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Sales AHA, Steiert C, Behringer SP, Bissolo M, Omer M, Loidl TB, Beck J, Grauvogel J. Falcotentorial Meningiomas: Insights from Surgical Strategies and Clinical Outcomes. J Clin Med 2024; 13:1963. [PMID: 38610728 PMCID: PMC11012864 DOI: 10.3390/jcm13071963] [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: 02/14/2024] [Revised: 03/16/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Falcotentorial meningiomas are exceptionally uncommon tumors, presenting a challenge for neurosurgeons due to their close proximity to vital structures. Gross total resection represents the standard of treatment for these tumors. However, care must be taken when surgically approaching these lesions, since damaging neurovascular structures may cause unacceptable morbidity. Selecting the optimal surgical approach for each tumor is of paramount importance when treating these patients. Methods: The authors reviewed medical records to identify all patients with falcotentorial meningiomas who underwent resection at the University Hospital of Freiburg between January 2001 and December 2021. Clinical and imaging data, surgical management, and clinical outcomes were analyzed. Results: Falcotentorial meningiomas occurred in 0.7% (15 of 2124 patients) of patients with intracranial meningiomas. Of these 15 patients, 8 were female and 7 male. The occipital interhemispheric approach was used in nine patients, the supracerebellar infratentorial approach in five patients, and the retrosigmoidal approach in one patient. Three patients developed visual field deficits after surgical resection. Incomplete resection was significantly associated with tumor progression (p < 0.05). Conclusions: Individualized surgical strategies, guided by preoperative imaging and classification systems, play a crucial role in optimizing patient care. Among the available approaches, the occipital interhemispheric and supracerebellar infratentorial approaches are frequently employed and considered among the safest options for these tumors.
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Affiliation(s)
| | | | | | | | | | | | | | - Jürgen Grauvogel
- Department of Neurosurgery, Medical Center, Faculty of Medicine, University of Freiburg, 79108 Freiburg, Germany; (A.H.A.S.); (C.S.); (S.P.B.); (M.B.); (M.O.); (T.B.L.); (J.B.)
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Volz F, Fung C, Wolf K, Lützen N, Urbach H, Kraus LM, Omer M, Beck J, El Rahal A. Recovery and long-term outcome after neurosurgical closure of spinal CSF leaks in patients with spontaneous intracranial hypotension. Cephalalgia 2023; 43:3331024231196808. [PMID: 37652456 DOI: 10.1177/03331024231195830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Spontaneous intracranial hypotension due to a spinal cerebrospinal fluid leak causes orthostatic headaches and impacts quality of life. Successful closure rates are often reported, whereas data on long-term outcome are still scarce. METHODS Between April 2020 and December 2022 surgically treated patients completed the Headache Impact Test-6 prior to surgery and at 14 days, three months, six months, and 12 months postoperatively. In addition to the Headache Impact Test-6 score, we extracted data related to orthostatic symptoms. RESULTS Eighty patients were included. Median Headache Impact Test-6 score preoperatively was 65 (IQR 61-69), indicating severe and disabling impact of headaches. At three months headache impact significantly improved to 49 (IQR 44-58) (p < 0.001) and remained stable up to 12 months (48, IQR 40-56), indicating little to no impact of headaches on quality of life. The need to lie down "always" or "very often" was reduced from 79% to 23% three months postoperatively (p < 0.001). CONCLUSIONS Surgical closure of spinal CSF leaks significantly improves the impact of headaches in the long term. At least three months should be expected for recovery. Despite permanent closure of the CSF-leak, a quarter of patients still have relevant long-term impairment, indicating the need for further research on its cause and possible treatment.
