COVID-19 infections among health care workers at a university hospital in Jeddah, Saudi Arabia.

BACKGROUND: The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. METHODS: A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022. RESULTS: A total of 746 HCWs were diagnosed with COVID-19. Patients' age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough (55.6%), sore throat (44.6%), headache (22.9%), runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died. CONCLUSIONS: HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment.

Robotic Revolution in Surgery: Diverse Applications Across Specialties and Future Prospects Review Article.

Robotic technology has transformed the field of surgery significantly. Since its inception in the 1970s, robotic surgery has advanced tremendously. The utilization of robotic systems, such as the da Vinci Surgical System, has become increasingly prevalent in minimally invasive procedures. These interventions offer enhanced precision, dexterity, and visualization. In general surgery, robotics has facilitated complex procedures, leading to reduced morbidity and shorter hospital stays. In urology, the robotic platform has revolutionized prostatectomies and other intricate interventions, demonstrating superior outcomes compared to traditional approaches. Orthopedic surgery has embraced robotics for precise joint replacements and spinal procedures. In pediatric surgery, the application of robotics has enabled intricate surgeries with reduced invasiveness and faster recovery times. Furthermore, the integration of artificial intelligence with robotic systems has paved the way for personalized treatment plans and data-driven decision-making. Despite these advancements, challenges such as cost and training persist. As robotic technology continues to evolve, its potential applications extend beyond current boundaries. This review aims to provide insights into the multifaceted impact of the robotic revolution in surgery and the exciting possibilities that lie ahead.

Maxillary and mandibular dental arch forms in a Jordanian population with normal occlusion.

BACKGROUND: Ethnic background has been claimed to affect arch form. The purpose of this study was to describe and elucidate the maxillary and mandibular arch forms in Jordanian population and to develop a classification method for these forms which could be employed to construct orthodontic archwires accordingly. METHODS: The sample was comprised of study casts of five hundred and twenty subjects (231 males and 289 females with a mean age of 15.4 ± 1.02 years). All subjects had permanent dentition with normal occlusion. A mathematical method associated with a polynomial function of 6th degree was employed to assess the dental arch forms. The resultant arch forms were classified into 5 groups for both the maxilla and mandible utilizing a computer software with special code designed for this study. Each group was subdivided into 3 subgroup sizes namely: small, medium, and large. RESULTS: Catenary arch form was found in 47% and 41.2% (p Ë‚ 0.01) of maxilla and mandible arch forms, respectively. Form 2 (which is halfway between ellipse and U-shaped arch form) was found in 27.7% and 26.7%. Medium size arch form was found in 55.4% of the maxillary and 65.6% of the mandibular arch forms. CONCLUSION: Catenary arch form was the most prevalent arch form, followed by wide elliptical form. The other forms, which included tudor arch, tapered equilateral and quadrangular forms were less frequent. Regarding size, the medium size was the most prevalent among the studied samples.

Effectiveness of a lower lingual arch as a space holding device.

The aims of this study were to evaluate the effectiveness of a lower lingual holding arch (LLHA) in maintaining arch length, and to compare the effectiveness of two LLHAs made of two different gauges (0.9 and 1.25 mm) of stainless steel (SS) wire. The sample comprised 44 subjects (24 males and 20 females) who for various reasons attended orthodontic clinics at Jordan University of Science and Technology Dental Teaching Center. The subjects were randomly divided into two treatment groups. The first group contained 20 subjects (12 males/8 females, average age 10.76 ± 0.75 years). The LLHA used in this group was made of 0.9 mm SS wire. The second group comprised 24 subjects (12 males/12 females, average age 10.57 ± 0.54 years). The LLHA used in this group was made of 1.25 mm SS wire. The third group consisted of 23 subjects (15 males/8 females, average age 10.63 ± 0.66 years) who served as the control. The records consisted of lateral cephalograms, dental pantomograms, and study casts. Paired t-test, analysis of variance, and chi-square tests were used to determine whether significant differences existed between the groups. In both treatment groups, the lower incisors proclined and moved forward, and space loss of the lower primary second molar occurred. The LLHA made of 0.9 mm SS was superior to that made of 1.25 mm SS in terms of arch length preservation.

