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1.
Quintessence Int ; 55(3): 232-243, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38224105

RESUMO

OBJECTIVE: Ideal implant placement in atrophied posterior mandibular regions is challenging due to surgical difficulties and anatomical limitations. This study aimed to evaluate the use of allogeneic bone rings for vertical augmentation of atrophied posterior mandibular regions with simultaneous implants compared to autogenous bone rings, while avoiding donor site morbidity. METHOD AND MATERIALS: A total of 24 vertically atrophied posterior mandibular segments (in 14 patients) were equally randomized into a study group in which mineralized freeze-dried allogeneic bone rings were used, and a control group in which autogenous bone rings with prepared implant osteotomies were harvested from the chin and used. All augmentation sites were prepared before inserting the bone rings. Implants were simultaneously inserted, fixing the bone rings into the native bone. All patients were clinically assessed after 1 week, 2 weeks, and 1 month. Crestal bone level was radiographically assessed after 1 week, 6 months, and 3 months of prosthetic loading. RESULTS: None of the 24 bone rings showed signs of implant or graft failure. There was no significant difference in the crestal bone level between the groups. CONCLUSION: Allogeneic bone rings can be a viable alternative to autogenous bone rings in augmenting the posterior aspect of the mandible, mitigating the concerns associated with donor site complications.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Transplante de Células-Tronco Hematopoéticas , Humanos , Resultado do Tratamento , Implantação Dentária Endóssea/métodos , Mandíbula/cirurgia , Transplante Ósseo/métodos , Aumento do Rebordo Alveolar/métodos
2.
Medicine (Baltimore) ; 102(46): e35770, 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37986405

RESUMO

BACKGROUND: There have been controversial findings from recent studies regarding anthracyclines use and the subsequent risk of arrhythmias. This study aimed to evaluate the existing evidence of the risk of arrhythmias in patients treated with anthracyclines. METHODS: PubMed, Scopus, and Web of Science databases were searched up to April 2022 using keywords such as "anthracycline" and "arrhythmia." Dichotomous data were presented as relative risk (RR) and confidence interval (CI), while continuous data were presented as mean difference (MD) and CI. Revman software version 5.4 was used for the analysis. RESULTS: Thirteen studies were included with a total of 26891 subjects. Pooled analysis showed that anthracyclines therapy was significantly associated with a higher risk of arrhythmia (RR: 1.58; 95% CI: 1.41-1.76; P < .00001), ST segment and T wave abnormalities (RR: 1.73, 95% CI: 1.18-2.55, P = .005), conduction abnormalities and AV block (RR = 1.86, 95% CI = 1.06-3.25, P = .03), and tachycardia (RR: 1.736, 95% CI: 1.11-2.69, P = .02). Further analyses of the associations between anthracyclines and atrial flutter (RR = 1.30, 95% CI = 0.29-5.89, P = .74), atrial ectopic beats (RR: 1.27, 95% CI: 0.78-2.05, P = .34), and ventricular ectopic beats (RR: 0.93, 95% CI: 0.53-1.65, P = .81) showed no statistically significant results. Higher doses of anthracycline were associated with a higher risk of arrhythmias (RR: 1.49; 95% CI: 1.08-2.05; P = .02) compared to the lower doses (RR: 1.36; 95% CI: 1.00-1.85; P = .05). Newer generations of Anthracycline maintained the arrhythmogenic properties of previous generations, such as Doxorubicin. CONCLUSION: Anthracyclines therapy was significantly associated with an increased risk of arrhythmias. Accordingly, Patients treated with anthracyclines should be screened for ECG abnormalities and these drugs should be avoided in patients susceptible to arrhythmia. The potential benefit of the administration of prophylactic anti-fibrotic and anti-arrhythmic drugs should also be explored.