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Affiliation(s)
- Florian Volz
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Christian Fung
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Katharina Wolf
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Niklas Lützen
- Department of Neuroradiology, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Luisa Mona Kraus
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Mazin Omer
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
| | - Amir El Rahal
- Department of Neurosurgery, Medical Center University of Freiburg, Freiburg im Breisgau, Germany
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Omer M, Posti JP, Gissler M, Merikukka M, Hoffmann I, Bärnighausen T, Wilson ML. The effect of birth order on length of hospitalization for pediatric traumatic brain injury: an analysis of the 1987 Finnish birth cohort. Arch Public Health 2022; 80:167. [PMID: 35820924 PMCID: PMC9275049 DOI: 10.1186/s13690-022-00919-x] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/24/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose This study examines the relationship between birth order and length of hospitalization due to pediatric traumatic brain injury (TBI). Methods We prospectively followed 59,469 Finnish newborns from 1987 until age 18 years. Data on first diagnosis of TBI was recorded within the 1987 Finnish Birth Cohort (FBC). Hospitalization period was divided into two categories: 2 days or less and more than 2 days. The latter was considered in this study as longer hospitalization. Results Compared with first born siblings, later born siblings had an increased risk of a longer hospitalization for TBI (12.7% of fourth or higher born birth children diagnosed with TBI were hospitalized for 2 or more days, 11.3% of first born, 10.4% of third born and 9.0% of second born). Fourth or higher born children were more likely to experience a repeat TBI; 13.4% of fourth or higher born children diagnosed with TBI had 2–3 TBIs during the study period compared to 9% of third born, 7.8% of second born and 8.8% of the first born. Injuries in the traffic environment and falls were the most common contributors to pediatric TBI and occurred most frequently in the fourth or higher birth category; 29.3% of TBIs among fourth or higher birth order were due to transport accidents and 21% were due to falls. Conclusions This study revealed a significant increase in risk for longer hospitalization due to TBI among later born children within the same sibling group. The study provides epidemiological evidence on birth order as it relates to TBI, and its potential to help to explain some of the statistical variability in pediatric TBI hospitalization over time in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00919-x.
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Omer M, Posti JP, Gissler M, Merikukka M, Bärnighausen T, Wilson ML. Birth order and pediatric traumatic brain injury. Sci Rep 2022; 12:14451. [PMID: 36002560 PMCID: PMC9402548 DOI: 10.1038/s41598-022-18742-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
Pediatric traumatic brain injury (TBI) is a significant problem of public health importance worldwide. Large population-based studies on the effect of birth order on health phenomena are exceedingly rare. This study examines the relationship between birth order and risk for pediatric TBI among sibling groups. We performed a retrospective cohort study following 59,469 Finnish newborns from 1987 until age 18 years. Data on first diagnosis of TBI was recorded within the 1987 Finnish Birth Cohort (FBC). Compared with first born siblings, later born siblings had an increased risk of TBI during the follow-up period (hazard ratio [HR] 1.02; 95% confidence interval [CI] 0.91–1.14 for second born, HR 1.09; 95% CI 0.95 1.26 for third born, HR 1.28; 95% CI 1.08–1.53 for fourth or higher). When adjusted for sex and maternal age at child’s birth, HRs (95% CIs) for TBI during the follow-up period were 1.12 (0.99–1.26) for second born, 1.31 (1.12–1.53) for third born and 1.61 (1.33–1.95) for fourth born or higher children, respectively. Within this large register-based population-wide study, order of birth modified risk for pediatric TBI among sibling groups. Taken together, these study findings may serve to stimulate further inquiry into genetic, psychological, or psychosocial factors which underlie differences in risk and depth of effect within and between sibling groups.
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Affiliation(s)
- Mazin Omer
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany. .,Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland.
