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1.
Oncology ; 101(6): 362-368, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37231874

RESUMEN

BACKGROUND: Therapy-related leukemia is a term that describes the occurrence of leukemia following exposure to hematotoxins and radiation to emphasize the difference from leukemia that arises de novo. Many agents and host factors contribute to this entity of leukemias. Therapy-related acute myeloid leukemia has an extensive literature review in contrast to therapy-related chronic myeloid leukemia (t-CML). Radioactive iodine (RAI), an established agent in the management of differentiated thyroid carcinomas, has raised concern due to its possible carcinogenic effects. SUMMARY: In this article, we reviewed all the reports from the 1960s to date related to t-CML following RAI on Google Scholar and PubMed. We have identified 14 reports and found that most reports were for men under the age of 60 years with primary papillary thyroid carcinoma and mixed follicular-papillary thyroid carcinoma who developed t-CML mainly between 4 and 7 years after exposure to varying doses of I131. However, the mean dose was 287.78 millicuries (mCi). It was reported that a statistically significant increase in leukemia following RAI therapy (relative risk of 2.5 for I131 vs. no I131). Also, there was a linear relationship between the cumulative dose of I131 and the risk of leukemia. Doses higher than 100 mCi were associated with a greater risk of developing secondary leukemia, and most of the leukemias developed within the initial 10 years of exposure. The precise mechanism through which RAI provokes leukemia is largely unclear. A few mechanisms have been proposed. KEY MESSAGES: Although the risk for t-CML appears to be low based on current reports and does not represent a contraindication to RAI therapy, it should not be disregarded. We suggest including it in the risk-benefit discussion before initiating this therapy. Long-term follow-up for patients is advisable for those who received doses over 100 mCi with a complete blood count, possibly yearly, for the first 10 years. The new onset of significant leukocytosis post RAI exposure should raise the suspicion for t-CML. Further studies are needed to establish or refute a causal relationship.


Asunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva , Neoplasias de la Tiroides , Masculino , Humanos , Persona de Mediana Edad , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/radioterapia , Radioisótopos de Yodo/efectos adversos , Cáncer Papilar Tiroideo/inducido químicamente , Cáncer Papilar Tiroideo/complicaciones , Cáncer Papilar Tiroideo/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/etiología , Leucemia Mielógena Crónica BCR-ABL Positiva/radioterapia , Medición de Riesgo
2.
Int J Neurosci ; : 1-8, 2023 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-38153438

RESUMEN

AIM: This work explores the effect of Cisplatin-a chemotherapeutic agent known to cause deterioration in cognitive function in cancer patients, and spatial memory in mice. It also investigates the potential neuroprotective effects of Piracetam, which is a nootropic drug recognized for improving cognitive ability. MATERIALS AND METHODS: The study incorporates four groups of mice receiving varied medication regimens, with memory tested using the Novel Location Recognition (NLR) method. RESULTS: The findings from our study revealed that memory decline and a suppression of cellular proliferation were observed in adult male mice subjected to Cisplatin treatment; furthermore, a decline in antioxidant efficacy within the hippocampal dentate gyrus was evident. Moreover, analysis of treatment effects on the animals' weight revealed that the Cisplatin and Piracetam group exhibited the most significant weight loss during drug administration. Despite the significant weight loss, the simultaneous use of Cisplatin and Piracetam demonstrated a notable improvement in memory and an augmentation of hippocampal proliferation and antioxidant effect. LIMITATIONS: It is important to note that our study was hampered by budget limits, a lack of additional animals, and mice's low tolerance for protracted treatment. CONCLUSIONS: Should the outcomes of Piracetam observed in this investigation be applicable to patients, it might offer a relatively straightforward approach to mitigate the cognitive impacts endured by cancer survivors following exposure to chemotherapy. Future research will be needed to study Piracetam's effect on mice with brain cancer after Cisplatin treatment in order to extrapolate the results onto cancer patients.