Assuntos
Antraciclinas , Leucemia Mieloide Aguda , Humanos , Antraciclinas/efeitos adversos , Arritmias Cardíacas/induzido quimicamente , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/tratamento farmacológico , Antibióticos Antineoplásicos/efeitos adversos , Doxorrubicina , Taquicardia/induzido quimicamente , Leucemia Mieloide Aguda/tratamento farmacológico
3.
Arch Ital Urol Androl ; 95(2): 11313, 2023 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-37254927

RESUMO

BACKGROUND: Transurethral resection (TUR) followed by adjuvant therapy is still the treatment of choice of Non-Muscle-Invasive Bladder Urothelial Carcinoma (NMIBUC). However, recurrence is one of the most troublesome features of these lesions. Early second resection and adjuvant BCG therapy has been shown to improve the outcome. OBJECTIVE: To evaluate the prognostic value of C-erbB-2 (HER2/neu) expression status in Non-Muscle-Invasive Bladder Urothelial Carcinoma cases, before and after intravesical Bacillus Calmette Guerin (BCG immunotherapy). MATERIALS AND METHODS: HER2/neu expression was studied in 120 (Ta-T1) Non-Muscle-Invasive Urothelial Carcinoma cases. The expression was evaluated and compared to the expression after Bacillus Calmette Guerin (BCG) immunotherapy. RESULTS: HER2/neu expression in low and high grade of the Non- Muscle-Invasive Urothelial Carcinoma was (38%) and (83%) respectively. The difference of the expression rates by tumor grade was statistically significant. In recurring lesions post BCG therapy, C-erbB-2 expression was markedly decreased (31.6%) when compared to its expression before therapy (65%). CONCLUSIONS: The HER2/neu expression increased as the tumor grade rose. The reduction in expression following BCG treatment in Non-Invasive transitional cell carcinoma cases could reflect a reduction of the potential malignancy of the tumor.


Assuntos
Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Humanos , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Vacina BCG/uso terapêutico , Bexiga Urinária/patologia , Administração Intravesical , Recidiva Local de Neoplasia , Adjuvantes Imunológicos/uso terapêutico , Invasividade Neoplásica
4.
Arch Ital Urol Androl ; 95(1): 11231, 2023 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-36943001

RESUMO

BACKGROUND: Uretero-pelvic junction obstruction is the most common form of congenital anomaly of the kidney and urinary tract with an incidence of about 1/1.000-1.500 of births and the aetiology and pathogenesis of this anomaly are still unclear until now. METHODS: This is a prospective randomized comparative study conducted from March 2022 to December 2022. Thirty children with uretero-pelvic junction obstruction were included and randomly divided into two groups according to a 1:1 ratio (computer-generated randomization, single blind). Fifteen cases (12 males and 3 female) were subjected to ureter first approach pyeloplasty, and another fifteen (9 males and 6 female) were subjected to conventional Anderson Hynes pyeloplasty. RESULTS: The mean age of all patients was 6.7 ± 5.4 years in ureter first approach group and 5.1 ± 4.3 years in conventional Anderson-Hynes pyeloplasty group. There were no significant differences between the two groups regarding age, gender, presentation, side, preoperative renogram and post-operative renogram. Also, there were no significant differences between the two groups regarding operative time (in first group 110.3 ± 12.4 and in the second group 111.2 ± 12.0 with p < 0.836), pre and post-operative complication rate. Two cases of urinary tract infections in the first group, one of them having fever, and four cases in the second group, two of them having fever (p < 0.651); four cases of loin pain in the first group and one case in the second group (p < 0.330); one case in the first group having pro- longed leakage of urine for 7 days in post-operative period (p < 0.309). However GFR and t 1/2 improved significantly after operation in both groups (p < 0.001). CONCLUSIONS: Ureter first approach is a simple and effective procedure in children with good short term outcomes and could be done safely especially for beginners and less expert surgeons. Finally, it can overcome the problem of long ureteric stricture that may be found intraoperatively because you can shift easily to a flap procedure and complete a tension free anastomosis.


Assuntos
Laparoscopia , Ureter , Obstrução Ureteral , Masculino , Criança , Humanos , Feminino , Lactente , Pré-Escolar , Ureter/cirurgia , Estudos Prospectivos , Método Simples-Cego , Procedimentos Cirúrgicos Urológicos/métodos , Laparoscopia/métodos , Pelve Renal/cirurgia , Obstrução Ureteral/cirurgia , Obstrução Ureteral/etiologia , Resultado do Tratamento
5.
Sci Rep ; 12(1): 20370, 2022 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-36437355

