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1.
Saudi Dent J ; 36(1): 123-128, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38375398

RESUMO

The fabrication of periodontal ligament (PDL) models for in vitro dental studies has seen a wide range of techniques and materials being utilized. This paper introduces a novel dental technique that employs a digital workflow for the fabrication of artificial PDL using three-dimensional printing of flexible resin. This innovative approach offers several advantages, including enhanced accuracy and realism in simulating PDL. The digital workflow facilitates a streamlined fabrication process, ensuring efficiency and precision. By presenting this novel technique, this digital approach contributes to the advancement of in vitro dental research, providing researchers with a reliable and realistic model for studying various dental phenomena.

2.
J Egypt Natl Canc Inst ; 35(1): 5, 2023 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-36872409

RESUMO

BACKGROUND: Multi-parametric magnetic resonance imaging may improve the detection of prostate cancer. The aim of this work is to compare between PI-RADS 3-5 and PI-RADS 4-5 as a threshold for targeted prostatic biopsy. METHODS: This is a prospective clinical study that included 40 biopsy-naïve patients referred for prostate biopsy. Patients underwent prebiopsy multi-parametric (mp-MRI), followed by 12-core transrectal ultrasound-guided systematic biopsy and cognitive MRI/TRUS fusion targeted biopsy from each detected lesion. The primary endpoint was to assess the diagnostic accuracy of the PI-RAD 3-4 versus PI-RADS 4-5 lesion by mpMRI for prostate cancer detection in biopsy-naive men. RESULTS: The overall prostate cancer detection rate and the clinically significant cancer detection rate were 42.5% and 35%, respectively. Targeted biopsies from PI-RADS 3-5 lesions showed a sensitivity of 100%, specificity of 44%, positive predictive value of 51.7%, and negative predictive value of 100%. Restricting targeted biopsies to PI-RADS 4-5 lesions resulted in a decrease in sensitivity and negative predictive value to 73.3% and 86.2%, respectively, while specificity and positive predictive value were increased to 100% for both parameters which was statistically significant (P value < 0.0001 and P value = 0.004, respectively). CONCLUSIONS: Limiting the TBs to PI-RADS 4-5 lesions improves the performance of mp-MRI in the detection of prostate cancer especially aggressive tumors.


Assuntos
Neoplasias da Próstata , Masculino , Humanos , Próstata , Imageamento por Ressonância Magnética , Estudos Prospectivos , Biópsia , Cognição
3.
PLoS One ; 17(7): e0271271, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35802733

RESUMO

BACKGROUND: In pandemic COVID-19 (coronavirus disease 2019), the prognosis of patients has been determined using clinical data and CT (computed tomography) scans, but it is still unclear whether chest CT characteristics are correlated to COVID-19 severity. AIM: To explore the potential association between clinical data and 25-point CT score and investigate their predictive significance in COVID-19-positive patients at Fayoum University Hospital in Egypt. METHODS: This study was conducted on 252 Egyptian COVID-19 patients at Fayoum University Hospital in Egypt. The patients were classified into two groups: a mild group (174 patients) and a severe group (78 patients). The results of clinical laboratory data, and CT scans of severe and mild patients, were collected, analyzed, and compared. RESULTS: The severe group show high significance levels of CRP, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, urea, ferritin, lactate dehydrogenase (LDH), neutrophil percent, and heart rate (HR) than the mild group. Lymphopenia, hypoalbuminemia, hypocalcemia, and decreased oxygen saturation (SpO2) were the most observed abnormalities in severe COVID-19 patients. Lymphopenia, low SpO2 and albumin levels, elevated serum LDH, ferritin, urea, and CRP levels were found to be significantly correlated with severity CT score (P<0.0001). CONCLUSION: The clinical severity of COVID-19 and the CT score are highly correlated. Our findings indicate that the CT scoring system can help to predict COVID-19 disease outcomes and has a strong correlation with clinical laboratory testing.