| | - Jussi P Posti
- Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, National Institute for Health and Welfare (THL), Helsinki, Finland.,Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Marko Merikukka
- Children, Adolescents and Families, National Institute for Health and Welfare (THL), Oulu, Finland.,ITLA Children's Foundation, Helsinki, Finland
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany
| | - Michael Lowery Wilson
- Heidelberg Institute of Global Health (HIGH), University of Heidelberg, Heidelberg, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany
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Popov V, Andreescu M, Patrinoiu O, Popescu M, Omer M, Mihai F, Ofiteru G, Despan C, Constantin O, Pirvu C, Grigorie A, Rus A, Badoiu Niculae MD, Badea A, Iliescu L. P1601: THE ASSESSMENT OF PREDICTIVE ROLE OF PROTEIN C AND S FOR CRITICAL FORM OF COVID-19. Hemasphere 2022. [PMCID: PMC9430941 DOI: 10.1097/01.hs9.0000849260.73241.b6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Omer M, Al-Afif S, Machetanz K, Bettag C, Tatagiba M, Rohde V, Krauss JK. Impact of COVID-19 on the Neurosurgical Resident Training Program: an Early Experience. J Neurol Surg A Cent Eur Neurosurg 2022; 83:321-329. [PMID: 35189640 DOI: 10.1055/s-0042-1743108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The present study evaluates the impact of COVID-19 pandemic restrictions during the first lockdown period in spring 2020 on the neurosurgical resident training program, and provides constructive approaches to deal with such situations. METHODS A concurrent embedded mixed methods design was used. Qualitative data were collected through in-depth interviews from all neurosurgical residents at three university hospitals in Germany. Concurrently, quantitative data of the number of performed surgeries, outpatient visits, and the usage of telemedicine in the period from October 2019 to July 2020 were collected and analyzed accordingly. RESULTS During the period of COVID-19 pandemic restrictions in spring 2020, there was a marked reduction in the number of surgeries performed by neurosurgical residents, from an average of 41.26 (median 41) surgeries per month to 25.66 (median 24) per month, representing a decrease of 37.80%. The decrease in the operations was concerning mainly spinal and functional surgery. Outpatient visits were reduced significantly, with a concurrent fivefold increase in the usage of telemedicine. General and pediatric neurosurgery outpatient clinics were the most affected. However, although surgical exposure was reduced during the lockdown phase, neurosurgical residents focused on conducting research and improving theoretical knowledge. Nevertheless, the global uncertainties caused by COVID-19 generated notable psychological stress among some residents. CONCLUSIONS The COVID-19 pandemic restrictions significantly affected the neurosurgical training program. Innovative solutions need to be developed to increase teaching and research capacities of neurosurgical residents as well as to improve surgical skills by installing surgical skill laboratories or similar constructs.
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Affiliation(s)
- Mazin Omer
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Shadi Al-Afif
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Kathrin Machetanz
- Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Christoph Bettag
- Department of Neurosurgery, Georg August University Göttingen, Göttingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Veit Rohde
- Department of Neurosurgery, Georg August University Göttingen, Göttingen, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
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Al-Afif S, Elkayekh H, Omer M, Heissler HE, Scheinichen D, Palmaers T, Nakamura M, Hermann EJ, Samii M, Krauss JK. Analysis of risk factors for venous air embolism in the semisitting position and its impact on outcome in a consecutive series of 740 patients. J Neurosurg 2021; 137:1-8. [PMID: 34740183 DOI: 10.3171/2021.7.jns211107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Routine use of the semisitting position, which offers several advantages, remains a matter of debate. Venous air embolism (VAE) is a potentially serious complication associated with the semisitting position. In this study, the authors aimed to investigate the safety of the semisitting position by analyzing data over a 20-year period. METHODS The incidence of VAE and its perioperative management were analyzed retrospectively in a consecutive series of 740 patients who underwent surgery between 1996 and 2016. The occurrence of VAE was defined by detection of bubbles on transthoracic Doppler echocardiography (TTDE) or transesophageal echocardiography (TEE) studies, a decrease of end-tidal CO2 (ETCO2) by 4 mm Hg or more, and/or an unexplained drop in systolic arterial blood pressure (≥ 10 mm Hg). From 1996 until 2013 TTDE was used, and from 2013 on TEE was used. The possible risk factors for VAE and its impact on surgical performance were analyzed. RESULTS There were 404 women and 336 men with a mean age at surgery of 49 years (range 1-87 years). Surgery was performed for infratentorial lesions in 709 patients (95.8%), supratentorial lesions in 17 (2.3%), and cervical lesions in 14 (1.9%). The most frequent pathology was vestibular schwannoma. TEE had a higher sensitivity than TTDE. While TEE detected VAE in 40.5% of patients, TTDE had a detection rate of 11.8%. Overall, VAE was detected in 119 patients (16.1%) intraoperatively. In all of these patients, VAE was apparent on TTDE or TEE. Of those, 23 patients also had a decrease of ETCO2, 18 had a drop in blood pressure, and 23 had combined decreases in ETCO2 and blood pressure. VAE was detected in 24% of patients during craniotomy before opening the dura mater, in 67% during tumor resection, and in 9% during wound closure. No risk factors were identified for the occurrence of VAE. Two patients had serious complications due to VAE. Surgical performance in vestibular schwannoma surgery was not affected by the presence of VAE. CONCLUSIONS This study shows that the semisitting position is overall safe and that VAE can be managed effectively. Persistent morbidity is very rare. The authors suggest that the semisitting position should continue to have a place in the standard armamentarium of neurological surgery.