RESUMO

In the present study, a green, sustainable, simple and low-cost method was adopted for the synthesis of ZnO NPs, for the first time, using the aqueous extract of sea lavender, Limonium pruinosum (L.) Chaz., as a reducing, capping, and stabilizing agent. The obtained ZnO NPs were characterized using ultraviolet-visible spectroscopy (UV-VIS), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), energy-dispersive X-ray analysis (EDX), transmission electron microscopy (TEM), X-ray diffraction (XRD) and thermogravimetric analysis (TGA). The UV-Vis spectra of the green synthesized ZnO NPs showed a strong absorption peak at about 370 nm. Both electron microscopy and XRD confirmed the hexagonal/cubic crystalline structure of ZnO NPs with an average size ~ 41 nm. It is worth noting that the cytotoxic effect of the ZnO NPs on the investigated cancer cells is dose-dependent. The IC50 of skin cancer was obtained at 409.7 µg/ml ZnO NPs. Also, the phyto-synthesized nanoparticles exhibited potent antibacterial and antifungal activity particularly against Gram negative bacteria Escherichia coli (ATCC 8739) and the pathogenic fungus Candida albicans (ATCC 10221). Furthermore, they showed considerable antioxidant potential. Thus, making them a promising biocompatible candidate for pharmacological and therapeutic applications.


Assuntos
Anti-Infecciosos , Lavandula , Nanopartículas Metálicas , Neoplasias , Plumbaginaceae , Óxido de Zinco , Óxido de Zinco/química , Antioxidantes/farmacologia , Antioxidantes/análise , Espectroscopia de Infravermelho com Transformada de Fourier , Testes de Sensibilidade Microbiana , Nanopartículas Metálicas/química , Folhas de Planta/química , Extratos Vegetais/química , Anti-Infecciosos/farmacologia , Anti-Infecciosos/análise , Antibacterianos/química
6.
Sci Rep ; 12(1): 19372, 2022 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-36371519

RESUMO

In this work, the synthesis of an rGO/nZVI composite was achieved for the first time using a simple and green procedure via Atriplex halimus leaves extract as a reducing and stabilizing agent to uphold the green chemistry principles such as less hazardous chemical synthesis. Several tools have been used to confirm the successful synthesis of the composite such as SEM, EDX, XPS, XRD, FTIR, and zeta potential which indicated the successful fabrication of the composite. The novel composite was compared with pristine nZVI for the removal aptitude of a doxycycline antibiotic with different initial concentrations to study the synergistic effect between rGO and nZVI. The adsorptive removal of bare nZVI was 90% using the removal conditions of 25 mg L-1, 25 °C, and 0.05 g, whereas the adsorptive removal of doxycycline by the rGO/nZVI composite reached 94.6% confirming the synergistic effect between nZVI and rGO. The adsorption process followed the pseudo-second order and was well-fitted to Freundlich models with a maximum adsorption capacity of 31.61 mg g-1 at 25 °C and pH 7. A plausible mechanism for the removal of DC was suggested. Besides, the reusability of the rGO/nZVI composite was confirmed by having an efficacy of 60% after six successive cycles of regeneration.


Assuntos
Ferro , Poluentes Químicos da Água , Água , Doxiciclina , Poluentes Químicos da Água/análise , Antibacterianos/farmacologia , Adsorção
7.
Medicine (Baltimore) ; 101(35): e30235, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107538

RESUMO

INTRODUCTION: The classical way to treat urethral stricture is the direct vision cold knife internal urethrotomy (DVIU). Along with advances in laser technology, laser urethrotomy is widely used, such as neodymium-doped yttrium aluminum garnet, argon, potassium titanyl phosphate, and thulium laser. We aimed to compare thulium laser urethrotomy (TLU) and cold knife visual urethrotomy (CKVU) in terms of short bulbomembranous urethral stricture management. MATERIALS AND METHODS: This prospective interventional study was conducted for 24 months, from January 2018 to January 2020, on 60 patients with primary short bulbo-membranous urethral stricture who came to the Department of Urology of Al-Azhar University Hospital, New Damietta, Egypt. We divided these patients into 2 age-matched groups; 30 patients treated with CKVU and 30 patients with TLU. RESULTS: Regarding efficacy, postvoid residual urine volume (PVR) was reduced significantly in both groups (P < .001) after 6 months of follow-up; however, the reduction in TLU was greater than CKVU (P = .008). The improvement of Qmax after 6 months was significant and comparable in both groups. Regarding the quality of life, both groups showed a significant (<0.05) improvement in international prostate symptom score (IPSS) and the Male Sexual Health Questionnaire (MSHQ) scale, without no significant difference between both groups (>0.05). TLU showed a significantly (P = .038) shorter operative duration (24 ± 4.17 min) than CKVU duration (33 ± 4.86 min). Compared with CKVU, TLU was associated with less blood loss during surgery (P = .001), lower recurrence rate (46.7% vs. 19.97%, respectively), and lower frequencies of urethral dilatation (P = .001). CONCLUSION: TLU is an effective and safe therapy for managing bulbomembranous urethral strictures, with a relatively low recurrence rate. Further investigations of other techniques are recommended to look for the most appropriate procedure to combat the urethral stricture problem.