3.
Medicina (Kaunas) ; 59(5)2023 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-37241192

RESUMEN

Background and objectives: The chronic nature of heart failure requires long-lasting consumption of various medications. Despite the therapeutic benefits of heart failure medications, about 50% of patients with heart failure don't adequately adhere to their medications as prescribed globally. This study aimed to determine medication adherence levels among Jordanians with heart failure and its influencing factors. Materials and Methods: A cross-sectional study was conducted among 164 patients with heart failure attending cardiac clinics in the north of Jordan. The Medication Adherence Scale was used to measure medication adherence. Results: Overall, 33.5% of patients had high adherence, and 47% had partial to poor adherence. The proportion of patients with good to high adherence was significantly higher among patients younger than 60 years, having >high school level of education, being married, living with somebody, and having insurance. Conclusions: Patient-centered approach, targeting age, level of education, marital status, and health insurance coverage, should be developed using evidence-based guidelines to enhance adherence to medication and health outcomes in Jordanian patients with heart failure. The development and implementation of new and feasible strategies, particularly suited to Jordan's healthcare system capabilities, is important to improve medication adherence.


Asunto(s)
Insuficiencia Cardíaca , Cumplimiento de la Medicación , Humanos , Estudios Transversales , Insuficiencia Cardíaca/tratamiento farmacológico , Estado Civil , Corazón
4.
J Egypt Public Health Assoc ; 98(1): 8, 2023 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-37037955

RESUMEN

BACKGROUND: Vancomycin-resistant Enterococci (VRE) represent a critical medical and public health concerns due to their association with serious nosocomial infections and a high risk of mortality. We aimed to reveal the pooled prevalence of VRE and antimicrobial resistance profiles among enterococci clinical isolates in Egypt. METHODS: A PubMed, Scopus, Google Scholar, and Web of Science literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Only published studies documenting the prevalence of VRE between 2010 and 2022 were included. Using the random effects model and the 95% confidence intervals, the pooled estimate of VRE was calculated by MedCalc Version 20.113. Cochran's Q and I2 tests were used to evaluate the degree of heterogeneity, and publication bias was examined by visually examining the funnel plot and its associated tests (Begg's and Egger's tests). RESULTS: The pooled prevalence of VRE among enterococci clinical isolates in Egypt was estimated to be 26% (95% CI 16.9 to 36.3). E. faecalis had a greater pooled prevalence than E. faecium, with 61.22% (95% CI 53.65 to 68.53) and 32.47% (95% CI 27 to 38.2), respectively. The VanA gene is more frequent than the VanB gene among VRE, with a pooled prevalence of 63.3% (95% CI 52.1 to 73.7) and 17.95% (95% CI 7.8 to 31), respectively. The pooled resistance rate of linezolid was substantially lower than that of ampicillin and high-level gentamicin (HLG) 5.54% (95% CI 2.33 to 10%), 65.7% (95% CI 50.8 to 79.2%), and 61.1% (95% CI 47.4 to 73.9), respectively. CONCLUSION: The prevalence of VRE is alarmingly high in Egypt. It is imperative that antimicrobial stewardship activities and infection control programs are strictly adhered to and implemented to prevent further escalation of the problem.

5.
Biotechnol Appl Biochem ; 67(6): 912-919, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31706261

RESUMEN

We aimed to evaluate serum vaspin and its gene expression in patients with type 2 diabetes mellitus (T2DM) and to assess the association of serum vaspin and its gene expression with susceptibility of ischemic stroke (IS). The prospective case-control study included 50 healthy individuals in a control group, and 90 patients with and T2DM were stratified into two subgroups: patients with IS and patients without IS. The serum vaspin concentration was measured by enzyme-linked immunosorbent assay (ELISA). Real-time PCR was performed to detect the mRNA expression of vaspin. Serum vaspin and vaspin expression levels were significantly higher in IS compared to the non-IS group. Interestingly, they were positively correlated with other vascular and metabolic risks. Diastolic and systolic blood pressure, as well as hemoglobin A1c cholesterol (HbA1c), were independently correlated with serum vaspin. After adjusting for the traditional risk factors, the logistic regression analysis test was done to evaluate the predictor of IS among T2DM patients; the vaspin expression level was a statistical significance predictor of IS among T2DM patients. In conclusion, the higher levels of serum vaspin and vaspin expression levels in T2DM emphasizes the pivotal role of vaspin serum level and expression in the progression of metabolic and glucose abnormalities, thus, they could be used as biomarkers of IS.


