Tropical Medicine Department, National Hepatology & Tropical Medicine Research Institute, Cairo, Egypt
| | - A Gaballah
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Y El Shazly
- Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M A M Makhlouf
- Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - I Waked
- Department of Hepatology, National Liver Institute, Menoufyia University, Menoufyia, Egypt
| | - A O Abdelaziz
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Yosry
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M El Serafy
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M Thursz
- Department of Hepatology, Imperial College London, London, UK
| | - W Doss
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - G Esmat
- Endemic Medicine and Hepatogastroentrology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
43
|
Sang R, Lutomiah J, Said M, Makio A, Koka H, Koskei E, Nyunja A, Owaka S, Matoke-Muhia D, Bukachi S, Lindahl J, Grace D, Bett B. Effects of Irrigation and Rainfall on the Population Dynamics of Rift Valley Fever and Other Arbovirus Mosquito Vectors in the Epidemic-Prone Tana River County, Kenya. J Med Entomol 2017; 54:460-470. [PMID: 28011732 PMCID: PMC5850818 DOI: 10.1093/jme/tjw206] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/01/2016] [Indexed: 06/06/2023]
Abstract
Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that is found in most regions of sub-Saharan Africa, and it affects humans, livestock, and some wild ungulates. Outbreaks are precipitated by an abundance of mosquito vectors associated with heavy persistent rainfall with flooding. We determined the impact of flood-irrigation farming and the effect of environmental parameters on the ecology and densities of primary and secondary vectors of the RVF virus (RVFV) in an RVF-epidemic hotspot in the Tana River Basin, Kenya. Mosquito sampling was conducted in farms and villages (settlements) in an irrigated and a neighboring nonirrigated site (Murukani). Overall, a significantly higher number of mosquitoes were collected in farms in the irrigation scheme compared with villages in the same area (P < 0.001), or farms (P < 0.001), and villages (P = 0.03) in Murukani. In particular, key primary vectors of RVFV, Aedes mcintoshi Marks and Aedes ochraceous Theobald, were more prevalent in the farms compared with villages in the irrigation scheme (P = 0.001) both during the dry and the wet seasons. Similarly, there was a greater abundance of secondary vectors, particularly Culex univittatus Theobald and Culex pipiens (L.) in the irrigation scheme than in the Murukani area. Rainfall and humidity were positively correlated with mosquito densities, particularly the primary vectors. Adult floodwater mosquitoes and Mansonia spp. were collected indoors; immatures of Ae. mcintoshi and secondary vectors were collected in the irrigation drainage canals, whereas those of Ae. ochraceous and Aedes sudanensis Theobald were missing from these water bodies. In conclusion, irrigation in RVF endemic areas provides conducive resting and breeding conditions for vectors of RVFV and other endemic arboviruses.
Collapse
Affiliation(s)
- R Sang
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - J Lutomiah
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - M Said
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - A Makio
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - H Koka
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - E Koskei
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - A Nyunja
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - S Owaka
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - D Matoke-Muhia
- Center for Virus Research, Kenya Medical Research Institute, P. O. Box 54840-00200, Mbagathi Way, Nairobi, Kenya (; ; ; ; ; ; ; )
| | - S Bukachi
- Institute of Anthropology, University of Nairobi, P.O. Box 30079-00100, Nairobi, Kenya
| | - J Lindahl
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - D Grace
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| | - B Bett
- Food Safety and Zoonosis Research Program, International Livestock Research Institute, P. O. Box 30709-00100, Nairobi, Kenya (; ; ; )
| |
Collapse
|
44
|
Barhoumi M, Rocca D, Said M, Lebègue S. A first principle study of graphene functionalized with hydroxyl, nitrile, or methyl groups. J Chem Phys 2017; 146:044705. [DOI: 10.1063/1.4974894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M. Barhoumi
- Laboratoire de la Matière Condensée et Nanosciences, Département de Physique, Faculté des Sciences de Monastir, 5019 Monastir, Tunisia