Assuntos
Estreitamento Uretral , Alumínio , Argônio , Humanos , Lasers , Masculino , Neodímio , Estudos Prospectivos , Qualidade de Vida , Túlio/uso terapêutico , Resultado do Tratamento , Estreitamento Uretral/cirurgia , Ítrio
8.
Ann Med Surg (Lond) ; 66: 102407, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34136206

RESUMO

A primary spinal Ewing sarcoma is extremely rare to be found. To the best of our knowledge, it is the first reported case for bilateral foot drop as a prodromal symptom of sacral Ewing sarcoma. The case, we are presenting, is of an 18-year-old athletic female, who was presented to the emergency department suffering from sudden severe low back pain radiated to the lower limbs, associated with bilateral foot drop and later urinary incontinence. Following the indicated surgery and subsequent histopathology study, we diagnosed this rare type of tumors. In the following article, we are describing the clinical presenting features of this tumor and discussing the clinical aspects.

9.
Sci Rep ; 11(1): 12547, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34131155

RESUMO

Environmentally friendly copper oxide nanoparticles (CuO NPs) were prepared with a green synthesis route without using hazardous chemicals. Hence, the extracts of mint leaves and orange peels were utilized as reducing agents to synthesize CuO NPs-1 and CuO NPs-2, respectively. The synthesized CuO NPs nanoparticles were characterized using scanning electron microscopy (SEM), Energy Dispersive X-ray Analysis (EDX), BET surface area, Ultraviolet-Visible spectroscopy (UV-Vis), and Fourier Transform Infrared Spectroscopy (FT-IR). Various parameters of batch experiments were considered for the removal of Pb(II), Ni(II), and Cd(II) using the CuO NPs such as nanosorbent dose, contact time, pH, and initial metal concentration. The maximum uptake capacity (qm) of both CuO NPs-1 and CuO NPs-2 followed the order of Pb(II) > Ni(II) > Cd(II). The optimum qm of CuO NPs were 88.80, 54.90, and 15.60 mg g-1 for Pb(II), Ni(II), and Cd(II), respectively and occurred at sorbent dose of 0.33 g L-1 and pH of 6. Furthermore, isotherm and kinetic models were applied to fit the experimental data. Freundlich models (R2 > 0.97) and pseudo-second-order model (R2 > 0.96) were fitted well to the experimental data and the equilibrium of metal adsorption occurred within 60 min.

10.
Orthop Traumatol Surg Res ; 107(8): 102843, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33548560

RESUMO

INTRODUCTION: There is a great surgical challenge when humeral diaphyseal fractures are initially open, complex, or associated with segmental bone loss. The challenge becomes even greater with previous multiple unsuccessful surgeries. The question of this study was: Does combining locked compression plating with non-vascularized fibular autograft in cases of resistant humeral diaphyseal nonunion yield reliable bony union and satisfactory functional outcome? HYPOTHESIS: The use of non-vascularized fibular autograft in conjunction with locked compression plating will provide stable construct, enhance bony union and improve functional outcome in cases of resistant humeral diaphyseal nonunion. MATERIALS AND METHODS: Thirty-three patients with resistant humeral diaphyseal nonunion who were surgically managed combining non-vascularized fibular autograft fixed with locked compression plating in the period from January 2011 to June 2017, were retrospectively studied. All patients were followed-up for a minimum of 24 months. The time to union, the postoperative disability of arm, shoulder and hand (DASH) score, in addition to the possible complications including infection or nonunion were reported and analyzed. RESULTS: Twenty-nine patients have achieved union at the final follow-up with a mean time to radiological union of 7.5±2.6 months (range: 3-12). The mean postoperative DASH score was 7.7±8.9 (range: 0-38.8) which was significantly better than the preoperative value (p<0.001) and superior in the patients of aseptic nonunion (p=0.04). Eight patients showed complications in the form of infection (four), nonunion (two cases), transient radial nerve palsy (one case) and one case of septic nonunion that was managed by two-stage reconstruction using vascularized fibular autograft. There were comparable results in patients with either open or closed fractures. However, patients with septic nonunion experienced more significant complications (p=0.02). DISCUSSION: The use of non-vascularized fibula autograft in cases of resistant humeral diaphyseal nonunion provides adequate fracture stability, quadrilateral screw purchase, enhances bony union in addition to promoting satisfactory functional outcome particularly in aseptic nonunion. LEVEL OF EVIDENCE: IV; retrospective case series.