Assuntos
COVID-19 , COVID-19/diagnóstico por imagem , Egito/epidemiologia , Ferritinas , Hospitais Universitários , Humanos , Linfopenia , Estudos Retrospectivos , SARS-CoV-2 , Tomografia Computadorizada por Raios X , Ureia
4.
Biomed Pharmacother ; 151: 113160, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35605300

RESUMO

Recently, we reported that quercetin (Que) could alleviate immunotoxicity induced by pristine multi-walled carbon nanotubes (MWCNTs) in mice. In the present study, we explored whether Que could also relieve MWCNTs-induced neurotoxicity. MWCNTs injection induced a dose-dependent neurotoxic effect in mice as evidenced by increased oxidative stress, inflammation, and pyroptosis in the brain. However, treatment with Que ameliorated MWCNTs-induced neurotoxicity as revealed by 1) elevated acetylcholinesterase (AChE) activity, 2) reduced lipid peroxidation biomarker malondialdehyde (MDA), 3) improved antioxidant status as indicated by increased levels of reduced glutathione (GSH) and activities of superoxide dismutase (SOD), catalase (CAT), as well as upregulated expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) genes, 4) decreased levels and expression of inflammatory biomarkers [nitric oxide (NO), interleukin 1 beta (IL1ß), tumor necrosis factor-alpha (TNFα), and nuclear factor kappa B (NF-κB)], 5) downregulated expression of pyroptosis-related genes [nod-like receptor protein inflammasome 3 (Nlrp3) and caspase 1 (Casp1)] but with no effect on the apoptotic Casp3 gene, 6) minimized axonal degeneration and number of microglia in the cerebral medulla, and 7) diminished the number of degenerated neurons in hippocampus and cerebellum. Taken together, Que could ameliorate MWCNT-induced neurotoxicity through antioxidant, anti-inflammatory, and anti-pyroptotic mechanisms.


Assuntos
Nanotubos de Carbono , Quercetina , Acetilcolinesterase/metabolismo , Animais , Antioxidantes/metabolismo , Inflamação/induzido quimicamente , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Camundongos , Fator 2 Relacionado a NF-E2/metabolismo , NF-kappa B/metabolismo , Nanotubos de Carbono/toxicidade , Estresse Oxidativo , Piroptose , Quercetina/farmacologia , Quercetina/uso terapêutico
5.
Molecules ; 27(7)2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35408516

RESUMO

The expanding uses of carbon nanotubes (CNTs) in industry and medicine have raised concerns about their toxicity on human and animal health. CNTs, including multi-walled nanotubes (MWCNTs), have been reported to induce immunotoxic, inflammatory, and oxidative effects. Quercetin is a natural flavonoid present in many vegetables and fruits and has immunomodulatory, anti-inflammatory, and antioxidant properties. Herein, we investigated the protective effects of quercetin on pristine MWCNTs-induced immunotoxicity in mice. In comparison with two doses of MWCNTs, high doses [0.5 mg/kg body weight (BW), once intraperitoneally (IP)] caused higher immunotoxic, inflammatory, and oxidative effects than low doses (0.25 mg/kg BW, once IP). Administration of quercetin (30 mg/kg BW, IP for 2 weeks) relieved these deleterious effects as evidenced by (1) reduced spleen weight, (2) increased number of total leukocytes, lymphocytes, and neutrophils, (3) elevated serum levels of IgM, IgG, and IgA, (4) decreased lipid peroxide malondialdehyde levels and increased levels of antioxidant markers reduced glutathione, superoxide dismutase, and catalase in the spleen, (5) decreased concentrations and mRNA levels of inflammatory markers tumor necrosis factor-alpha (TNFα), interleukin 1 beta (IL1ß), and IL6 in the spleen, (6) downregulated expression of immunomodulatory genes transforming growth factor-beta (TGFß), cyclooxygenase2 (COX2), and IL10, and (7) regenerative histological changes as indicated by decreased mononuclear cell infiltration, minimized degenerative changes and restored lymphocytes depletion in the spleen. These results infer that quercetin can ameliorate MWCNTs-induced immunotoxic, inflammatory, and oxidative effects.


Assuntos
Nanotubos de Carbono , Quercetina , Animais , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Glutationa/metabolismo , Camundongos , Nanotubos de Carbono/toxicidade , Estresse Oxidativo , Quercetina/farmacologia
6.
Clin Rheumatol ; 41(5): 1333-1342, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35048212