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Affiliation(s)
- Shadi Al-Afif
- 1Department of Neurosurgery, Medical School Hannover, Germany
| | - Hesham Elkayekh
- 1Department of Neurosurgery, Medical School Hannover, Germany
| | - Mazin Omer
- 1Department of Neurosurgery, Medical School Hannover, Germany
| | - Hans E Heissler
- 1Department of Neurosurgery, Medical School Hannover, Germany
| | - Dirk Scheinichen
- 3Department of Anesthesiology and Intensive Care, Medical School Hannover, Germany; and
| | - Thomas Palmaers
- 3Department of Anesthesiology and Intensive Care, Medical School Hannover, Germany; and
| | - Makoto Nakamura
- 2Department of Neurosurgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Cologne, Germany
| | - Elvis J Hermann
- 1Department of Neurosurgery, Medical School Hannover, Germany
| | - Madjid Samii
- 4International Neuroscience Institute, Hannover, Germany
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Omer M, Amir-Khalili A, Sojoudi A, Thao Le T, A Cook S, Faye Toh D, Bryant J, Chin C, Miguel Paiva J, Fung K, Aung N, Y Khanji M, Rauseo E, Cooper J, E Petersen S. Assessing automated CMR contouring algorithms using systematic contour quality scoring analysis. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.434] [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
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): SmartHeart EPSRC programme grant (www.nihr.ac.uk), London Medical Imaging and AI Centre for Value-Based Healthcare
Background
Quality measures for machine learning algorithms include clinical measures such as end-diastolic (ED) and end-systolic (ES) volume, volumetric overlaps such as Dice similarity coefficient and surface distances such as Hausdorff distance. These measures capture differences between manually drawn and automated contours but fail to capture the trust of a clinician to an automatically generated contour.
Purpose
We propose to directly capture clinicians’ trust in a systematic way. We display manual and automated contours sequentially in random order and ask the clinicians to score the contour quality. We then perform statistical analysis for both sources of contours and stratify results based on contour type.
Data
The data selected for this experiment came from the National Health Center Singapore. It constitutes CMR scans from 313 patients with diverse pathologies including: healthy, dilated cardiomyopathy (DCM), hypertension (HTN), hypertrophic cardiomyopathy (HCM), ischemic heart disease (IHD), left ventricular non-compaction (LVNC), and myocarditis. Each study contains a short axis (SAX) stack, with ED and ES phases manually annotated. Automated contours are generated for each SAX image for which manual annotation is available. For this, a machine learning algorithm trained at Circle Cardiovascular Imaging Inc. is applied and the resulting predictions are saved to be displayed in the contour quality scoring (CQS) application.
Methods: The CQS application displays manual and automated contours in a random order and presents the user an option to assign a contour quality score
1: Unacceptable, 2: Bad, 3: Fair, 4: Good. The UK Biobank standard operating procedure is used for assessing the quality of the contoured images. Quality scores are assigned based on how the contour affects clinical outcomes. However, as images are presented independent of spatiotemporal context, contour quality is assessed based on how well the area of the delineated structure is approximated. Consequently, small contours and small deviations are rarely assigned a quality score of less than 2, as they are not clinically relevant. Special attention is given to the RV-endo contours as often, mostly in basal images, two separate contours appear. In such cases, a score of 3 is given if the two disjoint contours sufficiently encompass the underlying anatomy; otherwise they are scored as 2 or 1.