Assuntos
Fraturas não Consolidadas , Fraturas do Úmero , Autoenxertos , Placas Ósseas , Transplante Ósseo/métodos , Fíbula/transplante , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas não Consolidadas/cirurgia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Úmero/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
11.
Clin Ophthalmol ; 14: 2411-2416, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32904754

RESUMO

PURPOSE: To evaluate the efficacy of human amniotic membrane in promoting closure of macular holes coexisting with rhegmatogenous retinal detachment. METHODS: This is a retrospective case series of 14 eyes (14 patients) with macula off retinal detachment. These patients had a macular hole coexistent with peripheral retinal breaks. A human amniotic membrane plug was used to close the macular hole during vitrectomy without ILM peeling. RESULTS: The mean preoperative BCVA (logMAR value) was 1.87 ± 0.31. At the 6-month follow-up visit, the mean LogMAR best-corrected visual acuity was 0.67 ± 0.17. At the 6-month follow-up, all patients showed complete retinal reattachment with macular hole closure. CONCLUSION: The use of human amniotic membrane is a valid option in surgery for macular holes coexisting with rhegmatogenous retinal detachment.

12.
Curr Pharm Des ; 26(14): 1622-1633, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32026770

RESUMO

BACKGROUND/OBJECTIVE: KRAS-mutant colorectal cancers (CRC) are tumors that are associated with poor prognosis. However, no effective treatments are available to target them. Therefore, we designed and synthesized novel chalcone analogs, small organic molecules, to investigate their effects on KRAS-mutant CRC cells. METHODS: Fourteen new chalcone analogs were synthesized, optimized, characterized, and tested against two KRAS-mutant CRC cell lines (HCT-116 and LoVo), one p-53 and BRAF mutant CRC cell line (HT-29) and one normal immortalized colon cells (NCE-1 E6/E7). Effects on cell viability, apoptosis, cell cycle, migration, colony formation, EMT, and angiogenesis were investigated. RESULTS: Compounds 3 and 14 were the most effective. Compound 3 showed potent activity against HCT-116 and LoVo cell lines (GI50 of 6.10 µM and 7.00 µM, respectively). While compound 14 showed GI50 of 8.60 µM and 8.80 µM on HCT-116 and LoVo cell lines, respectively. Both compounds were approximately 2-3 times more selective toward cancer cells rather than normal colon cells. Compound 3 was effective in inducing apoptosis in HCT-116 cells via Bax upregulation and Bcl-2 downregulation. Invasion and metastasis of KRAS-mutant cells were modulated by compounds 3 and 14 through significant inhibition of cell migration and the prevention of colony formation. In addition, they reversed EMT by downregulation of EMT markers (vimentin, fascin, and ß- catenin) and upregulation of cell-cell adhesion marker, E-cadherin. Furthermore, compounds 3 and 14 had significantly inhibited angiogenesis in ovo. CONCLUSION: Compounds 3 and 14 represent potent and selective leads for KRAS-mutant CRC cells, thus, further in vitro and in vivo studies are necessary to confirm their effect on KRAS-mutant CRCs.