RESUMO

PURPOSE: To assess vitamin D receptor (VDR) gene polymorphisms and bone mineral density and to investigate the possible risk factors of osteoporosis and fracture in rheumatoid arthritis (RA). METHODS: A total of 97 RA patients and 45 matched controls were enrolled. Serum vitamin D level, VDR genotyping, dual-energy X-ray absorptiometry (DEXA) scan, trabecular bone score (TBS), and fracture risk assessment (FRAX) in 10 years were assessed. Disease activity score (DAS28) and modified health assessment questionnaire (MHAQ) were measured. RESULTS: The mean age of the patients was 47.9 ± 8.9 years; 85 females, 12 males (F:M 7.1:1) and mean disease duration 9.4 ± 6.2 years. DAS28 was 4.52 ± 1.04 and MHAQ 0.6 ± 0.4. There was a significant difference between cases and controls as regards DEXA and FRAX (p < 0.0001) but the TBS and VDR genotyping were comparable (p = 0.29 and p = 0.12, respectively). The vitamin D level was comparable with the control (9.3 ± 6.5 vs 10.4 ± 7.5 ng/mL, p = 0.4). None of the patients was receiving anti-osteoporotic therapy or biologic therapy. There was a significant association between the presence of osteoporosis and age, disease duration, menopause, and rheumatoid factor (RF) positivity. The TBS was significantly lower and FRAX higher in patients with positive RF and anti-CCP. FRAX was significantly related and the TBS inversely with the age, disease duration, serum uric acid, alkaline phosphatase, and MHAQ. CONCLUSIONS: Reduced BMD and increased tendency to fractures are remarkable in RA patients. Vitamin D level was decreased in patients and control, and VDR gene polymorphisms were not linked to RA. TBS and FRAX are effective tools to assess osteoporotic fractures in RA. Key Points • Reduced bone mineral density (BMD) and increased tendency to fractures are remarkable in rheumatoid arthritis (RA) patients. • Vitamin D level was decreased in patients and control, and VDR gene polymorphisms were not linked to RA. • Trabecular bone score (TBS) and fracture risk assessment (FRAX) in 10 years are effective tools to assess osteoporotic fractures in RA.


Assuntos
Artrite Reumatoide , Osteoporose , Fraturas por Osteoporose , Absorciometria de Fóton/efeitos adversos , Adulto , Artrite Reumatoide/complicações , Artrite Reumatoide/genética , Densidade Óssea , Osso Esponjoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/genética , Fraturas por Osteoporose/genética , Polimorfismo Genético , Receptores de Calcitriol/genética , Medição de Risco , Ácido Úrico , Vitamina D
7.
Acta Ophthalmol ; 100(1): e246-e252, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33998179

RESUMO

PURPOSE: The aim of this study was to compare outcome of 3 different surgical modalities for management of uveitic glaucoma (UG). METHODS: This is a prospective comparative study, carried out on a cohort of 105 eyes (105 patients) with UG of different aetiologies. Patients were randomly allocated to group A (trabeculectomy), group B (Ahmed glaucoma valve; AGV) or group C (Trans-scleral diode laser cyclophotocoagulation, TDLC). Postoperatively, all patients were followed up for 2 years. Humphrey SITA standard perimetry was done 6, 12 and 24 months. Complete success was defined as IOP ≤ 21 mmHg and relative decrease of ≥20%, without additional glaucoma surgery or antiglaucoma medication, qualified success as IOP ≤ 21 mmHg and additional reduction of ≥20% in IOP, without additional glaucoma surgery, but with topical medications, while failure was considered when IOP was not controlled with topical medications and the patient needed additional surgery, or hypotony for ≥2 months. RESULTS: At first, IOP was significantly lower with AGV and significantly higher with TDLC, with significant drop and percentage drop between the three groups. Starting from the 6th month postoperatively till the end of the 2-year period, there was no statistically significant difference between the 3 groups. There was no significant difference between the three groups, with complete success achieved in 60% with trabeculectomy, 68.6% with AGV and 62.9% with TDLC. There was significant difference for inflammatory cells grading; 65.7% of eyes with trabeculectomy had 2+ cells, 57% with AGV had 0 cells while 45.7% with TDLC had 1+ cells. CONCLUSION: The three surgical modalities had the same IOP-lowering effect on the long run, with complete success rate that is close enough between them, with AGV revealing the least inflammation, which might be the cause of more stable VF with Ahmed's valve proving its superiority to the other 2 techniques for inflammatory glaucoma.