Results
A total of 50991 quality scores (24208 manual and 26783 automated) are generated by five expert raters. The mean score for all manual and automated contours are 3.77 ± 0.48 and 3.77 ± 0.52, respectively. The breakdown of mean quality scores by contour type is included in Fig. 1a while the distribution of quality scores for various raters are shown in Fig. 1b.
Conclusion
We proposed a method of comparing the quality of manual versus automated contouring methods. Results suggest similar statistics in quality scores for both sources of contours.
Abstract Figure 1
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Affiliation(s)
- M Omer
- Circle Cardiovascular Imaging Inc., Calgary, Canada
| | | | - A Sojoudi
- Circle Cardiovascular Imaging Inc., Calgary, Canada
| | - T Thao Le
- National Heart Centre Singapore, Singapore, Singapore
| | - S A Cook
- National Heart Centre Singapore, Singapore, Singapore
| | - D Faye Toh
- National Heart Centre Singapore, Singapore, Singapore
| | - J Bryant
- National Heart Centre Singapore, Singapore, Singapore
| | - C Chin
- National Heart Centre Singapore, Singapore, Singapore
| | | | - K Fung
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - N Aung
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - M Y Khanji
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - E Rauseo
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - J Cooper
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - S E Petersen
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
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Younis LG, Kroeger A, Joshi AB, Das ML, Omer M, Singh VK, Gurung CK, Banjara MR. Housing structure including the surrounding environment as a risk factor for visceral leishmaniasis transmission in Nepal. PLoS Negl Trop Dis 2020; 14:e0008132. [PMID: 32150578 PMCID: PMC7062236 DOI: 10.1371/journal.pntd.0008132] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/11/2020] [Indexed: 11/27/2022] Open
Abstract
Visceral leishmaniasis (VL) in Nepal is found in 61 out of 75 districts including areas previously listed as non- endemic. This study focused on the role of housing conditions and its immediate environment in VL transmission, to limit future transmissions, ensure sustainable vector control and support the VL elimination program. The objective was to explore the risk factors in rural housing-and land lot typologies contributing to clinical VL occurrence and transmission. Housing structures and land lots were examined based on characteristics as risk factors of VL transmission in a case-control analysis. VL cases from 2013–2017 were identified based on the existing database from the Epidemiology and Disease Control Division and District Public Health Office from the plain Terai area (Morang, and Saptari districts) and hilly area (Palpa district) of Nepal. Two hundred and three built environments were analyzed (66 cases and 137 controls). Inferential statistics and logistic regression analysis were performed to determine the association of risk factors with VL. The risk factors with the highest odds of VL were: bamboo walls (adjusted odds ratio (AOR)- 8.1, 95% CI 2.40–27.63, p = 0.001), walls made of leaves/branches (AOR- 3.0, 95% CI 0.84–10.93, p = 0.090), cracks in bedroom walls (AOR- 2.9, 95% CI 0.93–9.19, p = 0.065), and placing sacks near sleeping areas (AOR- 19.2, 95% CI 4.06–90.46, p <0.001). Significant outdoor factors were: lots with Kadam trees (AOR- 12.7, 95% CI 3.28–49.09, p <0.001), open ground-outdoor toilets (AOR- 9.3, 95% CI 2.14–369.85, p = 0.003), moisture in outdoor toilet sheds (AOR- 18.09, 95% CI 7.25–451.01, p = 0.002), nearby- open land (AOR- 36.8, 95% CI 3.14–430.98, p = 0.004), moisture inside animal sheds (AOR- 6.9, 95% CI 1.82–26.66, p = 0.005), and surrounding animals/animals wastes particularly goats (AOR- 3.5, 95% CI 1.09–10.94, p = 0.036). Certain housing and surrounding environmental conditions and characteristics are risk factors for VL. Hence, elimination and educational programs should include the focus on housing improvement and avoidance of risk factors. Longitudinal interventional studies are required to document temporal relationships and whether interventions on these factors will have an impact on Leishmania transmission or burden. Visceral leishmaniasis (VL) is a fatal disease if not treated in time. It is the disease of the poorest people. Poor housing and sanitation around the house are considered as the risk factors for the occurrence of VL. The main objective of our research was to explore multiple risk factors from different housing and land lot- typologies for VL occurrence and transmission through a case-control study. Some of our results reveal that inside the dwelling the likelihood of having clinical VL was substantially enhanced by providing suitable breeding sites for the insect vectors; as an example: the probability of getting VL disease was about ten times higher when there were sacks (empty or filled) near sleeping areas. Also cracks in walls and floors were found to contribute to vector transmission but also particular wall structures such as bamboo walls, and finishes such as animal manure were shown to be optimal for vector breeding. Furthermore, certain animals and plant types in the immediate environment seem to attract the vectors and to have a substantial effect on VL occurrence. Thus, given the alarming increase of VL in previously non-endemic areas of Nepal, these findings, among others, will allow readers and policymakers to better understand the “hidden” VL transmission factors, and will–hopefully- encourage initiating future studies.