- Laboratoire de Cristallographie, Résonance Magnétique et Modélisations (CRM2, UMR CNRS 7036) Institut Jean Barriol, Université de Lorraine, BP 239, Boulevard des Aiguillettes, 54506 Vandoeuvre-lès-Nancy, France
| | - D. Rocca
- Laboratoire de Cristallographie, Résonance Magnétique et Modélisations (CRM2, UMR CNRS 7036) Institut Jean Barriol, Université de Lorraine, BP 239, Boulevard des Aiguillettes, 54506 Vandoeuvre-lès-Nancy, France
| | - M. Said
- Laboratoire de la Matière Condensée et Nanosciences, Département de Physique, Faculté des Sciences de Monastir, 5019 Monastir, Tunisia
| | - S. Lebègue
- Laboratoire de Cristallographie, Résonance Magnétique et Modélisations (CRM2, UMR CNRS 7036) Institut Jean Barriol, Université de Lorraine, BP 239, Boulevard des Aiguillettes, 54506 Vandoeuvre-lès-Nancy, France
| |
Collapse
|
45
|
Marchisotto MJ, Harada L, Blumenstock JA, Bilaver LA, Waserman S, Sicherer S, Boloh Y, Regent L, Said M, Schnadt S, Allen KJ, Muraro A, Taylor SL, Gupta RS. Global perceptions of food allergy thresholds in 16 countries. Allergy 2016; 71:1081-5. [PMID: 27176492 DOI: 10.1111/all.12933] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - L. Harada
- Food Allergy Canada (formerly Anaphylaxis Canada); Toronto ON Canada
| | | | - L. A. Bilaver
- Department of Public Health; Northern Illinois University; DeKalb IL USA
- Chapin Hall at the University of Chicago; Chicago IL USA
| | - S. Waserman
- Division of Allergy and Clinical Immunology; McMaster University; Hamilton ON Canada
| | - S. Sicherer
- Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Y. Boloh
- Philéas Info; St Mars d'Outillé France
| | - L. Regent
- Anaphylaxis Campaign; Farnborough UK
| | - M. Said
- Allergy & Anaphylaxis Australia; Castle Hill NSW Australia
| | - S. Schnadt
- Deutscher Allergie- und Asthmabund e.V. (DAAB); Mönchengladbach Germany
| | - K. J. Allen
- Centre of Food and Allergy Research; Murdoch Children's Research Institute; The Royal Children's Hospital; Parkville Australia
- Department of Allergy and Clinical Immunology; The Royal Children's Hospital; Parkville Australia
- Department of Gastroenterology and Clinical Nutrition; The Royal Children's Hospital; Parkville Australia
- Department of Paediatrics; The Royal Children's Hospital; Parkville Australia
- Institute of Inflammation and Repair; University of Manchester; Manchester UK
| | - A. Muraro
- Department of Pediatrics; University of Padua; Padua Italy
| | - S. L. Taylor
- Food Allergy Research & Resource Program (FARRP); University of Nebraska; Lincoln NE USA
| | - R. S. Gupta
- Northwestern University Feinberg School of Medicine; Chicago IL USA
- Ann & Robert H. Lurie Children's Hospital of Chicago; Chicago IL USA
| |
Collapse
|
46
|
Smelt HJM, Pouwels S, Said M, Berghuis KA, Boer AK, Smulders JF. Comparison Between Different Intramuscular Vitamin B 12 Supplementation Regimes: a Retrospective Matched Cohort Study. Obes Surg 2016; 26:2873-2879. [PMID: 27146501 DOI: 10.1007/s11695-016-2207-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 11/28/2022]
Abstract
BACKGROUND The incidence of vitamin B12 deficiency after bariatric surgery can range from 26 to 70 %. There is no consensus on optimal vitamin B12 supplementation in postbariatric patients. The objective of this study was to compare three different regimes. METHODS In this retrospective matched cohort study, we included 63 patients with methylmalonic acid (MMA) levels ≥300 nmol/L. Group A (n = 21) received 6 intramuscular (im) vitamin B12 injections including a loading dose, group B (n = 21) received 3 im vitamin B12 injections without loading dose and group C (n = 21) received no im vitamin B12 injections. RESULTS The total post-bariatric patient population consisted of 14 males (22.2 %) and 49 women (77.8 %) with a mean current body mass index of 30.6 ± 8.0 kg/m2. There was no significant difference in vitamin B12 and MMA levels between 3 groups at baseline. There was a significant difference in follow-up vitamin B12 levels of group A compared to group B (p = 0.02) and group A compared to group C (p = 0.03). In the follow-up results, there is also a significant decrease in MMA levels of group A compared to group B (p = 0.02), group A compared to group C (p < 0.001), and group B compared to group C (p < 0.01). CONCLUSIONS In this study, a shorter injection regime is probably not sufficient to treat a vitamin B12 deficiency. An injection regime with 6 injections recovered all vitamin B12 deficiencies biochemically. MMA levels cannot recover spontaneously over time without additional im injection regime.