Assuntos
Gerenciamento Clínico , Implantes para Drenagem de Glaucoma , Glaucoma/cirurgia , Pressão Intraocular/fisiologia , Trabeculectomia/métodos , Uveíte/complicações , Acuidade Visual , Adolescente , Adulto , Feminino , Seguimentos , Glaucoma/etiologia , Glaucoma/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
8.
Leuk Res Rep ; 16: 100272, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34692402

RESUMO

PURPOSE: The present study aimed to compare treatment outcome of idarubicin versus doxorubicin in combination with Ara-C as induction therapy for untreated AML patients. PATIENTS AND METHODS: This retrospective study included 143 patients with de novo AML. All patients received full dose of standard induction therapy (3 + 7) using anthracyclines (doxorubicin or idarubicin) and cytarabine. RESULTS: The studied groups had comparable CR. No significant differences were noted between the studied groups regarding DFS and OS. The DXR group had significantly lower cost in comparison to IDA group. CONCLUSIONS: Idarubicin doesn't have a clear advantage over doxorubicin in treatment of AML.

9.
Egypt Heart J ; 73(1): 78, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34499263

RESUMO

BACKGROUND: Deferred stenting, despite being successful in early studies, showed no benefit in recent trials. However, these trials were testing routine deferral; not in patients with heavy thrombus burden. RESULTS: This is a prospective, Randomized Clinical Trial that included 150 patients who presented with STEMI, patients were allocated into three equal groups after the coronary angiography ± primary intervention and before stenting of the culprit lesion; group (A) included 50 patients with early deferral of stenting, group (B) included 50 patients with late deferral and group (C) included 50 patients with immediate stenting. No-reflow was significantly higher in group C, while Final TIMI flow grade 3 and MBG grade 3 were significantly higher in group A and B than group C; p = 0.019 and < 0.001 respectively, with no significant difference between groups A and B, only the thrombus resolution in group B was significantly higher than group A; p < 0.001. Finally, 6-months, over-all MACE was significantly higher in group C (34.7% vs. 14.6% and 16.3%, p = 0.029). CONCLUSIONS: Stent deferral was proved to be better than immediate stenting after recanalization of IRA, in achieving TIMI III flow, reducing risk of 6 months MACE, and restoration of myocardial function in a subset of STEMI patients presenting with large thrombus burden. While, no significant difference was found between both deferral times in final TIMI flow, or clinical outcomes.

10.
Stem Cell Res Ther ; 12(1): 441, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362466

RESUMO

BACKGROUND AND OBJECTIVES: The X-linked bleeding disorder, hemophilia A, is caused by defective production of factor VIII (FVIII). Hemophilic patients require regular FVIII infusions. Recombinant factor replacement poses the safest line of therapy. However, its main drawbacks are high expenses and the higher liability for formation of inhibitors. Recent studies confirmed the ability of bone marrow-derived stem cells to secrete FVIII. This study aims to generate bioscaffold from decellularized liver and subsequently seed it with trans-differentiated human stem cells into hepatic-like cells. This scaffold can then be implanted intraperitoneally or subcutaneously to provide FVIII. METHODS: After generation of the bioscaffold, seeding of discoid scaffolds with trans-differentiated human hepatocyte-like cells was performed. Then, the generated organoid was implanted into peritoneal cavity or subcutaneous tissue of experimental rats. RESULTS: Serum human FVIII was significantly increased in rats subjected to subcutaneous implantation compared intraperitoneal implantation. Immunostaining for detecting Cytokeratin 19 and human anti-globulin confirmed the presence of mature human hepatocytes that were significantly increased in subcutaneous implanted scaffold compared to the intraperitoneal one. CONCLUSION: Implantation of decellularized bioscaffold seeded with trans-differentiated stem cells in rats was successful to establish production of FVIII. Subcutaneous implantation showed higher FVIII levels than intraperitoneal implantation.


Assuntos
Hemofilia A , Tela Subcutânea , Animais , Diferenciação Celular , Hepatócitos , Humanos , Ratos , Células-Tronco
12.
Spectrochim Acta A Mol Biomol Spectrosc ; 251: 119428, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33485244

RESUMO

A exceedingly touchy resonance Rayleigh scattering (RRS) strategy for the assurance of nilotinib (NILO) was introduced. In the pH 3.4 acetate buffer solution, NILO reacted with erythrosine B to produce an ion-association complex, which increased the RRS intensity of the studied system. The enhanced RRS intensity (ΔI) was linearly proportional to the concentration of NILO, the linear range of the method was 0.1-1.0 µg/mL and the detection limit (DL) was 0.025 µg/mL. In like manner, this test was connected to distinguish the concentration of NILO in capsules and human plasma with palatable comes about.