Assuntos
Chalconas , Neoplasias Colorretais , Proteínas Proto-Oncogênicas p21(ras)/genética , Apoptose , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Chalconas/farmacologia , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Transição Epitelial-Mesenquimal , Humanos , Proteínas Proto-Oncogênicas p21(ras)/química
13.
Int Ophthalmol ; 40(5): 1147-1154, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31919773

RESUMO

PURPOSE: To evaluate the role of adjuvant micropulse laser with aflibercept injections in the management of treatment naive center involving DME, looking at decreased treatment burden and increased efficacy as outcomes after 1 year. METHODS: This was a prospective, single center, randomized trial that included 40 eyes (40 patients) with previously untreated center involved DME. Patients were randomly assigned to receive either aflibercept plus micropulse laser (group A) or aflibercept monotherapy (group B). RESULTS: Overall, 40 patients were included in the study; they were randomized into either group A (aflibercept + micropulse; 20 patients) or group B (aflibercept monotherapy; 20 patients). The mean number of injections after the loading dose was 4.5 ± 1.4 in group A and was 5.4 ± 1.7 in group B, and the difference between both groups was statistically significant (P = 0.029). CONCLUSION: Adding 577-nm micropulse laser to aflibercept is effective for treatment naïve DME and is associated with decreased number of injections.


Assuntos
Retinopatia Diabética/terapia , Fotocoagulação a Laser/métodos , Macula Lutea/patologia , Edema Macular/terapia , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Proteínas Recombinantes de Fusão/administração & dosagem , Acuidade Visual , Idoso , Inibidores da Angiogênese/administração & dosagem , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento
14.
Thorac Cardiovasc Surg ; 67(1): 28-36, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29232733

RESUMO

BACKGROUND: The increasing complexity of congenital cardiac surgery has resulted in the increased use of extracorporeal membrane oxygenation (ECMO) support for children who cannot be weaned from cardiopulmonary bypass. The purpose of this research was to assess the mortality and morbidity in children requiring ECMO support after the repair of congenital heart defects (CHDs). METHODS: The hospital records of all patients with CHD who required ECMO after a cardiac surgical procedure between January 2001 and December 2016 were retrospectively reviewed. Various outcomes were reported and tested for any association with hospital death. RESULTS: A total of 113 children required ECMO for cardiopulmonary support after congenital cardiac surgery; 88 (77.9%) were placed on ECMO in the operating room. Median age of the patients was 3 months (range, 4 days-15 years) and median weight was 3.5 kg (range, 2.2-42.5). Forty-two (37.2%) survived to hospital discharge. In children with single-ventricle physiology, survival to discharge was 37.3% (19/51 patients) and for biventricular physiology, it was 37.1% (23/62 patients). Univariate analysis revealed number of days on ECMO support, renal failure, and stroke as risk factors for hospital mortality, while age and cross-clamp time were found to be statistically nonsignificant. CONCLUSION: Satisfactory results can be achieved in pediatric patients by using ECMO support for postoperative cardiac and pulmonary failure refractory to medical management. Prolonged ECMO support, renal failure, and stroke are risk of mortality.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Ponte Cardiopulmonar/efeitos adversos , Oxigenação por Membrana Extracorpórea , Cardiopatias Congênitas/cirurgia , Insuficiência Cardíaca/terapia , Insuficiência Respiratória/terapia , Adolescente , Fatores Etários , Procedimentos Cirúrgicos Cardíacos/mortalidade , Ponte Cardiopulmonar/mortalidade , Criança , Pré-Escolar , Oxigenação por Membrana Extracorpórea/efeitos adversos , Oxigenação por Membrana Extracorpórea/mortalidade , Cardiopatias Congênitas/mortalidade , Cardiopatias Congênitas/fisiopatologia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Recuperação de Função Fisiológica , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Insuficiência Respiratória/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita , Fatores de Tempo , Resultado do Tratamento
15.
Int Ophthalmol ; 39(3): 557-562, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29392639

RESUMO

PURPOSE: To describe a new method of ILM staining with TB under perfluorocarbon in cases of full thickness idiopathic macular hole using the inverted ILM flap technique. METHODS: This study was a prospective interventional case series that included 42 eyes of 42 patients who had full thickness idiopathic macular hole with a minimum diameter more than 400 µm. Patients consecutively underwent vitrectomy with inverted ILM flap technique using the modified ILM staining method. RESULTS: Anatomic success was achieved in 40 patients (95.2%). The other two patients had flat-open macular holes with bare RPE (foveal defect of neurosensory retina). Among the 40 eyes with closed holes, 25 eyes were of the U-type closure (normal foveal contour) and 15 eyes were of the V-type closure (steep foveal contour). These 40 eyes remained closed during the 6 months follow-up period. CONCLUSION: The modified technique of ILM staining using TB under PFCL is safe and effective in cases of idiopathic macular hole combined with the inverted ILM flap technique.