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Affiliation(s)
- Lina Ghassan Younis
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Axel Kroeger
- University of Freiburg, Freiburg, Germany
- WHO Special Programme for Research and Training in Tropical Diseases (WHO-TDR), Geneva, Switzerland
| | - Anand B. Joshi
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Murari Lal Das
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Mazin Omer
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Vivek Kumar Singh
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Chitra Kumar Gurung
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
- * E-mail:
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Omer M, Shaikh MA, Stiller M, Lowery Wilson M. Physical Fighting among School-Attending Adolescents in El Salvador: An Examination of the 2013 Global School-Based Health Survey. Int J Environ Res Public Health 2020; 17:E1248. [PMID: 32075210 PMCID: PMC7068388 DOI: 10.3390/ijerph17041248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/22/2020] [Accepted: 02/10/2020] [Indexed: 11/25/2022]
Abstract
Background: Violence among school-attending adolescents is an important public health problem worldwide. The present study examined demographic correlates for physical fighting behavior among a nationally representative sample of school-attending adolescents in El Salvador. Methods: Initial cross-tabulations to screen for correlations was then followed by logistic regression to understand the direction and the strength of selected demographic variables for physical fighting behavior, which occurred within a 12 month period of recall. Results: Out of a sample of 1910 school-attending adolescents in El Salvador, 11.5% reported having been involved in two or more physical fights during the recall period. Regression analyses indicated that being male (OR = 3.55; 95% CI = 2.11-6.00); having experienced bullying (OR = 2.16; 95% CI = 1.44-3.24); physical activity (OR 0.61; 95% CI 0.46-0.80); a sedentary lifestyle (OR 1.54; 95% CI 1.05-2.27), suicide planning (OR 2.28; 95% CI 1.46-3.56), and having non-understanding parents (OR = 1.45; 95% CI 1.06-1.98) were significantly associated with physical fighting among the sampled adolescents. Conclusion: Within the limitations of cross-sectional surveys conducted in school settings, the results of the present study suggest that giving attention to preventing bullying behavior among males and involving parents should be components of a multi-pronged strategy to preventing physical fighting in schools in El Salvador.
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Affiliation(s)
- Mazin Omer
- Injury Epidemiology and Prevention Research Unit, Heidelberg Institute of Global Health (HIGH), University of Heidelberg, 69120 Heidelberg, Germany; (M.O.); (M.S.)
| | - Masood Ali Shaikh
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, 20520 Turku, Finland;
| | - Mariella Stiller
- Injury Epidemiology and Prevention Research Unit, Heidelberg Institute of Global Health (HIGH), University of Heidelberg, 69120 Heidelberg, Germany; (M.O.); (M.S.)
| | - Michael Lowery Wilson
- Injury Epidemiology and Prevention Research Unit, Heidelberg Institute of Global Health (HIGH), University of Heidelberg, 69120 Heidelberg, Germany; (M.O.); (M.S.)
- Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Turku University Hospital and University of Turku, 20520 Turku, Finland;
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Alarfaj R, Aljihani S, Alzayer M, Johani SA, Balkhy H, Yassin A, Omer M, AlKhulaifi M, Alghoribi M, Halwani M. The Inhibitory activity of Tobramycin and Liposomal-Tobramycin-N-Acetylcysteine formulations Against Uropathogenic Escherichia coli (UPEC) Biofilms. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.067] [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: 10/25/2022] Open
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12
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Omer M, Kroeger A, Joshi AB, Das ML, Younis LG, Singh VK, Gurung CK, Banjara MR. Role of female community health volunteers for visceral leishmaniasis detection and vector surveillance in Nepal. Health Promot Perspect 2020; 10:50-58. [PMID: 32104657 PMCID: PMC7036200 DOI: 10.15171/hpp.2020.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/16/2019] [Indexed: 11/14/2022] Open
Abstract
Background: As visceral leishmaniasis (VL) has recently expanded in previously non-endemic areas of Nepal, the health system is facing new challenges. Female community health volunteers(FCHVs) are playing an important role for VL elimination in Nepal. This study aimed to analyze the actual and potential role of FCHVs for VL elimination program as well as community awareness of the disease (VL) and protective measures. Methods: We used a concurrent embedded mixed methods design. Qualitative data were collected through in-depth interviews and focus group discussions with FCHVs of 22 VLendemic villages of 3 districts. Concurrently quantitative data were collected through formal interviews of 203 household heads of the same villages. Results: FCHVs are able to perform their duties in an efficient way with the support of their families and specific incentives. FCHVs in the VL-endemic region have a good ability to recognize the VL suspects and refer to health facilities. The feedback by the district health office on referred patients was weak thus missing the opportunity of involving FCHVs in the 6-months follow up. In houses with a previous VL case knowledge levels of prevention and treatment ofVL were significantly better than in houses without a previous VL case. More people in houses with a former VL patient were aware on VL transmission. Conclusion: FCHVs are playing an important role for VL elimination in Nepal through detection of suspected cases and referral and may play a role in vector surveillance.
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Affiliation(s)
- Mazin Omer
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Axel Kroeger
- Freiburg University, Freiburg, Germany, WHO Special Programme for Research and Training in Tropical Diseases (WHOTDR), Geneva, Switzerland
| | - Anand Ballabh Joshi
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Murari Lal Das
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Lina Ghassan Younis
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Vivek Kumar Singh
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Chitra Kumar Gurung
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Abdalla AS, Salih A, Chicken W, Idaewor P, Elamass M, Omer M, Eldruki S, Comez T, Barron M, Asaad A. Ki-67 expression impact on lympho-vascular invasion presence in early breast cancer. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Apaydin A, Kocaelli H, Omer M. Management of self-inflicted gunshot (pellet) wounds of the jaws with Le fort I osteotomy followed by implant insertion and prosthetic rehabilitation. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.017] [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]
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15
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Montes VN, Subramanian S, Goodspeed L, Wang SA, Omer M, Bobik A, Teshigawara K, Nishibori M, Chait A. Anti-HMGB1 antibody reduces weight gain in mice fed a high-fat diet. Nutr Diabetes 2015; 5:e161. [PMID: 26075638 PMCID: PMC4491852 DOI: 10.1038/nutd.2015.11] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/05/2015] [Accepted: 04/22/2015] [Indexed: 01/19/2023] Open
Abstract
Insulin resistance in obesity is believed to be propagated by adipose tissue and liver inflammation. HMGB1 is a multifunctional protein that is pro-inflammatory when released from cells. It has been previously demonstrated that anti-HMGB1 antibody reduces atherosclerotic lesion pro-inflammatory cells and progression of atherosclerosis in a mouse model. To test the potential beneficial role of blocking HMGB1 in adipose tissue and liver inflammation in mice fed an obesogenic diet, we administered anti-HMGB1 antibody to C57Bl/6 mice fed a high (60%)-fat diet. The mice were treated with weekly injections of an anti-HMGB1 antibody or anti-KLH antibody (isotype control) for 16 weeks. Mice that received the anti-HMGB1 antibody gained less weight than the control-treated animals. Anti-HMGB1 treatment also reduced hepatic expression of TNF-alpha and MCP-1, molecules that promote inflammation. However, adipose tissue inflammation, as measured by gene expression analyses and immunohistochemistry, did not differ between the two groups. There also were no differences in glucose or insulin tolerance between the two groups. When feeding mice a high-fat diet, these data suggest that HMGB1 may have a crucial role in weight gain and liver inflammation.