Assuntos
Antineoplásicos , Eritrosina , Cápsulas , Humanos , Concentração de Íons de Hidrogênio , Pirimidinas , Espalhamento de Radiação , Espectrometria de Fluorescência
13.
Int Ophthalmol ; 41(4): 1179-1190, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33387108

RESUMO

PURPOSE: To compare outcome of 4 methods for management of angle closure neovascular glaucoma (NVG) in diabetic eyes. METHODS: Prospective comparative study, on 40 eyes (40 patients) with NVG. Patients were randomly assigned to group A (Trabeculectomy with MMC), B (Ahmed valve), C (Ex-Press Minishunt with MMC) or D (Diode cyclophotocoagulation). Patients were followed regularly for 1 year. MAIN OUTCOME MEASURES: intraocular pressure (IOP), best corrected visual acuity (BCVA), central foveal thickness (CFT), intraoperative bleeding, postoperative complications and 2ry intervention. RESULTS: Preoperative data were not significantly different between 4 groups. Postoperatively, there was significant drop in IOP in each group at each follow-up. Ahmed valve group showed least mean postoperative IOP and highest mean drop of the IOP at 1 day and 1 week postoperatively, while Ex-Press minishunt group had least mean postoperative IOP at 1 month and 3 months postoperatively. At 6 months and 1 year, there was no significant difference between 4 groups. BCVA was not significantly different between 4 groups. At 1 year, CFT was significantly lower in each of the 4 groups, and it was significantly the least in group A and highest in group D. Highest intraoperative bleeding was observed with trabeculectomy. Success rate was not significantly different among the 4 groups. CONCLUSION: The 4 management options showed a significant long-term effect on IOP, and on long-terms there was no significant difference between them for IOP and BCVA. Trabeculectomy showed highest incidence of intraoperative bleeding, while cyclophotocoagulation showed none.


Assuntos
Diabetes Mellitus , Glaucoma Neovascular , Trabeculectomia , Glaucoma Neovascular/diagnóstico , Glaucoma Neovascular/etiologia , Glaucoma Neovascular/cirurgia , Humanos , Pressão Intraocular , Estudos Prospectivos , Tonometria Ocular , Resultado do Tratamento
14.
Ophthalmologica ; 244(1): 76-82, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32731247

RESUMO

PURPOSE: To assess the impact of the COVID-19 pandemic on ophthalmology practice in the Cairo metropolitan area. METHODS: This is a cross-sectional observational analytic study among ophthalmologists practicing in different hospitals in the Cairo metropolitan area. The data were collected through a self-administered questionnaire covering general measures taken during practice. RESULTS: The questionnaire was sent to 250 ophthalmologists, with an 82% response rate. Most of the participants were concerned about the economic impact of the pandemic, as there is a 60-80% reduction in the flow of patients with a consequent 80-100% reduction in surgical cases. Most of the participants have access to personal protective equipment, and the safety protocols are followed, especially by the older ophthalmologists. Thus, the surgeons are willing to perform elective surgeries, adhering to strict safety protocols (70.8, 42.6, and 18.8% of the refractive surgeons, corneal surgeons, and retinal surgeons, respectively; p = 0.00). Furthermore, 63.9% of the participants, especially the young ophthalmologists, are willing to see COVID-19 patients and operate on them if needed. CONCLUSIONS: The COVID-19 pandemic could go on for months or even years with a significant impact on ophthalmology practice. Trying to keep a balance between safety and economic burden, the majority of ophthalmologists are willing to see elective patients and urgently operate on a COVID-19 patient, under adherence to the safety protocols.


Assuntos
COVID-19/epidemiologia , Oftalmologia/tendências , Padrões de Prática Médica/tendências , SARS-CoV-2 , Adulto , Idoso , Estudos Transversais , Egito/epidemiologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmologistas/psicologia , Oftalmologistas/estatística & dados numéricos , Equipamento de Proteção Individual/estatística & dados numéricos , Inquéritos e Questionários
15.
BJR Open ; 2(1): 20190006, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33178957