Asunto(s)
Complicaciones de la Diabetes/sangre , Diabetes Mellitus Tipo 2/sangre , Regulación de la Expresión Génica , Accidente Cerebrovascular Isquémico/sangre , Serpinas/sangre , Femenino , Humanos , Accidente Cerebrovascular Isquémico/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
6.
Eur J Dent Educ ; 24(2): 186-192, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31765508

RESUMEN

PURPOSE: Many countries and institutions have a fixed passing score of 60%. For example, this is a national policy in all Saudi universities where students at all levels must score 60% or higher to pass courses. The purpose of this study is to broaden the scope of standard-setting applications, using data from five major dental courses (Endodontics, Operative, Removable and Fixed Prosthodontics, and Pedodontics) in the 5th dental academic year for two consecutive years to determine the cut-off scores. METHODOLOGY: Four expert raters conducted Angoff's method on final examinations of five dental courses to determine the cut-off scores for the two academic years (2015, and 2016). Cohort size of 2015 was 120 students, whilst that of 2016 was 142 students. The study was conducted at the faculty of Dentistry, at King Abdulaziz University (KAU) from December 2017 to June 2018. RESULTS: All five dental courses yielded different cut-off scores than the fixed 60%. The cut-off scores for 2015 and 2016 examinations were 59.15%, 63.75% for Removable Prosthodontics, 51.86%, 53.75% for Fixed Prosthodontics, 47.42%, 50.5% for Pedodontics, 74.22%, 74.31% for Endodontics and 58%, 55.55% for Operative Dentistry. CONCLUSION: Angoff method yielded different cut-off scores than the fixed 60% passing score currently used by the dental school, yielding a difference in pass-fail rates by as much as a staggering 41%. This finding provides support to use evidence-based standard-setting methods to determine the cut-off score for the courses in Dentistry programme.


Asunto(s)
Educación en Odontología , Endodoncia , Operatoria Dental , Evaluación Educacional , Humanos , Prostodoncia , Facultades de Odontología
9.
Heliyon ; 10(19): e38423, 2024 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-39430443

RESUMEN

Background: The collaboration between pharmacists and veterinarians plays a crucial role in ensuring optimal animal healthcare. Understanding the willingness of veterinarians to collaborate with pharmacists and analyzing the prescribing trends by veterinarians are essential factors in improving the quality of veterinary care. By analyzing these aspects, valuable insights can be gained to enhance interprofessional collaboration and optimize medication management in veterinary practice. Objectives: To examine the willingness of veterinarians towards interprofessional collaboration with community pharmacist. Methods: A cross-sectional study was conducted among 40 veterinary clinics in Klang Valley, Malaysia. Data was collected via online using Google Forms from registered veterinarians working in private veterinary clinics in Klang Valley, Malaysia. Descriptive statistics and statistical analysis were performed using SPSS version 27. Results: The overall willingness of veterinarians to collaborate with community pharmacists was measured with a median score of 51 out of 75. The results indicated that 55 % of veterinarians demonstrated high willingness to collaborate. Specifically, 52.5 % of veterinarians had a positive attitude towards collaboration, 55 % recognized the roles of pharmacists positively, and 57.5 % identified barriers to collaboration. These findings highlight a generally positive inclination towards interprofessional collaboration among veterinarians. Conclusion: More veterinarians demonstrated a positive willingness to collaborate with pharmacists for optimal patient care. However, several constraints were identified, including a lack of face-to-face communication, concerns about pharmacists' knowledge or skills in veterinary medicine, and financial interests. Addressing these issues could further enhance collaboration between veterinarians and pharmacist.