Technical quality of root fillings performed by dental students at the dental teaching centre in Reims, France.

AIM: To evaluate the technical quality of root fillings performed by undergraduate students at a dental teaching centre in France. METHODOLOGY: A random sample of 419 records of patients who received dental treatment at the dental service of the teaching Hospital, in Reims, France between 2005 and 2006 was investigated. Evaluation of root filled was based on radiographical criteria defined by the French National Health Service. The length of root fillings, the radiodensity and the presence of voids in the root filling or between root filling and root canal walls were recorded and scored. Chi-square analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. RESULTS: Of the 304 teeth included in the study, 69% had an adequate length of root filling and 42.7% had a dense root filling without voids; only 30.3% of teeth fulfilled these criteria at the same time. The relationship between the technical quality of root fillings and tooth type was statistically significant (P < 0.001), the highest percentage of adequate root fillings occurred in single-rooted teeth (36.1%). The highest percentage of inadequate root fillings according to the criteria of root filling length and lateral adaptation was found in molar teeth (71.9%). CONCLUSION: Overall, the technical quality of root fillings performed by undergraduate students was poor.

Transcatheter closure of fontan fenestrations using the Amplatzer septal occluder: initial experience and follow-up.

We have recently used the Amplatzer septal occluder to close Fontan fenestrations. Between June 1998 and December 1999, 13 patients underwent transcatheter occlusion of their Fontan fenestrations. Systemic blood flow decreased significantly without a concomitant decrease in pulmonary blood flow. All residual shunts detectable by oximetry were at sites separate from those into which occlusion devices were implanted. One patient developed severe tricuspid regurgitation following the procedure requiring surgical removal of the device. At the last follow-up, all patients were doing well clinically. There were no shunts detectable through or around the devices by echocardiography. Our experience indicates that the location of the fenestration within the Fontan baffle is critical to avoiding device interference with other intracardiac structures. The Amplatzer septal occluder offers an effective means of transcatheter closure of Fontan baffle fenestrations. Although more experience is needed, our current follow-up data suggest that long-term outcomes will be favorable. Cathet. Cardiovasc. Intervent. 51:301-304, 2000.

Optimization of adenoviral vector-mediated gene transfer to pulmonary arteries in newborn swine.

Efficient pulmonary vascular gene transfer in neonates would aid in understanding the pathophysiology of, and ultimately allow the development of specific therapies for, pulmonary vascular diseases. The purpose of this study was to optimize efficiency, and evaluate the duration, of catheter-based adenoviral vector-mediated pulmonary artery gene transfer in newborn pigs. An adenovirus vector encoding LacZ was infused via percutaneously placed catheters that were advanced to segmental pulmonary arteries under fluoroscopic guidance. Optimal viral dose and duration of expression were determined by histochemical evaluation of gene transfer efficiency 72 hr, 2 weeks, and 1 month after gene delivery. The effect of protamine on the efficiency of gene transfer was studied by assaying transgene protein in lung at 72 hr. The optimal viral dose was 2 x 10(10) plaque-forming units (PFU). Seventy-two hours after infusion, expression predominated in medium-sized artery endothelial cells, 40% of which expressed beta-galactosidase. At 2 weeks, the distribution of expression had changed such that the majority of transduced cells were seen not in arteries but in gas exchange units of lung. No histochemical evidence of transgene expression was seen 1 month after virus infusion. The addition of protamine to virus infusate resulted in a fivefold increase in transgene protein product in lung tissue assayed 72 hr after gene transfer. Adenoviral vector-mediated gene transfer in neonatal swine results in high-efficiency transduction of arterial endothelial cells. However, the time course of gene transfer is not significantly prolonged compared with the adult. The addition of protamine results in a significant improvement in transduction efficiency, permitting lower doses of virus.