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Affiliation(s)
- V N Montes
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S Subramanian
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
| | - L Goodspeed
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
| | - S A Wang
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
| | - M Omer
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Bobik
- BakerIDI Heart and Diabetes Institute, Melbourne, Australia
| | - K Teshigawara
- Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - M Nishibori
- Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - A Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA
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Abstract
In this paper, we present a case review of a 58-year-old female who presented to our emergency department with pyrexia, dyspnoea, dehydration and pain in her left breast six months following coronary artery bypass grafting (CABG). Although her sternotomy wound had healed well, examination revealed fluctuance of the whole precordium and left breast. She underwent antibiotic treatment and subsequent surgical debridement, followed by the application of vacuum-assisted dressings. Surgical reconstruction was deemed unsuitable and therefore the patient continued to be managed with vacuum dressings followed by routine dressings to allow the wound to heal by secondary intention. The patient was discharged three months after initial presentation in a good condition. The wound had completely healed four months later.
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Affiliation(s)
- A Mustafa
- Specialist Cardiothoracic Surgeon, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - C Carr
- Cardiothoracic Surgeon, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - S Alkhafagi
- Specialist Cardiothoracic Surgeon,Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - N Mughal
- Clinical Associate, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - M Omer
- Clinical Associate, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - A Alkhulaifi
- Chairman of Cardiothoracic Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Omer M. O717 Establishment of a gynecological laparoscopy unit in Omdurman Maternity Hospital, Sudan - challenges and outcome. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61090-0] [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]
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18
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Salman M, Omer M. O819 Implementation of health systems in reducing maternal mortality. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61192-9] [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: 11/27/2022]
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Dobinson KF, Harrington MA, Omer M, Rowe RC. Molecular Characterization of Vegetative Compatibility Group 4A and 4B Isolates of Verticillium dahliae Associated with Potato Early Dying. Plant Dis 2000; 84:1241-1245. [PMID: 30832175 DOI: 10.1094/pdis.2000.84.11.1241] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Forty isolates of Verticillium dahliae, collected from potato seed tubers and potato plants from various regions in North America and previously assigned to vegetative compatibility groups (VCGs) 4A or 4B, were characterized using molecular markers. The VCG 4A isolates were previously shown to be a highly virulent pathotype of potato and to interact synergistically with the root-lesion nematode Pratylenchus penetrans to cause potato early dying. All but one of the VCG 4A isolates characterized in this study lacked the subspecies-specific repetitive DNA sequence E18 and could be differentiated from the remaining isolates by restriction fragment length polymorphisms (RFLPs) in the nuclear rDNA and Trp1 loci. The E18 RFLP patterns of several VCG 4B isolates from Maine and New York were highly similar to those of VCG 4B isolates previously collected from potato and tomato fields in Ontario. The data presented here suggest that the molecular markers will be useful for the detection and classification of isolates of V. dahliae associated with potato early dying.
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Affiliation(s)
- K F Dobinson
- Agriculture and Agri-Food Canada, London, ON, Canada N5V 4T3
| | - M A Harrington
- Department of Plant Sciences, University of Western Ontario, London, ON, Canada N6A 5B7
| | - M Omer
- Department of Plant Pathology, Ohio State University, Ohio Agricultural Research and Development Center, Wooster 44691
| | - R C Rowe
- Department of Plant Pathology, Ohio State University, Ohio Agricultural Research and Development Center, Wooster 44691
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