10.
Sci Total Environ ; 948: 174758, 2024 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-39025152

RESUMEN

Over the past decade, deep eutectic systems (DES) have become popular, yet their potential toxicity to living organisms is not well understood. This study fills this gap by examining the toxicity, antibacterial activity and biodegradability of p-toluenesulfonic acid monohydrate (PTSA)-based DESs prepared from ammonium or phosphonium salts. Brine shrimp assays revealed varying toxicity levels of PTSA and salts. Allyltriphenylphosphonium bromide showing the longest survival time among all tested salts while PTSA exhibited a significantly longer duration of cell survival compared to other hydrogen bond donors. PTSA and ammonium salts (N,N-diethylethanolammonium chloride and choline chloride) as individual components showed non-toxic behavior for Gram-negative and Gram-positive bacteria while different PTSA-based DESs showed significant inhibition zones. Fish acute ecotoxicity tests indicated moderately toxicity for individual components and DESs, though higher concentrations increased fish mortality, highlighting the need for careful handling and disposal of PTSA-based DESs to the environment. Biodegradability analyses found all tested DESs to be readily biodegradable and it was reported that, DES 3 prepapred form PTSA and choline chloride has the highest biodegradability level. Notably, all tested DESs showed over 60 % biodegradability after 28 days. This groundbreaking study explores PTSA-based DESs, highlighting their biodegradability and potential use as antibacterial agents. Results revealed that PTSA as individual component is much better from toxicity point of view in comparison with PTSA-based DESs for any further industrial applications.


Asunto(s)
Artemia , Biodegradación Ambiental , Disolventes Eutécticos Profundos , Contaminantes Químicos del Agua , Contaminantes Químicos del Agua/toxicidad , Animales , Artemia/efectos de los fármacos , Disolventes Eutécticos Profundos/toxicidad
11.
Cureus ; 16(7): e64219, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39130921

RESUMEN

This study aims to examine the relationship between gestational diabetes mellitus (GDM) and the likelihood of postpartum depression (PPD) symptoms. PubMed, Scopus, Web of Science, ScienceDirect, and the Wiley Online Library were systematically searched for relevant literature. Our results included eight studies with a total of 4,209 women diagnosed with GDM and/or PPD. The prevalence of PPD in women diagnosed with GDM ranged from 6.5% to 48.4%. The included studies demonstrated that PPD was more likely to strike women with GDM. One study reported that the most severe type of GDM is more likely to occur in those with a history of depression. Perinatal depression during pregnancy can be strongly predicted by age, BMI, and a personal history of depression. The findings imply that GDM and the likelihood of depression during the postpartum phase are related. It was also found that there was a positive correlation between depression and the chance of having GDM. This emphasizes how the association between GDM and depression appears to be reciprocal. However, the association does not imply causation, and the data at hand do not allow for the establishment of causality. Subsequent studies ought to endeavor to show causative connections between GDM and depression as well as pinpoint shared underlying endocrine variables that may play a role in the genesis of both conditions. The available information that is now available is limited due to the complexity of the etiology of both GD and depression in pregnant women; nonetheless, prevention of both conditions depends on a better understanding of the link between GD and depression. The risk of bias in the included studies was moderate to high.