Snare-assisted vascular access: a new technique.

Access to the central circulation can be difficult in small infants, particularly when normal anatomic landmarks have been altered. We describe a new technique that utilizes any existing central catheter to establish additional sites of vascular access. A 4 Fr end hole catheter is advanced under fluoroscopic guidance to the desired site of new vascular access. A 10-mm Amplatz snare catheter is advanced through the end hole catheter and the loop opened within the target vessel lumen. The snare is then used to guide percutaneous placement of a Cope wire through a 21-gauge needle and then to pull the wire into the central circulation. New access is then achieved by introducing an additional catheter over the guidewire. This technique has now been successfully utilized 16 times in 13 patients. Snare assistance is a safe and effective technique that provides a reliable means of establishing additional secure vascular access. Cathet. Cardiovasc. Intervent. 47:315-318, 1999.

Comparative in vivo and in vitro studies with the potent GABAB receptor antagonist, CGP 56999A.

CGP 56999A ([3-[1-(R)-[(3-cyclohexylmethyl)hydroxyphosphinyl]-2-(S)- hydroxy-propyl] amino]ethyl]-benzoic acid) is a potent GABAB receptor antagonist showing much more pronounced convulsant features in mice than do other previously studied GABAB receptor antagonists. The goal of this study was to elucidate the physiological mechanisms underlying this effect. In mice a dose of 0.6 mg/kg intraperitoneal (i.p.) CGP 56999A elicited behavioral activation and stereotypy with periods of intensive scratching and grooming. At 1 mg/kg i.p. most mice displayed myoclonic seizure-like episodes lasting several min. Pretreatment with the lower dose of 0.6 mg/kg i.p. also induced seizures after treatment with a subthreshold dose of pentylenetetrazole (40 mg/kg i.p.). In rats a dose of 3 mg/kg CGP 56999A (i.p.) induced convulsions of tonic-clonic nature. Intracellular sharp microelectrode recordings from rat cortical neurons in slices revealed no paroxysmal actions of CGP 56999A (10 microM). Similar to other GABAB receptor antagonists, CGP 56999A suppressed the late inhibitory postsynaptic potential (i.p.s.p.), but had no effect on the excitatory postsynaptic potential (e.p.s.p.) in the cortex. In cortical slices exposed to picrotoxin (10 microM), the compound evoked pronounced, spontaneous and intense epileptiform discharges. In conclusion, these findings demonstrated that the convulsive feature of the potent GABAB receptor antagonist, CGP 56999A, may be due to suppression of the late i.p.s.p., which becomes apparent in the intact brain only, whereas this action remains undetected in untreated brain slices. This remarkable discrepancy between in vitro and in vivo may be a consequence either of disruption of neuronal circuits during slice preparation or of the pronounced hyperpolarization of pyramidal neurons, at least in the case of cortical slice preparations.

Arabic children's pain descriptions.

A convenience sample of 60 children, aged five to 12 years, reporting to Kuwait government hospital emergency departments was studied. All were native Arabic speakers. Our aim was to compare the diagnostic usefulness of the pain information provided by children and by accompanying adults when interviewed under standard emergency department conditions. Children were asked to describe their current pain and how it had changed and to signify pain intensity using a 10-point visual analog scale (VAS). Comparable data were then collected from the accompanying adult. Senior clinicians rated these verbal and VAS descriptions for their usefulness in arriving at a diagnosis. Most children provided useful pain information. Mothers received consistently higher scores for their VAS descriptions than their children did; otherwise, the pain data provided by adults were not judged to be significantly more useful. When clinicians and teachers were asked to differentiate which data they thought had been provided by a child and which by the accompanying adult, nearly half of their decisions were wrong.