Assuntos
Membrana Basal/patologia , Perfurações Retinianas/cirurgia , Coloração e Rotulagem/métodos , Tomografia de Coerência Óptica/métodos , Vitrectomia/métodos , Idoso , Feminino , Seguimentos , Fóvea Central/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Perfurações Retinianas/diagnóstico
16.
J Cardiothorac Surg ; 13(1): 60, 2018 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-29871684

RESUMO

BACKGROUND: Junctional ectopic tachycardia is a serious arrhythmia that frequently occurs after tetralogy of Fallot repair. Arrhythmia prophylaxis is not feasible for all pediatric cardiac surgery patients and identification of high risk patients is required. The objectives of this study were to characterize patients with JET, identify its predictors and subsequent complications and the effect of various treatment strategies on the outcomes in selected TOF patients undergoing total repair before 2 years of age. METHODS: From 2003 to 2017, 609 patients had Tetralogy of Fallot repair, 322 were included in our study. We excluded patients above 2 years and patients with preoperative arrhythmia. 29.8% of the patients (n = 96) had postoperative JET. RESULTS: JET patients were younger and had higher preoperative heart rate. Independent predictors of JET were younger age, higher preoperative heart rate, cyanotic spells, non-use of B-blockers and low Mg and Ca (p = 0.011, 0.018, 0.024, 0.001, 0.004 and 0.001; respectively). JET didn't affect the duration of mechanical ventilation nor hospital stay (p = 0.12 and 0.2 respectively) but prolonged the ICU stay (p = 0.011). JET resolved in 39.5% (n = 38) of patients responding to conventional measures. Amiodarone was used in 31.25% (n = 30) of patients and its use was associated with longer ICU stay (p = 0.017). Ventricular pacing was required in 4 patients (5.2%). Median duration of JET was 30.5 h and 5 patients had recurrent JET episode. Timing of JET onset didn't affect ICU (p = 0.43) or hospital stay (p = 0.14) however, long duration of JET increased ICU and hospital stay (p = 0.02 and 0.009; respectively). CONCLUSION: JET increases ICU stay after TOF repair. Preoperative B-blockers significantly reduced JET. Patients with preoperative risk factors could benefit from preoperative arrhythmia prophylaxis and aggressive management of postoperative electrolyte disturbance is essential.


Assuntos
Taquicardia Ectópica de Junção/epidemiologia , Tetralogia de Fallot/cirurgia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Feminino , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais , Taquicardia Ectópica de Junção/etiologia
17.
Cardiovasc Intervent Radiol ; 40(9): 1473-1476, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28386707

RESUMO

Transjugular intrahepatic portosystemic shunt (TIPS) dysfunction is conventionally managed with balloon angioplasty, stent extension, and sharp recanalization when necessary. We describe percutaneous transjugular recanalization and neointimal excision of a chronically occluded 17-year-old TIPS using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and shunt patency were documented three weeks post-intervention.


Assuntos
Oclusão de Enxerto Vascular/cirurgia , Terapia a Laser/métodos , Lasers de Excimer/uso terapêutico , Neointima/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Doença Crônica , Humanos , Resultado do Tratamento
18.
Int J Phytoremediation ; 18(6): 619-25, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26375406

RESUMO

In this research, dead leaves of a common ornamental plant, Dracaena draca known also as dragon tree was used as a biosorbent for the removal of Cadmium (Cd(2+)) from aqueous solutions using a full 2(3) factorial experimental design. Three factors were investigated at two different levels, metal ion concentration (X = 10 and 100 ppm), hydrogen ion concentration (Ph = 2 and 7) and biomass dose (BD = 0.1 and 0.5g). Experiments were carried out in duplicates with 50 ml of Cd(2+) solutions at room temperature. When comparing observed values (experimental) with calculated values (model), they were set closely together that allowed suggesting a normal distribution where (R(2) = 0.9938). A characterization of the biosorbent was done by pHzpc and SEM-EDAX. Results also showed that the most significant effect for Cd(2+) biosorption was ascribed to (X). The interaction effects of (pH BD) and (X pH) were found to have significant influence on Cd(2+) removal efficiency. The highest Cd(2+) removal percentage attained by 79.60% at X = 10 ppm, pH = 7 and BD = 0.5g. The reusability of the biosorbent was tested in three desorption cycles and the regeneration efficiency was above 99.7%.