12.
Front Vet Sci ; 10: 1180539, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37332736

RESUMEN

The present study explored the influence of supplemental herbal mixtures on cow milk production, quality, and blood parameters in dairy cows under high ambient temperatures. Thirty Holstein cows were randomly assigned into three experimental groups of 10 each. The first control group was supplied with the commercial basal diet, whereas two treatment groups were provided with the commercial basal diet supplemented with 50 and 100 g/head/day of the herbal mixture, respectively. The results showed that the mixture of herbal supplementation did not influence weekly milk production. Milk total fat, triglyceride, and total protein values were not affected (p < 0.05) in cows fed on basal diets supplemented with herbal mixture; however, milk cholesterol was decreased significantly by 100 mg/head/day of the herbal mixture. On the other hand, lactose has increased significantly by adding 100 mg/head/day of herbal mixture. Furthermore, the total cholesterol level in serum was decreased by adding 100 mg/head/day of the herbal mixture, while plasma prolactin, cortisol, GOT, and GPT were unaffected. Regarding fatty acids (C18, C18:1 (c9), 18:1 (c11), 18:2 (c9, c12), 18:2 (t9, t12), and CLA (c9, t11)), there was no significant variation between the groups. Meanwhile, both C19:00 and 18:3 (c6, c9, and c12) were noticeably higher (p < 0.05) in the group that received 100gm, followed by 50 mg, compared to the control. In conclusion, the supplement with a herbal mixture positively affected milk quality by decreasing total cholesterol and increasing lactose, milk fatty acid profile by increasing unsaturated fatty acids content, and plasma cholesterol levels.

13.
Med Glas (Zenica) ; 20(1)2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36574270

RESUMEN

Aim Anterior cruciate ligament (ACL) injury is among the most common orthopaedic injuries. The elevated body mass index (BMI) can contribute to non-contact ACL injury. This study aims to assess the risk of ACL injury among elevated BMI population people (BMI ≥25 Kg\m2 ). Methods This is a cross sectional study that was conducted in a tertiary care centre in the Kingdom of Saudi Arabia. A total of 302 patients, who had an ACL reconstruction surgery in a ten-year-period (January 2008 to December 2018) were included. Results Sport related injury is significantly higher among the overweight and obese groups (p=0.002). Moreover, the combined ACL tear was higher among the overweight and obese groups (p=0.001). In univariate regression analysis for the selected baseline characteristics, it was found that individuals with higher BMI have chance to develop combined (ACL) injury 2 times higher when compared to those with isolated ACL injury (p=0.003). Also, the ACL type, mode of injury, types of injury and type of sports were statistically significant in univariate regression analysis. However, only the mode of injury was statistically significant after controlling the confounding factors. Other selected variables like type of sport, type of injury and ACL type were not significant. Conclusion Elevated BMI was associated with a higher risk of developing combined ACL tear as well as reinjured individuals.

14.
Healthcare (Basel) ; 11(20)2023 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-37893821

RESUMEN

The administration of corticosteroids may have possible hazards, ranging from minor adverse medication reactions to more serious considerations. We aimed to assess levels of public awareness concerning corticosteroid use, side effects, and predictors of its use. A cross-sectional study was conducted online throughout the period of May to July 2023. The present investigation utilized a previously developed questionnaire tool. The study encompassed a cohort of 732 individuals. Upon inquiry regarding the adverse effects of corticosteroid treatment, the participants predominantly reported weight gain, skin alterations, and fluid retention leading to breathing difficulties, constituting 44.4%, 30.3%, and 27.7% of the responses, respectively. The prevailing adverse effects observed in individuals using corticosteroids were weight gain, alterations in mood, and changes in skin characteristics, which accounted for 38.1%, 25.7%, and 21.8% of reported cases, respectively. Individuals within the age range of 41-50 years and those who are currently not working show a higher propensity for utilizing corticosteroids in comparison to other demographic groups (p < 0.05). The level of general public knowledge about corticosteroids and the side effects connected with them in Saudi Arabia was adequate. Demographic factors, such as age, gender, and education, have an impact on the use of corticosteroids.