Collapse
Affiliation(s)
- H J M Smelt
- Department of Dietetics, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands.
| | - S Pouwels
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - M Said
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - K A Berghuis
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - A K Boer
- Department of Clinical chemistry - Endocrinology, Catharina Hospital, Eindhoven, The Netherlands
| | - J F Smulders
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| |
Collapse
|
47
|
Dangor Y, Said M, Kwatra G, Madhi S, Mbelle N, Ismail F. Prevalence and characterization of group B streptococcus among pregnant women at a tertiary hospital in South Africa. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.501] [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
|
48
|
Kandeel A, Dawson P, Labib M, Said M, El-Refai S, El-Gohari A, Talaat M. Morbidity, mortality, and seasonality of influenza hospitalizations in Egypt, november 2007 - november 2014. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.748] [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: 11/30/2022] Open
|
49
|
Abstract
IntroductionAntipsychotic drugs effectively control psychotic symptoms, but may cause important side effects, significantly increasing morbidity and mortality. Hematologic abnormalities are frequent and may be life-threatening in some patients. Many prospective investigations confirmed neutropenia as a frequent occurrence with virtually all atypical antipsychotics.Objective and methodsDefine epidemiological, clinical and therapeutic characteristics of antipsychotics – induced leukopenia and neutropenia through a case report and a review of literature.Case reportPatient 28 years old native of Tunis, with family history: brother who suffer of undifferentiated schizophrenia. Since the age of 16 years he has been followed for disorganized schizophrenia (DSM IV). He was initially put under Haldol Decanoate (2 months), fluphenazine (2 months), amisulpride (3 months), sulpride (2 months), olanzapine (3 months), Rispreridone (1 month), aripiprazole (5 months) leukopenia/neutropenia is occurring during treatment with each molecule and which promptly resolved after discontinuation. Reduced white blood cell count has also been reported after addition of lithium. Actually an ECT is proposed for this patient.ConclusionThis case report shows the importance of hematological monitoring during the course of typical or atypical treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
50
|
Abstract
BackgroundPsychiatric disorders have a remarquable frequency in multiple sclerosis. The leading group of these disorders consists of affective disorders. These psychiatric conditions can worsen the outcome of multiple sclerosis, thus contributing to increase the burden of the disease to both patients and relatives. Managing such a complicated situation needs a focus on the underlying links between affective disorders and multiple sclerosis.ObjectiveTo examine the hypotheses proposed to explain the high prevalence of affective disorders in patients with multiple sclerosis.MethodsLiterature was reviewed using the Medline database and the following keywords “bipolar disorder” “affective disorder”, “mania” and “multiple sclerosis”.ResultsPubMed research returned 13 results. After manual inspection, 10 articles were retained and examined. The cause of the high comorbidity between multiple sclerosis and mood disorders is regarded as being multifactorial: the medication used in multiple sclerosis possibly inducing/exacerbating mood disturbances, the demyelinazing brain lesions which could bring about depression or mania, genetic overlapping with affective disorders and last the psychological reactions and adjustment difficulties to the neurological handicap.ConclusionDespite the fact that the higher prevalence of affective disorders in multiple sclerosis is well established, these disorders still remain underdiagnosed and undertreated. A shift towards a better assessment of the psychiatric comorbidity in multiple sclerosis patients and the optimal treatment of those disorders is fundamental.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|