Assuntos
Cádmio/química , Dracaena/química , Recuperação e Remediação Ambiental/métodos , Folhas de Planta/química , Poluentes Químicos da Água/química , Adsorção , Biodegradação Ambiental , Cádmio/metabolismo , Dracaena/metabolismo , Recuperação e Remediação Ambiental/instrumentação , Folhas de Planta/metabolismo , Poluentes Químicos da Água/metabolismo
19.
J Egypt Public Health Assoc ; 90(1): 35-9, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25853544

RESUMO

BACKGROUND: Results from recent reports suggest that the mortality and the morbidity from coronary heart disease (CHD) is leveling, especially in younger adults. Studies conducted in both Saudi Arabia and Egypt, aiming at the estimation of the prevalence of cardiovascular risk factors among the young population, demonstrated a high prevalence of risk factors. OBJECTIVE: The aim of this study was to compare the prevalence of cardiovascular risk factors among medical students aged 18-25 years in two Middle East countries (Egypt and Saudi Arabia). PARTICIPANTS AND METHODS: This was a cross-sectional comparative study involving a sample of 360 medical students of both sexes randomly selected from students enrolled into two medical colleges in Saudi Arabia and Egypt. RESULTS: The prevalence of risk factors for cardiovascular disease was relatively high among both Saudi and Egyptian medical students, particularly a sedentary life style, obesity, and abdominal obesity. Smoking was practiced by 29.7% of both populations. A significantly higher prevalence of obesity and a reported family history of premature CHD were observed among the Saudi students and a significantly higher prevalence of hypertension was found among male Egyptian students as compared with male Saudi students. A relatively high proportion of both populations (23.9% of Saudi students and 16.7% of the Egyptian students) was at an increased risk of developing fatal cardiovascular disease within 10 years. CONCLUSION: Apart from the higher prevalence of obesity and reported family history of premature CHD among the Saudi students and the significantly higher prevalence of hypertension among the Egyptian students, there was no statistically significant difference between the risk profiles of both populations. Participatory behavior change programs in medical schools for the adoption of healthy lifestyles, particularly involvement in regular physical activity and smoking cessation are highly recommended.


Assuntos
Doenças Cardiovasculares/epidemiologia , Obesidade Abdominal/epidemiologia , Comportamento Sedentário , Estudantes de Medicina , Adolescente , Adulto , Estudos de Casos e Controles , Egito/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais
20.
Thromb J ; 10(1): 20, 2012 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-22950681

RESUMO

BACKGROUND: Venous thromboembolism (VTE) is a leading cause of hospital-related deaths worldwide. However, the proportion of patients at risk of VTE who receive appropriate prophylaxis in Egypt is unknown. The ENDORSE study in Egypt is part of a global initiative to uncover the incidence of high-risk surgical and medical patients and determine what proportion of these patients receive appropriate VTE prophylaxis. METHODS: Ten Egyptian hospitals participated in this observational study, enrolling all surgical and medical patients that met the study criteria. This resulted in a cohort of 1,008 patients in acute care facilities who underwent a retrospective chart review. Each patient's VTE risk status and the presence or absence of appropriate prophylactic care was assessed according to the American College of Chest Physicians (ACCP) guidelines 2004. RESULTS: Of the 1,008 patients enrolled, 395 (39.2%) were found to be at high-risk for VTE. Overall, 227 surgical patients were at high-risk, although only 80 (35.2%) received ACCP-recommended prophylaxis. Similarly, 55/268 (32.75%) of high-risk medical patients received appropriate VTE prophylaxis. Low molecular weight heparin was the most commonly used anticoagulant, while mechanical prophylactic use was quite low (1.5%) in high-risk patients. CONCLUSIONS: In Egypt, more than one-third of all patients hospitalized for surgery or acute medical conditions are at high risk for developing VTE. However, only a small fraction of these patients receive appropriate VTE prophylaxis. Corrective measures are necessary for preventing VTE morbidity and mortality in these high risk patients.

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