15.
Cureus ; 15(11): e48878, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38106726

RESUMEN

Background Thyroid dysfunction represents the most commonly observed endocrine illness within the population of Saudi Arabia. Thyroid cancer has been recognized as the second most commonly occurring malignant neoplasm among women in Saudi Arabia. Furthermore, there is evidence suggesting that COVID-19 and, to a certain degree, immunization may have an impact on thyroid function. The aim of this study was to evaluate the level of public knowledge, awareness, and attitudes pertaining to the manifestations and risk factors of thyroid disease. Additionally, the study sought to examine the potential role of COVID-19 as a risk factor and explore preventive measures in the context of Riyadh, Saudi Arabia. Methods A cross-sectional online survey was conducted targeting the Saudi population living in Riyadh aged 18 years and older. A self-administered questionnaire constructed on Google Forms was distributed to the general population using an online platform. The questionnaire consisted of five sections: demographic data, risk factors for thyroid disorders, clinical manifestations, prevention, and history of thyroid disease. Binary logistic regression analysis was used to identify predictors of better knowledge of thyroid diseases.  Results Among the 693 participants enrolled, 57.7% were female, and 31.7% were aged between 18 and 25 years. The overall mean knowledge score was 12.2 (SD = 6.57) out of 23 points. Poor knowledge of the risk factors, clinical manifestations, and prevention was observed in 50.4% of the participants. A total of 27.6% had moderate knowledge, and 22.1% had good knowledge levels. Furthermore, only 33.9% of the participants believed that COVID-19 infection was a risk factor. The results of the binary logistic regression analysis revealed that individuals within the age range of 36-45 years, females, and students had a significantly higher level of knowledge compared to other participants (p<0.05). Conclusion This study revealed that the general population of Riyadh, Saudi Arabia, lacked adequate knowledge, awareness, and attitudes regarding the risk factors, clinical symptoms, and prevention of thyroid problems. However, middle-aged individuals, females, and those who were enrolled as students showed a higher level of knowledge. Regarding the pathogenesis of COVID-19, it was observed that all participants had a limited understanding and a lack of awareness. Insufficient public awareness may result in misunderstandings, insufficient identification, and potential oversight of COVID-19-infected patients with thyroid dysfunction. Therefore, it is imperative that healthcare authorities intensify their efforts to broaden the dissemination of information throughout the population.

16.
Medicine (Baltimore) ; 101(29): e29588, 2022 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-35866773

RESUMEN

BACKGROUND: Saudi Arabia ranks 7th globally in terms of diabetes prevalence, and its prevalence is expected to reach 45.36% by 2030. The cost of diabetes is expected to increase to 27 billion Saudi riyals in cases where undiagnosed individuals are also documented. Prevention and early detection can effectively address these challenges. OBJECTIVE: To improve healthcare services and assist in building predictive models to estimate the probability of diabetes in patients. METHODS: A chart review, which was a retrospective cohort study, was conducted at the National Guard Health Affairs in Riyadh, Saudi Arabia. Data were collected from 5 hospitals using National Guard Health Affairs databases. We used 38 attributes of 21431 patients between 2015 and 2019. The following phases were performed: (1) data collection, (2) data preparation, (3) data mining and model building, and (4) model evaluation and validation. Subsequently, 6 algorithms were compared with and without the synthetic minority oversampling technique. RESULTS: The highest performance was found in the Bayesian network, which had an area under the curve of 0.75 and 0.71. CONCLUSION: Although the results were acceptable, they could be improved. In this context, missing data owing to technical issues played a major role in affecting the performance of our model. Nevertheless, the model could be used in prevention, health monitoring programs, and as an automated mass population screening tool without the need for extra costs compared to traditional methods.


Asunto(s)
Diabetes Mellitus , Teorema de Bayes , Minería de Datos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Humanos , Prevalencia , Estudios Retrospectivos , Arabia Saudita/epidemiología
17.
Clin Case Rep ; 9(7): e04331, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34267898

RESUMEN

Further studies are needed on this unique population to better manage them and increase their chances of normal pregnancy and fewer complications and more favorable outcomes.

18.
Case Rep Oncol ; 14(2): 1004-1009, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34326735

RESUMEN

Chronic myeloid leukemia (CML) is a myeloproliferative disorder diagnosed by demonstrating the Philadelphia chromosome (Ph) or the BCR-ABL fusion gene. Tyrosine kinase inhibitors (TKIs) are the standard of therapy. There are increasing reports of hepatitis B virus reactivation (HBVr) in patients on this treatment. We report a case of a 46-year-old male patient diagnosed to have CML in the chronic phase and resolved hepatitis B infection. He was treated with imatinib as upfront therapy for CML and with lamivudine as prophylaxis against HBVr. The patient tolerated both treatments well with no adverse effects. The aim is to address the deficiencies in the literature in regard to managing these patients, prevention, and follow-up.