RESUMO

OBJECTIVE: To assess the short-term efficacy of ultrasound-guided caudal epidural steroid injections (ESIs) in improving pain, and nerve function as measured by electrophysiological testing in chronic radicular low back pain. METHODS: Patients diagnosed with chronic radicular low back pain were randomized into one of two groups. The injection group (n = 20) underwent a single ultrasound-guided Caudal ESI of 1 ml of 40 mg ml-1 Triamcinolone Acetonide (Kenacort-A), with local anesthetic. The control group (n = 20) underwent a 12-session physiotherapy program. Both groups were evaluated before and 2 weeks after the intervention using visual analog scale for pain and electrophysiological testing comprising peroneal and tibial terminal motor latencies and F-response latencies and chronodispersion. RESULTS: Both groups showed significant pain reduction on the visual analog scale after the intervention. The injection group showed a significant reduction in F wave chronodispersion post-treatment (<0.01). In the control group, there were no significant differences in F wave parameters pre- and post-treatment (p > 0.05). CONCLUSION: Caudal ESIs were shown to provide short-term improvement of nerve function as evident by improvement in the electrophysiological parameters sensitive to radiculopathy. It was found to be superior to standard physical therapy in this regard. ADVANCES IN KNOWLEDGE: This work shows a novel electrophysiologic evidence of the short-term efficacy ultrasound-guided caudal ESI.

16.
Semin Ophthalmol ; 35(5-6): 296-306, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-33017198

RESUMO

PURPOSE: To assess the concerns of the residents and young ophthalmologists as well as the change in their practice during the COVID era. DESIGN: This is an cross-sectional study. METHODS: A questionnaire was directed to the young Ophthalmologists of Ophthalmology department in Cairo University hospitals. The primary outcome measures were the effects of COVID-19 pandemic on ophthalmology practice. RESULTS: Seventy-nine young Ophthalmologists responded to the questionnaire, with an age ranging from 24 to 36 years of age of which 57% were females. They all practiced Ophthalmology from less than one year up to 9 years long, with 55.8% of them feeling unlucky starting ophthalmic practice during this era, 7.6% are extremely anxious regarding their psychological concern about the pandemic, and some feel they need psychological assessment especially those with 1-3 years duration of practice (41.2%) (p = .011) , especially females (82.4%, p = .015 ). As for access to PPE, 94.9% are wearing masks in the clinic, but only 8.9% of patients are wearing masks. Before this lockdown, 16.7% of the enrolled candidates attended on line lectures and webinars, but since then, this has significantly surged to 80.5% (p < .001) . CONCLUSION: Due to COVID-19 pandemic, as with everybody else, our young ophthalmologists have been affected on many different levels; psychologically, education and practice levels.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Internato e Residência , Oftalmologistas/psicologia , SARS-CoV-2 , Adulto , COVID-19/transmissão , Estudos Transversais , Egito/epidemiologia , Feminino , Hospitais Universitários , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Oftalmologia/educação , Equipamento de Proteção Individual , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
17.
Eur Heart J ; 41(27): 2579-2588, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32584388

RESUMO

AIMS: The European Association of Percutaneous Cardiovascular Interventions (EAPCI) Atlas of Interventional Cardiology has been developed to map interventional practice across European Society of Cardiology (ESC) member countries. Here we present the main findings of a 16-country survey in which we examine the national availability of interventional infrastructure, human resource, and procedure volumes. METHODS AND RESULTS: Sixteen ESC member countries participated in the EAPCI Atlas survey. Interventional data were collected by the National Cardiac Society of each participating country. An annual median of 5131 [interquartile range (IQR) 4013-5801] diagnostic heart procedures per million people were reported, ranging from <2500 in Egypt and Romania to >7000 in Turkey and Germany. Procedure rates showed significant correlation (r = 0.67, P = 0.013) with gross national income (GNI) per capita. An annual median of 2478 (IQR 1690-2633) percutaneous coronary interventions (PCIs) per million people were reported, ranging from <1000 in Egypt and Romania to >3000 in Switzerland, Poland, and Germany. Procedure rates showed significant correlation with GNI per capita (r = 0.62, P = 0.014). An annual median of 48.2 (IQR 29.1-105.2) transcatheter aortic valve implantation procedures per million people were performed, varying from <25 per million people in Egypt, Romania, Turkey, and Poland to >100 per million people in Denmark, France, Switzerland, and Germany. Procedure rates showed significant correlation with national GNI per capita (r = 0.92, P < 0.001). CONCLUSION: The first report from the EAPCI Atlas has shown considerable international heterogeneity in interventional cardiology procedure volumes. The heterogeneity showed association with national economic resource, a reflection no doubt of the technological costs of developing an interventional cardiology service.