19.
Expert Rev Mol Diagn ; 21(5): 505-514, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33840351

RESUMEN

Background: The world urgently requires surrogate markers to diagnose COVID-19 and predict its progression. The severity is not easily predicted via currently used biomarkers. Critical COVID-19 patients need to be screened for hyperinflammation to improve mortality but expensive cytokine measurement is not routinely conducted in most laboratories. The neutrophil-to-lymphocyte ratio (NLR) is a novel biomarker in patients with various diseases. We evaluated the diagnostic and prognostic accuracy of the NLR in COVID-19 patients.Methods: We searched for relevant articles in seven databases. The quantitative analysis was conducted if at least two studies were evaluating the NLR role in COVID-19.Results: We included 8,120 individuals, including 7,482 COVID-19 patients, from 32 articles. Patients with COVID-19 had significantly higher levels of NLR compared to negative individuals. Advanced COVID-19 stages had significantly higher levels of NLR than earlier stages.Expert Opinion: We found significantly higher levels of NLR in advanced stages compared to earlier stages of COVID-19 with good accuracy to diagnose and predict the disease outcome, especially mortality prediction. A close evaluation of critical SARS-CoV-2 patients and efficient early management are essential measures to decrease mortality. NLR could help in assessing the resource allocation in severe COVID-19 patients even in restricted settings.


Asunto(s)
COVID-19/sangre , COVID-19/mortalidad , Recuento de Linfocitos , Neutrófilos , Adulto , Anciano , COVID-19/etiología , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pronóstico , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
20.
J Surg Res ; 162(2): 170-6, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19524265

RESUMEN

BACKGROUND: Many studies have shown that gastrografin can be used for diagnosis of adhesive small bowel obstruction (ASBO) and for assessing the need for surgical intervention. However, several studies have reported conflicting results. Therefore, the aim of this study is to assess the diagnostic and therapeutic effect of gastrografin in ASBO. PATIENTS AND METHODS: Altogether, 110 patients with ASBO were randomized into control and gastrografin groups. In the gastrografin group, 100 mL of the dye was administered through a nasogastric tube. Obstruction was considered complete if the contrast failed to reach the colon on the 24-h film. Patients with gastrografin in the colon within 24 h after dye administration were considered as partially obstructed, and were submitted to nonoperative treatment. The patients were operated on if they developed signs of strangulation or failed to improve within 48 h. RESULTS: The overall operative rate was 14.5% in gastrografin group versus 34.5% in control group, P=0.04. The time from admission to resolution of symptoms was significantly lower in gastrografin group (19.5 versus 42.6 h, P=0.001), and the length of hospital stay was shorter in gastrografin group (3.8 versus 6.9 d 0.002), and in nonoperative patients (3.1 versus 5.1 days). Sensitivity, specificity, positive predictive value, and negative predictive value for gastrografin follow-through as an indicator for operative treatment of ASBO were 87.5%, 100%, 100 % , and 97.9%, respectively. CONCLUSIONS: Oral gastrografin helps in the management of ASBO. Oral gastrografin is safe and reduces the operative rate and time of resolution as well as hospital stay.


Asunto(s)
Diatrizoato de Meglumina/uso terapéutico , Obstrucción Intestinal/tratamiento farmacológico , Obstrucción Intestinal/cirugía , Adulto , Anciano , Medios de Contraste/uso terapéutico , Egipto , Servicio de Urgencia en Hospital , Femenino , Humanos , Obstrucción Intestinal/etiología , Laparotomía/efectos adversos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Selección de Paciente , Recurrencia , Reoperación/estadística & datos numéricos , Resultado del Tratamiento , Adulto Joven
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