Assuntos
Cardiologia , Intervenção Coronária Percutânea , Europa (Continente) , França , Alemanha , Humanos , Polônia , Suíça
18.
Glob Cardiol Sci Pract ; 2020(3): e202032, 2020 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-33598492

RESUMO

Emergency treatment for thrombosed mechanical valve prothesis during pregnancy is not uncommon in low- and middle-income countries. The presence of a mechanical valve continues to be an important cause of maternal morbidity and mortality. There is a pressing need for increasing awareness and feasible solutions for this huge problem. We here describe four patients who needed emergency treatment for thrombosis of mechanical valve prothesis during pregnancy and review the evolving comprehensive strategies for dealing with this issue.

19.
J Fr Ophtalmol ; 42(5): 457-463, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30979559

RESUMO

PURPOSE: The goal of this study was to assess changes in OCT parameters occurring in high myopic glaucoma patients, so as to enable early diagnosis and prevention of progressive glaucomatous damage. It was performed at the department of ophthalmology, Kasr Alainy Hospital, Cairo University, over a twenty-month period. METHODS: This study was a cross-sectional randomized single blinded study. It included 62 eyes of highly myopic individuals. Patients were divided into 2 groups: Group A included myopic non-glaucomatous individuals, and Group B included the myopic glaucoma patients. All patients had a full ophthalmological examination, as well as OCT assessment of the RNFL, GCC and ONH parameters. The VF was tested as well as AXL and CCT. Correlation of the data was performed. RESULTS: Regarding the GLV, its mean in group A was 11.88±6.71% versus 19.69±9.69% in group B; the difference between both groups was statistically significant (P=0.001). Regarding the cup area, the mean in group A was 0.51±0.41mm2, while that in group B was 1.25±0.72mm2; the difference between both groups was statistically significant (P<0.001). CONCLUSION: The ONH parameter, cup area, and the GCC parameter, GLV, are key parameters in supporting the diagnosis of glaucoma in myopic patients. Other parameters measured by OCT, such as inferior RNFL thickness, FLV, and C/D ratio, could aid in diagnosis as well.


Assuntos
Glaucoma/diagnóstico , Miopia/diagnóstico , Tomografia de Coerência Óptica/métodos , Adulto , Estudos de Casos e Controles , Estudos Transversais , Diagnóstico Precoce , Feminino , Glaucoma/complicações , Glaucoma/patologia , Glaucoma/fisiopatologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/patologia , Miopia/fisiopatologia , Fibras Nervosas/patologia , Fibras Nervosas/ultraestrutura , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Distribuição Aleatória , Índice de Gravidade de Doença , Método Simples-Cego
20.
BMC Urol ; 18(1): 99, 2018 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-30413201

RESUMO

PURPOSE: Warm ischemia (WI) and bleeding constitute the main challenges for surgeons during laparoscopic partial nephrectomy (LPN). Current literature on the use of lasers for cutting and coagulation remains scarce and with small cohorts. We present the largest case series to date of non-ischemic LPN using a diode laser for small exophytic renal tumors. METHODS: We retrospectively evaluated 29 patients with clinically localized exophytic renal tumors who underwent non-ischemic laser-assisted LPN with a 1318-nm wavelength diode laser. We started applying the laser 5 mm beyond the visible tumor margin, 5 mm away from the tissue in a non-contact fashion for coagulation and in direct contact with the parenchymal tissue for cutting. RESULTS: The renal vessels were not clamped, resulting in a WIT (warm ischaemic time) of 0 min, except for one case that required warm ischemia for 12 min and parenchymal sutures. No transfusion was needed, with a mean Hemoglobin drop of 1,4 mg/dl and no postoperative complications. The eGFR did not significantly change by 6 months. Histologically, the majority of lesions (n = 22/29) were renal-cell carcinoma stage pT1a. The majority of malignant lesions (n = 13/22) had a negative margin. However, margin interpretation was difficult in 9 cases due to charring of the tumor base. A mean follow-up of 1.8 years revealed no tumor recurrence. The mean tumor diameter was 19.4 mm. CONCLUSION: The 1318-nm diode laser has the advantages of excellent cutting and sealing properties when applied to small vessels in the renal parenchyma, reducing the need for parenchymal sutures. However, excessive smoke, charring of the surgical margin, and inability to seal large blood vessels are encountered with this technique.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Laparoscopia/métodos , Lasers Semicondutores/uso terapêutico , Nefrectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/diagnóstico por imagem , Estudos de Coortes , Feminino , Seguimentos , Humanos , Neoplasias Renais/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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